Effects of Social and Outcome Expectancies on Hazardous Drinking among Chinese University Students: The Mediating Role of Drinking Motivations

Development and validation of a Chinese Drinking Expectancies Questionnaire for young adults: A Hong Kong study

INTRODUCTION

Drinking expectancies, the perceived consequences of alcohol consumption, are noted to predict drinking behaviours. However, there is comparatively little research of drinking expectancies in non-Western populations. This study aimed to develop and validate a Chinese Drinking Expectancy Questionnaire (CDEQ-Adult) for Chinese young adults.

METHODS

Face and content validity were first assessed of items generated from literature review and previously conducted focus groups. Exploratory (EFA) and confirmatory factor analyses (CFA) were conducted with split-half samples from a random telephone survey that was conducted on Hong Kong Chinese adults between the ages of 18-34 (n = 675). The instrument's convergent validity and internal reliability were also examined.

RESULTS

The preliminary instrument items showed good content validity (Item Content Validity Index range: 0.8-1.0). The EFA yielded a 31-item, five-factor model consisting of five domains: Negative Consequences, Interpersonal Benefits, Increased Confidence, Health Benefits and Tension/Stress Reduction (variance explained 63.7%). The CFA revealed that the fit indices for the five-factor model using diagonal weighted least squares estimator were χ2 (256, N = 338) = 394.04, p < 0.001, comparative fit index 0.97, SRMR 0.07, RMSEA 0.06 (95% confidence interval 0.06, 0.08), suggesting a good fit of the model. The Cronbach's α coefficients were 0.94, 0.90, 0.86, 0.77 and 0.57, respectively for each of the five domains (n = 675). Significant associations with past month drinking behaviours and future drinking intentions give strong support for convergent validity.

DISCUSSION AND CONCLUSIONS

The CDEQ-Adult is a culturally relevant instrument for assessing drinking expectancies in Chinese young adults for use in future studies.

Drinking Expectancies among Chinese Young Adults: A Qualitative Study from Hong Kong

BACKGROUND

Alcohol expectancies, i.e., the perceived consequences of drinking, have been reported to be important factor in predicting drinking behaviors. However, studies in the Asia region were largely limited to school-based samples. This study aimed to be the first to explore drinking expectancies among urban Chinese young adults.

METHODS

In 2020, eight focus group discussions were conducted with Hong Kong Chinese young adults aged 18-34 (n = 53). The participants included heavy drinkers, light drinkers, and non-drinkers from a wide range of occupations and educational backgrounds. Thematic analysis was conducted to uncover common alcohol expectancies.

RESULTS

Six themes emerged from this study. Four themes that were commonly reported in the literature were the negative consequences of drinking, social bonding, confidence enhancement, and tension reduction. The study also uncovered two culturally relevant alcohol expectancies: health benefits and business drinking expectancies. In contrast to Western samples, Chinese young adults did not report drinking expectancies related to cognitive enhancement or increased sexual interest.

CONCLUSION

Alcohol harm reduction strategies will need to address the positive drinking expectancies uncovered in this study. Future policy discussions in this emerging alcohol market region should consider greater scrutiny of the role of alcohol marketing in the propagation of positive drinking expectancies.

Assessing alcohol consumption in a Chinese urban population and a university town using high temporal resolution wastewater-based epidemiology

BACKGROUND

Alcohol consumption is a leading preventable risk factor for morbidity and mortality in China. Understanding drinking patterns provides important data to inform public health policies in alcohol control, especially in specific groups like university students. This study aims to assess the alcohol consumption patterns and level of use in an urban population and a university town in a Chinese city using wastewater-based epidemiology (WBE).

METHODS

Daily wastewater sample was collected from an urban catchment (n = 270) and every Wednesday's sample from a university town of 10 university campus (n = 43) in 2017-2018. Concentration of alcohol consumption biomarker in wastewater, ethyl sulfate, was measured by direct injection LC-MS/MS analysis. Per capita daily alcohol consumption was then back calculated for assessment purposes.

RESULTS

Per capita daily alcohol consumption was 1.4 ± 0.6 mL/ person aged 15 + /day (EPD) (range: 0.2-4.9) in the urban catchment and 1.3 ± 0.6 EPD (range: 0.3-2.6) in the university town. Trends of alcohol consumption were stable in both catchments in 2017-2018. Alcohol consumption on weekends (1.5 EPD) and weekdays (1.4 EPD) were at a similar level. Additionally, no difference was observed between holidays (1.5 EPD) and non-holidays (1.4 EPD).

CONCLUSION

There is a stable weekly drinking level in the studied urban population, which is different compared to studies conducted in Western countries. Our study suggested a similar consumption level between the urban population and university students. Drinking during weekdays could negatively affect China's economic productivity and future public health policies could be adapted to reflect this pattern of drinking.

Understanding alcohol-specific antecedents among Chinese vocational school adolescents

BACKGROUND

Alcohol use among Chinese vocational school students is widespread and associated with many negative consequences. However, alcohol-specific antecedents for this population are understudied.

OBJECTIVES

The current study explored: (a) which alcohol-specific antecedents are the most salient predictors for alcohol use intentions, (b) whether any mediational relationships exist among these alcohol-specific antecedents, and (c) whether gender-based differences exist among these relationships.

METHODS

This study analyzed data from 1,230 vocational school adolescents in three Chinese cities. Survey data were analyzed using dominance analysis and structural equation modeling.

RESULTS

Personal norms were the most salient antecedents for alcohol use intentions, followed by injunctive norms from friends and parents, descriptive norms from friends and classmates, and positive belief about drinking. We observed a statistically significant mediational chain from descriptive norms to injunctive norms, and in turn to personal norms and positive beliefs, and finally to alcohol use intentions. Gender moderated some of the paths.

CONCLUSIONS

Alcohol use norms and beliefs among Chinese vocational school students have distinct predictive relationships with alcohol use intentions. Alcohol use prevention programs designed for this population need to address normative beliefs (descriptive, injunctive, and personal norms) and the perceived benefit of alcohol use.