Deconstructing contexts of binge drinking among college students

Examining the Impact of Simultaneous Alcohol and Cannabis Use on Alcohol Consumption and Consequences: Protocol for an Observational Ambulatory Assessment Study in Young Adults

BACKGROUND

There is significant conflicting evidence as to how using cannabis while drinking alcohol (ie, simultaneous alcohol and cannabis use) impacts alcohol volume consumed, patterns of drinking, and alcohol-related consequences. The impact of simultaneous use on drinking outcomes may be influenced by several within-person (eg, contextual) and between-person (individual) factors.

OBJECTIVE

This study was designed to examine naturalistic patterns of alcohol and cannabis use to understand how simultaneous use may impact drinking outcomes. The primary aims were to understand the following: (1) if simultaneous use is associated with increased alcohol consumption and riskier patterns of drinking, (2) if simultaneous use leads to increased alcohol consequences, and (3) how contextual circumstances moderate the impact of simultaneous use on consumption and consequences.

METHODS

Data collection involves a 28-day ambulatory assessment protocol in which a sample of non-treatment-seeking young adults who report simultaneous use of alcohol and cannabis complete ecological momentary assessments (random, event-contingent, and time-contingent surveys) of alcohol and cannabis use, contexts, motives, and consequences on their personal smartphones while continuously wearing an alcohol biosensor bracelet. Participants also complete a baseline assessment, brief internet-based check-in on day 14, and a final session on day 28. Community-based recruitment strategies (eg, social media and flyers) were used to enroll 95 participants to obtain a target sample of 80, accounting for attrition.

RESULTS

Recruitment and data collection began in May 2021 and continued through June 2024. Initial results for primary aims are expected in October 2024. As of March 2024, the project had recruited 118 eligible participants, of whom 94 (79.7%) completed the study, exceeding initial projections for the study time frame. Remaining recruitment will provide the capacity to probe cross-level interactions that were not initially statistically powered. Strengths of the project include rigorous data collection, good retention and compliance rates, faster-than-expected enrollment procedures, use of a novel alcohol biosensor, and successful adaptation of recruitment and data collection procedures during the COVID-19 pandemic.

CONCLUSIONS

This is the first investigation to assess the key momentary predictors and outcomes of simultaneous use as well as self-reported and objective (via alcohol biosensor) measures of alcohol consumption and patterns. The results of this study will inform prevention efforts and studies of individuals who use cannabis who are engaged in alcohol treatment.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/58685.

Person-specific and pooled prediction models for binge eating, alcohol use and binge drinking in bulimia nervosa and alcohol use disorder

BACKGROUND

Machine learning could predict binge behavior and help develop treatments for bulimia nervosa (BN) and alcohol use disorder (AUD). Therefore, this study evaluates person-specific and pooled prediction models for binge eating (BE), alcohol use, and binge drinking (BD) in daily life, and identifies the most important predictors.

METHODS

A total of 120 patients (BN: 50; AUD: 51; BN/AUD: 19) participated in an experience sampling study, where over a period of 12 months they reported on their eating and drinking behaviors as well as on several other emotional, behavioral, and contextual factors in daily life. The study had a burst-measurement design, where assessments occurred eight times a day on Thursdays, Fridays, and Saturdays in seven bursts of three weeks. Afterwards, person-specific and pooled models were fit with elastic net regularized regression and evaluated with cross-validation. From these models, the variables with the 10% highest estimates were identified.

RESULTS

The person-specific models had a median AUC of 0.61, 0.80, and 0.85 for BE, alcohol use, and BD respectively, while the pooled models had a median AUC of 0.70, 0.90, and 0.93. The most important predictors across the behaviors were craving and time of day. However, predictors concerning social context and affect differed among BE, alcohol use, and BD.

CONCLUSIONS

Pooled models outperformed person-specific models and the models for alcohol use and BD outperformed those for BE. Future studies should explore how the performance of these models can be improved and how they can be used to deliver interventions in daily life.

Alcohol consumption, alcohol expectancies, and drinking contexts in young Argentinean college students before and during the COVID-19 pandemic: a one-year follow-up study

Background: The COVID-19 pandemic and lockdowns are known to affect alcohol consumption. This study examines drinking expectancies and contexts upon alcohol consumption of Argentinean students.Objectives: To assess within-person changes in alcohol consumption in Argentinean college students (aged 18-24), from August 2019 with a one-year follow-up during the COVID-19 lockdown, considering alcohol expectancies, drinking contexts, and main socio-demographic variables. To validate the stability of these predictors, we discuss the effects on the alcohol consumption across dependent and independent measures.Methods: We assessed one longitudinal (N = 300, 70% female) and one cross-sectional (N = 165, 78% female) sample via online surveys and applied multilevel analysis and regressions, respectively.Results: Alcohol consumption significantly increased during lockdown compared to one-year before (mean: 6.91 and 8.26 alcohol units, correspondingly). In the longitudinal sample, social facilitation (medium effect sizes [ES]: 0.21, 0.22) and parental presence (medium ES: 0.12, 0.21) significantly and stable (through time) predicted increasing effects on consumption. In the cross-sectional sample, stress control (high ES: 0.78) and parental presence (high ES: 0.42) were associated with higher consumption during lockdown.Conclusion: College students increased their alcohol consumption during lockdown, suggesting that restrictive sanitary measures may negatively affect consumption. Literature is not conclusive as both decreases and increases in alcohol consumption in students from developed countries were reported. Before and during COVID-19 lockdown, parental presence is a stable predictor of increased alcohol consumption, though unusual according to the literature. Health policies aimed at modifying the behavior of parents who promote/share alcohol consumption with their offspring may help reduce drinking in college students.

Social incentives are stronger predictors of drinking decisions than alcohol incentives in young adults: The role of alcohol use disorder

This study investigated the influence of social incentives, alcohol incentives, and responsibility disincentives on decisions to attend and drink at party events in young adult college students (n = 82; 55 women, 27 men) where 36 (20 women; 16 men) had an Alcohol Use Disorder (AUD) and 46 (35 women; 11 men) were control participants without an AUD. In this within-subjects design, participants were presented with a series of hypothetical drinking event scenarios that varied in terms of social incentives (knowing many vs. few people), alcohol incentives (more vs. less alcohol available), and next-day responsibility disincentives (high vs. moderate vs. low). Participants were asked whether they would attend the event and how many drinks they would consume. Social incentives significantly predicted both decisions to attend party events and decisions about how much to drink for all participants. Participants were more likely to decide to attend and drink more at high social incentive party events (where they knew more people). However, while low social incentives generally discouraged attendance decisions, AUD participants were more likely than controls to decide to attend party events in low social incentive contexts. Alcohol incentives did not affect attendance decisions. However, alcohol incentives did increase drinking amount decisions for AUD participants. Finally, while disincentives decreased attendance and drinking amount decisions in general, AUD participants were less deterred by responsibility disincentives than controls. The results highlight the important influence of social rewards on drinking-related decisions and suggest individual differences in how incentives and disincentives affect drinking decisions in persons with an AUD.

Social Network Composition, Relationship Type, and Alcohol Use Among Young Adults Not in Four-Year College

Background: The drinking of social network members has been consistently associated with personal drinking. However, less attention has been paid to emerging adult populations outside of four-year college students and to potential moderators of this relationship. In a sample of emerging adults who never attended four-year college, this research examined: 1) the compositional characteristics of the social networks, 2) the association between the drinking of network members and personal drinking, and 3) how the association between network and personal drinking was moderated by relationship type (e.g., friend, parents, significant other). Methods: Data was provided by a sample of 525 emerging adults who participated in Qualtrics Panels. Results: In this noncollege sample, the composition of the social network was diverse, with roughly one-third of network members being friends and a little less than half being family members. Parents tended to consume alcohol more frequently than friends and significant others, but participants consumed alcohol more frequently with friends and significant others. Furthermore, drinking among friends and significant others tended to have stronger associations with personal alcohol use than drinking among parents. However, relationship type did not moderate the association between drinking with network members and personal alcohol use. Conclusions: Because of this, interventions need to be delivered to drinking groups.

The association between intended drinking contexts and alcohol expectancies in college students: A daily diary study

BACKGROUND

Because of the role alcohol outcome expectancies play in subsequent drinking, it is important to understand factors that can shape alcohol expectancies to guide intervention efforts. This study examined among college students whether intended social contexts for drinking were associated with positive and negative alcohol expectancies at the daily-level.

METHODS

Participants included in analyses were 323 students, ages 18 to 24 years, enrolled at a 4-year university in the Pacific Northwest. At four 2-week measurement bursts across one year, participants were asked each afternoon to report whether they planned to drink alcohol later that day. If so, they were further asked how much they intended to drink, whether they plan to drink alone or with others, whether they plan to drink at home or bar/party, and their positive and negative expectancies of alcohol use that evening.

RESULTS

A total of 2953 person-day observations from planned drinking days were used. Results from linear mixed models, adjusted for covariates including intended number of drinks, showed that students reported greater positive alcohol expectancies on days when they intended to drink with others vs. alone and intended to drink at a bar or party vs. at home. For negative expectancies, only intended drinking with others showed a statistically significant association.

CONCLUSION

This study suggests that contextual factors may shape college students' expectancies about effects of alcohol at the daily-level. Intended drinking contexts may be important to address in event-level interventions to reduce high-risk drinking in young adults.

Is Alcohol Consumption Related to Lifestyle Factors in Romanian University Students?

Poor eating habits and substance abuse are major public health concerns among young adults transitioning into university life. This study's objective was to assess Romanian students' alcohol consumption and correlate it with other lifestyle factors. We performed a cross-sectional study of 1212 students with a mean age of 21.1 ± 2.4 years. We applied a valid online questionnaire to evaluate and statistically analyze the interrelation between alcohol consumption and lifestyle factors by multivariate statistical analysis. The prevalence of alcohol consumption among the student population enrolled in the study was 79.9%. Multiple regression showed that alcohol consumption was positively associated with gender (p < 0.001), level of physical activity (p = 0.009), number of cigarettes (p < 0.001), and fast-food consumption (p < 0.001), and negatively associated with sleep (p = 0.012) and study hours (p < 0.001). The study revealed a high prevalence (18%) of binge drinking among males. The frequent use of illicit drugs is associated with alcohol consumption (p < 0.001) but present at low levels (1.6%). The study evidenced a high prevalence of alcohol consumption in students, especially in males, and poor food behavior related to the intake of vegetables and fruits. Health promotion campaigns regarding the harmful effects of alcohol, smoking, poor nutrition, and ongoing illicit drug prevention campaigns are needed to improve students' performances.

Drinking contexts and their association with acute alcohol-related harm: A systematic review of event-level studies on adults' drinking occasions

ISSUES

Event-level alcohol research can inform prevention efforts by determining whether drinking contexts-such as people or places-are associated with harmful outcomes. This review synthesises evidence on associations between characteristics of adults' drinking occasions and acute alcohol-related harm.

APPROACH

We systematically searched Ovid MEDLINE, Ovid PsycInfo and the Web of Science Social Sciences Citation Index. Eligible papers used quantitative designs and event-level data collection methods. They linked one or more drinking contexts to acute alcohol-related harm. Following extraction of study characteristics, methods and findings, we assessed study quality and narratively synthesised the findings.

PROSPERO ID

CRD42018119701.

KEY FINDINGS

Searches identified 95 eligible papers, 65 (68%) of which study young adults and 62 (65%) of which are set in the United States, which limits generalisability to other populations. These papers studied a range of harms from assault to drink driving. Study quality is good overall although measures often lack validation. We found substantial evidence for direct effects of drinking context on harms. All of the contextual characteristics types studied (e.g. people, place, timing, psychological states, drink type) were consistently associated with harms. Certain contexts were frequently studied and associated with harms, in particular, weekend drinking, drinking in licensed premises and concurrent illicit drug use.

IMPLICATIONS

The findings of our review indicate target drinking contexts for prevention efforts that are consistently associated with increased acute alcohol-related harm.

CONCLUSION

A large range of contextual characteristics of drinking occasions are directly associated with acute alcohol-related harm, over and above levels of consumption.

Social and Situational Party Characteristics Associated With High-Intensity Alcohol Use Among Youth and Young Adults

BACKGROUND

Rates of high-intensity drinking, which is alcohol consumption that exceeds standard heavy drinking levels, have increased in recent years and peak in young adulthood. To identify modifiable environmental targets for prevention of high-intensity drinking, we identified characteristics of parties attended by youth and young adults that were associated with high-intensity drinking and the consequences of this excessive form of drinking.

METHODS

Data are from 15- to 20-year-old participants in an online survey (n = 2,442; 55.4% female, 74.8% White) who resided in 24 communities across 7 states that were a part of a community randomized intervention trial to reduce the incidence and consequences of underage drinking parties. We used multinomial logistic regression to predict level of drinking by 6 party characteristics (size, location, age and gender composition, supervision, others' drinking behavior), and to predict 6 consequences (hangover, not remember event, passed out, punished by parents, broke something/got in fight, and sex against will) from level of drinking. We tested study hypotheses in 2 models, one that used a single binge drinking threshold (below binge vs. at or above binge level) and one that additionally used a high-intensity drinking level (below binge, 1 to 2 times binge, 2+ times binge level).

RESULTS

We found that larger party size and a mostly male composition were unique predictors of high-intensity drinking when compared to those who consumed 1 to 2 times the binge drinking level. Odds of passing out, not remembering the drinking event, breaking/damaging property, or getting in a fight were more than double for high-intensity drinkers compared to standard binge level drinkers.

CONCLUSIONS

Results from this study indicate there are unique precursors and consequences of high-intensity alcohol consumption among youth and young adults. These environmental factors associated with high-risk drinking contexts can be used to develop prevention strategies to mitigate the harms associated with excessive alcohol consumption.

Mortality salience leads to greater consumption of an ostensibly alcoholic beverage on Friday versus other weekdays

OBJECTIVES

We build on findings from terror management theory to examine how non-conscious mortality concerns may lead individuals to adhere to cultural meanings yoked to discrete time periods, in this case influencing consumption of an ostensibly alcoholic beverage.

DESIGN

The study took the form of a 2 (death vs. uncertainty reminder) × 3 (Monday vs. Wednesday vs. Friday) between-subjects laboratory-based quasi-experimental design.

METHODS

A total of 210 participants (age: M = 21.92 years, SD = 5.33; 103 males and 107 females) recruited from a UK university answered either an open-ended question to prime mortality or uncertainty cognition on either a Monday, Wednesday, or Friday. As part of an ostensible taste test, they then consumed as much or as little of a purportedly alcoholic drink as they desired.

RESULTS

Death reminders (vs. control topic) were found to result in more consumption of the beverage on a Friday, less consumption on a Monday, and no difference in consumption on a Wednesday.

CONCLUSIONS

Findings point to the flexible, time-contingent nature of culture-oriented defences against mortality concerns with potential implications for the efficacy of alcohol health warnings featuring mortality-related stimuli. Statement of contribution What is already known on this subject? Death reminders can spur people to adhere to cultural scripts for behaviour in the service of maintaining existential security. Death reminders can lead people to consume alcohol (particularly for those who are low in self-esteem). What does this study add? Death reminders may lead people to adhere to temporally yoked scripts related to drinking behaviour. Specifically, death reminders led to more positive drinking attitudes and more alcohol consumed on Friday compared to Monday or Wednesday. Cultural script following may be specifically tied to non-conscious mortality awareness.

Alcohol Use by Youth

Alcohol use continues to be a major concern from preadolescence through young adulthood in the United States. Results of recent neuroscience research have helped to elucidate neurobiological models of addiction, substantiated the deleterious effects of alcohol on adolescent brain development, and added additional evidence to support the call to prevent and reduce underage drinking. This technical report reviews the relevant literature and supports the accompanying policy statement in this issue of Pediatrics.

Psychological correlates and binge drinking behaviours among Canadian youth: a cross-sectional analysis of the mental health pilot data from the COMPASS study

OBJECTIVE

The objective of this study was to examine associations between depression, anxiety and binge drinking among a large sample of Canadian youth, while testing the moderating effect of flourishing. This research uses data from the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, Sedentary Behaviour (COMPASS) study (2012-2021) with a large sample size collecting data on youth health behaviours within Canadian secondary schools.

DESIGN

Cross-sectional SETTING: 14 secondary schools across Ontario and British Columbia, Canada.

PARTICIPANTS

A sample of grade 9-12 students (n=6570) who participated in the Mental Health pilot of the COMPASS study PRIMARY AND SECONDARY OUTCOME MEASURES: Self-reported questionnaires assessed student binge drinking behaviours (5≥drinks), symptoms of depression (Center for Epidemiologic Studies Depression Scale (Revised)-10 scores≥10) and anxiety (Generalised Anxiety Disorder 7-item Scale scores≥10), and flourishing (Diener's Flourishing Scale: 8-40).

RESULTS

In our sample of 6570 students, 37.0% of students reported binge drinking in the last year, and 41.4% and 31.7% of students report clinically-relevant symptoms of depression and anxiety, respectively. Anxiety (adjusted OR (AOR): 0.57, (99% CI 0.15 to 2.22)) and depression (AOR: 1.98, (99% CI 0.76 to 5.13)) symptoms were not found to be associated with binge drinking and we did not detect any moderating role of flourishing. Rather, factors that were associated with increased odds of binge drinking included sports team participation (AOR: 1.67, (99% CI 1.37 to 2.03)) and use of other substances (tobacco (AOR: 3.00, (99% CI 2.12 to 4.25)) and cannabis (AOR: 7.76, (99% CI 6.36 to 9.46))). Similar associations were found for frequency of binge drinking.

CONCLUSIONS

Consistent with existing literature, binge drinking behaviours were problematic, as well as clinically-relevant symptoms of depression and anxiety. However, mental health problems and well-being may not be responsible for explaining patterns of binge drinking in youth. Targeted intervention efforts towards student athletes and concurrent substance users are necessary for addressing binge drinking in youth populations.

Alcohol and social connectedness for new residential university students: implications for alcohol harm reduction

Starting university is a significant life-event, commonly involving detachment from existing social networks and emotional stresses that increase risk of drop-out. The developmental need to form new peer relationships is prominent during this period and is correlated with successful adaptation. This study investigated the role of alcohol in the process of transition and peer group development for new students. Thematic analysis of semi-structured interviews is presented, conducted within a broader instrumental case study of campus approaches to alcohol policy and management. Twenty-three first-year students participated in interviews lasting between 45-60 minutes. Verbatim transcription was followed by within- and cross-case analysis. Drawing on social connectedness theory, we illustrate how pre-arrival concern over new peer relationships was subsequently reduced by drinking together. This reinforced participant perceptions of alcohol as beneficial for hastening development of social connections, in turn reducing anxiety and supporting successful transition. For non-/low-drinkers in the study, social connectedness without alcohol use was reported as more challenging. Alcohol was perceived as a readily-available, effective tool for hastening social connectedness, increasing student resistance to alcohol education messages provided at the start of term. Implications for addressing alcohol-related harms in students are discussed.

Contrasting staff and student views on alcohol education provision in a UK university

Alcohol education and awareness aims to teach individuals the risks of excess consumption. It is common in UK universities, despite limited evidence of success with student cohorts. This research explored the development and delivery of such alcohol activities at one UK university. In-depth, one-to-one interviews were carried out with non-academic staff and with first-year students. These aimed to understand the development of alcohol awareness messages and staff involvement in delivery, as well as exploring student responses to key alcohol educational activities. Results indicate that alcohol is a normalized aspect of UK student identity and is accepted as such by students and staff. Despite this, there is a widely held view that the university has a responsibility to provide alcohol education and awareness, which forms the basis of current practice on campus. This reflects perception of education interventions as non-coercive and acceptable within the staff-student relationship, with limited support for more interventionist approaches with a group engaging in a legal behavior with strong cultural associations. However, staff approval of education as appropriate for this audience is contradicted by students, who reject these same approaches as reminiscent of school, instead favoring self-directed learning or peer-led programs.

Characteristics of prospectively identified negative alcohol-related events among college students

BACKGROUND

Throughout the first two years of college, the majority of drinkers experience one or more alcohol-related consequences. Research that examines the characteristics surrounding negative consequences typically utilizes global retrospective survey methods. The objective of the current study was to apply an event-based methodology to describe the circumstances of a recent drinking episode that resulted in one or more alcohol-related consequences among first- and second-year college students.

METHODS

We used a prospective web-based survey method to identify participants (N=296) who had one or more alcohol-related consequences in the past week. Shortly after reporting the consequence(s), participants attended an in-person interview during which they described the circumstances that preceded and followed the consequence(s), including the use of alcohol and other substances, proximal contextual factors including peer drinking, the characteristics of the negative alcohol-related consequence(s), and the reaction of others to the event.

RESULTS

The majority of participants reported experiencing the event at either their own (32.4%) or a friend's (32.8%) residence, and 87.1% of participants were with peers when the event happened. Most (85.0%) of the sample indicated that their closest friend knew about their event.

CONCLUSION

The high peer involvement at all stages of the event suggest the potential for training college students to help each other avoid or prevent consequences.

All drinking is not equal: how a social practice theory lens could enhance public health research on alcohol and other health behaviours

BACKGROUND

The social meanings, settings and habitual nature of health-related activities and their integration into our daily lives are often overlooked in quantitative public health research. This reflects an overly individualized approach to epidemiological surveillance and evaluations of public health interventions, based on models of behaviour that are rooted in social cognition and rational choice theories. This paper calls for a new approach to alcohol epidemiology and intervention research informed by theories of practice.

ARGUMENT

Practices are conceptualized as routinized types of human activity that are made up of, and can be recognized by, the coming together of several interwoven elements in the same situation (e.g. materials, meanings, skills, locations, timings). Different practices are interconnected-they can occur simultaneously (e.g. drinking and eating), hold each other in place (e.g. after-work drinks) or compete for time (e.g. parenting versus socializing). Applying these principles to alcohol research means shifting attention away from individuals and their behaviours and instead making drinking practices an important unit of analysis. Studying how drinking practices emerge, persist and decay over time, how they spread through populations and local or social networks and how they relate to other activities of everyday life promises new insights into how, why, where, when and with whom drinking and getting drunk occur.

CONCLUSIONS

Theories of practice provide a framework for generating new explanations of stability and change in alcohol consumption and other health behaviours. This framework offers potential for novel insights into the persistence of health inequalities, unanticipated consequences of policies and interventions and new interventions targets through understanding which elements of problematic practices are likely to be most modifiable. We hope this will generate novel insights into the emergence and decay of drinking practices over time and into the geographical and socio-demographic patterning of drinking. Theories of practice-informed research would consider how alcohol policies and population-level interventions might differentially affect different drinking practices.

Places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults

INTRODUCTION AND AIMS

Little is known about social-ecological correlates of simultaneous use of alcohol with other substances. This study examined places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults.

DESIGN AND METHODS

We used survey data obtained from 1538 young adult recent alcohol drinkers (49% male; 18-30 years old) in 24 non-contiguous cities in California. Event-level measures included alcohol, tobacco and marijuana use, drinking places and social characteristics of the event. Individual-level measures included alcohol expectancies, depression and demographics.

RESULTS

Bars and restaurants had less alcohol and marijuana use (odds ratio = 0.34; 95% confidence interval 0.18, 0.62; P < 0.001) and alcohol, marijuana and tobacco use (odds ratio = 0.27; 95% confidence interval 0.14, 0.54; P < 0.001) compared with alcohol use only. Perceived percent of intoxicated people at an event was associated with greater likelihood of using alcohol with tobacco and marijuana at the event. At the individual level, greater age was generally associated with increased odds of simultaneous use. Participants who were male, less educated, more depressed and had positive alcohol expectancies were more likely to simultaneously co-use alcohol with tobacco and marijuana. Those with negative expectancies were less likely to simultaneously use these substances.

DISCUSSION AND CONCLUSIONS

Social events in private settings with a high percentage of people who are intoxicated had increased likelihood of simultaneous use of alcohol, tobacco and marijuana. Prevention efforts in these settings may reduce simultaneous use of these substances and related harms. [Lipperman-Kreda S, Paschall MJ, Saltz RF, Morrison CN. Places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults. Drug Alcohol Rev 2017;00:000-000].

When Do Friends Prevent Friends from Hooking Up Intoxicated? An Examination of Sex Differences and Hypothetical Intoxication in Peer Interventions

Despite the risks involved when mixing alcohol with casual sexual activity, the majority of college students engage in hookups, and the majority of those hookups involve alcohol. This study focused on the protective role college students' peers can play and the situational factors that might influence their willingness to intervene when a close friend is about to hook up intoxicated. Drawing on the theory of planned behavior (TPB), this study investigated differences in students' (N = 1270) attitudes, norms, perceived behavioral control, and intentions to persuade a close friend not to engage in a hypothetical drunken hookup using a 2 (friend sex) × 2 (participant sex) × 2 (sober/intoxicated) factorial design. Results indicated significant differences in the TPB variables. Participants intended to intervene with female friends, but not male friends, and women were more likely to intervene than men. Participants in the sober condition had stronger intentions to intervene than those in the intoxicated condition, but this effect was driven by increases in men's intentions when sober. Implications for theory and prevention programming are discussed.

Decisions to Attend and Drink at Party Events: The Effects of Incentives and Disincentives and Lifetime Alcohol and Antisocial Problems

BACKGROUND

Alcohol use disorders are associated with patterns of impulsive/risky decision making on behavioral economic decision tasks, but little is known about the factors affecting drinking-related decisions.

METHODS

The effects of incentives and disincentives to attend and drink at hypothetical alcohol-related party events as a function of lifetime (LT) alcohol and antisocial problems were examined in a sample of 434 young adults who varied widely in LT alcohol and antisocial problems.

RESULTS

Moderate and high disincentives substantially discouraged decisions to attend the party events and were associated with decisions to drink less at the party events. High versus low party incentives were associated with more attendance decisions. LT antisocial problems were associated with being less deterred from attending by moderate and high disincentives. LT alcohol problems were associated with greater attendance at high party incentive contexts. LT alcohol problems were associated with drinking more at the majority of events; however, the results indicate that young adults with high levels of alcohol problems moderate their drinking in response to moderate and high disincentives. Finally, attendance and drinking decisions on this hypothetical task were significantly related to actual drinking practices.

CONCLUSIONS

The results suggest that antisocial symptoms are associated with a reduced sensitivity to the potential negative consequences of drinking, while alcohol problems are associated with a greater sensitivity to the rewarding aspects of partying. The results also underline the value of directly assessing drinking-related decisions in different hypothetical contexts as well as assessing decisions about attendance at risky drinking events in addition to drinking amount decisions.

A Multilevel Study of Students in Vietnam: Drinking Motives and Drinking Context as Predictors of Alcohol Consumption

BACKGROUND

This study used multi-level analysis to estimate which type of factor explains most of the variance in alcohol consumption of Vietnamese students.

METHODS

Data were collected among 6011 students attending 12 universities/faculties in four provinces in Vietnam. The three most recent drinking occasions were investigated per student, resulting in 12,795 drinking occasions among 4265 drinkers. Students reported on 10 aspects of the drinking context per drinking occasion. A multi-level mixed-effects linear regression model was constructed in which aspects of drinking context composed the first level; the age of students and four drinking motives comprised the second level. The dependent variable was the number of drinks.

RESULTS

Of the aspects of context, drinking duration had the strongest association with alcohol consumption while, at the individual level, coping motive had the strongest association. The drinking context characteristics explained more variance than the individual characteristics in alcohol intake per occasion.

CONCLUSIONS

These findings suggest that, among students in Vietnam, the drinking context explains a larger proportion of the variance in alcohol consumption than the drinking motives. Therefore, measures that reduce the availability of alcohol in specific drinking situations are an essential part of an effective prevention policy.

Sexual-orientation differences in drinking patterns and use of drinking contexts among college students

BACKGROUND

Evidence suggests there are important sexual-orientation differences in alcohol consumption, particularly among women. Little is known about where gay/lesbian and bisexual college students drink or differences in drinking patterns derived from graduated frequency measures between heterosexual, gay/lesbian, and bisexual students. The goal of this analysis was to examine patterns of alcohol consumption-including drinking prevalence, quantity, frequency, and contexts of use-by sexual orientation.

METHODS

Data on sexual identity, gender, drinking behaviors, and drinking contexts were examined from repeated cross-sectional samples of undergraduate students attending 14 public California universities from 2003-2011 (n=58,903). Multivariable statistical techniques were employed to examine sexual-orientation differences stratified by gender.

RESULTS

Gay males, lesbians, and bisexual females were significantly more likely to report drinking alcohol in the current semester than their same-gender heterosexual peers (relative risks ranged from 1.07 to 1.10, p-values <0.01). Among current drinkers, bisexual females consumed 7 or more drinks and lesbians consumed 10 or more drinks on significantly more days than heterosexual females. On the other hand, gay male drinkers consumed 8 or more drinks on significantly fewer days than heterosexual male drinkers. Compared to their same-gender heterosexual peers: lesbian/gay and bisexual students drank less frequently at Greek parties (incidence rate ratios [IRRs] ranged from 0.52 to 0.73, p-values <0.01); lesbians (IRR=0.84, p=0.043) and bisexual males (IRR=0.82, p=0.009) drank less frequently at off-campus parties; and gay males drank more frequently outdoors (IRR=1.63, p<0.001) and at bars/restaurants (IRR=1.21, p=0.013).

CONCLUSIONS

Alcohol prevention programs and future research should consider sexual-orientation differences in drinking patterns and use of drinking contexts.

'What a man can do, a woman can do better': gendered alcohol consumption and (de)construction of social identity among young Nigerians

BACKGROUND

The misuse of alcohol and other drugs among young people, especially students, is a growing global phenomenon. In traditional Nigerian society, different locally-produced alcoholic beverages served complex roles but were mainly consumed among adult males for pleasure. Though adult females in some communities consumed alcohol, the practice of drinking was culturally controlled. In contemporary Nigeria, available quantitative studies reveal changing patterns of alcohol use amongst youth but fail to unravel the social variables that motivate alcohol use among this group.

METHODS

Qualitative data were collected through in-depth interviews with 31 (22 males and 9 females, aged 19-23 years) undergraduate students attending a university located in a metropolitan city in Anambra State, south-eastern Nigeria. Data were collected and analysed to generate themes with the aid of Nvivo 10 software.

RESULTS

There appears to be a resilient socio-cultural belief in which men see alcohol as 'good for males' while the females in contrast believe that alcohol does not discriminate according to gender and should be drunk by both males and females. Findings also point to the ways in which male-gendered drinking behaviours, such as heavy or fast drinking are employed by women to develop social capital.

CONCLUSIONS

These results do suggest how gendered constructions of alcohol consumption create risks for both men and women, how they negotiate and ameliorate those risks, and how women challenge gender roles through their use of alcohol. Some focus on formulating evidence-based policies and comprehensively evaluated campaigns are needed to disseminate information about the risks and potential consequences of heavy alcohol consumption in order to promote safer alcohol use by young people.

Use of drinking protective behavioral strategies and sexual perceptions and behaviors in U.S. college students

Alcohol use among college students is linked to an increased likelihood of engaging in risky sexual behaviors, including casual sex and unprotected sex. These behaviors increase college students' risks for negative social and health-related consequences. This study examined the relationship between drinking behaviors and protective behavioral strategies (PBS), expectancies and perceptions of sexual risk, and actual alcohol-related sexual behaviors and consequences. Sexually active college students completed Web-based self-report measures of drinking behaviors and use of PBS, alcohol expectancies and perceptions of risk, and sexual behaviors and related consequences (n = 524; 57.1% women). Findings indicated that PBS were related to lower expectancies of sexual risk and sexual disinhibition, and among lighter drinkers, lower expectancies of sexual enhancement from alcohol. PBS were also related to decreased perceptions of sexual-related risks, some alcohol-related sexual behaviors, including number of drinks before/during sex, and number of sexual consequences, but were not related to abstaining during sex, frequency of alcohol-related sexual behaviors, or general condom use. These findings demonstrate a disconnect between perceived and actual risks among college students, such that decreased perceptions of risk may not be associated with protective behaviors. Prevention and intervention implications are discussed.

"A cool little buzz": alcohol intoxication in the dance club scene

In recent years, there has been increasing concern about youthful "binge" drinking and intoxication. Yet the meaning of intoxication remains under-theorized. This paper examines intoxication in a young adult nightlife scene, using data from a 2005-2008 National Institute on Drug Abuse-funded project on Asian American youth and nightlife. Analyzing in-depth qualitative interview data with 250 Asian American young adults in the San Francisco area, we examine their narratives about alcohol intoxication with respect to sociability, stress, and fun, and their navigation of the fine line between being "buzzed" and being "wasted." Finally, limitations of the study and directions for future research are noted.

The nature and correlates of young women's peer-directed protective behavioral strategies

OBJECTIVE

Recently, a number of studies have identified self-employed Protective Behavioral Strategies (PBS) as effective in decreasing the level of alcohol-related harm among young people. However, much of the published research has ignored important gender differences, such as women's increased tendency to rely on PBS that are social in nature. To further the understanding of women's PBS, the current study sought to investigate the nature and correlates of the strategies young women employ to keep their friends safe when drinking (i.e., peer-directed PBS).

METHOD

A scale measuring peer-directed PBS was developed and administered in conjunction with existing measures of alcohol consumption, personal PBS, and peer attachment. Participants consisted of 422 women aged 18-30 years, recruited among psychology students and the general public.

RESULTS

Exploratory factor analysis revealed two clusters of peer-directed PBS; those that were aimed at reducing intoxication among one's friends and those that were designed to minimize alcohol-related harms. Further analysis found a positive relationship between women's tendency to implement personal and peer-directed PBS and that risky drinkers were less likely to engage in personal or peer-directed PBS (either type).

CONCLUSION

Findings indicate that personal and peer-directed PBS are related behaviors that are less frequently adopted by risky drinkers.

A critical systematic review of alcohol-related outcome expectancies

To assess the validity of the research into alcohol-related outcome expectancies a systematic review of 80 articles published between 1970 and 2013 was conducted. Participant gender, age, and contextual influences are highlighted as possible causes of the observed variations in research findings. There is a need for fuller consideration of the influences of demographics and environmental and social contexts on research findings. It is recommended that alcohol intake measures should be standardized to a greater degree in future research. Contextual influences on expectancies also require extensive future investigation to increase the validity of research and improve alcohol-related interventions.

Compulsive use of alcohol among college students

Among college students alcohol consumption is associated with other high-risk behaviors that can lead to short- and long-term negative health consequences. Identification of college students consuming alcohol who are at high risk for problems may have important public health implications. This study examines the ability of the CHQ compulsive use of alcohol item to detect high-risk behaviors relative to other screening measures and its association with different dimensions of compulsive drinking. Three hundred thirty-two college students completed measures on compulsive drinking and hazardous behaviors. Results showed that among male students the CHQ compulsive use of alcohol item was not sensitive to detect hazardous alcohol consumption but co-occurred with the use of illicit drugs. Among female students it was sensitive to detect heavy drinking but not alcohol or drug problems. Among college students compulsive use of alcohol corresponds to an urge to consume alcohol that may be associated with use of illicit drugs in male students, with heavy drinking in female students and with substance use problems. This study suggest that the CHQ compulsive use of alcohol item should not be used as a stand-alone screening for alcohol or drug problems but it could be considered a marker for at-risk behaviors.

Young adults and casual sex: the relevance of college drinking settings

This study investigated the relevance of college drinking settings on the likelihood of students having sexual intercourse with a stranger. A random sample of 7,414 undergraduates at 14 public California universities responded to questions regarding frequency of attendance at six different setting types since the beginning of the semester (e.g., Greek, residence-hall parties, and bars or restaurants), drinking behavior, and sexual activity. Multi-level modeling examined the association between each setting type and the occurrence of alcohol-related sexual intercourse with a stranger. Findings indicated strong, positive associations between frequency of attendance at Greek parties, residence-hall parties, off-campus parties, and the occurrence of alcohol-related sex with a stranger. Frequency of attending the six settings and proportion of times drunk at the settings were also positively associated with alcohol-related sex with a stranger. Efforts aimed at preventing outcomes associated with casual sex (e.g., pregnancy, sexually transmitted infections, or mental health) should target specific drinking settings where students might be at high risk for risky alcohol use and unsafe sex behaviors.

Drinking at college parties: examining the influence of student host-status and party-location

The present research focuses on the party related drinking behaviors of college students and explores the differences in these behaviors based on students' host status (i.e. party host vs. party attendee). Furthermore, we examine if the differences in party hosts and attendees' drinking behaviors vary as a function of the party location (on-campus vs. off-campus). Multiple regression analyses were conducted using data from 3796 undergraduates at a Midwestern University. Findings revealed a significant interaction between host status and party location, such that student party hosts reported significantly greater drink consumption and related consequences as compared to party attendees, only when the party was organized off-campus. For parties organized on-campus, student hosts reported lower drink consumption as compared to attendees. College-based preventive interventions should target students likely to host off-campus parties due to their high risk for involvement in heavy drinking.

Use and correlates of protective drinking behaviors during the transition to college: analysis of a national sample

OBJECTIVE

This study examined patterns and correlates of protective drinking behaviors among incoming first-year college students.

METHOD

Incoming first-year students (n=76,882) from 258 colleges across the U.S. provided baseline data on demographics, drinking practices, and protective behaviors as part of a web-based alcohol education program. Across the several colleges, responses to protective behavior questions were collected from seven weeks before the start of the school year to five weeks after.

RESULTS

Factor analysis identified three protective behavior sub-factors: Limit Drinking, Avoid Drinking and Driving, and Intent to Get Drunk. Both Limit Drinking and Avoid Drinking and Driving generally declined over the course of the data collection period while Intent to Get Drunk and peak blood alcohol concentration increased immediately after the start of school. In multiple regression analyses, the number of heavy drinking episodes in the past two weeks had a strong negative association with a Total Protective Behavior Score and the Limit Drinking Score, and a positive association with the Intent to Get Drunk Score. With the exception of the Intent to Get Drunk Score, women were more likely to use protective behaviors than men. Underage drinkers used protective behaviors less often than their of-age peers, though the effect was small. Race/ethnicity, time to matriculation, and intent to join/membership in a fraternity/sorority had negligible effects on protective behavior scores.

CONCLUSIONS

College students increase risky drinking after the start of school while progressively using fewer behaviors that might mitigate the consequences of drinking.

Drinking plans and drinking outcomes: examining young adults' weekend drinking behavior

This study examined relationships among drinking intentions, environments, and outcomes in a random sample of 566 undergraduate college students. Telephone interviews were conducted with respondents before and after a single weekend assessing drinking intentions for the coming weekend related to subsequent drinking behaviors. Latent class analyses found evidence for four distinct drinking environments distinguished by private/public setting and presence of few/many intoxicated people. There was evidence that the drinking environment mediated the relationship between drinking intentions and heavy episodic drinking in this young adult sample. Future research might focus on examining person/environment interactions as they relate to heavy episodic drinking.

Use of drinking protective behavioral strategies in association to sex-related alcohol negative consequences: the mediating role of alcohol consumption

Alcohol use has been implicated as a risk factor for sexual negative consequences, such as unprotected sexual intercourse. The present research was conducted to examine the relationship between drinking protective behavioral strategies and consensual sex-related alcohol negative consequences, and whether this relationship varied by gender. Additionally, typical number of drinks during sexual behavior was evaluated as a potential mediator of this association. Heavy drinking, sexually active college students (N = 297, 50.2% women) completed self-report measures of drinking protective behavioral strategies, alcohol consumption, and sex-related alcohol negative consequences. Findings indicated that women who used drinking protective behavioral strategies more frequently were less likely to experience sex-related alcohol negative consequences whereas this relationship was not significant for men. For women, this relationship was mediated by the typical number of drinks consumed during sexual behavior. The current research demonstrates that use of drinking protective behavioral strategies is related to a reduction in women's sex-related risks when drinking. Findings are discussed in terms of alcohol myopia theory. Implications for interventions aimed to reduce higher risk sexual behavior among college students are discussed.

Attendance at alcohol-free and alcohol-service parties and alcohol consumption among college students

OBJECTIVE

To examine attendance at alcohol-service and alcohol-free parties among college students, and to compare alcohol consumption on nights of these parties.

METHOD

A random sample of 556 students (38.6% male) completed a web survey that measured past-semester alcohol use, alcohol-service party attendance, alcohol-free party attendance, and alcohol consumed on the nights of recent parties.

RESULTS

Participants were twice as likely to attend alcohol-service parties as they were to attend alcohol-free parties (90% vs. 44%). First-year students and Black students were more likely than other students to attend alcohol-free parties. Alcohol use was higher in students who attended alcohol-service parties but there were no differences in levels of alcohol use between students who attended alcohol-free parties and those who did not. Pre-gaming was more prevalent, but the number of drinks and intoxication were lower on nights of alcohol-free parties than on nights of alcohol-service parties.

CONCLUSIONS

The lack of association between attendance at alcohol-free parties and alcohol use indicates both heavy and light drinkers attend these parties. The lower drinking and intoxication on alcohol-free party nights suggests alcohol-free programming should be investigated to determine if it may reduce alcohol use on college campuses.

Drinking game participation among undergraduate students attending National Alcohol Screening Day

OBJECTIVES, PARTICIPANTS, METHODS: Drinking game participation has increased in popularity among college students and is associated with increased alcohol consumption and alcohol-related problems. The current study investigated drinking game participation among 133 undergraduates attending National Alcohol Screening Day (NASD) in April of 2007.

RESULTS

A large percentage of the sample reported lifetime (77%) and recent (52%) drinking game participation. Males were more likely to report recent participation and reported higher levels of consumption while playing drinking games. Drinking game participants were more likely to experience a range of alcohol-related problems, and the relationship between drinking game participation and alcohol-related problems was mediated by weekly alcohol consumption.

CONCLUSIONS

These results suggest that drinking game participation is a risk factor for elevated levels of alcohol consumption and alcohol-related problems. Programs should be developed to educate students about the risks of drinking game participation, and prevention programs like NASD should address drinking games.

Drunk in Public, Drunk in Private: The Relationship Between College Students, Drinking Environments and Alcohol Consumption

This study examines environmental differences in public (bars) and private (parties) drinking settings among of-age (21 and up years of age) and underage (18-20 years of age) college students attending college near the US/Mexico border. A random telephone survey of graduate and undergraduate students attending two large public universities in the southwestern United States was conducted during the 2000-2003 academic years. A university-based social science research laboratory conducted the telephone interviews with respondents who reported an occasion in the past 28 days where alcohol was being consumed (N = 4,964). The data were analyzed using ordinary least squares multiple regression. The results suggests that drinking settings contributed to the amount of alcohol consumed by respondents. Additionally, environmental factors contributing to drinking vary by setting. In general, having many people intoxicated at an event, BYOB parties, playing drinking games, and having illicit drugs available contribute to heavier drinking.

Blood alcohol concentrations among bar patrons: A multi-level study of drinking behavior

This paper presents data from a study that collected observational data, survey data, and breath samples to estimate blood alcohol concentrations (BrAC) from patrons attending 30 bars. The study examines: (1) drinking behavior and settings prior to going to a bar; (2) characteristics of the bar where respondents are drinking; (3) person and environmental predictors of BrAC change (entrance to exit). Purposive sampling of bars that cater to young adults gave a sample of 30 bars. Patrons were randomly selected from bars (n=839). Approximately half of the sample was female (48.7%). Nearly three-quarters of participants reported drinking before attending the bar. Serving practices of the bars were observed; majority of bars served excessive amounts of alcohol in short periods of time. On average, those who drank before attending the bar had BrACs at approximately half the legal limit. Implications for responsible beverage service coupled with law enforcement strategies are discussed.

Three exploratory studies of college theme parties

INTRODUCTION AND AIMS

The objectives of this exploratory research were to (1) explore the characteristics and risks associated with college theme parties, (2) assess differences in risk associated with college theme parties compared to non-theme parties and (3) to assess differences in risk associated with risqué theme parties as compared to non-risqué theme parties.

DESIGN AND METHODS

We used a mixed methods design. Results are presented from three exploratory studies of alcohol consumption in college theme parties: (1) four qualitative focus groups of students who have attended such events, (2) a web-based survey and (3) a multi-level (observational, survey, breath blood alcohol samples) study of 226 college parties, 29 of which were themed events. Focus group participants included a convenience sample of 17 college students aged 18-24 years; participants for the web survey included a convenience sample of 407 college students; participants for the multi-level study of college parties included 1725 randomly selected individuals at college parties.

RESULTS

Themes tended to be highly sexualized. Compared to non-themed parties, theme parties have been observed to be more rowdy, louder, involve drinking games, feature kegs and feature hard liquor.

DISCUSSION AND CONCLUSIONS

Themed parties are associated with heavy drinking and are consistent with environments sought by heavy drinkers. As a result, themed parties are marked by a greater number of alcohol-related problems. Further research is needed to understand more clearly the risks involved in themed and risqué themed events.

Relationships between college settings and student alcohol use before, during and after events: a multi-level study

INTRODUCTION AND AIMS

We examined how alcohol risk is distributed based on college students' drinking before, during and after they go to certain settings.

DESIGN AND METHODS

Students attending 14 California public universities (N=10,152) completed a web-based or mailed survey in the fall 2003 semester, which included questions about how many drinks they consumed before, during and after the last time they went to six settings/events: fraternity or sorority party, residence hall party, campus event (e.g. football game), off-campus party, bar/restaurant and outdoor setting (referent). Multi-level analyses were conducted in hierarchical linear modeling (HLM) to examine relationships between type of setting and level of alcohol use before, during and after going to the setting, and possible age and gender differences in these relationships. Drinking episodes (N=24,207) were level 1 units, students were level 2 units and colleges were level 3 units.

RESULTS

The highest drinking levels were observed during all settings/events except campus events, with the highest number of drinks being consumed at off-campus parties, followed by residence hall and fraternity/sorority parties. The number of drinks consumed before a fraternity/sorority party was higher than other settings/events. Age group and gender differences in relationships between type of setting/event and 'before,''during' and 'after' drinking levels also were observed. For example, going to a bar/restaurant (relative to an outdoor setting) was positively associated with 'during' drinks among students of legal drinking age while no relationship was observed for underage students.

DISCUSSION AND CONCLUSIONS

Findings of this study indicate differences in the extent to which college settings are associated with student drinking levels before, during and after related events, and may have implications for intervention strategies targeting different types of settings.

Where, with whom, and how much alcohol is consumed on drinking events involving aggression? Event-level associations in a Canadian national survey of university students

BACKGROUND

Epidemiological research using event-level data can provide a better understanding of the association between alcohol consumption, characteristics of drinking contexts, and the likelihood of aggressive behavior. The present research assessed whether alcohol intake and characteristics of the drinking context were associated with the likelihood of aggression within individuals across 3 drinking events based on a national sample of university students, taking into account individual characteristics and university level variables. Additionally, we determined whether individual characteristics, particularly drinking pattern, were associated with alcohol-related aggression controlling for drinking event characteristics, and whether relations of aggression to alcohol and drinking contexts differed by gender.

METHODS

Secondary analyses of the 2004 Canadian Campus Survey (CCS), a national survey of 6,282 university students (41% response rate) at 40 Canadian universities, were conducted. Respondents were asked about their three most recent drinking events, including whether they were in an argument or fight with someone, number of drinks consumed, and characteristics of the drinking context as well as their usual drinking frequency and heavy episodic drinking. We used multi-level analyses to account for the nested structure of the data (i.e., drinking events nested within individuals who were nested within universities).

RESULTS

The number of drinks consumed was positively associated with aggression. Drinking contexts found to be positively associated with aggression included being at a party, at a fraternity/sorority and/or residence, at three or more drinking places (versus 1 or 2), and having a partner present whereas having a meal reduced the likelihood of aggression. A significant interaction was found between gender and being at a party, with a significant effect found for women but not for men.

CONCLUSIONS

These results support experimental evidence indicating a direct role of alcohol in aggression and point to characteristics of the drinking context that might be targeted in future prevention initiatives.

Person and environment predictors of blood alcohol concentrations: a multi-level study of college parties

AIMS

This study builds upon previous research by assessing the relationship of breath blood alcohol concentrations (BrAC) to environmental and individual characteristics.

DESIGN

We conducted a multi-level study of college parties. Our design included observational measures of party environments, a brief self-administered questionnaire, and the collection of breath samples from partygoers.

SETTING

Data were collected in private residences of students living in a neighborhood adjacent to a large public university located in the Southwestern United States.

PARTICIPANTS

A total of 1,304 individuals attending 66 parties participated in the study.

MEASURES

Observational measures of party characteristics were made by 2 trained research assistants at each party. Four to 5 trained interviewers administered a brief field survey to partygoers at each party. In addition, the trained interviewers collected breath samples using handheld breathalyzer devices.

FINDINGS

Hierarchical linear modeling analyses revealed significant variation at the party and individual levels. At the individual level, motivations to socialize were significantly associated with lower BrAC, while drinking games and providing the sample after 11:00 pm were associated with higher BrACs. At the party level, large parties were significantly associated with lower BrACs while reports of many intoxicated partygoers were associated with higher BrACs. Finally, we identified a significant gender by theme party interaction, indicating women had higher BrACs at theme parties relative to nontheme parties; however, BrACs for men were similar regardless of the type of party attended.

CONCLUSIONS

Alcohol consumption among young adults in natural settings is a function of both person and environmental factors.

Measuring college students' alcohol consumption in natural drinking environments: field methodologies for bars and parties

In recent years researchers have paid substantial attention to the issue of college students' alcohol use. One limitation to the current literature is an over reliance on retrospective, self-report survey data. This article presents field methodologies for measuring college students' alcohol consumption in natural drinking environments. Specifically, we present the methodology from a large field study of student drinking environments along with some illustrative data from the same study. Field surveys, observational methods, sampling issues, and breath alcohol concentration sample collection are detailed.

Hardcore drinking drivers and other contributors to the alcohol-impaired driving problem: need for a comprehensive approach

OBJECTIVE

Understanding the hardcore drinking driver concept in the context of the alcohol-impaired driving problem.

METHOD

Review of the relevant literature.

RESULTS

As progress against alcohol-impaired driving slowed in the early 1990s, public and political attention turned to "hardcore" drinking drivers, and they have been a priority for the past 15 years. Though intuitive, the hardcore concept has been difficult to conceptualize. Its definition of hard-to-change chronic heavy drinking drivers focuses on a group that is not easily identifiable and ignores many who account for a large portion of alcohol-impaired driving crashes. These include drivers who drink heavily on occasion and drivers who drink at more moderate levels that elevate crash risk. Emphasis on the hardcore has focused attention on the small proportion of drinking drivers who have been detected and arrested, whereas the vast majority of drinking drivers go undetected. Some countermeasures aimed at the hardcore group have been effective in reducing recidivism, but attention and resources also need to be given to general deterrent initiatives (e.g., 0.08 g/dL, sobriety checkpoints, administrative license suspension). There has been no reduction in the overall alcohol-impaired driving problem since the mid-1990s.

CONCLUSION

Reductions in the alcohol-impaired driving problem require that attention be focused on all relevant target groups. Some benefits could accrue by recognizing that countermeasures developed for hardcore drinking drivers, such as alcohol ignition interlocks and vehicle or plate impoundment, might also be effective with more numerous first-time offenders. However, such strategies are likely to be most effective against recidivism (specific deterrence). Greater gains could be achieved through general deterrent efforts (increasing the real and perceived risk of arrest and punishment to all drinking drivers), along with application of public health measures designed to reduce overall consumption. Additional ways need to be found to separate drinking and driving, either through cultural changes in drinking and/or driving behavior or, in the future, with the use of technology that can make vehicles inoperable by drivers with illegal blood alcohol concentrations.

Drinking game participation among college students: gender and ethnic implications

Participation in drinking games by college students has recently sparked research attention. While previous research indicates that women play drinking games at lower frequencies than men, the current study reveals that college women may be playing games at rates similar to college men. In a sample of 105 coed college students, participants completed a 3-month Timeline Followback recording every drinking event and quantity consumed. They then were prompted to identify which drinking events involved drinking games and how much alcohol was consumed during game playing. Both men and women engaged in drinking games at similar rates and consumed more drinks on game playing days than on non-game drinking days. However, drinking game participation was related to alcohol-related consequences in women only. Further, while Caucasian participants played drinking games more often than non-Caucasian participants, an association between game participation and alcohol-related consequences emerged in non-Caucasian participants.

Etiological contributions to heavy drinking from late adolescence to young adulthood

The authors examined genetic and environmental contributions to stability and change in heavy drinking from late adolescence to young adulthood in a sample of 1,152 twin pairs. In men, heavy drinking was similarly heritable at ages 17 (h2=.57) and 20 (h2=.39), and its stability owed primarily to common genetic factors. In women, heavy drinking was less heritable than in men at ages 17 (h2=.18) and 20 (h2=.30) and its stability was primarily due to enduring shared environmental influences. P3 amplitude, an event-related brain potential marker of alcoholism risk, was less predictive of heavy drinking in women than in men, providing further support for the proposition that biological factors have less impact on heavy drinking in young adult women than in young adult men.

Heavy alcohol use compared to alcohol and marijuana use: do college students experience a difference in substance use problems?

This study examines the risk for alcohol and other drug (AOD) problems resulting from alcohol plus marijuana use compared to alcohol-only use. Data are from telephone interviews with 1113 randomly selected college students attending two large urban universities in the southwestern United States. Alcohol and marijuana users (dual users) were more likely to be younger and report a higher mean number of drinks per occasion and experiencing all AOD problems studied compared to alcohol-only users. Multivariate logistic regression analysis findings reveal the relationship between dual-substance use and increased risk for AOD problems remained after controlling for demographics and alcohol use behaviors. Such problems include greater odds of legal problems and riding with or being an intoxicated driver. College students using alcohol and marijuana are at much higher risk for AOD problems than are students who use alcohol only, even when heavy drinking is taken into account.