Loosening the Grip: a handbook of Alcohol Information 9th

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College Students

Baer JS, Kivlahan DR, Marlatt GA. High-risk drinking across the transition from high school to college. Alcoholism: Clinical and Experimental Research 19(1): 54–61, 1995. (27 refs.)

Alcohol use and related problems were studied from the senior year in high school to the first autumn in college for 366 heavy drinking students. Four risk factors -- subject sex, family history of drinking problems, prior conduct problems, and type of college residence -- were evaluated as predictors of: (1) differential changes in drinking rates, (2) differential changes in alcohol-related problems, and (3) alcohol dependence symptoms during the first college term. Results suggests that both dispositional and environmental factors are associated with changes in drinking rates and the existence of dependence symptoms. Increases in the frequency of drinking were specifically and strongly associated with residence in a fraternity (men) or sorority (women). Three risk factors were associated with increased quantity of drinking: male gender, residence in a fraternity or sorority, and a history of conduct problems. Prior conduct problems were also consistently associated with dependence symptoms during the first term in college. A family history of alcohol problems was not consistently related to changes in use rates or problems, although some analyses suggest interactive effects. Early interventions on college campuses should target individuals using additive risk profiles. Copyright 1995, Research Society on Alcoholism

Beirness DJ, Foss RD, Vogel-Sprott M. Drinking on campus: Self-reports and breath tests. Journal of Studies on Alcohol 65(5): 600–604, 2004. (16 refs.)

Objective: Concern about excessive alcohol consumption by college students has been raised by surveys indicating that more than 40% of students are "heavy" drinkers. This definition is based on students' reports of consuming five or more drinks (four or more for women) on an occasion sometime during the past 2 weeks. The present survey examines the degree to which this 2-week 5+/4+ drink criterion characterizes a student's pattern of alcohol use, and whether a 5+/4+ criterion for a drinking occasion is a valid indicator of high blood alcohol concentration (BAC). Method: Students (N = 856, 70% male) were interviewed as they returned home between 10 PM and 3 AM. Students reported their drinking of the past 2 weeks and of the night they were interviewed, then provided breath samples to determine their BAC. Results: Among the students in the sample classified as "heavy" drinkers on the basis of self-reports, 49% had zero BAC on the night they were interviewed. Those who reported consuming 5+/4+ drinks the evening of the interview had a mean BAC <0.08%. The distribution of BACs in the entire sample showed 74.4% of students had a BAC of zero and 11.8% had a BAC <0.05%. Very high BACs (i.e., greater than or equal to0.15%) were rare (1.3%). Conclusions: Self-reports of consuming 5+/4+ drinks on at least one occasion during the previous 2 weeks did not reliably identify a pattern of heavy drinking. Moreover, reports of 5+/4+ drinks on an occasion were not necessarily associated with high BACs. (Copyright 2004, Alcohol Research Documentation Inc.)

Bents RT, Tokish JM, Goldberg L. Ephedrine, pseudoephedrine, and amphetamine prevalence in college hockey players: Most report performance-enhancing use. Physician and Sportsmedicine 32(9): 30–34, 2004. (20 refs.)

BACKGROUND: Performance-enhancing drugs are used by some athletes, even though the substances may be potentially dangerous and some are banned. OBJECTIVE: To assess the use of metabolic stimulants among collegiate hockey players. METHODS: Surveys were administered to college hockey players on five teams. Participation was voluntary, and respondents remained anonymous. The survey included questions regarding use of specific stimulants (eg, ephedrine, amphetamines, pseudoephedrine), awareness of potential side effects, and knowledge of National Collegiate Athletic Association (NCAA) rules. RESULTS: More than half (58%) of the 122 college hockey players who completed the survey reported past or present use of the specific stimulants. Almost half (46%) reported pseudoephedrine use to enhance performance, including 24% who indicated current use, and 38% reported ephedrine use, including 11% who admitted current use. Stimulant users had good knowledge about the potential side effects of ephedrine, including sudden death, hypertension, and insomnia. Nearly all (92%) stimulant users were aware of the current NCAA ban of ephedrine. Over 33% stated they would use a banned substance if it would help them get to the National Hockey League. CONCLUSION: A large number of collegiate hockey players admit to using metabolic stimulants despite knowledge of side effects and the NCAA ban on two of these substances. More effective educational interventions, perhaps coupled with a stronger testing policy, may be necessary to curb this potentially dangerous practice. (Copyright 2004, McGraw-Hill)

Borsari B. Drinking games in the college environment: A review. Journal of Alcohol fand Drug Education 48(2): 29-51, 2004. (54 refs.)

Drinking games among American college students, although popular, contribute significantly to excessive drinking and alcohol-related problems. Drinking games appear to facilitate socialization, and are especially prevalent among younger students. This article reviews the qualitative and quantitative research on drinking games. Findings from qualitative studies suggest that students participate in drinking games to intoxicate themselves and others, to facilitate socialization, and for competition. Quantitative studies have identified motives for initiating and stopping drinking games, as well as age and gender differences in participation. Research findings highlight the importance of educating students about the risks associated with playing drinking games. Specifically, students should be alerted about the heightened risk of extreme intoxication and consequences that can result from playing drinking games. Women are at particular risk for experiencing sexual assault in the drinking game context. Alternative socialization opportunities should be provided to the students to counteract the inherent social advantages of drinking game participation. (Copyright 2004, American Alcohol and Drug Information Foundation)

Borsari B, Carey KB. Two brief alcohol interventions for mandated college students. Psychology of Addictive Behaviors 19(3): 296-302, 2005, (32 refs.)

Encouraging but limited research indicates that brief motivational interventions may be an effective way to reduce heavy episodic drinking in college students. At 2 campuses, students (83% male) mandated to a substance use prevention program were randomly assigned to I of 2 individually administered conditions: (a) a brief motivational interview (BMI; n = 34) or (b) an alcohol education session (AE; n = 30). Students in the BMI condition reported fewer alcohol-related problems than the AE students at 3- and 6-month assessments. Trends toward reductions in number of binge drinking episodes and typical blood alcohol levels were seen in both groups. Process measures confirmed the integrity of both interventions. The findings demonstrate that mandated BMIs can reduce alcohol problems in students referred for alcohol violations. (Copyright 2005, Educational Publishing Foundation)

Campo S, Cameron KA. Differential effects of exposure to social norms campaigns: A cause for concern. Health Communication 19(3): 209–219, 2006. (88 refs.)

College students' processing of alcohol social norms messages, related effects on normative judgments, attitudes toward their own behaviors, and perception of undergraduate attitudes were examined using expectancy violation theories and social norms marketing. Data were collected from 2 universities (N = 393). Following message exposure, the majority moved their normative judgments toward the statistic provided in the message. Slight attitude change occurred but not always in the desired direction. Those most likely to develop unhealthier attitudes drank more than those who developed healthier attitudes, consistent with psychological reactance to the messages. Therefore, the effects of social norms campaigns on those at greatest risk for primary and secondary alcohol effects due to their increased alcohol consumption could lead to increased risk for those participants, indicating that the widespread use of social norms campaigns needs to be scrutinized. (Copyright 2006, Lawrence Erlbaum Associates)

Caudill BD, Crosse SB, Campbell B, Howard J, Luckey B, Blane HT. High-risk drinking among college fraternity members: A national perspective. Journal of American College Health 55(3): 141–155, 2006. (51 refs.)

This survey, with its 85% response rate, provides an extensive profile of drinking behaviors and predictors of drinking among 3406 members of one national college fraternity, distributed across 98 chapters in 32 states. Multiple indexes of alcohol consumption measured frequency, quantity, estimated blood alcohol concentration levels (BACs), and related problems. Among all members, 97% were drinkers, 86% binge drinkers, and 64% frequent binge drinkers. On the basis of self-reports concerning the 4 weeks preceding the time of survey, the authors found that members drank on an average of 10.5 days and consumed an average of 81 drinks. Drinkers had an average BAC of 0.10, reaching at least 0.08 on an average of 6 days. These fraternity members appear to be heavier drinkers than previously studied fraternity samples, perhaps because they were more representative and forthright. All 6 preselected demographic attributes of members and 2 chapter characteristics were significantly related to the drinking behaviors and levels of risk, identifying possible targets for preventive interventions. (Copyright 2006, American College Health Association)

Engs RC, Hanson DJ. University students’ drinking patterns and problems: Examining the effects of raising the purchase age. Public Health Report 133(6): 647–673, 1988. (61 refs.)

An extensive review of the literature on college students' drinking patterns and problems since the mid-1930's revealed no radical changes over the past several decades. However, during the past 10 years, drinking and problems related to drinking and driving have gradually decreased among college students. Results of a study of students at the same 56 colleges and universities throughout the United States (3,145 in 1982-1983, 2,797 in 1984-85, and 3,375 in 1987-1988) revealed few changes in collegiate drinking patterns and problems attributable to the nationwide increase in the minimum age for alcohol purchase. There was a decline in the proportion of students who drank in the period during which the law changed. However, the proportion of students categorized as heavy drinkers remained constant over time and the proportion of underage students (81 percent) who drank was higher than the proportion of legal age students who drank (75 percent). Of 17 problems related to drinking, all but 5 remained stable over the time periods. Three of the problems represent the continuum of an established trend of fewer students indicating drinking and driving-related problems. As discussed in this paper, creative alcohol programming can assist in controlling alcohol abuse among college students. Public domain.

Fournier AK, Ehrhart IJ, Glindemann KE, Geller ES. Intervening to decrease alcohol abuse at university parties: Differential reinforcement of intoxication level. Behavior Modification 28(2): 167–181, 2004. (34 refs.)

This quasi-experimental field study assessed whether an incentive/reward intervention can change the drinking behavior and the subsequent levels of intoxication among college students attending fraternity parties. A total of 356 blood alcohol concentration (BAC) assessments, using hand-held breathalyzers, were obtained at two baseline and at two intervention parties at the same fraternity house. At the intervention parties, the students were informed they could win a cash prize if their BAC was below .05, and they were given nomograms to aid in monitoring their levels of intoxication. Mean BAC and the percentage of partiers with intoxication levels above .05 were significantly lower at the two intervention parties. More than twice as many partygoers were legally intoxicated (i.e., BAC > .08) at the two baseline parties than at the two intervention parties, indicating a clinically significant impact of the incentive/reward intervention. Greek-life students, in particular, were significantly less intoxicated at intervention parties, compared to baseline parties (p < .001). (Copyright 2004, Sage Publications)

Grossbard J, Geisner IM, Neighbors C, Kilmer JR, Larimer ME. Are drinking games sports? College athlete participation in drinking games and alcohol-related problems. Journal of Studies on Alcohol 68(1): 97–105, 2007. (31 refs.)

Objective: Studies indicate greater heavy episodic drinking and related consequences for college student-athletes compared with nonathletes. Surprisingly, little research has examined college athletes' participation in drinking games, a context associated with excessive alcohol consumption and negative alcohol-related consequences in college students. Method: We examined how drinking game participation contributes to alcohol consumption and alcohol-related consequences among college-level intramural and intercollegiate athletes compared with nonathletes in two independent samples. Study 1 consisted of 1,395 randomly selected students (61% women) at a West Coast college campus, including 335 students who reported intramural athletic participation. Study 2 consisted of 6,055 randomly selected college students (63% women) from three college campuses, including 1,439 intramural athletes and 317 intercollegiate athletes. Results: Results of Study 1 indicated that intramural athletes consumed significantly more drinks per week, had significantly higher typical and peak blood alcohol concentration levels, and reported more negative consequences than nonathletes. Drinking game participation mediated the relationship between intramural athlete status and measures of consumption and consequences. Results of Study 2, including both intramural and intercollegiate athletes, were consistent with those of Study 1, revealing drinking game participation as a mediator of the relationships between athlete status and alcohol consumption and consequences. Conclusions: Drinking games represent contexts for college athletes to engage in heavy episodic drinking, and participation in drinking games mediates the relationship between alcohol consumption and negative consequences in athletes. Interventions targeted at college athletes should consider the impact of drinking game participation. (Copyright 2007, Alcohol Research Documentation)

Ham LS, Hope DA. College students and problematic drinking: A review of the literature. Clinical Psychology Review 23(5): 719–759, 2003. (152 refs.)

Problem drinking during the college years is a significant public health concern. The goal of the current review was to examine the primary psychosocial factors that predict problem drinking in college students. Variables examined included demographic variables, personality, drinking history, alcohol expectancies, drinking motives, stress and coping, activity involvement, and peer and family influence. Evidence from studies of college drinking indicated that the variables associated with college drinking seem to vary at levels dealing with one's personality and coping mechanisms, one's thought processes about drinking, and the environment. It seems that expectancies and drinking motives may serve as explanations for the pathways from certain personality types (i.e., sensation seeking and neurotic) to problem drinking in the college setting. Factors that predicted future drinking problems after college were also examined. Overall, it seems that interventions and prevention programs would need to reach college students at all three levels -- the environment, individual personality traits, and cognitive processes. Future research should address the limitations in the previous research as well as test comprehensive models of college drinking. (Copyright 2003, Elsevier Science)

Hammersley R, Ditton J. Binge or bout? Quantity and rate of drinking by young people in the evening in licensed premises. Drugs: Education, Prevention and Policy 12(6): 493–500, 2005. (16 refs.)

A sample of 291 people aged 16-25 responded to an interviewer-completed questionnaire seeking information on their quantity and rate of alcohol consumption. The survey was conducted in licensed premises in the centre of a large English city. Analysis revealed that men drank more than women, but adjusting for body size and recommended alcohol intake removed this difference. Most respondents planned to drink far more than recommended upper limits. However, they did so at a moderate rate of intake over many hours and only a minority planned to drink so fast that they would become extremely drunk. "Binge'' drinking was typically defined by this sample to be fast and excessive drinking. There was no evidence of a distinct minority of bingers, for intake was a skewed unimodal distribution. Binge drinking is a politically highly charged concept, but is rarely defined with any precision. It is confused with drinking to excess and with drunkenness. This study suggests that drinking rate must be a key part of any competent definition. Study participants were on a drinking "bout'' that involved drinking too much for health over 5 or 6 hours, but were not planning to get very drunk. Young people need to be encouraged to drink less even when they are not getting drunk, and warnings about binges and their dire consequences may distract from this message. (Copyright 2005, Taylor and Francis Ltd.)

Hasking P, Shortell C, Machalek M. University students’ knowledge of alcoholic drinks and their perception of alcohol-related harm. Journal of Drug Education 35(2): 95–109, 2005. (21 refs.)

A total of 371 university students were asked to estimate the amount of alcohol contained in a standard drink and to estimate the number of standard drinks contained in popular alcoholic beverages. In addition, students completed questionnaires assessing their perception of short and long term harm related to the consumption of beer, wine, spirits and pre-mixed alcopops. Results revealed that students were generally inaccurate in their estimate of alcoholic content of beverages, and national guidelines for low risk drinking. Students were also found to hold different perceptions regarding how harmful different alcoholic beverages were. While both male and female students considered spirits to be more harmful than beer, wine and pre-mixed drinks, males also believed beer to be more harmful than wine when considering the short term consequences. The pattern of beliefs reported by this sample suggest a high-risk population who are not aware of the risks they are exposing themselves to through their drinking behavior. (Copyright 2005, Baywood Publishing)

Hingson R, Heeren T, Winter M, Wechsler H. Magnitude of alcohol-related mortality and morbidity among US college students ages 18–24: Changes from 1998 to 2001. (review). Annual Review of Public Health (26): 259–279, 2005 (83 refs.)

Integrating data from the National Highway Traffic Safety Administration, the Centers for Disease Control and Prevention, national coroner studies, census and college enrollment data for 18-24-year-olds, the National Household Survey on Drug Abuse, and the Harvard College Alcohol Survey, we calculated the alcohol-related unintentional injury deaths and other health problems among college students ages 18-24 in 1998 and 2001. Among college students ages 18-24 from 1998 to 2001, alcohol-related unintentional injury deaths increased from nearly 1600 to more than 1700, an increase of 6% per college population. The proportion of 18-24-year-old college students who reported driving under the influence of alcohol increased from 26.5% to 31.4%, an increase from 2.3 million students to 2.8 million. During both years more than 500,000 students were unintentionally injured because of drinking and more than 600,000 were hit/assaulted by another drinking student. Greater enforcement of the legal drinking age of 21 and zero tolerance laws, increases in alcohol taxes, and wider implementation of screening and counseling programs and comprehensive community interventions can reduce college drinking and associated harm to students and others. (Copyright 2005, Annual Reviews)

Johnston LD, O’Malley PM, Bachman JG. Monitoring the Future. National Survey Results on Drug Use 1975–2005. Volume II: College Students and Young Adults, Rockville MD: National Institute on Drug Abuse, 2006.

This volume, part of a report on an annual national survey of drug use, focuses upon college students and adults through age 45. available online

Koski P. Nordic sport around the bottle. IN: Bouroncle A; Rauhamaki S, eds. Sport and Substance Use in the Nordic Countries. NAD Monograph No. 45. Helsinki Finland: Nordic Council for Alcohol and Drug Research, 2005. pp. 5-16. (19 refs.)

This main focus of this introductory chapter is with substances and sports, both of which are prominent features of social life in Nordic countries as they are in many cultures. For many social interaction is an important aspect of both alcohol use and sport or physical exercise and both are rooted in masculine hegemony. It summarizes the major themes of the volume, which consider both athletes and spectators. It is noted that role of alcohol in culture and the connections with sport is not new in Nordic countries, but have their roots in Viking tradition. Modern sports and its capitulation into the world of entertainment has found alcohol becoming a target of marketing and alcohol a part of the fan culture and carnivalesque behavior of sporting events. While hooliganism is an issue in other countries and is intertwined with alcohol use, it is not a significant factor in Nordic countries, with the greater concerns being the impact upon health, values, and models for young people. Copyright 2006, Project Cork. [Note: Possibly an odd item to include within a bibliography on college alcohol use, there is probably no other domain where alcohol and sport is so closely linked.

Mallett KA, Lee CM, Neighbors C, Larimer ME, Turrisi R. Do we learn from our mistakes? An examination of the impact of negative alcohol-related consequences on college students’ drinking patterns and perceptions. Journal of Studies on Alcohol 67(2): 269–276, 2006. (41 refs.)

Objective: Little research has examined antecedents of specific drinking consequences (vomiting, regretted sex, hangover, blackouts) among college students. This research examined how students' experiences of past consequences relate to their beliefs of experiencing similar consequences in the future and how these beliefs relate to current drinking patterns. Method: Self-reported past drinking behavior and resulting consequences associated with specific occasions were assessed among 303 (66% women) college students. Students also estimated number of drinks associated with risk of experiencing future similar consequences. Results: Paired-samples t tests indicated that students significantly overestimated the number of drinks it would take to vomit, have unwanted sexual experiences, experience hangovers, and black out in comparison with the actual self-reported number of drinks consumed the last time identical consequences were experienced. In addition, a series of multiple-regression analyses revealed that greater misperceptions between the perceived and actual number of drinks associated with each type of consequence were consistently associated with heavier drinking. Conclusions: Results suggest that heavier-drinking students do not learn from their mistakes but instead overestimate the amount of alcohol they can consume without experiencing negative consequences. Clinical implications of these findings are discussed in terms of augmenting brief interventions aimed at heavy-drinking college students. (Copyright 2006, Alcohol Research Documentation, Inc.)

National Collegiate Athletic Association (NCAA). Study of Substance Abuse Habits of College-Student Athletes. Indianapolis, IN: NCAA, 2001. available online

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