Environmental correlates of underage alcohol use and related problems of college students

BACKGROUND: Underage alcohol use is a major contributor to morbidity and mortality in adolescents and young adults. This study examined drinking levels and ensuing problems among college students and factors associated with binge drinking. METHOD: The Harvard School of Public Health College Alcohol Study conducted a self-administered survey. The participants include a random sample of 7061 students aged <21 years (defined as underage drinkers), and 4989 between ages 21 and 23 in 1997 at 116 nationally representative 4-year colleges in 39 states. The outcomes of the study include self-reports of alcohol use, binge drinking (defined as five or more drinks in a row for men and four or more for women at least once in a 2-week period), alcohol-related problems, preferred type of drink, access to alcohol, and price paid per drink. RESULTS: Underage students drink less often but have more drinks per occasion, are more likely to drink in private settings (off-campus, dormitory, and fraternity parties), and pay less per drink than do of-age students. Correlates of underage binge drinking include residence in a fraternity or sorority (odds ratio [OR]=6.2), very easy access to alcohol (OR=3.3), obtaining drinks at lower prices (OR=2.1, for under $1 each or a set fee for unlimited drinks), and drinking beer (OR=9.5). CONCLUSIONS: Effective controls on price, access, and fraternity and off-campus parties, and reinforcing minimum drinking age laws are needed to reduce the high levels of binge drinking and related health and behavioral problems of underage students.     

大学生饮酒模式调查分析

目的分析影响大学生饮酒模式的因素,针对饮酒教育及酒精政策提出建议。方法采用整群抽样方法,选择来自北京和郑州的530名大学生完成有效问卷调查。采用 Epidata 录入数据,SAS 12.0和 R 2.7.2进行数据描述和分析。结果74.5%的大学生在过去1年内饮过酒,啤酒是饮酒者的主要选择（85.9%）,餐馆和家里是饮酒比较频繁的场所,饮用酒多来自同学/朋友及家庭成员提供,25.3%饮酒者并无特别原因饮酒,各有约1/5的饮酒者是出于社交目的或喜欢饮酒的感觉。认为“饮酒有助于社交暠或“饮酒促进交流暠者、父母及同学/朋友饮酒者、来自农村地区或小城镇者及吸烟者更容易发生饮酒行为（均 P 〈0.05）,男生大学生、规律饮酒者更容易遭遇强迫劝酒场面、更易发生醉酒（均 P 〈0.05）。超过一半饮酒者出现酒后脸红、肌肉软弱无力等生理反应,饮酒对被调查大学生产生的社会心理影响依次是记忆丧失（23.9%）、宿醉（14.6%）、做了后悔的事（低于10%）等。结论目前大学生仍保持着一种低风险饮酒模式。大学生饮酒教育应提供关于饮酒利弊的科学信息,使其对饮酒保持一种现实的期望。应制定针对性酒精政策和教育鼓励和支持低风险且满足社交功能的饮酒模式,控制高风险饮酒模式。     

What harms do young Australians experience in alcohol‐use situations?

OBJECTIVE: An insight into the alcohol-related experiences of young students in Perth, Western Australia, with particular emphasis to alcohol-related harm. METHOD: The sample of 2,329 students (female: n = 1,089, male: n = 1,240) is a school-based group selected using cluster sampling, with stratification by socio-economic area and represents 11 to 12 year olds' experiences with alcohol and alcohol-related harm. The SHAHRP survey instrument was developed and pre-tested to measure students' knowledge, attitudes, patterns and context of use, harms associated with the students' own alcohol consumption and harms associated with other people's use of alcohol and incorporates the students' perceptions of alcohol-related harm. RESULTS: Nearly two-thirds of all young people consumed alcohol under adult supervision; nearly 40% of all young males and 34% of all young females drink alcohol in unsupervised situations; and a fifth of young males consumed alcohol alone. Young males start drinking younger and consumed alcohol more regularly than young females, and consumed more alcohol per occasion. In the past 12 months, young males experienced more than five and young females more than three alcohol-related harms associated with their own alcohol consumption. They experienced a similar number of harms associated with other people's use of alcohol. Unsupervised drinkers were nearly seven times more likely to experience alcohol-related harm than supervised drinkers and nearly 13 times more likely to experience alcohol-related harm than non-drinkers. CONCLUSION AND IMPLICATIONS: The results can help inform the development of alcohol education programs for young people.     

大学生对饮酒所致脸红反应社会学涵义的认知

目的了解大学生对饮酒所致脸红反应的理解,以及对饮酒脸红者的行为反应,为探讨饮酒所致脸红反应的遗传-环境联系提供线索。方法以自行设计的问卷对中国中部某大学医学院和教育学院的442名大学生进行匿名调查。以Epi Data 3.02录入数据,利用SPSS 13.0完成数据分析。结果71.0%的学生在过去一年里饮过酒。50.4%的学生认为脸红反应是表示脸红者不应再继续饮酒,有此认知的非饮酒学生和饮酒学生比例分别为63.6%和44.9%。55.4%的学生表示饮酒群体中的其他人将劝阻脸红者继续饮酒。针对饮酒场合中男生的脸红反应,41.9%的男生和49.2%的女生认为饮酒群体中的男生仍会鼓励男生脸红者继续饮更多的酒;如果出现脸红反应者是女生,此比例分别为7.8%和10.5%。结论大学生对饮酒所致脸红反应的社会学涵义缺乏正确认知,这种缺乏不仅影响其对脸红反应者、尤其是对不同性别脸红者的行为反应,而且有可能影响其自身的饮酒经历。     

What Do Binge Drinkers Drink?: Implications for Alcohol Control Policy

BACKGROUND: Although binge drinking (drinking five or more drinks on an occasion) is an important public health problem, little is known about which beverage types are consumed by binge drinkers. This knowledge could guide prevention efforts because beer, wine, and liquor are taxed, marketed, and distributed differently. METHODS: Data from 14,150 adult binge drinkers who responded to the Behavioral Risk Factor Surveillance System binge-drinking module in 2003 and 2004 were analyzed. Information pertained to the amount of alcohol consumed during a binge drinker's most recent binge episode, including beverage-specific consumption. RESULTS: Overall, 74.4% of binge drinkers consumed beer exclusively or predominantly, and those who consumed at least some beer accounted for 80.5% of all binge alcohol consumption. By beverage type, beer accounted for 67.1%, liquor for 21.9%, and wine accounted for 10.9% of binge drinks consumed. Beer also accounted for most of the alcohol consumed by those at highest risk of causing or incurring alcohol-related harm, including people aged 18-20 years (67.0% of drinks were beer); those with three or more binge episodes per month (70.7%); those drinking eight or more drinks per binge episode (69.9%); those binging in public places (64.4%); and those who drove during or within 2 hours of binge drinking (67.1%). CONCLUSIONS: Beer accounted for two thirds of all alcohol consumed by binge drinkers and accounted for most alcohol consumed by those at greatest risk of causing or incurring alcohol-related harm. Lower excise taxes and relatively permissive sales and marketing practices for beer as compared with other beverage types may account for some of these findings. These findings suggest that equalizing alcohol control policies at more stringent levels would be an effective way to prevent excessive drinking.     

Adolescent Gender Differences in Alcohol Problem Behaviors and the Social Contexts of Drinking

ABSTRACT: This study of more than 1,300 high school students examined gender differences in the social context of drinking associated with four alcohol problem behaviors (high intensity drinking, binge drinking, driving while intoxicated, and riding with an alcohol impaired driver). A series of analyses treated five social contexts of drinking (Social Facilitation, School Defiance, Stress Control, Peer Acceptance, and Parental Approval) as dependent variables and revealed significant multivariate interaction effects between gender and all four alcohol problem behaviors. Male problem drinkers were more likely to drink in all social contexts than female problem drinkers or non-problem drinkers of both genders. Females were no more likely to drink in the context of Stress Control than males, a finding inconsistent with some previous research. The social contexts of Social Facilitation, School Defiance, and Stress Control were the best discriminators of problem versus non-problem drinkers of both genders (although the order of importance varied by gender and specific problem behavior). Implications for designing targeted interventions are discussed. (J Sch Health. 1996;66(8):299–304)     

Alcohol abuse among U.S. Navy recruits who were maltreated in childhood

AIMS: To examine relationships between childhood maltreatment and alcohol-related problems among U.S. Navy recruits. METHODS: An anonymous sample of 5697 Navy recruits completed a survey regarding their alcohol consumption, alcohol problems (binge drinking, drinking until drunk, alcohol dependence, alcohol-related arrests), and experiences of childhood physical and sexual abuse. RESULTS: Most of the recruits used alcohol, and a substantial proportion reported histories of childhood maltreatment. Recruits who had been victimized as children were more likely to use alcohol. Furthermore, among drinkers, those who had been abused were more likely to exhibit alcohol problems than were non-abused drinkers. CONCLUSION: Substantial numbers of personnel with alcohol-related problems may be using alcohol to self-medicate due to a history of childhood abuse. Attention to the association between alcohol abuse and childhood maltreatment might help improve the efficacy of military alcohol reduction programs.     

Alcohol use and abuse by adolescents: the impact of living in a border community.

PURPOSE: To determine the rates of alcohol consumption and alcohol-related risk behaviors among a sample of high school students living on the U.S.-Mexico border, as well as to investigate factors associated with alcohol use among this population. METHODS: A self-administered anonymous questionnaire was administered to students in grades 9-12 during Fall and Spring semesters of 2001 (n = 1366; 639 males and 722 females) in 16 high schools in a community along the U.S.-Mexico border. The questionnaire addressed demographic factors, alcohol consumption, and alcohol-related behaviors. Surveys were completed by Chi-square tests for homogeneity of the odds ratio and logistic regression models were used to identify factors significantly associated with the outcome variables. RESULTS: Rates of binge drinking (45%), drinking and driving (19%), and riding with a driver who had been drinking (46%) were higher for our study population when compared with state and national rates. Students who consumed alcohol were more likely to report alcohol-related problems and lower academic grades. Drinking while in Mexico was significantly associated with binge drinking (OR = 6.44), drinking and driving (OR = 5.39), and riding with a driver who has been drinking (OR = 3.12). CONCLUSIONS: The high rates of alcohol risk behaviors among students living on the U.S.-Mexico border underscore the need to develop and implement culturally appropriate prevention programs that address alcohol consumption in Mexico, particularly in terms of students driving back home.     

北京市2014年高中生饮酒行为及其影响因素分析

了解北京市高中生饮酒相关行为现状及其影响因素,为预防青少年过早饮酒和过量饮酒提供依据.方法 2014年3-5月,采用分层整群随机抽样方法,抽取北京市18个区县的15 726名高中生进行健康危险行为自填问卷调查.结果 北京市高中生曾饮酒率为67.9%,13岁前饮酒率为35.2%,现在饮酒率为41.0%,过量饮酒率为16.6%.“与家人朋友喝”是北京市高中生饮酒的最主要原因.职业技术学校、男生、高二、母亲高中文化水平、重组家庭、人均月收入高和学习成绩差的高中生各项饮酒率均较高.有健康危险行为的高中生更容易出现饮酒相关行为,如有吸烟行为的学生更容易发生现在饮酒行为(OR=4.41,95%CI=3.90~4.98),有打架行为的学生更容易出现过量饮酒行为(OR=2.00,95%CI=1.77~2.26),有性行为的学生更容易出现13岁前饮酒行为(OR=1.58,95%CI=1.36~1.84),有尝试自杀行为的学生更容易出现过量饮酒行为(OR=1.67,95%CI=1.27~2.19).结论 在预防青少年饮酒相关行为时,应考虑年龄、家庭、性别等因素,并重视其他健康危险行为因素的影响,家庭和学校需尽早积极开展预防青少年饮酒行为的综合性健康教育.     

广州地区高中生饮酒模式及过量饮酒的社会经济地位影响因素

目的 分析广州市高中生饮酒模式,探讨不同社会经济地位指标与青少年过量饮酒行为的关系,为制定控制策略措施提供依据。方法 采用多阶段分层随机整群抽样方法,抽取广州市4个区高一和高二学生共3 282人,采用自填问卷进行调查。结果 75.61%的学生有饮酒经历;过去一年内,60.22%的学生曾饮酒,27.67 %曾醉酒;过去30 d内,22.75%的学生曾饮酒,7.17%曾重度饮酒。总体上,男生五种饮酒行为流行率均高于女生,差异均有统计学意义(P<0.05);采用广义混合线性模型,分析不同社会经济地位指标对青少年过量饮酒的影响。结果显示,与家庭富裕程度低、学业成就高的青少年相比,来自家庭富裕程度高、学业成就低的青少年较可能有重度饮酒及醉酒行为。结论 广州地区高中生饮酒普遍化,提示防治工作的紧迫性,应及早开展健康教育和干预工作来减少酒精的可及性和青少年的饮酒行为。     

Evaluating the believability and effectiveness of the social norms message "most students drink 0 to 4 drinks when they party"

In an effort to reduce dangerous drinking levels among college students, university health educators have initiated social norms campaigns based on the rationale that students will be more likely to reduce their own drinking behaviors if they think that most students on campus are not heavy or binge drinkers. Within the framework of social comparisons theory, this study reports the findings of a survey of 277 college students and explores the correlates of accuracy and bias in students' estimates of whether or not most other students think that binge drinking on campus is a problem and whether or not most other students believe the campaign message. The overwhelming majority (72.6%) of students did not believe the norms message that most students on campus drink "0 to 4" drinks when they party, and 52.7% reported drinking "5 or more" drinks in a sitting. The social norms campaign was effective in motivating 61% of the respondents to think about binge drinking as a problem. For the most part, group or social network norms were more influential on students' own drinking behavior than were their estimates of the campus drinking norm. The findings also clarify that accuracy in estimating the campus social norm in and of itself does not necessarily lead to an increase or reduction in alcohol consumption. The social comparisons approach underscores the complex and social nature of human interaction and reinforces the need for the development of multiple approaches to alcohol education with messages that are designed to target the specific needs of students based on their orientations toward alcohol consumption.     

Socio-demographic correlates of alcohol consumption in the Danish general population

AIMS: Little is known about specific Danish drinking patterns. This paper investigates how various socio-demographic factors are related to Danish alcohol consumption with special focus on age and sex. METHODS: Data come from a national telephone survey of the Danish general population conducted in 2003 with a final sample size of 2,030 cases. Measures of beverage specific current drinking, overall drinking, daily drinking, heavy episodic drinking, mean consumption, volume per drinking occasion and frequency of drinking were analysed. RESULTS: A little over 5% of the population are abstainers. Fourteen per cent of men and 9% of women are heavy drinkers; 38% of men and 18% of women are heavy episodic drinkers. Youth of both sexes drink heavily, and especially in a binge drinking style. Regular, more temperate drinking is associated with increasing age. Multivariate analyses suggest that other than age and sex, classical socioeconomic factors do not play a great a role in determining drinking patterns. Social integrative factors in particular influence women's drinking. CONCLUSIONS: With respect to the rest of Europe and North America, Danes consume high levels of alcohol with a large percentage of youth drinking in a binge pattern. Classical socioeconomic factors play a lesser role in determining drinking patterns compared to other Western countries. Longitudinal studies and studies of alcohol-related consequences in the Danish general population should be conducted to better formulate alcohol and public health policy.     

Alcohol mixed with energy drinks: consumption patterns and motivations for use in U.S. college students

Binge drinking in college students is widespread and known to cause significant harms and health hazards for the drinker. One factor that may be exacerbating hazardous drinking in young people is the new popular trend of consuming alcohol mixed with energy drinks (AmED). However, rates of AmED use and motivations for AmED consumption in college students have not been well established. In this study, 706 undergraduate college students from a university in the United States participated in a web-based survey that queried self-reported alcohol, energy drink, and AmED use. In addition, motivations for using AmEDs were assessed. The results indicated that for all participants, 81% reported that they have tried at least one energy drink in the past and 36% reported consumption of at least one energy drink in the past 2 weeks. Alcohol consumption patterns were similar to findings from U.S. national surveys of college drinking, as 37% of respondents were classified as binge drinkers and 23% abstained from drinking. In the whole sample (including the alcohol abstainers), 44% reported trying AmED at least once and 9% reported AmED consumption at least once in the past 2 weeks. 78% of respondents agreed with the statement that AmEDs appeal to underage drinkers. When AmED users were asked about various motivations for consuming AmEDs, users reported that they consumed these beverages to get drunk and reduce sedation compared to alcohol alone. In conclusion, the consumption of AmEDs is common in U.S. college students. Motivations for using AmEDs include the reduction of the sedative effects of alcohol, an important interoceptive cue that one should stop drinking.     

A comparison of cognitive performance in binge versus regular chronic alcohol misusers.

One hundred cases of individuals assessed for alcohol-related cognitive performance were examined. The assessment included demographic and alcohol consumption data, as well as performance on tests of auditory verbal learning, memory, motor skills, general intellectual functioning, and visuospatial functioning. All participants regularly drank in excess of 10 standard drinks/session. Fifty cases were binge drinkers who consumed alcohol on 2 days/week or less and 50 cases were individuals who consumed alcohol daily. The two groups of drinkers were statistically matched on a number of demographic and misuse factors. The results indicated similar performance for both the binge drinkers and the regular drinkers in visuo-motor speed, visuo-spatial organization and planning, learning, proactive interference, retroactive interference, and retrieval efficiency. However, performance differences were observed on tasks that required semantic organizational ability, with binge drinkers performing better than regular drinkers on these tasks. Due to the differences in the cognitive performance of the two groups, it was concluded that drinking pattern is an important factor in investigating cognitive performance in alcoholics.     

Drinking history, current drinking and problematic sexual experiences among university students

Objective: To estimate the prevalence of potentially harmful sexual experiences attributed to drinking in university students, their association with current drinking, and the influence of past high school binge drinking and age at first drink. Method: A web‐based survey of undergraduates on six university campuses in New Zealand (n=2,548; response rate 63%) measured self‐reported alcohol consumption and harms from own or others' drinking in the preceding four weeks, previous binge drinking and age of drinking onset. Results: Among drinkers during the four weeks, 5% of women and 8% of men reported unsafe sex due to drinking, 3% of women and 4% of men had sex they were unhappy about at the time, and 8% of women and 9% of men had sex they later regretted. Unwanted sexual advances due to someone else's drinking affected 21% of women and 12% of men, with 0.5% of both men and women reporting sexual assault. Current level of drinking was positively associated with all outcomes, but most strongly with unsafe sex. Binge drinking at high school and early drinking onset were also associated with each outcome, and only partly explained by current drinking. Conclusion: Unsafe, unhappy and unwanted sexual experiences attributed to drinking are common at university and associated with heavier drinking, previous high school binge drinking and early drinking onset. Implications: Despite an incomplete understanding of contributing causes, reduction in hazardous drinking among university students is likely to reduce risky and unwanted sexual experiences along with other alcohol‐related harm. Strategies to reduce drinking at earlier ages are also warranted.     

Differences in alcohol risk profiles between college students and college-age non-students presenting for care in the emergency department

PURPOSE: Determine whether college students and non-students seeking emergency medical care experience different lifestyle choices, alcohol-use patterns, and risk profiles.METHODS: Patients aged 18-25 seen in a university-affiliated ED between August 1998 and June 1999 who had >/=1 drinks within the past year were eligible. Patients scoring >5 out of a possible 40 on the Alcohol Use Disorder Identification Test (AUDIT) were considered at elevated risk for alcohol problems and were interviewed further to determine alcohol-use patterns and history.RESULTS: Of 1,436 consenting patients, students were more likely to screen positive for alcohol problems than non-students (55% vs 43%; 478/870 vs 245/566). Furthermore, among screen-positive patients, students were more likely than non-students to binge drink in the two weeks prior to screening (82% vs 65%) and to drink illegally (60% vs 38%). Students needed fewer drinks to feel the effects of alcohol (3.9 drinks vs 5.1) and were less likely to request a referral for alcohol treatment (2% vs 8%). However, students had lower baseline risk for alcohol problems than non-students (AUDIT = 11.2 vs 13.2). Students were younger than non-students (20.2 years vs 21.4), older at their first drunken experience (15.3 vs 14.7), and less likely to smoke (51% vs 76%) or have a family history of heavy drinking (5% vs 23%). (p <.01 for all comparisons).CONCLUSIONS: Students exhibit a higher risk than non-students for behaviors associated with acute alcohol-related problems. However, they may be at lower risk for chronic alcohol problems. This university-based ED seems an appropriate venue for early identification and brief, on-site intervention for students with alcohol problems.     

Prevalence and characteristics of employees reporting heavy or problem drinking

INTRODUCTION. This study examined the prevalence and demographic characteristics of chronic heavy drinkers, binge drinkers, those who report a problem with alcohol, and those at high risk for alcohol-related problems. METHODS. The sample comprised a worksite population of 18,053 employees. The study was based on responses to questions contained in a confidential health profile administered to employees at seven companies by an outside vendor (Johnson & Johnson Health Management, Inc.). RESULTS. Almost 1 in 4 participants (23.0%) was found to be at risk for alcohol-related problems. About 1 in 5 respondents (20.1%) reported binging, 1 in 10 reported chronic heavy drinking (9.8%), and 2.6% reported a drinking problem within the past month. Younger respondents were more likely to report binging but older respondents were more likely to report chronic heavy drinking. Men were more than twice as likely to report binging and almost four times as likely to report chronic heavy drinking, but only one and one-half times as likely to report a drinking problem within the past month. Other differential demographic associations with alternative measures of heavy drinking are described. CONCLUSION. The results suggest that a health profile administered at the worksite can be an effective screening tool for identifying employees at high risk for alcohol-related problems.     

Watering down the drinks: The moderating effect of college demographics on alcohol use of high-risk groups

OBJECTIVES: This study examined whether colleges with larger enrollments of students from demographic groups with lower rates of binge drinking exert a moderating effect on students from groups with higher binge drinking rates. METHODS: The study analyzed data from 114 colleges included in the 1993, 1997, 1999, and 2001 College Alcohol Study surveys. RESULTS: The binge drinking rates of White, male, and underage students were significantly lower in schools that had more minority, female, and older students. Students who do not binge drink in high school are more likely to start binge drinking at colleges with fewer minority and older students. CONCLUSIONS: Student-body composition and demographic diversity should be examined by colleges wishing to reduce their binge drinking problems.     

High prevalence,persistent hazardous drinking among New Zealand tertiary students

AIMS: To determine the prevalence of hazardous drinking and alcohol-related negative consequences in New Zealand tertiary students, and to identify predictors of hazardous drinking across a 6-month period. METHODS: A total of 1480 tertiary students living in halls of residence was surveyed at the start of the academic year, and a subsample of 967 students was followed up 6 months later. Questionnaire items included quantity and frequency of drinking, alcohol-related problems, use of other substances, and the Alcohol Use Disorders Identification Test (AUDIT). Drinking at follow-up was modelled using demographic characteristics, mental well-being, other substance use, alcohol-related problems, and hall drinking norms, measured at baseline. RESULTS: Among drinkers, mean (+/- SD) weekly consumption was 243 +/- 241 and 135 +/- 157 g of ethanol for males and females respectively. The majority of male (60.0%) and female (58.2%) drinkers typically consumed more than national safe drinking guidelines. Mean (+/- SD) AUDIT scores were 10.9 +/- 7.6 for males and 7.6 +/- 5.9 for females. After controlling for AUDIT scores at baseline, increased AUDIT scores at follow-up were higher with lower age, Maori ethnicity, smoking, cannabis use, high levels of alcohol-related negative consequences, and higher levels of drinking in the student's hall of residence. CONCLUSIONS: Hazardous drinking is widespread and persistent among students living in the halls of residence. There is a need for university alcohol policies and intervention approaches among New Zealand tertiary students.     

The regional geography of alcohol consumption in England: Comparing drinking frequency and binge drinking

Alcohol consumption frequency and volume are known to be related to health problems among drinkers. Most of the existing literature that analyses regional variation in drinking behaviour uses measures of consumption that relate only to volume, such as ’binge drinking’. This study compares the regional association of alcohol consumption using measures of drinking frequency (daily drinking) and volume (binge drinking) using a nationally representative sample of residents using the Health Survey for England, 2011–2013. Results suggest the presence of two differentiated drinking patterns with relevant policy implications. We find that people in northern regions are more likely to binge drink, whereas people in southern regions are more likely to drink on most days. Regression analysis shows that regional variation in binge drinking remains strong when taking into account individual and neighbourhood level controls. The findings provide support for regional targeting of interventions that aim to reduce the frequency as well as volume of drinking.