A review of social host policies focused on underage drinking parties: suggestions for future research

Underage drinking continues to be a public health concern, partially due to the ease in which adolescents obtain alcohol and consume it in private locations. States and municipalities have implemented strategies to counteract this, including adopting public policies called social host policies, despite limited evidence of effectiveness. Traditionally, these laws have held adults accountable for furnishing alcohol to underage drinkers. However, states and communities are using another policy, also called social host, to deter underage drinking parties where easy access to alcohol and high-risk use occurs. These innovative laws hold individuals who control the property accountable for underage drinking that occurs there, regardless of alcohol source. We conducted a critical analysis of social host policies focused on hosting underage drinking parties and constructed a conceptual model to understand their targeted factors. Future research recommendations are discussed.     

Starting to drink: the experiences of Australian lower secondary students with alcohol

This study describes Australian year eight students' (13-14 years old) experiences with alcohol in terms of communication with parents, initiation into drinking, patterns of consumption, context of use, and harms experienced. The sample comprised 521 year eight students from four state government secondary schools in the state of Victoria. Three of the schools are in Melbourne, the capital of Victoria; the fourth is in a rural center. Female and rural students were more likely to talk to parents about alcohol, but this was not associated with safer drinking. Initiation into drinking was higher among rural students. Rural students also drank more, were more likely to drink without adult supervision, to drink to get drunk, and drink more than planned. Student drinkers experienced just over four alcohol-related harms on average in 12 months, with some indication of greater harm among rural students. Higher levels of drinking by rural students, accompanied by more risky patterns of consumption and the possibility of greater harm, supports prioritizing interventions in rural schools.     

Bad luck or bad decisions: college students' perceptions of the reasons for and consequences of their alcohol overdose

Reasons for and immediate consequences of an alcohol overdose were explored for 217 undergraduate students requiring a medical emergency transport because of excessive alcohol consumption. The sample was categorized into 26 students attributing their overdose solely to bad luck and 191 students citing bad decision making as an explanation. A discriminant analysis portrayed the bad luck students as more likely to change the type of alcohol consumed, worrying more about problems with friends, less likely to change how much they drink and less likely to feel that they learned something about themselves. Friends were not named as being involved, but lapses in knowing how to pace consumption were frequently cited. Design of preventive educational programs for underage drinkers with the aim of avoiding an overdose is discussed.     

Does knowledge of college drinking policy influence student binge drinking?

The authors explored alcohol policies at 5 historically black colleges and universities (HBCUs) to gain an understanding of how students' awareness of these policies might correlate with campus binge drinking rates. Findings indicated that male students who reported being unaware of certain alcohol policies were more likely to report binge drinking than their counterparts who reported they were aware of the policies. Gender differences in awareness of alcohol policy might be an important variable influencing binge drinking on HBCU campuses.     

Trends in College Binge Drinking During a Period of Increased Prevention Efforts: Findings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993–2001

Abstract

The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use.     

A Study of Alcohol Use by Designated Drivers Among College Students

Abstract

Objective: College students tend to drink while serving as a designated driver (DD). The predictors of alcohol use by DDs among college students were examined. Participants: Participants were 119 undergraduate students in introductory psychology courses who had experience with DD use. Methods: Survey data were analyzed to examine the predictors of planning components of DD use, such as choosing a DD before drinking and choosing an abstinent DD, and the relations of these components to alcohol use by DDs. Results: History of DD use, friends’ willingness to be the DD, frequency of riding with a driver who drank and drove, and age of drinking onset were associated with planning components of DD use. Among the planning components of DD use, choosing a DD before drinking was significantly related to less alcohol use by DDs. Conclusions: Increasing awareness of the planning components of DD use could deter alcohol use by DDs among college students.     

College binge drinking in the 1990s: a continuing problem. Results of the Harvard School of Public Health 1999 College Alcohol Study

In 1999, the Harvard School of Public Health College Alcohol Study resurveyed colleges that participated in the 1993 and 1997 surveys. Responses to mail questionnaires from more than 14,000 students at 119 nationally representative 4-year colleges in 39 states were compared with responses received in 1997 and 1993. Two of 5 students (44%) were binge drinkers in 1999, the same rate as in 1993. However, both abstention and frequent binge-drinking rates increased significantly. In 1999, 19% were abstainers, and 23% were frequent binge drinkers. As before, binge drinkers, and particularly frequent binge drinkers, were more likely than other students to experience alcohol-related problems. At colleges with high binge-drinking rates, students who did not binge drink continued to be at higher risk of encountering the second-hand effects of others' heavy drinking. The continuing high level of binge drinking is discussed in the context of the heightened attention and increased actions at colleges. Although it may take more time for interventions to take effect, the actions college health providers have undertaken thus far may not be a sufficient response.     

Trends in college binge drinking during a period of increased prevention efforts. Findings from 4 Harvard School of Public Health College Alcohol Study surveys: 1993-2001

The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use.     

An evaluation of college online alcohol-policy information

Excessive and underage drinking by US college and university students continues to be a significant problem. Curtailing the misuse of alcohol on college campuses is an important goal of college and university administrators because of the many negative consequences resulting from alcohol misuse. As part of their prevention programs, US colleges and universities are required by law to make information about their alcohol policies available to students. Often the source of this information is the school's Web site. The authors evaluated the alcohol-policy information that is available on the Web sites of the 52 top national universities listed in the 2002 rankings of US News and World Report. In general, they found that the information was difficult to find, was located in many areas of the Web site, and did not provide complete information about the school's alcohol policy.     

The Relationship of Smoking Status to Alcohol Use,Problems, and Health Behaviors in College Freshmen

Differences in drinking, consequences, and perceptions were examined between alcohol‐using college students by smoking status (current, past, and lifetime nonsmoker). Entering freshmen (N = 558: 45% male, 72% Caucasian, age M = 18) completed a questionnaire assessing smoking, drinking and current health perceptions. Results indicated current smokers drank more frequently, were more likely to drink to intoxication, and had more physiological consequences (e.g., blackouts, coordination problems) than past or lifetime nonsmokers, but past smokers also reported riskier drinking than lifetime nonsmokers. Despite a higher prevalence of alcohol‐related health problems in both current and past smokers, no current health differences were found. Results replicate findings that current smokers are at increased risk for problematic drinking and identify past smokers as another risk group.     

College Binge Drinking in the 1990s: A Continuing Problem Results of the Harvard School of Public Health 1999 College Alcohol Study

Abstract

In 1999, the Harvard School of Public Health College Alcohol Study resurveyed colleges that participated in the 1993 and 1997 surveys. Responses to mail questionnaires from more than 14 000 students at 119 nationally representative 4-year colleges in 39 states were compared with responses received in 1997 and 1993. Two of 5 students (44%) were binge drinkers in 1999, the same rate as in 1993. However, both abstention and frequent binge-drinking rates increased significantly. In 1999, 19% were abstainers, and 23% were frequent binge drinkers. As before, binge drinkers, and particularly frequent binge drinkers, were more likely than other students to experience alcohol-related problems. At colleges with high binge-drinking rates, students who did not binge drink continued to be at higher risk of encountering the secondhand effects of others' heavy drinking. The continuing high level of binge drinking is discussed in the context of the heightened attention and increased actions at colleges. Although it may take more time for interventions to take effect, the actions college health providers have undertaken thus far may not be a sufficient response.     

Underage drinking and the role of parents

Last week's article on underage drinking and DWIs touched on the role of parents in helping to prevent both (see “Binge drinking in 12th grade predicts DWIs, blackouts and ‘extreme’ binge drinking,” ADAW, Feb. 3, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32610 ). The article was based on a study published in Pediatrics, co‐authored by Ralph W. Hingson, Sc.D., M.P.H., director of the Division of Epidemiology and Prevention Research at the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Last week, Hingson, who presented on underage drinking at the annual leadership meeting of Community Anti‐Drug Coalitions of America (CADCA), also explained more about the role of parents. “Parents do have an influence over whether and how much their children drink,” he told us. For example, if a parent binge drinks, their children will be twice as likely to binge drink — and to have alcohol use disorder.     

Drinking patterns, problems, and motivations among collegiate bisexual women

OBJECTIVE AND PARTICIPANTS: The authors compared the drinking behaviors, motivations, and problems of collegiate bisexual women with those of heterosexual women (N = 2,788; n = 86 bisexual women). METHODS: Data came from the 2003 Student Life Survey, a random population-based survey at a large midwestern university. The authors explored the hypothesis that bisexual women would be more likely than heterosexual women to report drinking motivations related to stress and coping as a result of sexual identity stigma. RESULTS: They found that bisexual women drank significantly less than did heterosexual women. There were few differences between the 2 groups in drinking motivations and problems. Bisexual women reported a comparable number of problems related to their drinking but were significantly more likely to report contemplating suicide after drinking than were heterosexual women. CONCLUSIONS: More research is needed to understand the finding that despite lower levels of alcohol consumption, bisexual women reported a comparable number of drinking problems. College health educators and health care providers need to be aware of findings related to heightened suicidal risk among bisexual women.     

College student perceptions on campus alcohol policies and consumption patterns

Environmental strategies for colleges and universities to reduce alcohol consumption among their students include the development and enforcement of campus alcohol policies. This study examines students' knowledge and attitudes toward campus alcohol policies and how they relate to alcohol consumption and alcohol social norms. A sample of 422 freshman students was surveyed during their first month at a 4-year public college. Findings indicated that the majority of students (89%) were aware of campus policies, yet of those who were aware, less than half (44%) were accepting of these campus rules and regulations. In addition, the majority (79%) of students drank at social events, despite this behavior being in direct violation of campus alcohol policies. However, those who supported campus rules consumed significantly less alcohol at social events than those who opposed or had no opinion of the rules. Also, those who supported the rules perceived that their peers and students in general consumed significantly less alcohol at social events than those who were opposed or had no opinion. This outcome supports the premise established by several theories of behavior change including the theory of planned behavior, which state that behavior is influenced less by knowledge than by attitude and intention.     

Colleges respond to student binge drinking: reducing student demand or limiting access

Administrators at 68% of 4-year colleges nationwide (N = 747) responded to a survey concerning the types of programs and policies they used in response to students' heavy drinking. Most schools conducted targeted alcohol education and invested in institutional prevention efforts; half conducted social norms campaigns; a sizeable minority restricted alcohol on campus. Schools that focused on demand reduction were less likely to ban alcohol use. One in 3 schools received funding for these programs from governmental agencies, and 1 in 5 from the alcohol industry. Such schools were more likely to conduct targeted alcohol education and social norms programs and were less likely to restrict alcohol use on campus or at college events. Colleges may want to reconsider prevention initiatives that focus exclusively on demand or supply. They may also want to examine the extent to which funding is the driving force shaping the direction of their alcohol initiatives.     

College alcohol use: a full or empty glass?

Data from the Harvard School of Public Health College Alcohol Study (1993) were used to describe weekly alcohol consumption and its associated problems among a representative national sample of college students. The median number of drinks consumed/week by all students, regardless of drinking status, was 1.5. When students were divided by drinking pattern, the median number of drinks/week was 0.7 for those who did not binge drink and 3.7 for those who did so infrequently. For frequent binge drinkers, the median was considerably higher: 14.5 drinks/week. Nationally, 1 in 5 five college students is a frequent binge drinker. Binge drinkers consumed 68% of all the alcohol that students reported drinking, and they accounted for the majority of alcohol-related problems. The data indicate that behavioral norms for alcohol consumption vary widely among students and across colleges. Therefore, it may not be possible to design an effective "one size fits all" approach to address college alcohol use.     

The Role of Positive Alcohol Expectancies in Underage Binge Drinking Among College Students

Abstract

Objective: This study explored associations between positive alcohol expectancies, and demographics, as well as academic status and binge drinking among underage college students. Participants: A sample of 1,553 underage college students at 3 public universities and 1 college in the Southeast who completed the Core Alcohol and Drug Survey in the Spring 2013 semester. Methods: A series of bivariate analyses and logistic regression models were used to examine associations between demographic and academic status variables as well as positive alcohol expectancies with self-reported binge drinking. Positive alcohol expectancies were examined in multivariable models via 2 factors derived from principal component analyses. Results: Students who endorsed higher agreement of these 2 emergent factors (sociability, sexuality) were more likely to report an occurrence of binge drinking in the past 2 weeks. Conclusions: Study results document associations between positive alcohol expectancies and binge drinking among underage students; implications for prevention and treatment are discussed.     

The effects of drinking status and believability of ads featured in a social norms campaign on college students' estimation and accuracy of other students' celebratory drinking

This study examined estimation and accuracy of normative perceptions for students during one celebratory drinking occasion. Students who drank on St. Patrick's Day overestimated the percentage of others who also drank, whereas the students who did not drink on St. Patrick's Day underestimated the percentage of others who also did not drink. The students' drinking behaviors on St. Patrick's Day did not substantially differentiate their accuracy scores. However, of the students who drank on St. Patrick's Day, those who did not believe the ads showed stronger overestimation of others who drank than did those who believed the ads.     

Perceptions of drinking and related findings from the Nationwide Campuses Study

Proponents of social norms approaches maintain that correcting misperceptions of alcohol use among college students may reduce drinking and its consequences. The author used aggregate campus-level data from the Nationwide Campuses Study to test this hypothesis. He defined the misperceptions ratio as the ratio of the frequency of the "average student's" perceived alcohol use to the frequency of self-use at each campus. Each of the 57 colleges reported misperceptions ratios greater than unity. At campuses where students had more accurate perceptions of alcohol use, students were more likely to desire alcohol availability at campus events and to drink on more days throughout the year than at campuses where students had greater misperceptions of alcohol use. The author found no data to support the preferential use of social norms programming on campuses with high levels of self-reported alcohol use or binge drinking. These findings raise questions about potentially unexpected and unintended effects of social norms approaches.