Declining negative consequences related to alcohol misuse among students exposed to a social norms marketing intervention on a college campus

OBJECTIVE: The authors examined whether alcohol-related negative consequences decreased among students exposed to an intervention. PARTICIPANTS: Beginning in 1999, approximately 2,500 randomly selected undergraduates from a 4-year US university annually participated in a Web-based survey over 6 years. METHODS: The educational intervention used social norms initiatives. Main outcome measures included recall of intervention, estimated blood alcohol content (eBAC) when drinking, and 10 negative consequences from alcohol within the past year. RESULTS: First-year students recalling exposure had lower odds of negative consequences (odds ratio [OR] = 0.78, 95% confidence interval [CI] = 0.64-0.95) and of having an eBAC higher than .08 (OR = 0.76, 95% CI = 0.62-0.92). Over the 6 study years, the odds among all participants of experiencing (a) none of 10 alcohol consequences nearly doubled (OR = 2.13, 95% CI = 1.82-2.49) and (b) multiple consequences decreased by more than half (OR = 0.43, 95% CI = 0.36-0.50). CONCLUSIONS: These findings have important implications for US colleges and universities engaged in the reduction of harm associated with alcohol misuse.     

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.     

Sociocognitive factors and perceived consequences associated with alternative forms of alcohol use

Objective: Popular media have highly publicized alternative forms of alcohol use (eg, eyeballing, inhaling alcohol vapor) among college students as a growing concern, possibly associated with severe health risks. Formative research indicates rarity of use. Participants and Methods: College students (Study 1: n = 411; Study 2: n = 687) completed an online survey. Results: Findings confirmed infrequent use of alternative methods of alcohol use and low likelihood of trying them in the future (Study 1). Participants indicated varied reasons for possibly trying each alternative form of alcohol use, but consistently perceived consequences for all forms (ie, health concerns), as well as very low perceived approval from close friends (Study 2). Social and environmental contextual factors associated with possible use were also explored. Conclusions: College students in the current sample have low prevalence and future likelihood of alternative forms of alcohol use. This information can be used by campus health practitioners to promote accurate normative data for alternative forms of alcohol use. However, with increased perceptions of approval and media presence, future trends could change. Findings revealed important risk factors for these potentially hazardous forms of alcohol use.     

Validation of a measure of college students' intoxicated behaviors: associations with alcohol outcome expectancies, drinking motives, and personality

OBJECTIVE: The authors aimed to develop a measure of college students' intoxicated behaviors and to validate the measure using scales assessing alcohol outcome expectancies, motives for drinking, and personality traits. PARTICIPANTS AND METHOD SUMMARY: The authors administered these measures and an inventory describing 50 intoxicated behaviors to 198 college students and conducted factor analysis on intoxicated behaviors. Logistic regression models examined relationships between intoxicated behavior dimensions and expectances, motives, and personality traits. RESULTS: Self-reported behaviors during intoxication episodes were reducible to 3 basic dimensions that formed reliable and valid scales: social, antisocial, and emotionally labile intoxication. CONCLUSIONS: Researchers can use the Intoxicated Behaviors Inventory to evaluate the effectiveness of interventions targeting drinking or to identify college students at risk for problematic consequences of alcohol use. In addition, results point to the need for community efforts to encourage more moderate drinking among college students.     

Emotional intelligence: a moderator of perceived alcohol peer norms and alcohol use

This study investigated the roles of emotional intelligence and perceived alcohol peer norms in relation to alcohol use. Two hundred and forty-two undergraduates completed the Campus Survey of Alcohol and Other Drug Norms (Core Institute, 1997) and the Emotional Intelligence Scale (Schutte, Malouff, Hall, Haggerty, & Cooper, 1998). Contrary to emerging research findings, emotional intelligence (EI) was not directly associated with the study's alcohol-use variables. However, the moderating role of EI was supported in the relationship between perceived alcohol peer norms and students' alcohol use. Among college students with lower EI, there was a significantly stronger association between these variables, compared to students with higher EI.     

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.     

The impact of a tailgating policy on students' drinking behavior and perceptions

In the fall of 2004, a midwestern public university changed its tailgating policy from one that did not allow alcohol consumption to one that did. OBJECTIVE, PARTICIPANTS, AND METHODS: The authors surveyed students before and after the policy change to measure consumption, problems, perceptions of peer consumption, and reported game attendance. RESULTS: Results showed no change in drinking quantities or prevalence of problems after the policy change; however, there was an increase in students' misperceptions, with students overestimating drinking quantities and the number of students who drank while tailgating. Last, students' predictions about their game attendance if alcohol was allowed were higher than their reported attendance after the policy change. CONCLUSIONS: Conclusions suggest that although drinking quantities may not be influenced by policies at tailgating events, misperceptions may be influenced. Administrators should note that the policy did not affect students' self-reported game attendance.     

Athletic involvement and its relevance to hazardous alcohol use and drinking game participation in female college athletes: a preliminary investigation

OBJECTIVE AND PARTICIPANTS: The authors designed this cross-sectional study to examine sports team differences in hazardous alcohol use and drinking game participation, as well as the social correlates of these behaviors among female college athletes (N = 176; M age = 19.9 years, SD = 1.24, range = 18-22). METHODS: Respondents completed self-report surveys in small groups. They reported drinking behaviors, frequency of team social events involving alcohol use, and team cohesion. RESULTS: The authors found significant differences across sports teams with regard to hazardous alcohol use and participation in drinking games with teammates. Findings also revealed that a high frequency of team social events involving alcohol use was associated with elevated use and an increased likelihood of drinking game participation. CONCLUSIONS: The authors discuss future research directions and implications.     

Work stress and alcohol effects: a test of stress-induced drinking

Drawing on both tension reduction and social learning theories, we hypothesized that work stressors lead to increased distress, which in turn promotes problematic alcohol use among vulnerable individuals. Vulnerable individuals are hypothesized to possess few personal and social resources for responding adaptively to work-related stressors and distress and to hold positive expectancies for alcohol's effects. We tested our model in a random sample of 574 employed adults, using a combination of path analytic and hierarchical moderated regression techniques. Results revealed no support for a simple tension reduction model of work stress-induced drinking and only limited support for a social learning model. We conclude that a much more circumscribed view of the etiologic role of work stress in problematic alcohol use is indicated.     

Underage college students' drinking behavior, access to alcohol, and the influence of deterrence policies. Findings from the Harvard School of Public Health College Alcohol Study

Underage drinking is a major problem at American colleges, but little is known about the extent of alcohol use in different student groups, in different colleges, and in states with different control policies. We used data from the 2001 and 3 previous Harvard School of Public Health College Alcohol Studies that compared responses of underage students with those of their 21-23-year-old peers. Underage students drank alcohol less frequently but were more likely to drink to excess when they drank. College educational efforts and deterrent policies were limited in their outreach, and half of underage students obtained alcohol very easily. Underage students in states with extensive laws restricting underage and high-volume drinking were less likely to drink and to binge drink. A majority of underage students supported increasing efforts to control underage drinking. The results suggest that additional policy efforts to control underage drinking may be effective and feasible.     

Differences in African American and White college students' drinking behaviors: consequences, harm reduction strategies, and health information sources

The authors explored the differences between African American and White college students' drinking behaviors and their attitudes toward consequences, harm-reduction strategies, and health information sources. They collected data from a randomly selected sample of 1,110 students in a large public university to examine the effects of a high-risk drinking prevention intervention. In the current analysis, they compared African American and White students on indicators of high-risk drinking, drinking consequences, harm-reduction strategies, the sources that students typically used for health information, and the believability of those sources. The African American students scored lower on drinking measures than the White students did, reported fewer negative consequences, and more regularly employed drinking-reduction strategies, with one exception--choosing a designated driver. Both African and White respondents reported that their parents were their most frequent and usual sources of health-related information and said that parents and health professionals were the most credible sources.     

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.     

Differences between actual and perceived student norms: an examination of alcohol use, drug use, and sexual behavior

Researchers in the social norms area have previously focused primarily on alcohol consumption, paying comparatively less attention to drug use and sexual behavior. The major purposes of this study were to (1) compare perceptions of peer norms in the areas of alcohol use, drug use, and sexual behavior with actual behavior and (2) determine if a relationship existed between a student's perceptions of normative behavior and a student's actual behavior. Participants were 833 college students at a large, public university in the Northeast. Study participants overestimated alcohol use, drug use, and sexual behavior among their peers. There was also a positive relationship between actual behavior and perceived peer norms, although the effect sizes for all behaviors were small to moderate. The authors provide further support for the tenets of social norms theory and suggest that social norms interventions are appropriate both campus-wide and to targeted high-risk groups.     

Unplanned sexual activity as a consequence of alcohol use: a prospective study of risk perceptions and alcohol use among college freshmen

OBJECTIVE: The authors' goal was to show how risk perceptions regarding unplanned sexual activity following alcohol use are prospectively related to subsequent alcohol consumption. PARTICIPANTS: Undergraduate students (N = 380) completed questionnaires at 2 time points during their freshman year. METHODS: In the middle of the academic year (T1), students estimated their risk of engaging in unplanned sex and reported their alcohol use during the previous term. Four months later (T2), they again reported alcohol use and indicated whether they had engaged in unplanned sex since T1. RESULTS: Students who consumed more alcohol at T1 rated their risk of unplanned sex more highly, suggesting relative accuracy. Those with higher risk perceptions consumed more alcohol at T2 (controlling for T1 use), suggesting that they maintained the high-risk behavior. Last, those who were unrealistically optimistic (ie, estimated low risk at T1 yet had unplanned sex by T2) reported greater alcohol use at T2. CONCLUSIONS: These findings highlight the role that risk perceptions regarding sexual activity may play in college students' alcohol use.     

The effects of prices on alcohol use and its consequences

Over the past three decades, economists and others have devoted considerable effort to assessing the impact of alcoholic-beverage taxes and prices on alcohol consumption and its related adverse consequences. Federal and State excise taxes have increased only rarely and, when adjusted for inflation, have declined significantly over the years, as have overall prices for alcoholic beverages. Yet studies examining the effects of increases of monetary prices (e.g., through raising taxes) on alcohol consumption and a wide range of related behavioral and health problems have demonstrated that price increases for alcoholic beverages lead to reduced alcohol consumption, both in the general population and in certain high-risk populations, such as heavier drinkers or adolescents and young adults. These effects seem to be more pronounced in the long run than in the short run. Likewise, price increases can help reduce the risk for adverse consequences of alcohol consumption and abuse, including drinking and driving, alcohol-involved crimes, liver cirrhosis and other alcohol-related mortality, risky sexual behavior and its consequences, and poor school performance among youth. All of these findings indicate that increases in alcoholic-beverage taxes could be a highly effective option for reducing alcohol abuse and its consequences.     

Evaluating retailer behavior in preventing youth access to harmful legal products a feasibility test

This article reports results from a feasibility study of a community effort to reduce the availability of legal products that youth can use to get high. The study evaluated the potential of youth purchase attempts to detect actual changes in retail availability of harmful legal products. These results were triangulated with self-reports from retailers about their own policies and practices. Before the intervention, less than half of retailers reported using any of six possible strategies identified as ways to reduce youth access to harmful products, and less than 8% of baseline youth attempts to purchase potentially harmful legal products were refused or questioned. After the low-dosage intervention, retailers reported increased use of three strategies and a statistically significant increase in the percentage of purchase attempts that were either questioned or refused by retail clerks. These findings (a) demonstrate the potential feasibility of retailer-focused environmental strategies and (b) support continued use of youth purchase attempts as a measure of actual retailer behavior.     

Reducing alcohol use in college students: a controlled trial of two brief interventions

This study tested two forms of alcohol reduction programming for college students. Thirty-seven moderate to heavy drinkers completed measures of quantity/frequency, drinking consequences, and attitude questionnaires. Participants were randomly assigned to one of three groups: 1) a two-hour information and motivation session plus mailed personal feedback on their drinking; 2) mailed feedback only; or 3) no treatment. At a 6-week follow-up session, the feedback-only group decreased drinks per month as compared to control. No other differences were statistically significant, though decreases favored the treatment conditions about equally over control. Implications for research and treatment are discussed.     

Social stigma and negative consequences: factors that influence college students' decisions to seek testing for sexually transmitted infections

College students often delay or avoid seeking testing for sexually transmitted infections (STIs), even if the services are readily available. We used in-depth, semistructured interviews to survey 41 college students aged 18 to 23 years about factors that influence decisions about STI testing. We grouped statements into 9 themes that represent influences on the decision. The most frequently mentioned factors were negative consequences of testing and perceived vulnerability to infection; other issues that influenced decision making included perceived benefits, perceived severity of diseases, public knowledge and opinion, social norms, provider characteristics, test-site characteristics, and personal considerations. Social stigmas and negative consequences appear to represent significant barriers to college students' being tested, which could increase the risk of spreading infections to others. Clinicians and health educators should raise students' awareness of the need for screening and should work to reduce the barriers to screening, including social stigmas and negative consequences.