Urging college alcohol and drug policies that target adverse behavior, not use

Although "zero tolerance" policies are being enacted on campuses nationwide, these policies may not be the most effective means of creating safer and healthier environments for students. Many historical precedents illustrate the value of moderation over prohibition. College drug and alcohol policies should focus primarily on dysfunctional and disruptive student behaviors, not on student drug and alcohol use only.     

Support for Alcohol-Control Policies and Enforcement Strategies Among US College Students at 4-Year Institutions

Objective: The authors examined college student support for policies and enforcement strategies to reduce alcohol problems on campus. Participants: A random sample of students from each of 32 four-year colleges and universities participated. Methods: Students completed an anonymous mail survey. Results: A majority of students supported 5 of the 12 policy proposals. Whatever percentage of students indicated support for a policy, a far smaller percentage reported that other students supported it. The majority at all 32 schools supported using stricter disciplinary sanctions for students who engage in alcohol-related violence and repeatedly violate campus alcohol policy. The majority at more than half of the schools supported applying stricter penalties for the use of false IDs to purchase alcohol illegally and prohibiting kegs on campus. Conclusions: Higher-education administrators should survey students to learn which policies a majority of their students will endorse.     

Canadian Campus Smoking Policies: Investigating the Gap Between Intent and Outcome From a Student Perspective

Abstract

Background: Young adults remain the earliest legal target for the tobacco industry. Against this, the existence of smoking policies would appear to offer some protection to students on campus. However, little research has been conducted into the outcomes of such policies from a student perspective. Methods: The authors conducted 8 focus groups at 4 selected Canadian undergraduate campuses to investigate student perceptions and behaviors resulting from campus smoking policies. Results: Results indicated that student smoking behaviors are minimally impacted by campus smoking policies due to seriously compromised implementation and enforcement. Conclusions: These findings imply that the presence of campus smoking policies and claims of “smoke-free” campuses should not be misinterpreted as achievement and without renewed focus and adequate tobacco control infrastructure, it will remain possible for young adults to initiate and maintain tobacco smoking on campus.     

University Binge Drinking Patterns and Changes in Patterns of Alcohol Consumption Among Chinese Undergraduates in a Hong Kong University

Abstract

Objective: To examine patterns of binge drinking and changes in drinking patterns among Chinese university students. Participants and Methods: Responses to an anonymous questionnaire were compared between a random sample of 411 second year Chinese undergraduate students in 2006 and 2,630 first year students from the previous year. Students reporting any symptoms of alcohol abuse were classified as alcohol abusers whereas those reporting repeated inability to curtail use were categorized as alcohol dependent. Results: After 1 year of university, greatly increased rates of past-month drinking of different degrees were found in both genders. Binge drinking among second year undergraduates was significantly correlated with male gender, living in a student residence hall, smoking, drinking to relieve stress, and having friends who frequently drank. Conclusions: Alcohol misuse is a health hazard to Chinese students in a university environment. Proactive policies aimed at preventing harmful alcohol use should be considered by university authorities.     

Referent Group Proximity,Social Norms,and Context: Alcohol Use in a Low-Use Environment

Abstract

Objective: The purpose of this study was to investigate the relationship between perceived normative use of alcohol and reported consumption in an environment where relatively little alcohol use occurs. Participants: A total of 585 undergraduate students completed an online survey on alcohol use in March 2006. Methods: Participants reported personal alcohol use and perceptions of use by “friends,” “the average student,” and “the average student who drinks.” Results: Due to the large number of students reporting zero alcohol use, zero-inflated negative binomial regression was used to analyze the data. Results showed that perceptions of use and beliefs about the acceptability of use by proximal groups were strongly and positively correlated with personal alcohol use. Perceptions of distal groups were either not correlated or were correlated negatively with personal use. Conclusion: These findings suggest that the use of distal referent groups for a social norms campaign in a low-use environment may have paradoxical effects.     

Correlates of AUDIT Risk Status for Male and Female College Students

Abstract

Objective: The current study identified gender-specific correlates of hazardous drinker status as defined by the AUDIT. Participants: A total of 462 college student volunteers completed the study in 2006. The sample was predominantly Caucasian (75%) and female (55%). Methods: Participants completed a survey assessing demographics, alcohol use patterns, and health indices. Scores of 8 or more on the AUDIT defined the at-risk subsample. Logistic regression models determined which variables predicted AUDIT risk status for men and women. Results: The at-risk participants reported higher alcohol use and related problems, elevated sleep problems and lower health ratings. High typical blood alcohol concentration (BAC), lifetime drug use, and psychosocial problems predicted risk status for males. Binge frequency and psychosocial problems predicted risk status for females. Conclusions: Different behavioral profiles emerged for men and women identified as hazardous drinkers on the AUDIT. The efficacy of brief alcohol interventions could be enhanced by addressing these behavioral correlates.     

Impact of the Adoption of Tobacco-Free Campus Policies on Student Enrollment at Colleges and Universities,North Carolina, 2001–2010

Abstract

Objective: College and university administrators have expressed concern that adoption of tobacco-free policies may reduce applications and enrollment. This study examines adoption and implementation of 100% tobacco-free campus policies by institutions of higher education on applications and enrollment. Participants: North Carolina private colleges and universities and public community colleges. Analysis was conducted in 2011. Methods: Student enrollment and application data were analyzed by campus type to determine (a) if there was a difference in student applications and enrollment before and after policy implementation, and (b) if there was a difference in student applications and enrollment for campuses with versus without a policy. Results: No significant differences were found in student enrollment or applications when comparing years prior to and following policy implementation or when comparing with institutions without 100% tobacco-free campus policies. Conclusions: The authors found no evidence that 100% tobacco-free policy adoption had an impact on student enrollment or applications.     

Toward Understanding the Adjustment Problems of Foreign Families in the College Community: The Case of Japanese Wives at the Harvard University Health Services

Abstract

Four hundred fifty-six undergraduates at a Scottish university completed the Core Alcohol and Drug Survey, an instrument widely used in the United States to examine the nature, scope, and consequences of alcohol and other drug use on college campuses. The Scottish students were found to drink more frequently, consume more alcohol, and engage in binge drinking more often than their American counterparts. The Scottish students also demonstrated higher rates of hangovers, missed classes, and blackouts than the Americans, but the percentage of American students who had driven while intoxicated was greater than that of the Scots. Focus groups of students in Scotland and interviews with student affairs personnel and local officials indicated that student drinking is not generally viewed as a problem because extensive alcohol use appears to be part of Scottish culture and is readily accepted. Students reported that their drinking, other than in pubs, was spread out over time and was associated with eating and social activities. At student social events where alcohol was served, there was little evidence of loud, inappropriate, aggressive, or otherwise rowdy behavior; drinking appeared to be handled in a more controlled, safe, and responsible way than among US college students.     

Abortion,Limited Medical Resources,and the Meaning of Health Care

Abstract

Although accidents are the leading cause of death among college students, literature about developing student health safety programs is limited. In this article, we present preliminary recommendations based on literature review, epidemiologic data, and Nominal Group Process (NGP) activities, for developing university student safety programs. Our recommendations include appointing a coordinator to oversee all on-campus safety activities, providing for university-wide education programs dealing with alcohol and drug use, promoting personal safety efforts in areas such as family violence and rape prevention, and encouraging students to use safe transportation alternatives.     

Comparisons of Gambling and Alcohol Use Among College Students and Noncollege Young People in the United States

Abstract

Objective: Gambling and alcohol use were compared for college and noncollege young adults in the US population. Participants: Participants were 1,000 respondents aged 18 to 21. Methods: Data were analyzed from a representative household sample of US young people aged 14 to 21 years old. Telephone interviews were conducted between August 2005 and January 2007. Results: After taking into account gender, age, race/ethnicity, and socioeconomic status, college student status did not predict gambling, frequent gambling, or problem gambling. In contrast, being a college student was associated with higher levels of alcohol use and problem drinking. Being male was the strongest predictor of both problem gambling and problem drinking. Blacks were less likely than whites to drink heavily; yet they were more likely than whites to gamble heavily. Conclusion: Young males should be targeted for prevention and intervention efforts for both problem gambling and problem drinking regardless of college student status.     

Flourishing: Exploring Predictors of Mental Health Within the College Environment

Abstract

Objective: To explore the predictive factors of student mental health within the college environment. Participants: Students enrolled at 7 unique universities during years 2008 (n = 1,161) and 2009 (n = 1,459). Methods: Participants completed survey measures of mental health, consequences of alcohol use, and engagement in the college environment. Results: In addition to replicating previous findings related to Keyes’ Mental Health Continuum, multiple regression analysis revealed several predictors of college student mental health, including supportive college environments, students’ sense of belonging, professional confidence, and civic engagement. However, multiple measures of engaged learning were not found to predict mental health. Conclusions: Results suggest that supportive college environments foster student flourishing. Implications for promoting mental health across campus are discussed. Future research should build on exploratory findings and test confirmatory models to better understand relationships between the college environment and student flourishing.     

Effects of a web-based pre-enrollment alcohol brief motivational intervention on college student retention and alcohol-related violations

Objective: To determine whether completing a pre-enrollment Web-based alcohol brief motivational intervention (BMI) increased student retention and reduced student alcohol-related violations. Participants: Fall 2011 (3,364) and Fall 2012 (3,111) entering cohorts of all first-year students at a midwestern state university. Method: Students completing the brief intervention (BI) were compared to students not completing the BI. Retention was tracked for four years for the 2011 cohort and three years for the 2012 cohort. Campus and community alcohol violations were tracked for two academic years following enrollment. Kaplan–Meier survival analysis and Cox regression were used to test retention survival. Logistic regression was used to test campus and community violations. Results: Students in both cohorts who completed the BI had significantly higher retention and significantly fewer alcohol-related violations than noncompleters. Conclusions: Population-level Web-based BIs help prevent student dropout and decrease alcohol-related violations, with impacts extending multiple years. Web-based BI is an efficacious population-level prevention tool.     

Characteristics of university students who mix alcohol and energy drinks

Objective: Research has identified correlates (eg, drug use, risky sex, smoking) of using alcohol mixed with energy drinks (AMEDs). Few studies have investigated common mental health-related concerns (eg, depression, sleep). Participants: Alcohol-using college students (n = 380 never used AMEDs, n = 180 used AMEDs) were recruited in the study during the fall 2011 semester. Methods: The study examined demographics, substance use, depressive symptoms, and sleep problems in association with AMED use. Results: Multivariable logistic regression indicated that alcohol use severity (AOR = 1.24; 95% CI = 1.14+1.34), drug use severity (AOR = 1.20; 95% CI = 1.04–1.39), depressive symptoms (AOR = 1.06; 95% CI = 1.01–1.12), and smoking (AOR = 2.12; 95% CI = 1.22–3.68) were independently associated with AMED use; sleep problems were non-significant. Conclusions: Administrators may consider policies regarding energy drink availability on campus, and campus health personnel may increase screening and education surrounding AMED use to reduce risks among students.     

Examining residence status as a risk factor for health risk behaviors among college students

Objective: The current study is aimed to evaluate college student residence as a unique risk factor for a range of negative health behaviors. Participants: We examined data from 63,555 students (66% females) from 157 campuses who completed the National College Health Assessment Survey in Spring 2011. Methods: Participants answered questions about the frequency of recent use of alcohol, tobacco, marijuana, and illicit drugs, as well as sexual risk behavior in the last 30 days. Sexual risk behaviors were operationalized as having unprotected vaginal sex (yes/no) and the number of sexual partners. Results: Logistic regression analyses revealed that living off-campus is a unique predictor of alcohol, tobacco, marijuana, and illicit drug use, as well as engaging in unprotected sex and a greater number of sexual partners (all ps <. 01). Conclusions: Students living off-campus exhibit more substance use and sexual risk behaviors than students living on-campus, independent of gender, age, or race.     

Peer,social media,and alcohol marketing influences on college student drinking

Objective: To investigate how alcohol marketing and peers may promote college students' alcohol use through social media. Participants: College students (N = 682) aged 18 to 22 years from a large Southern university completed paper surveys in April 2014. Methods: Structural equation modeling was used to investigate relationships among variables as well as moderation by gender and race. Results: Drinking behavior was directly related to perceived norms and attitudes toward alcohol that develop, in part, from direct and indirect interactions with their online and offline peers, as well as engagement with alcohol-related content on social media. Gender and ethnicity moderated some effects. Conclusions: College student drinking is influenced by friends' alcohol-related content posted on social networking sites and by greater engagement with traditional and online alcohol marketing. College campus alcohol misuse interventions should include components to counter peer influences and alcohol marketing on social media.     

US Public Universities' Compliance With Recommended Tobacco-Control Policies

Abstract

To address the rise in tobacco use among college students, several national health organizations, including the American College Health Association, recommend that colleges enact smoking bans in and around all campus buildings, including student housing, and prohibit the sale, advertisement, and promotion of tobacco products on campus. Key informants at 50 US public universities, one from each state, were interviewed during the 2001/2002 academic year to assess the prevalence of these recommended policies. More than half (54%) of the colleges banned smoking in all campus buildings and student residences, 68% had no tobacco sales on campus, and 32% of the schools' newspapers did not accept tobacco advertising. Regional differences in adoption of these campus tobacco-control policies were present. Although this national sample of public universities had implemented some of the recommended policies, they must take further actions to comply fully with campus tobacco-control guidelines.     

A Survey of 100 Community Colleges on Student Substance Use,Programming, and Collaborations

Abstract

Objective: The objective was to survey community college personnel about student substance use, and infrastructure (staff and funding), programs, and collaborations dedicated to substance use prevention. Participants: The sample included 100 administrators, faculty, and health services staff at 100 community colleges. Methods: Participants completed a Web-based survey. Results: Participants reported a number of alcohol and other drug (AOD) related concerns. Despite limited staff and funding dedicated to AOD, institutions are implementing a number of programs, although many are not implementing some of the programs popular at traditional 4-year colleges. They are also collaborating with a number of on- and off-campus groups. The availability of staff and funding dedicated to AOD, and the presence of residence halls, is associated with health programming and substance abuse collaborations. Conclusions: Results suggest that there is a need for increased research to understand the most effective AOD prevention strategies for community colleges.     

College Student Behavior: A Ten-Year Look

Abstract

Lester and Perez¹ have suggested that student behavior can be usefully construed in terms of a traditional-hedonic, implicit value system. They demonstrated that drug use and sexual activity provide simple behavioral anchors for this dimension, and observed an increasingly hedonic orientation among students. Ten years after their initial study, the student population at the same institution was again sampled using an anonymous questionnaire. The 1980 sample included 208 subjects, and these were compared with 688 subjects who responded to the 1970 survey. This comparison was supplemented by an intensive week-long study of 53 students within one campus living unit.

Significant increases in pre-college sexual activity were noted for both men and women. Marijuana use in high school also increased for both men and women during this period, while alcohol use increased only among women. Previously observed differences between male and female pre-college sexual activity and marijuana use had largely disappeared by 1980. Significant increases in sexual activity while in college were found for women but not for men. For men, overall marijuana and alcohol use in college did not change during the study period, but there was an increase in the frequent use of these drugs. Increases in all categories of marijuana use were noted among women, along with overall increases in their alcohol use. The significant differences between male and female marijuana use noted in the 1970 study were absent in 1980. The intensive week-long study revealed that alcohol use was part of the daily lives of one-third to two-thirds of the students sampled, although they reported interpersonal conflicts, absences from class, accidents, and injuries among the consequences of their drinking. A significant inverse relationship between sleep and alcohol use was observed among women, but not among men.

These data suggest that student behavior has become increasingly hedonic during the past ten years, with women in particular closing the gap which previously differentiated their behavior from that of their male peers. Institutions of higher learning must take these changes into account in the planning of academic programs, residential life, and health services.     

Condom Use in Heavy Drinking College Students: The Importance of Always Using Condoms

Abstract

Objective: The authors examined whether alcohol use decreased condom use. Participants: The subjects were heavy-drinking students on 5 different college campuses. Methods: A face-to-face interview, administered between November of 2004 and February of 2007, gathered information about condom use, alcohol use, and other behaviors. Multivariate logistic regression was used to assess predictors of condom use. Results: Of the 1715 participants, 64% reported that they did not always use condoms. Male students who drank heavily were less likely to always use condoms (adjusted odds ratio [AOR] 0.61). Participants with more sexual partners used condoms less when drinking (AOR 1.93 for men, 1.45 for women). Conclusions: Many students do not use condoms consistently, especially those who drink heavily or have multiple sexual partners. Clinicians at student health need to encourage all students to use condoms every time they have intercourse.