Challenges and Recommendations to Enforcement of Alcohol Policies on College Campuses: An Administrator's Perspective

Abstract

Objective: The purpose of this study was to examine challenges and recommendations (identified by college administrators) to enforcing alcohol policies implemented at colleges in the southeastern United States. Methods: Telephone interviews were conducted with 71 individuals at 21 institutions. Results: Common challenges included inconsistent enforcement, mixed messages received by students, and students’ attitudes toward alcohol use. The most common recommendations were ensuring a comprehensive approach, collaboration with members of the community, and enhanced alcohol education.     

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.     

Diagnostic sequence of cocaine use disorder in relation to other mental health conditions among college students

Abstract

Objective: Cocaine use is increasing. Comorbidities and diagnostic sequencing are needed among college students to inform treatment of cocaine use disorder (CUD). Method: Using electronic medical records from the psychiatric clinic at the student health care center of a large, public university from 2005 to 2015, patients diagnosed with CUD were identified. Their top mental health conditions were identified and assessed to see whether the first diagnosis of these conditions was made (1) before, (2) at the same time as, or (3) after the first diagnosis of CUD. Results: Among the 50 CUD patients, their most common mental health comorbidities were alcohol use disorder, anxiety, depression, and cannabis use disorder. Anxiety and depression were likely to be diagnosed before CUD; alcohol and cannabis use disorders were likely to be diagnosed concurrently with CUD. Conclusion: Diagnostic sequencing can be used to inform screening, workup, and treatment for patients with CUD.     

Patterns of alcohol use and marijuana use among students at 2- and 4-year institutions

Objective: The objective of this study was to understand substance use patterns of alcohol, marijuana, and simultaneous alcohol and marijuana (SAM) use among 2- and 4-year college students. Participants: Participants were 526 young adults aged 18–23 (n?=?355 4-year students; n?=?171 2-year students) recruited from February 2015 to January 2016 who were participating in a larger longitudinal study. Methods: Latent class analysis (LCA) was used to identify past-month classes of alcohol, marijuana, and SAM use. Results: Among both 2- and 4-year students, a four-class solution yielded the best-fitting model, with 2-year classes tending to include greater marijuana use and less alcohol use and 4-year classes tending to include heavy alcohol use. Demographic characteristics were largely similar across classes. Conclusions: Classes of alcohol, marijuana, and SAM use differed by education status. Screening and prevention efforts for 4-year students may need to be tailored for the needs of 2-year students.     

Perceptions of Drinking and Related Findings From the Nationwide Campuses Study

Abstract

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.     

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.     

Physical Activity,Exercise, and Sedentary Behavior in College Students

Abstract

Objective: This article examines students’ perceptions of individual and institutional responsibility for sexual health so that institutions can better provide for the needs of their students to increase academic success and healthy relationship outcomes. Participants: Students from 2- and 4-year colleges in 1 state (N = 78). Methods: From May through November 2010, the authors used go-along interviews to examine students’ perceptions of resources for sexual health on their campuses. Results: Participants believed that it is the college's responsibility to provide resources and the responsibility of students to access resources. Participants at 2-year schools wanted referrals to resources, whereas participants at 4-year schools expected resources to be available and emphasized the importance of a supportive community. Conclusions: Students at 2- and 4-year colleges have different expectations of their institutions; by making resources and referrals for sexual health available, colleges can better serve their students, which will result in improved health outcomes.     

Cigarette Smoking and Cessation Among Trade or Technical School Students in Texas

Although students enrolled in trade or technical colleges are at an elevated risk for tobacco use, virtually no information exists regarding their smoking behaviors. Objective and Participants: In the present study, the authors examined (1) the prevalence of smoking and quitting among 617 students in 2 trade or technical colleges in East Texas and (2) on-campus media exposure to antitobacco messages. Methods: Students voluntary completed the 42-item Texas Trade and Technical School Tobacco Survey during a required introductory-level class. Results: Of the participating students, 34% reported past-30-day smoking (current smoking). Of current smokers, 74% reported a previous quit attempt and 64% wanted to quit before graduation. Although most current smokers expressed a desire to quit smoking, the antitobacco message they were least likely to see on campus was that regarding how to quit. Current smokers cited their own health as the most likely reason to quit smoking, and most reported wanting to quit on their own, without the use of resources. However, of the 9 listed resources, students were most likely to report the possible use of medication. Conclusions: Given that most smoking students desire to quit smoking—and that they are enrolled in trade or technical schools for an extended period of time—additional research should examine how successful interventions can be delivered at the trade or technical school itself.     

Alcohol use and strenuous physical activity in college students: A longitudinal test of 2 explanatory models of health behavior

Objective: To help clarify the effect of gender on the bidirectional relationship between alcohol use and strenuous physical activity in college students. Participants: Five hundred twenty-four (52% female) college students recruited in August 2008 and 2009 and followed up in April 2009 and April 2011, respectively. Methods: Participants reported their alcohol use and strenuous physical activity on 2 occasions (baseline and follow-up) spaced approximately 1 or 2 years apart. Results: For females, alcohol use quantity at baseline was associated with increased strenuous physical activity at 1- and 2-year follow-ups, and alcohol use frequency at baseline was associated with decreased strenuous physical activity at 2-year follow-up. For males, alcohol use frequency at baseline predicted decreased strenuous physical activity at 1-year follow-up. Conclusions: Gender differences may be explained from an eating disorders perspective such that women use physical activity as a compensatory strategy to combat potential weight gain from calories consumed during alcohol use.     

Different pathways explain alcohol-related problems in female and male college students

ABSTRACT

Objectives: Comprehensive models elucidating the intricate associations of depressive symptoms, coping motives, alcohol use, alcohol-related problems (ARPs), and gender among young adults have been scarcely examined. This study investigated relationships among these variables and the effect of gender on these pathways. Methods: College students (N = 163; 49.7% female) completed self-report measures on alcohol consumption, depressive symptoms, coping motives, and ARPs. Results: Structural equation modeling showed that the association between depressive symptoms and ARPs was mediated by coping motives in both females and males. However, frequency of heavy alcohol use mediated the association between depressive symptoms and ARPs in females but not in males. Conclusions: Different models explain the association between depressive symptoms and ARPs in male and female college students. Prevention programs aimed at reducing ARPs should focus on increasing alcohol screening among students with depressive symptoms, teaching coping skills, and emphasizing moderation in alcohol consumption.     

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.     

Hospitalizations for Students With an Alcohol-Related Sanction: Gender and Pregaming as Risk Factors

Abstract

Objective: The purpose of this study is to investigate whether pregaming (ie, drinking prior to a social event) is a risk factor for hospitalization. Participants: Participants (N = 516) were undergraduate students with an alcohol-related sanction. Methods: Participants completed a survey about alcohol use, as well as behaviors and experiences, prior to and during the referral event. The dependent variable was whether participants received medical attention at an emergency department during the sanction event. Results: Results indicated that older students, females who pregame, students with higher alcohol use screening scores, lighter drinkers, and higher numbers of drinks before the referral event all increased the odds of receiving medical attention. Pregaming alone was not significantly related to receiving medical attention in the multivariate analysis. Conclusions: Female students who pregame appear to be at risk for requiring hospitalization after drinking when controlling for the number of drinks consumed.     

Dimensions of ethnic identity as protective factors for substance use and sexual risk behaviors in African American college students

Objective: To examine ethnic identity and ethnic socialization as potential protective factors for risk behaviors among US college students. Participants: Participants were 398 African American and Afro-Caribbean students recruited from 30 colleges and universities during September 2008–October 2009. Methods: Data on hazardous alcohol use, substance use, sexual behaviors, ethnic identity, and ethnic/racial socialization were collected. Hierarchical linear and negative binomial regression analyses were conducted to determine the degree to which ethnic identity and ethnic/racial socialization predicted the risk behaviors. Results: Ethnic Identity affirmation, belonging, and commitment (EI-ABC) significantly predicted lower substance use and hazardous alcohol use. Ethnic/racial socialization was not a significant predictor of substance use or sexual risk behaviors. Conclusions: Components of ethnic identity are potentially protective against alcohol and substance use behaviors. Additional research is recommended to determine effective intervention strategies.     

Alcohol Use and Participation in Organized Recreational Sports Among University Undergraduates

Objective: The authors examined alcohol use among students involved in recreational sports. To the authors' knowledge, this is the first study of alcohol use in which researchers separate recreational sports participants from intercollegiate athletes and examine them as a separate group of interest. Participants: The authors generated a random sample of 494 students from the undergraduate population at a 4-year university. Methods: They used a Web-based survey to collect data and stratified and weighted the sample by residence status to more accurately reflect the population. Results: Students who participated in recreational sports used alcohol at a greater frequency and intensity than did those who were not involved in recreational sports across a variety of measures, even alongside other variables, including race, sex, and Greek membership. Conclusions: On the basis of these findings, alcohol consumption among those participating in recreational sports appears to be an area worthy of consideration in future research.     

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.     

The Political,Social, and Public Health Problems of Binge Drinking in College

Abstract

Despite extensive efforts to decrease alcohol abuse among college students, prevention approaches have had limited success. This study attempted to clarify reasons for this limited success and to identify directions for future interventions by directly interviewing college students on this topic. Five issues were discussed in the focus group interviews: (1) reasons for drinking alcohol, (2) reasons for not drinking alcohol, (3) circumstances surrounding overconsumption of alcohol, (4) topics and methods for prevention, and (5) gender differences in drinking patterns.

The focus group interviews were found to be a valid tool for elucidating sensitive aspects of these issues and the relative importance of these issues to each other. The students revealed how susceptible they are to societal pressures to drink alcohol and how the limitations of their intrapersonal skills affect their alcohol consumption, most notably regarding sexuality issues. The authors contend that improving intrapersonal skills should be a major focus of programs to prevent alcohol abuse.     

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.     

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.     

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.