College Students Define Binge Drinking and Estimate Its Prevalence: Results of a National Survey

Abstract

Data from the 1999 College Alcohol Study were used to examine how students define the term binge drinking, to determine how much binge drinking the students think exists on their campuses, and to analyze how students' estimates compare with aggregated self-reports of student drinking. The findings indicate that the median of the students' definitions of binge drinking is 6 drinks in a row for men and 5 for women, 1 drink higher than the definition used by researchers. Students' definitions of binge drinking vary with their own drinking levels, suggesting that dissenting views of the research definition may represent voices of the heaviest drinkers. At the median, students estimated that 35% of all students were binge drinkers. Half (47%) of the students underestimated the binge drinking rate at their school, 29% over-estimated it, and 13% were accurate. Although programs designed to reduce the frequency or prevalence of binge drinking by emphasizing healthier norms would be most useful in addressing binge drinkers who overestimate drinking norms, this group includes only 13% of college students.     

Binge Drinking During the First Semester of College: Continuation and Desistance From High School Patterns

Abstract

Students' first semester on campus may set the stage for their alcohol use/misuse throughout college. The authors surveyed 274 randomly sampled first-semester freshmen at a large southwestern university on their past 2 weeks' binge drinking, their high school binge drinking, and psychosocial factors possibly associated with drinking. They conducted separate analyses among high school nonbinge drinkers (testing for predictors of college binge onset vs continued nonbinge drinking) and high school binge drinkers (testing for predictors of continued binge drinking in college vs desistance from drinking). In both analyses, the variables that predicted college binge drinking largely revolved around gregarious socializing (eg, partying, having a social network of individuals who drank relatively heavily). Gender was predictive only among high school nonbinge drinkers; women had a higher probability than did men of adopting binge drinking in college.     

Results of a Social Norm Intervention to Prevent Binge Drinking Among First-year Residential College Students

Abstract

The effects of a primary prevention social norm intervention on binge drinking among 1st-year residential college students were examined. Six hundred thirty-four students attending a medium-sized public university in the South were randomly assigned to receive a two-phase social norm intervention or the standard campus psychoeducational prevention program. At posttest, no differences were found between intervention and control group students on any of the alcohol use and alcohol-use risk factor measures. Significant subgroup differences were found by stage of initiating binge drinking behaviors, for frequency of alcohol use, F(3, 507) = 3.69, p = .01; quantity of alcohol use, F(3, 507) = 2.51, p = .05; and social norms, F(3, 505) = 2.53, p = .05. These findings suggest the need for tailoring social norm binge drinking interventions to students' stage of initiating heavy drinking and carefully monitoring for potential negative, as well as positive, effects of norm-based prevention messages.     

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.     

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.     

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.     

Binge Drinking Among Undergraduate College Students in the United States: Implications for Other Substance Use

Abstract

The authors examined the relationship between binge drinking and other substance use among US college students, using nationally representative data from the 1995 National College Health Risk Behavior Survey implemented by the Centers for Disease Control and Prevention. Compared with nonbinge drinkers, current binge drinkers were significantly more likely to report “ever” using and current use of cigarettes, marijuana, cocaine, and other illegal drugs. The researchers also found that the more often students binge drank, the more likely they were to have ever used cigarettes, marijuana, cocaine, and other drugs, and the more likely they were to report current use of cigarettes and marijuana. Those who design programs to prevent binge drinking and use of other substances should take into account the reality that many students use more than one substance and that the more frequently students report binge drinking, the more likely they are to be using other substances as well.     

The Utility of a Gender-Specific Definition of Binge Drinking on the AUDIT

Abstract

Objective: Although binge drinking is commonly defined as the consumption of at least 5 drinks in 1 sitting for men and 4 for women, the Alcohol Use Disorders Identification Test (AUDIT) defines binge drinking as the consumption of 6 or more drinks in 1 sitting for both men and women. This study examined the effect of using gender-specific binge drinking definitions on overall AUDIT scores. Participants: Participants were 331 college men and 1224 college women. Methods: Participants completed a self-report questionnaire, which included the AUDIT. Results: Findings showed that defining binge drinking as 4 or more drinks for women, rather than 6 or more, does impact their AUDIT scores and could affect the percentage of women classified as hazardous users. Among men, AUDIT scores were unaffected by the use of a gender-specific definition of binge drinking. Conclusions: Results suggest that the AUDIT might be underidentifying hazardous users among college women.     

Prevention Efforts Underlying Decreases in Binge Drinking at Institutions of Higher Education

Abstract

Analyses of 94 Fund for the Improvement of Post-Secondary Education (FIPSE)-sponsored drug-prevention programs and their outcomes used the Core Survey to identify 34 institutions where college students' binge drinking increased (M = 5.44%) and 60 institutions where it decreased (M = -4.59%) during 2 years of program operation. The authors used an inductively derived taxonomy of prevention program elements, student variables, student substance use, use-related variables, and institutional variables to compare the 2 groups of institutions. Only prevention program elements discriminated between groups. Factor analysis of discriminating elements identified 8 prevention factors that improved base-rate prediction of institutional decrease in binge drinking by 28.1%. Factor synthesis yielded a 3-construct binge-drinking prevention model based on student participation and involvement strategies, educational and informational processes, and campus regulatory and physical change efforts. This model improved base-rate prediction of decreased binge drinking by 33.2%.     

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.     

Pregaming: An Exploratory Study of Strategic Drinking by College Students in Pennsylvania

Abstract

Objectives: This exploratory study examined pre-event drinking, or pregaming, by US college students. Participants: 112 undergraduates from 10 Pennsylvania colleges participated. Method: A focus group, including a written questionnaire, was conducted at each institution. Results: Only 35.7% of the participants had not pregamed during the last 2 weeks. Pregamers consumed an average of 4.9 (SD = 3.1) drinks during their most recent session. Gender, class year, and other demographic variables did not predict pregaming. Heavier drinkers, and those stating that the average student pregamed 3+ times in the last 2 weeks, were more likely to report pregaming in the last 2 weeks. How much students drink when pregaming is influenced by how much they expect to drink later on. Conclusion: Pregaming presents a growing challenge for campus officials. Additional research is needed on the nature of the problem and which combination of prevention strategies might best address this behavior.     

An Examination of Risky Drinking Behaviors and Motivations for Alcohol Use in a College Sample

Abstract

Objective: The current study examined (1) drinking motives as a mediator of risky drinking behaviors (ie, pregaming and drinking games) and alcohol-related problems and (2) whether gender moderates the association between risky drinking behaviors and negative consequences. Participants: Participants (N = 368; 68% female) were drinkers aged 18 to 25. Data were collected from September to November 2010 and January to May 2011. Methods: Participants completed measures regarding typical pregaming and drinking game alcohol consumption, drinking motives, and alcohol-related consequences. Results: Social, coping, and enhancement motives partially explained relationships, with enhancement motives explaining the most variance for pregaming (31%) and drinking games (44%). Relationships between risky drinking and consequences were not moderated by gender. Conclusions: Drinking to enhance positive affect may be the most salient motivation for drinking related to pregaming and drinking games for college drinkers. Findings have implications for interventions tailored to students engaging in various heavy drinking practices.     

The Health Belief Model and the Contraceptive Behavior of College Women: Implications for Health Education

Abstract

“The Incidence of Primary Cardiac Arrest During Vigorous Exercise,” David S. Siscovick, et al. To examine the risk of primary cardiac arrest during vigorous exercise, we interviewed the wives of 133 men without known prior heart disease who had had primary cardiac arrest. Cases were classified according to their activity at the time of cardiac arrest and the amount of their habitual vigorous activity. From interviews with wives of a random sample of healthy men, we estimated the amount of time members of the community spent in vigorous activity.

Among men with low levels of habitual activity, the relative risk of cardiac arrest during exercise compared with that of other times was 56 (95% confidence limits, 23 to 131). The risk during exercise among men at the highest level of habitual activity was also elevated, but only by a factor of 5 (95% confidence limits, 2 to 14). However, among the habitually vigorous men, the overall risk of cardiac arrest—i.e., during and not during vigorous activity—was only 40% that of the sedentary men (95% confidence limits, 0.23 to 0.67).

Although the risk of primary cardiac arrest is transiently increased during vigorous exercise, habitual vigorous exercise is associated with an overall decreased risk of primary cardiac arrest. (New England Journal of Medicine 1984;311:874-7.)

“Osteoporosis in Women with Anorexia Nervosa,” Nancy A. Rigotti, et al. Because estrogen deficiency predisposes to osteoporosis, we assessed the skeletal mass of women with anorexia nervosa, using direct photon absorptiometry to measure radial bone density in 18 anorectic women and 28 normal controls. The patients with anorexia had significantly reduced mean bone density as compared with the controls (0.64 ±0.06 vs. 0.72 ±0.04 g per square centimeter, P < 0.001). Vertebral compression fractures developed in two patients, and bone biopsy in one of them demonstrated osteoporosis. Bone density in the patients was not related to the estradiol level (r = 0.02). Levels of parathyroid hormone, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D were normal despite low calcium intakes.

The patients with anorexia who reported a high physical activity level had a greater bone density than the patients who were less active (P < 0.001); this difference could not be accounted for by differences in age, relative weight, duration of illness, or serum estradiol levels. The bone density of physically active patients did not differ from that of active or sedentary controls.

We conclude that women with anorexia nervosa have a reduced bone mass due to osteoporosis, but that a high level of physical activity may protect their skeletons. (New England Journal of Medicine 1984;311:1601-6.)     

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.     

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.     

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.     

Sleep Quality and Alcohol Risk in College Students: Examining the Moderating Effects of Drinking Motives

Abstract

Objective: Sleep problems and alcohol misuse are common issues experienced by college students that can have detrimental effects on overall health. Previous work indicates a strong relationship between poor sleep quality and alcohol risk in this population. This study explored the moderating effect of drinking motives in the relationship between global sleep quality and experience of alcohol-related negative consequences. Participants: College students (N = 1,878) who reported past-month drinking. Methods: Participants completed online surveys assessing sleep and alcohol-related behaviors. Results: Poorer sleep quality and higher drinking motives (coping, conformity, and enhancement) predicted greater alcohol-related consequences, controlling for drinking. Further, coping motives moderated the relationship between sleep quality and consequences such that participants reporting poor sleep and high coping motives experienced heightened levels of consequences. Conclusions: These findings advance the understanding of the relationship between sleep problems and alcohol-related risk and provide implications for targeted campus-based health promotion interventions.     

Trends in marijuana and other illicit drug use among college students: results from 4 Harvard School of Public Health College Alcohol Study surveys: 1993-2001

The authors examined changes in college students' illicit drug use, patterns of polydrug use, and the relationship between students' ages of initiation of substance use and later use of marijuana and other illicit drugs between 1993 and 2001. Data from 119 US colleges and universities in the Harvard School of Public Health College Alcohol Study were used in the study. They found significant increases in percentages of students' use of marijuana in the past 30 days (from 13% to 17%), past year (from 23% to 30%), and lifetime (from 41% to 47%) between 1993 and 2001, with most of the increase occurring between 1993 and 1997. Past 30-day use of other illicit drugs increased from 4% to 7% and past year use increased from 11% to 14%. More than 98% of marijuana and other illicit drug users used another substance. They also either smoked, were binge drinkers, and/or were users of another illicit drug. Drug prevention programs should emphasize heavy alcohol use and smoking and should start when students are in high school or earlier.     

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.     

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.