alcohol abuse in college students essay

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Why Colleges Haven't Stopped Binge Drinking

By Beth Mcmurtrie | The Chronicle Of Higher Education

• Dec. 14, 2014

Despite decades of research, hundreds of campus task forces and millions invested in bold experiments, college drinking in the United States remains as much of a problem as ever.

More than 1,800 students die every year of alcohol-related causes. An additional 600,000 are injured while drunk, and nearly 100,000 become victims of alcohol-influenced sexual assaults. One in four say their academic performance has suffered from drinking, all according to the National Institute on Alcohol Abuse and Alcoholism.

The binge-drinking rate among college students has hovered above 40 percent for two decades, and signs are that partying is getting even harder. More students now drink to get drunk, choose hard liquor over beer and drink in advance of social events. For many the goal is to black out.

Drinking is so central to students’ expectations of college that they will fight for what they see as a basic right. After Syracuse University, named the nation’s No.1 party school by The Princeton Review, tried to limit a large outdoor gathering, outraged students labeled the campus a police state.

Why has the drumbeat of attention, effort and money failed to influence what experts consider a public-health crisis? It is not for lack of information. Dozens of studies show exactly why, when, where and how students drink. Plenty more identify effective intervention and prevention strategies. A whole industry has sprung up around educating students on the dangers of alcohol abuse.

For the most part, undeterred by evidence that information alone is not enough, colleges continue to treat alcohol abuse as an individual problem, one that can be fixed primarily through education.

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Volume 35 Issue 2 December 1, 2013

The Burden of Alcohol Use: Excessive Alcohol Consumption and Related Consequences Among College Students

Part of the Topic Series: Alcohol’s Evolving Impact on Individuals, Families, and Society

Aaron White, Ph.D., and Ralph Hingson, Sc.D.

Aaron White, Ph.D., is program director, College and Underage Drinking Prevention Research; and

Ralph Hingson, Sc.D., is director, Division of Epidemiology and Prevention Research, both at the National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland.

Research shows that multiple factors influence college drinking, from an individual’s genetic susceptibility to the positive and negative effects of alcohol, alcohol use during high school, campus norms related to drinking, expectations regarding the benefits and detrimental effects of drinking, penalties for underage drinking, parental attitudes about drinking while at college, whether one is member of a Greek organization or involved in athletics, and conditions within the larger community that determine how accessible and affordable alcohol is. Consequences of college drinking include missed classes and lower grades, injuries, sexual assaults, overdoses, memory blackouts, changes in brain function, lingering cognitive deficits, and death. This article examines recent findings about the causes and consequences of excessive drinking among college students relative to their non-college peers and many of the strategies used to collect and analyze relevant data, as well as the inherent hurdles and limitations of such strategies.

Since 1976, when the National Institute on Alcohol Abuse and Alcoholism (NIAAA) issued its first report on alcohol misuse by college students, research advances have transformed our understanding of excessive drinking on college campuses and the negative outcomes that follow from it. For instance, we now know that a broad array of factors influence whether a particular college student will choose to drink, the types of consequences they suffer from drinking, and how they respond to those consequences. We have learned that predisposing factors include an individual’s genetic susceptibility to the positive and negative effects of alcohol, alcohol use during high school, campus norms related to drinking, expectations regarding the benefits and detrimental effects of drinking, penalties for underage drinking, parental attitudes about drinking while at college, whether one is member of a Greek organization or involved in athletics, and conditions within the larger community that determine how accessible and affordable alcohol is. Consequences include missed classes and lower grades, injuries, sexual assaults, overdoses, memory blackouts, changes in brain function, lingering cognitive deficits, and death.

This article reviews recent research findings about alcohol consumption by today’s college students and the outcomes that follow. It examines what we know about the causes and consequences of excessive drinking among college students relative to their non-college peers and many of the strategies used to collect and analyze relevant data, as well as the inherent hurdles and limitations of such strategies.

Excessive Drinking At College

Currently, only two active national survey studies are able to characterize the drinking habits of college students in the United States. The National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), involves face-to-face interviews with approximately 67,500 persons ages 12 and older each year regarding use of alcohol and other drugs. Monitoring the Future (MTF) is an annual, paper-and-pencil national survey of alcohol and other drug use with a sample comprising nearly 50,000 students in 8th, l0th, and 12th grades drawn from roughly 420 public and private schools. Approximately 2,400 graduating seniors are resurveyed in subsequent years, allowing for the monitoring of trends in college drinking.

In addition, two prior surveys yielded data on college drinking that remain valuable and relevant. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), sponsored by NIAAA, collected data on alcohol and other drug use from a sample of roughly 46,500 citizens 18 and older using face-to-face computer-assisted interviews. Two waves of data (2001 and 2004) were collected from the same sample, and data from an independent sample are scheduled to be collected in 2013. The Harvard College Alcohol Study (CAS), although no longer active, was a landmark paper-and-pencil survey that provided national data (years 1993, 1997, 1999, and 2001) from roughly 15,000 students on more than 100 college campuses each year (Wechsler and Nelson 2008). Data from both NESARC and Harvard CAS remain useful for examining associations between patterns of drinking at college and the frequency and prevalence of alcohol-related consequences for both drinkers and nondrinkers.

Data from NSDUH and MTF suggest that roughly 65 percent of college students drink alcohol in a given month (see figure 1 for data from MTF), and Harvard CAS all suggest that a large percentage of college students who drink do so to excess. Excessive, or “binge,” drinking is defined in NSDUH, MTF, and NESARC as consuming five or more drinks in an evening, although the instruments vary in the specified time frames given (i.e., once or more in the past month for NSDUH, past 2 weeks for MTF, and multiple time periods for NESARC) (Johnston et al. 2001 a ; SAMHSA 2011). The Harvard CAS was the first national study of college students to utilize a gender-specific definition of binge drinking (i.e., four or more drinks in an evening for females or five or more for males in the past 2 weeks) to equate the risk of alcohol-related harms (Wechsler et al. 1995). The Centers for Disease Control and Prevention (CDC) utilizes the same four or more/five or more gender-specific measures but specifies a 30-day time period (Chen et al. 2011). NIAAA uses the four or more/five or more gender-specific measure but specifies a time frame of 2 hours for consumption, as this would generate blood alcohol levels of roughly 0.08 percent, the legal limit for driving, for drinkers of average weight (NIAAA 2004).

 According to NSDUH, the percentage of 18- to 22-year- old college students who reported drinking five or more drinks on an occasion in the previous 30 days remained relatively stable from 2002 (44 percent) to 2010 (44 percent) (SAMHSA 2011). Among 18- to 22-year-olds not enrolled in college, the percentage who engaged in binge drinking decreased significantly from 2002 (39 percent) to 2010 (36 percent) (see figure 2).

Looking at a longer time period, data from MTF suggest that there have been significant declines in the percentage of college students consuming five or more drinks in the previous 2 weeks, from 44 percent in 1980 to 36 percent in 2011 (Johnston et al. 2012) (see figure 3). This time frame includes the passage of the National Minimum Drinking Age Act of 1984, which effectively increased the drinking age from 18 to 21 in the United States.

 Across the four waves of data collection in the Harvard CAS (1993, 1997, 1999, and 2001), rates of binge drinking remained relatively stable (44, 43, 45, and 44 percent, respectively) (Wechsler et al. 2002) (see figure 4). However, the number of non–binge drinkers decreased, whereas the number of frequent binge drinkers (three or more binge-drinking episodes in a 2-week period) increased. Wechsler and colleagues (2002) reported that binge drinkers consumed 91 percent of all the alcohol consumed by college students during the study period. Frequent binge drinkers, a group comprising only 1 in 5 college students, accounted for 68 percent of all alcohol consumed (Wechsler and Nelson 2008).

Individual and Environmental Contributors to Excessive Drinking

Survey data indicate that males outpace females with regard to binge drinking. According to MTF, in 2011, 43 percent of male and 32 percent of female college students crossed the binge threshold in a given 2-week period. Further, 40 percent of students—more males (44 percent) than females (37 percent)—reported getting drunk in a given month. Research suggests that gender differences in alcohol use by college students have narrowed considerably over the years. In their landmark 1953 report on college drinking, Yale researchers Straus and Bacon indicated that, based on survey data from more than 15,000 students on 27 college campuses, 80 percent of males and 49 percent of females reported having been drunk at some point. Nearly 60 years later, in 2011, data from MTF indicated that 68 percent of males and 68 percent females reported having been drunk. These new, higher levels of drinking among females seem to be ingrained in the youth drinking culture. Whereas binge-drinking rates declined significantly among high-school seniors over the last decade, the effect was driven by a decline among males only. Binge-drinking rates among females remained relatively stable (Johnston et al. 2012) (see figure 5).

Beyond gender, survey studies of college drinking reveal a range of characteristics of both individual students and campus environments that influence the likelihood of binge drinking. Data from the Harvard CAS and other studies reveal that males, Caucasians, members of Greek organizations, students on campuses with lower percentages of minority and older students, athletes, students coping with psychological distress, those on campuses near a high density of alcohol outlets, students with access to cheap drink specials, a willingness to endure the consequences of alcohol misuse, and drinking at off-campus parties and bars all contribute to excessive drinking (Mallett et al. 2013; Wechsler and Kuo 2003; Yusko et al. 2008). Further, students living off campus and/or in Greek housing, those who drink to try to fit it, students with inflated beliefs about the proportion of other students who binge drink, and those with positive expectations about the results of drinking are more likely to drink excessively (Scott-Sheldon et al. 2012; Wechsler and Nelson 2008). Importantly, excessive drinking prior to college relative to other college-bound students is predictive of both excessive drinking at college and experiencing alcohol-related consequences (Varvil-Weld et al. 2013; White et al. 2002).

Strengths and Weaknesses of Binge-Drinking Measures

Several studies indicate that crossing commonly used binge-drinking thresholds increases a college student’s risk of experiencing negative alcohol-related consequences. For instance, data from the Harvard CAS indicate that students who binge one or two times during a 2-week period are roughly three times as likely as non–binge drinkers to get behind in school work, do something regretful while drinking, experience a memory blackout, have unplanned sex, fail to use birth control during sex, damage property, get in trouble with police, drive after drinking, or get injured (Wechsler et al. 2000). The more often a student binges, the greater the risk of negative outcomes. Further, the more binge drinking that occurs on a campus, the more likely non–binge drinkers and abstainers are to experience secondhand consequences of alcohol use, such as having studying or sleep disrupted, being a victim of sexual assault, and having property damaged (Wechsler and Nelson 2008).

Because of the increased risk of consequences to self and others that occurs when a person drinks at or beyond the binge threshold, a great deal of emphasis is placed on tracking the percentage of college students that cross binge thresholds. Although this has proven extremely valuable, as Wechsler and Nelson (2001, p. 289) state, “Alcohol use is a complex behavior. No single measure will capture all the relevant aspects of alcohol use.” One limitation of using a single threshold is that it removes data regarding just how heavily students actually drink (Alexander and Bowen 2004; Read et al. 2008) and assigns the same level of risk to all students who cross the thresholds regardless of how far beyond the threshold they go. This is an important consideration as recent studies suggest that plenty of college students who cross the binge threshold when they drink go far beyond it.

In a study of 10,424 first-semester college freshmen, more than one-half of all males and one-third of all females categorized as binge drinkers drank at levels two or more times the binge threshold (8 or more drinks for women and 10 or more drinks for men) at least once in the 2 weeks before the survey. Indeed, one in four binge-drinking males consumed 15 or more drinks at a time during that period (White et al. 2006). Naimi and colleagues (2010) reported that 18- 24-year-olds in the United States drink an average of 9.5 drinks per binge episode, nearly twice the standard binge threshold. Data from MTF also reveal that both college students and their non-college peers often drink at levels that exceed the binge threshold. On average, between 2005 and 2011, 7 percent of college females surveyed and 24 percent of college males consumed 10 or more drinks at least once in a 2-week period, compared with 7 percent of females and 18 percent of males not in college. Further, 2 percent of all college females surveyed and 10 percent of college males consumed 15 or more drinks in a 2-week period. Rates among non-college peers were similar, at 2 percent among females and 9 percent among males (Johnston et al. 2012). For a 140-pound female, consuming 15 drinks over a 6-hour period would produce an estimated blood alcohol level above 0.4 percent, a level known to have claimed, directly, several lives on college campuses in recent years. For a 160-pound male, drinking in this way would lead to a blood alcohol level above 0.3 percent, a potentially lethal level associated with memory blackouts and injury deaths.

Data from the Harvard CAS suggested that students who binge drink frequently (three or more times in a 2-week period) are at particularly high risk of negative alcohol-related outcomes. Compared with students who binge drink one or two times in a 2-week period, those who binge three or more times are twice as likely to experience alcohol-induced memory losses (27 percent vs. 54 percent, respectively), not use protection during sex (10 percent vs. 20 percent, respectively), engage in unplanned sex (22 percent vs. 42 percent, respectively), and get hurt or injured (11 percent vs. 27 percent, respectively), and are equally likely to need medical treatment for an overdose (1 percent vs. 1 percent). Whereas binge frequency is associated with an increased risk of negative outcomes, additional research indicates that there is a relationship between how often a student binges and the peak number of drinks he or she consumes. White and colleagues (2006) reported that 19 percent of frequent binge drinkers consume three or more times the binge threshold (12 or more drinks for females and 15 or more for males) at least once in a 2-week period compared with only 5 percent of infrequent binge drinkers. As a result of the association between frequency of binge drinking and peak levels of consumption, it is difficult to determine if the increase in risk that comes with frequent bingeing is a result of the number of binge episodes, per se, or the number of drinks consumed in an episode.

Importantly, although evidence suggests that many students drink at levels far beyond the binge threshold, additional research suggests that the majority of alcohol-related harms on college campuses result from drinking at levels near the standard four/five-drink measure. This is related to the well-known prevention paradox in which the majority of health problems, such as alcohol-related consequences, tend to occur among those considered to be at lower risk (Rose 1985).

For a particular individual, the odds of experiencing alcohol-related harms increase as the level of consumption increases (Wechsler and Nelson 2001). However, at the population level, far fewer people drink in this manner. As a result, more total consequences occur among those who drink at relatively lower risk levels. For instance, based on data from roughly 9,000 college-student drinkers across 14 college campuses in California, Gruenewald and colleagues (2010) estimated that more than one-half of all alcohol-related consequences resulted from drinking occasions in which four or fewer drinks were consumed. Similarly, using national data from nearly 50,000 students surveyed across the four waves of the Harvard CAS, Weitzman and Nelson (2004) observed that roughly one-quarter to one-third of alcohol-related consequences, including getting injured, vandalizing property, having unprotected sex, and falling behind in school, occurred among students who usually consume three or four drinks per occasion. Such findings raise the possibility that a reduction in high peak levels of consumption might not necessarily result in large overall reductions in alcohol-related consequences on a campus. However, a reduction in high peak levels of drinking would certainly help save the lives of students who drink at these high levels.

In summary, while binge-drinking thresholds are useful for sorting students into categories based on levels of risk, a single threshold cannot adequately characterize the drinking habits of college students or the risks associated with alcohol use on college campuses (Read et al. 2008). It is not uncommon for college students to far exceed standard binge thresholds. Presently, only MTF tracks and reports the incidence of drinking beyond the binge threshold on college campuses. Such data are important as they allow for better tracking of changes in the drinking habits of students. For instance, it is possible that the number of students who drink at extreme levels could increase, whereas the overall percentage of students who binge drink declines or remains stable. Such a phenomenon might help explain why some consequences of excessive alcohol use, like overdoses requiring hospitalization, seem to be on the rise despite relatively stable levels of binge drinking on college campuses across several decades. Finally, although sorting students into binge drinking categories fails to capture high peak levels of consumption among students, a large proportion of harms actually occurs at or near the standard four or more/five or more threshold.

Do Students Know How to Define Standard Servings?

Despite concerns about the accuracy of self-report data for assessing levels of alcohol use among college students and the general population, such surveys remain the most common tool for assessing alcohol use. One major concern is whether students and other young adults are aware of what constitutes a single serving of alcohol. Research shows that college students and the general public tend to define and pour single servings of alcohol that are significantly larger than standard drinks, suggesting they might underestimate their true levels of consumption on surveys (Devos-Comby and Lange 2008; Kerr and Stockwell 2012). For instance, White and colleagues (2003, 2005) asked students to pour single servings of different types of alcohol beverages into cups of various sizes. Overall, students poured drinks that were too large. When asked to simply define standard drinks in terms of fluid ounces, students tended to overstate the number of ounces in a standard drink. The average number of ounces of liquor in student-defined mixed drinks was 4.5 ounces rather than the 1.5 ounces in actual standard drinks (White et al. 2005). When students were provided with feedback regarding discrepancies between their definitions of single servings and the actual sizes of standard drinks, they tended to revise their self-reported levels of consumption upward, leading to a significant increase in the number of students categorized as binge drinkers (White et al. 2005). Such findings suggest that students underreport their levels of consumption on surveys, raising the possibility that more students drink excessively than survey data indicate.

Although a lack of knowledge regarding standard serving sizes could lead students to underestimate, and thus under­report, how much they drink, field research suggests that the discrepancy between self-reported and actual levels of consumption might be smaller than expected from lab studies. For instance, Northcote and Livingston (2011) conducted a study in which they monitored the number of drinks consumed by research participants in bars and then asked them to report their consumption a few days later. Reports by study participants were consistent with the observations made by researchers for participants who had consumed less than eight total drinks. Only those who consumed eight drinks or more tended to underestimate their consumption. When comparing estimated blood alcohol concentrations (BAC) based on self-report to actual BAC readings in college students returning to campus from bars, actual BAC levels tended to be lower, rather than higher, than levels calculated using self-reported consumption (Kraus et al. 2005). Similarly, when actual BAC levels are compared with estimated BAC levels in bar patrons, estimates are spread evenly between accurate, underestimates, and overestimates (Clapp et al. 2009).

In short, although self-reported drinking data might not be perfect, and college students lack awareness of how standard drink sizes are defined, research does not suggest that the discrepancies between self-reported and actual drinking levels are large enough to question the general findings of college drinking surveys.

Paper-and-Pencil, Face-To-Face, and Electronic Surveys: Does It Make a Difference?

National surveys of college drinking often utilize paper-and-pencil questionnaires (e.g., MTF and Harvard CAS) or face-to-face computer-assisted personal interviews (e.g., NSDUH and NESARC). It now is possible to collect survey data electronically via the Internet and also using handheld devices, such as smartphones and personal digital assistants. This raises questions about the comparability between traditional survey methods and electronic data collection.

Several studies comparing traditional (e.g., paper and pencil) and electronic means of data collection suggest that the approaches yield generally similar results from survey participants (Boyer et al. 2002; Jones and Pitt 1999; LaBrie et al. 2006; Lygidakis et al. 2010). For instance, in a comparison of Web-based and paper-and-pencil survey approaches, Knapp and Kirk (2003) found no differences in outcomes, suggesting that Web-based surveys do not diminish the accuracy or honesty of responses. Similarly, LaBrie and colleagues (2006) observed similar outcomes of self-reported alcohol consumption in a paper-and-pencil survey and an electronic survey. However, other studies suggest that students actually feel more comfortable answering personal questions truthfully when completing questionnaires electronically (Turner et al. 1998), which can lead to higher levels of self-reported substance use and other risky behaviors. Both Lygidakis and colleagues (2010) and Wang and colleagues (2005) indicate that adolescents completing electronic surveys reported higher levels of alcohol and other drug use compared with those completing paper-and-pencil versions.

Response rate is an important consideration, with higher response rates increasing the representativeness of the sample and limiting the likelihood that response biases will influence the outcomes. Two national paper-and-pencil surveys mentioned above, MTF and Harvard CAS, report response rates for college students of approximately 59 percent. For MTF, this response rate represents a retention rate, as the participants were followed up after high school. Response rates for the in-person computer-assisted personal interviews, NSDUH and NESARC, which assess college student drinking but are not limited to college students, are roughly 77 percent and 81 percent, respectively. Currently, there is no basis for assessing response rates for national Web-based assessments of college drinking. However, smaller studies suggest that response rates might be comparable, if not higher, than other approaches. McCabe and colleagues (2002) reported that, among 7,000 undergraduate students, one-half of whom were surveyed about alcohol and other drug use via the Internet and half surveyed via paper-and-pencil surveys delivered through the mail, the response rates were 63 percent for the Web survey and 40 percent for the paper-and-pencil survey. Further, response rates for Web-based surveys can be improved by sending reminders via e-mail (van Gelder et al. 2010).

In summary, in recent years an increasing number of researchers have utilized electronic survey methods to collect college-drinking data. At present, evidence suggests that these methods can yield results quite similar to those obtained from traditional survey methods and that response rates might actually be higher.

Alcohol-Related Consequences Among College Students

Drinking to intoxication leads to widespread impairments in cognitive abilities, including decisionmaking and impulse control, and impairments in motor skills, such as balance and hand-eye coordination, thereby increasing the risk of injuries and various other harms. Indeed, research suggests that students who report “getting drunk” even just once in a typical week have a higher likelihood of being injured, experiencing falls that require medical treatment, causing injury in traffic crashes, being taken advantage of sexually, and injuring others in various ways (O’Brien et al. 2006). Students who drink with the objective of getting drunk are far more likely to experience a range of consequences, from hangovers to blackouts, than other students who drink (Boekeloo et al. 2011).

National estimates suggest that thousands of college students are injured, killed, or suffer other significant consequences each year as a result of drinking. However, researchers have questioned the manner in which such national estimates are calculated. In many cases, the lack of college identifiers in datasets means that the actual amount of annual alcohol-attributable harm that occurs among college students is unknown. Although the Harvard CAS collected data regarding the consequences of drinking, its final year of administration was 2001. Currently, assessing the damage done, on a national level, by college drinking requires estimating rates of consequences using a variety of data sources. Such assessments are complicated by the fact that outcomes considered to be negative consequences by researchers (e.g., blackouts and hangovers) are not always perceived as negative by students (Mallett et al. 2013). Further, college students often drink off campus, such as during spring breaks and summer vacations, meaning that many alcohol-related consequences experienced by college students are not necessarily associated with college itself. As such, our understanding of alcohol-related consequences among college students remains somewhat cloudy.

In one set of estimates, Hingson and colleagues (2002, 2005, 2009) utilized census data and national datasets regarding traffic crashes and other injury deaths to estimate the prevalence of various alcohol-related harms among all young people aged 18–24. Next, they attributed an amount of harm to college students equal to the proportion of all 18- to 24-year-olds who were enrolled full time in 4-year colleges (33 percent in 2005, the most recent year analyzed) (Hingson et al. 2009). Because college students drink more heavily than their non-college peers, it is possible this approach underestimated the magnitude of alcohol-related consequences on college campuses. Hingson and colleagues (2002, 2005, 2009) also used the percentage of college students who reported various alcohol-related behaviors (e.g., being assaulted by another drinking college student) in national surveys to derive national estimates of the total numbers of college students who experienced these consequences.

Based on the above strategies along with other sources of data, researchers have estimated the following rates and prevalence of alcohol-related harms involving college students:

• Death:  It is possible that more than 1,800 college students between the ages of 18 and 24 die each year from alcohol- related unintentional injuries, including motor-vehicle crashes (Hingson et al. 2009).
• Injury:  An estimated 599,000 students between the ages of 18 and 24 are unintentionally injured each year under the influence of alcohol (Hingson et al. 2009).
• Physical Assault:  Approximately 646,000 students between the ages of 18 and 24 are assaulted each year by another student who has been drinking (Hingson et al. 2009).
• Sexual Assault:  Perhaps greater than 97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape each year (Hingson et al. 2009).
• Unsafe Sex:  An estimated 400,000 students between the ages of 18 and 24 had unprotected sex and nearly 110,000 students between the ages of 18 and 24 report having been too intoxicated to know if they consented to having sex (Hingson et al. 2002).
• Health Problems:  More than 150,000 students develop an alcohol-related health problem each year (Hingson et al. 2002).
• Suicide Attempts:  Between 1.2 and 1.5 percent of college students indicate that they tried to commit suicide within the past year as a result of drinking or drug use (Presley et al. 1998).
• Drunk Driving:  Roughly 2.7 million college students between the ages of 18 and 24 drive under the influence of alcohol each year (Hingson et al. 2009).
• Memory Loss:  National estimates suggest that 10 percent of non–binge drinkers, 27 percent of occasional binge drinkers, and 54 percent of frequent binge drinkers reported at least one incident in the past year of blacking out, defined as having forgotten where they were or what they did while drinking (Wechsler et al. 2000; White 2003).
• Property Damage:  More than 25 percent of administrators from schools with relatively low drinking levels and more than 50 percent from schools with high drinking levels say their campuses have a “moderate” or “major” problem with alcohol-related property damage (Wechsler et al. 1995).
• Police Involvement:  Approximately 5 percent of 4-year college students are involved with the police or campus security as a result of their drinking (Wechsler et al. 2002) and an estimated 110,000 students between the ages of 18 and 24 are arrested for an alcohol-related violation such as public drunkenness or driving under the influence (Hingson et al. 2002). A more recent national study reported that 8.5 percent of students were arrested or had other trouble with the police because of drinking (Presley and Pimentel 2006).
• Alcohol Abuse and Dependence:  Roughly 20 percent of college students meet the criteria for an alcohol use disorder in a given year (8 percent alcohol abuse, 13 percent alcohol dependence). Rates among age mates not in college are comparable (17 percent any alcohol use disorder, 7 percent alcohol abuse, 10 percent alcohol dependence) (Blanco et al. 2008).

With regard to assessing the number of college students who die from alcohol each year, in addition to the lack of college identifiers in datasets, another barrier is the fact that levels of alcohol often are not measured in nontraffic fatalities. As such, attributable fractions, based on analyses of existing reports in which alcohol levels were measured postmortem, are used to estimate the number of deaths by various means that likely involved alcohol. The CDC often uses attributable fractions calculated by Smith and colleagues (1999) based upon a review of 331 medical-examiner studies. An updated approach is needed. The combination of including college identifiers in medical records and measuring alcohol levels in all deaths would allow for accurate assessments of the role of alcohol in the deaths of college students and their non-college peers.

Academic Performance

About 25 percent of college students report academic consequences of their drinking, including missing class, falling behind in class, doing poorly on exams or papers, and receiving lower grades overall (Engs et al. 1996; Presley et al. 1996 a , b; Wechsler et al. 2002). Although some published research studies have not found a statistically significant association between binge drinking and academic performance (Gill 2002; Howland et al. 2010; Paschall and Freisthler 2003; Williams 2003; Wood et al. 1997), studies linking binge drinking to poorer academic performance outnumber the former studies two to one. Presley and Pimentel (2006) reported that in a national survey of college students, those who engaged in binge drinking and drank at least three times per week were 5.9 times more likely than those who drank but never binged to perform poorly on a test or project as a result of drinking (40.2 vs. 6.8 percent), 5.4 times more likely to have missed a class (64.4 vs. 11.9 percent), and 4.2 times more likely to have had memory loss (64.2 vs. 15.3 percent) (Thombs et al. 2009). Singleton and colleagues (2007, 2009), in separate prospective studies, found negative associations between heavy alcohol use and grade point average. Jennison (2004), based on a national prospective study, reported binge drinkers in college were more likely to drop out of college, work in less prestigious jobs, and experience alcohol dependence 10 years later. Wechsler and colleagues (2000) and Powell and colleagues (2004), based on the Harvard CAS, found frequent binge drinkers were six times more likely than non–binge drinkers to miss class and five times more likely to fall behind in school. White and colleagues (2002) observed that the number of blackouts, a consequence of heavy drinking, was negatively associated with grade point average (GPA). It is important to note that although data regarding GPA often are collected via self-report, the negative association between alcohol consumption and GPA holds even when official records are obtained (Singleton 2007). Collectively, the existing research suggests that heavy drinking is associated with poorer academic success in college.

Alcohol Blackouts

Excessive drinking can lead to a form of memory impairment known as a blackout. Blackouts are periods of amnesia during which a person actively engages in behaviors (e.g., walking, talking) but the brain is unable to create memories for the events. Blackouts are different from passing out, which means either falling asleep or becoming unconscious from excessive drinking. During blackouts, people are capable of participating in events ranging from the mundane, such as eating food, to the emotionally charged, such as fights and even sexual intercourse, with little or no recall (Goodwin 1995). Like milder alcohol–induced short-term memory impairments caused by one or two drinks, blackouts primarily are anterograde, meaning they involve problems with the formation and storage of new memories rather than problems recalling memories formed prior to intoxication. Further, short-term memory often is left partially intact. As such, during a blackout, an intoxicated person is able to discuss events that happened prior to the onset of the blackout and to hold new information in short-term storage long enough to have detailed conversations. They will not, however, be able to transfer new information into long-term storage, leaving holes in their memory. Because of the nature of blackouts, it can be difficult or impossible to know when a drinker in the midst of one (Goodwin 1995).

There are two general types of blackouts based on the severity of the memory impairments. Fragmentary blackouts, sometimes referred to as gray outs or brown outs, are a form of amnesia in which memory for events is spotty but not completely absent. This form is the most common. En bloc blackouts, on the other hand, represent complete amnesia for events (Goodwin 1995).

Blackouts surprisingly are common among college students who drink alcohol. White and colleagues (2002) reported that one-half (51 percent) of roughly 800 college students who had ever consumed alcohol at any point in their lives reported experiencing at least one alcohol-induced blackout, defined as awakening in the morning not able to recall things one did or places one went while under the influence. The average number of total blackouts in those who experienced them was six. Of those who had consumed alcohol during the 2 weeks before the survey was administered, 9 percent reported blacking out. Based on data from 4,539 inbound college students during the summer between high-school graduation and the start of the freshmen year, 12 percent of males and females who drank in the previous 2 weeks experienced a blackout during that time (White and Swartzwelder 2009). Data from the Harvard CAS indicate that blackouts were experienced in a 30-day period by 25 percent of students in 1993 and 27 percent of students in 1997, 1999, and 2001 (Wechsler et al. 2002). A small study by White and colleagues (2004), in which 50 students with histories of blackouts were interviewed, suggests that fragmentary blackouts are far more common than en bloc blackouts. Roughly 80 percent of students described their last blackout as fragmentary.

Blackouts tend to occur following consumption of relatively large doses of alcohol and are more likely if one drinks quickly and on an empty stomach, both of which cause a rapid rise and high peak in BAC (Goodwin 1995; Perry et al. 2006). For this reason, pregaming, or prepartying, which typically involves fast-paced drinking prior to going out to an event, increases the risk of blacking out. Labrie and colleagues (2011) reported that 25 percent of 2,546 students who engaged in prepartying experienced at least one blackout in the previous month. Playing drinking games and drinking shots were risk factors. Further, skipping meals to restrict calories on drinking days is associated with an increased risk of blackouts and other consequences (Giles et al. 2009).

Because blackouts typically follow high peak levels of drinking, it is not surprising that they are predictive of other alcohol-related consequences. Mundt and colleagues (2012) examined past-year blackouts in a sample of more than 900 students in a randomized trial of a screening and brief intervention for problem alcohol use and found that blackouts predicted alcohol-related injuries over a subsequent 2-year period. Compared with students who had no history of blackouts, those who reported one to two blackouts at baseline were 1.5 times more likely to experience an alcohol-related injury, whereas those with six or more blackouts were 2.5 times more likely. In a follow-up report based on the same sample, Mundt and Zakletskaia (2012) estimated that among study participants, one in eight emergency-department (ED) visits for alcohol-related injuries involved a blackout. On a campus of 40,000 students, this would translate into roughly $500,000 in annual costs related to blackout-associated ED visits.

In the study of 50 students with blackout histories by White and colleagues (2004), estimated peak BACs during the night of the last blackout generally were similar for males (0.30 percent) and females (0.35 percent), although it is unlikely that self-reported alcohol consumption during nights in which blackouts occur is highly accurate. A study of amnesia in people arrested for either public intoxication, driving under the influence, or underage drinking found that the probability of a fragmentary or en bloc blackout was 50/50 at a BAC of 0.22 percent and the probability of an en bloc blackout, specifically, was 50/50 at a BAC of 0.31 percent, based on breath alcohol readings (Perry et al. 2006). In their study of blackouts in college students, Hartzler and Fromme (2003 a ) noted a steep increase in the likelihood of blackouts above a BAC of 0.25 percent, calculated from self-reported consumption. Thus, from existing research, it seems that the odds of blacking out increase as BAC levels climb and that blackouts become quite common at BAC levels approaching or exceeding 0.30 percent. As such, the high prevalence of blackouts in college students points to the magnitude of excessive consumption that occurs in the college environment. It should be noted, however, that BAC levels calculated based on self-reported consumption are unlikely to be accurate given the presence of partial or complete amnesia during the drinking occasion.

It seems that some people are more sensitive to the effects of alcohol on memory than others and are therefore at increased risk of experiencing blackouts. Wetherill and Fromme (2011) examined the effects of alcohol on contextual memory in college students with and without a history of blackouts. Performance on a task was similar while the groups were sober, but students with a history of blackouts performed more poorly when intoxicated than those without a history of blackouts. Similarly, Hartzler and Fromme (2003 b ) reported that when mildly intoxicated, study participants with a history of blackouts performed more poorly on a narrative recall task than those without a history of blackouts. When performing a memory task while sober, brain activity measured with functional magnetic resonance imaging is similar in people with a history of blackouts and those without such a history (Wetherill et al. 2012). However, when intoxicated, those with a history of blackouts exhibit lower levels of activity in several regions of the frontal lobes compared with subjects without a history of blackouts.

Thus, studies suggest that there are differences in the effects of alcohol on memory and brain function between those who experience blackouts and those who do not. Research by Nelson and colleagues (2004), using data from monozygotic twins, suggests that there could be a significant genetic component to these differences. Controlling for frequency of intoxication, the researchers found that if one twin experienced blackouts, the other was more likely than chance to experience them as well. Further, Asian-American students with the aldehyde dehydrogenase ALDH2*2 allele 1  are less likely to experience blackouts than those without it, even after adjusting for maximum number of drinks consumed in a day (Lucsak et al. 2006).

1  The ALDH2*2 allele results in decreased action by the enzyme acetaldehyde dehydrogenase, which is responsible for the breakdown of acetaldehyde. The accumulation of acetaldehyde after drinking alcohol leads to symptoms of acetaldehyde poisoning, such as facial flushing and increased heart and respiration rates.

Several challenges hinder the assessment of blackouts and the events that transpire during them. Blackouts represent periods of amnesia. As such, it is difficult to imagine that self-reported drinking levels are highly accurate for nights when blackouts occur. Further, in order for a person to know what transpired during a blackout, and sometimes to be aware that a blackout occurred at all, they need to be told by other individuals. Often, the information provided by these other individuals is unreliable as they were intoxicated themselves (Nash and Takarangi 2011). Thus, it is quite likely that self-reported rates and frequencies of blackouts, drinking levels during nights in which blackouts occur, and the rates of various types of consequences that occur during them, are underestimated.

Alcohol Overdoses

When consumed in large quantities during a single occasion, such as a binge episode, alcohol can cause death directly by suppressing brain stem nuclei that control vital reflexes, like breathing and gagging to clear the airway (Miller and Gold 1991). Even a single session of binge drinking causes inflammation and transient damage to the heart (Zagrosek et al. 2010). The acute toxic effects of alcohol in the body can manifest in symptoms of alcohol poisoning, which include vomiting, slow and irregular breathing, hypothermia, mental confusion, stupor, and death (NIAAA 2007 b ; Oster-Aaland et al. 2009). Using data from the Global Burden of Disease Study, the World Health Organization (WHO) estimated that, in 2002, alcohol poisoning caused 65,700 deaths worldwide, with 2,700 poisoning deaths occurring in the United States (WHO 2009). New stories about alcohol overdoses among college students and their non-college peers have become increasingly common, a fact that is perhaps not surprising given the tendency toward excessive drinking in this age-group.

To investigate the prevalence of hospitalizations for alcohol overdoses—which stem from excessive intoxication or poisoning—among college-aged young people in the United States, White and colleagues (2011) examined rates of inpatient hospitalizations for 18- to 24-year-olds between 1999 and 2008 using data from the Nationwide Inpatient Sample, which contains hospital discharge records from roughly 20 percent of all hospitals in the country. Hospitalizations for alcohol overdoses without any other drugs involved increased 25 percent among 18- to 24-year-olds from 1999 to 2008, highlighting the risks involved in heavy drinking. In total, nearly 30,000 young people in this age-group, more males (19,847) than females (9,525) were hospitalized for alcohol overdoses with no other drugs involved in 2008. Hospitalizations for overdoses involving other drugs but not alcohol increased 55 percent over the same time period, while those involving alcohol and drugs in combination rose 76 percent. In total, there were 59,000 hospitalizations in 2008 among 18- to 24-year-olds for alcohol overdoses only or in combination with other drugs. Given that 33 percent of people in this age-group were full-time college students at 4-year colleges in 2008, a conservative estimate would suggest approximately 20,000 hospitalizations for alcohol overdoses alone or in combination with other drugs involved college students, although the exact number is not known.

Data from the Drug Abuse Warning Network (DAWN) indicate that ED visits for alcohol-related events increased in a similar fashion as those observed for inpatient hospitalizations. Among those ages 18 to 20, ED visits for alcohol-related events with no other drugs increased 19 percent, from 67,382 cases in 2005 to 82,786 cases in 2009. Visits related to combined use of alcohol and other drugs increased 27 percent, from 27,784 cases in 2005 to 38,067 cases in 2009. In 2009, 12 percent of ED visits related to alcohol involved use of alcohol in combination with other drugs (SAMHSA 2011).

Alcohol interacts with a wide variety of illicit and prescription drugs, including opioids and related narcotic analgesics, sedatives, and tranquilizers (NIAAA 2007 a ; Tanaka 2002). Importantly, BAC required for fatal overdoses are lower when alcohol is combined with prescription drugs. An analysis of 1,006 fatal poisonings attributed to alcohol alone or in combination with other drugs revealed that the median postmortem BACs in those who overdosed on alcohol alone was 0.33 percent, compared with 0.13 percent to 0.17 percent among those who overdosed on a combination of alcohol and prescription drugs (Koski et al. 2003, 2005). The combined use of alcohol and other drugs peaks in the 18- to 24-year-old age range (McCabe et al. 2006), suggesting that college-aged young adults are at particularly high risk of suffering consequences from alcohol-and-other-drug combinations.

The above findings reflect the fact that heavy consumption of alcohol quickly can become a medical emergency. One does not need to get behind the wheel of a car after drinking or jump off a balcony into a swimming pool on a dare to risk serious harm. Simply drinking too much alcohol is enough to require hospitalization and potentially cause death. Further, combining alcohol with other drugs can increase the risk of requiring medical intervention substantially. Thus, efforts to minimize the consequences of alcohol-related harms on college campuses should not lose sight of the fact that alcohol often is combined with other drugs and, when this is the case, the risks can be greater than when alcohol or drugs are used alone.

Measuring the true scope of medical treatment for alcohol overdoses among college students is difficult for several reasons. First, in datasets such as the Nationwide Emergency Department Sample (NEDS) and the Nationwide Inpatient Sample (NIS), no college identifiers are included to indicate whether a young person treated for an alcohol overdose is enrolled in college. Many schools do not track or report the number of students treated for an alcohol overdose, and many students drink excessively when away from campus. Further, schools that implement Good Samaritan or Amnesty policies, which allow students to get help for overly intoxicated peers without fear of sanctions, could create the false impression that overdoses are on the rise. For instance, after Cornell University implemented an amnesty policy, they witnessed an increase in calls to residence assistants and 911 for help dealing with an intoxicated friend (Lewis and Marchell 2006). Given the dangerous nature of alcohol overdoses, with or without other drugs involved, it is important to improve the tracking of these events at colleges and in the larger community.

Sexual Assault

Sexual assault is a pervasive problem on college campuses, and alcohol plays a central role in it. A study of roughly 5,500 college females on two campuses revealed that nearly 20 percent experienced some form of sexual assault while at college (Krebs et al. 2009). Data from the Harvard CAS suggested that 5 percent of women surveyed were raped while at college (Mohler-Kuo et al. 2004). In a national sample of students who completed the Core Alcohol and Drug Survey in 2005, 82 percent of students who experienced unwanted sexual intercourse were intoxicated at the time. Similarly, nearly three-quarters (72 percent) of respondents to the Harvard CAS study who reported being raped were intoxicated at the time. In many cases, rape victims are incapacitated by alcohol. In one study, 3.4 percent of rape victims reported being so intoxicated they were unable to consent (Mohler-Kuo et al. 2004). In a study of 1,238 college students on three campuses over a 3-year period, 6 percent of students reported being raped while incapacitated by alcohol (Kaysen et al. 2006).

Research suggests that the involvement of alcohol increases the risk of being victimized in several ways, such as by impairing perceptions that one is in danger and by reducing the ability to respond effectively to sexual aggression (Abbey 2002; McCauley et al. 2010; Testa and Livingston 2009). Further, alcohol might increase the chances that a male will commit a sexual assault by leading them to misinterpret a female’s friendly gestures or flirtation as interest in sex and by increasing sexual aggression (Abbey 2002). When asked to read a story about a potential date rape involving intoxicated college students, both male and female subjects who are intoxicated were more likely to view the female as sexually aroused and the male as acting appropriately (Abbey et al. 2003).

It is widely held that sexual assaults, with and without alcohol involvement, are underreported on college campuses. Title IX of the Education Amendments Act of 1972, a Federal civil rights law, requires universities to address sexual harassment and sexual violence. However, universities vary with regard to how they handle such cases, and a student’s perception of safety and protection can influence the likelihood of reporting a sexual assault. Indeed, many universities have indicated changes in rates of reports of assaults consistent with changes in campus policies regarding how such cases are handled. As such, although it is clear that alcohol often is involved in sexual assaults on college campuses, questions about the frequency and nature of such assaults remain.

Spring Break and 21st Birthday Celebrations— Event-Specific Drinking Occasions

More college students drink, and drink more heavily, during specific celebratory events, such as spring break and 21st birthday celebrations, than during a typical week. Spring break is a roughly weeklong recess from school that takes place in the spring at colleges throughout the United States. While some students continue to work, travel home, or simply relax, others use the opportunity to travel to beaches and other party destinations. During spring break, approximately 42 percent of students get drunk on at least 1 day, 11 percent drink to the point of blacking out or passing out, 32 percent report hangovers, and 2 percent get into trouble with the police (Litt et al. 2013). Students with a history of binge drinking and those intending to get drunk tend to drink the heaviest (Patrick et al. 2013), suggesting that prevention efforts aimed at altering students’ intentions to get drunk while on spring break might lead to a reduction in peak drinking and the consequences that follow (Mallett et al. 2013). Interestingly, students who typically are light drinkers are more likely than those who typically are binge drinkers to experience consequences from excessive drinking during spring break (Lee et al. 2009).

In addition to spring break, 21st birthday celebrations are another event-specific opportunity for students to drink excessively. An estimated 4 out of 5 college students drink alcohol to celebrate their 21st birthdays (Rutledge et al., 2008) and many students drink more than they plan. Of 150 male and female college students surveyed about their intentions to drink during their upcoming 21st birthday celebrations, 68 percent consumed more than they anticipated while only 21 percent drank less and 11 percent were accurate. On average, males intended to consume 8.5 drinks but consumed 12.5, while females expected to drink 7 but had 9 (Brister et al., 2010). As with spring-break drinking, students with a history of binge drinking and those who intended to drink heavily on their 21st birthday consumed the most (Brister et al., 2011). In one study, roughly 12 percent of students reported consuming 21 or more drinks while celebrating, and one-third of females (35 percent) and nearly half of males (49 percent) reached estimated BACs above 0.25 percent (Rutledge et al., 2008). Such high levels of consumption substantially increase the odds of sexual assaults, fights, injuries, and death (Mallett et al., 2013). Research indicates that brief interventions conducted in the week leading up to the 21st birthday celebration can reduce levels of consumption and associated consequences, suggesting that the risks of experiencing alcohol related consequences stemming from 21st birthday celebrations could be partially mitigated through specifically timed prevention efforts (Neighbors et al. 2009, 2012).

We have learned a considerable amount about the drinking habits of college students and the consequences that follow since NIAAA first reported on the matter in 1976. Surprisingly, drinking levels have remained relatively stable on and around college campuses over the last 30 years, with roughly two out of five male and female students engaging in excessive, or binge, drinking. Excessive drinking results in a wide range of consequences, including injuries, assaults, car crashes, memory blackouts, lower grades, sexual assaults, overdoses and death. Further, secondhand effects from excessive drinking place non–binge-drinking students at higher risk of injury, sexual assaults, and having their studying disrupted.

Estimates of the rates of alcohol use and related consequences are imperfect. Lack of knowledge of standard drink sizes and the effects of alcohol on memory formation all complicate the collection of accurate data from traditional self-report surveys. Underreporting of sexual assaults leads to difficulty in estimating the true extent of the problem. Lack of college identifiers in mortality records and the fact that alcohol levels are tested too infrequently in non–traffic-related deaths leaves uncertainty regarding the actual number of college students who die each year from alcohol-related causes. Similarly, college identifiers are not present in most crime reports and hospital reports.

Although it is beyond the scope of this review to examine efforts to prevent excessive drinking on college campuses, it should be noted that important strides have been made in this area (Carey et al. 2012). In addition, data from MTF suggest that levels of binge drinking are decreasing among 12th graders, particularly males. Hopefully, as our understanding of the nature of the problem continues to improve with better measurement strategies, improvements in prevention approaches combined with declines in precollege drinking will lead to reductions in both the levels of alcohol consumption by college students and the negative consequences that result.

Disclosures

The authors declare that they have no competing financial interests.

Abbey, A. Alcohol-related sexual assault: A common problem among college students.  Journal of Studies on Alcohol  (Suppl 14):118–128, 2002.  PMID: 12022717

Abbey, A.; Buck, P.O.; Zawacki, T.; and Saenz, C. Alcohol’s effects on perceptions of a potential date rape.  Journal of Studies on Alcohol  64(5):669–677, 2003.  PMID: 14572189

Alexander, E.N., and Bowen, A.M. Excessive drinking in college: Behavioral outcome, not binge, as a basis for prevention.  Addictive Behaviors  29(6):1199–1205, 2004.  PMID: 15236823

Blanco, C.; Okuda, M.; Wright, C. et al. Mental health of college students and their non-college-attending peers: Results from the National Epidemiologic Study on Alcohol and Related Conditions.  Archives of General Psychiatry  65(12):1429–1437, 2008.  PMID: 19047530

Boekeloo, B.O.; Novik, M.G.; and Bush, E. Drinking to get drunk among incoming freshmen college students.  American Journal of Health Education  42(2):88–95, 2011.  PMID: 23440674

Boyer, K.K.; Olson, J.R.; Calatone, R.J.; and Jackson, E.C. Print versus electronic surveys: A comparison of two data collection methodologies.  Journal of Operations Management  20(4):357–373, 2002.

Brister, H.A.; Wetherill, R.R.; and Fromme, K. Anticipated versus actual alcohol consumption during 21st birthday celebrations.  Journal of Studies on Alcohol and Drugs  71(2):180–183, 2010.  PMID: 20230714

Brown, S.A.; Tapert, S.F.; Granholm, E.; and Delis, D.C. Neurocognitive functioning of adolescents: Effects of protracted alcohol use.  Alcoholism: Clinical and Experimental Research  24(2):164–171, 2000.  PMID: 10698367

Butler, L.H., and Correia, C.J. Brief alcohol intervention with college student drinkers: Face-to face versus computerized feedback.  Psychology of Addictive Behaviors  23(1):163–167, 2009.  PMID: 19290702 .

Campbell, C.A.; Hahn, R.A.; Elder, R.; et al. The effectiveness of limiting alcohol outlet density as a means of reducing excessive alcohol consumption and alcohol-related harms.  American Journal of Preventive Medicine  37(6):556–569, 2009.  PMID: 19944925

Carey, K.B.; Scott-Sheldon, L.A.; Carey, M.P.; and DeMartini, K.S. Individual-level interventions to reduce college student drinking: A meta-analytic review.  Addictive Behaviors  32(11):2469–2494, 2007.  PMID: 17590277

Carey, K.B.; Scott-Sheldon, L.A.; Elliott, J.C.; et al. Face-to-face versus computer-delivered alcohol interventions for college drinkers: A meta-analytic review, 1998 to 2010.  Clinical Psychology Review  32(8):690–703, 2012.  PMID: 23022767

Carpenter, C., and Dobkin, C. The minimum legal drinking age and public health.  Journal of Economic Perspectives  25(2):133–156, 2011.  PMID: 21595328

Chavez, P.R.; Nelson, D.E.; Naimi, T.S.; and Brewer, R.D. Impact of a new gender-specific definition for binge drinking on prevalence estimates for women.  American Journal of Preventive Medicine  40(4):468–471, 2011.  PMID: 21406282

Clapp, J.D.; Johnson, M.; Voas, R.B.; et al. Reducing DUI among US college students: Results of an environmental prevention trial.  Addiction  100(3):327–334, 2005.  PMID: 15733246

Clapp, J.D.; Min, J.W.; Trim, R.S.; et al. Predictors of error in estimates of blood alcohol concentration: A replication.  Journal of Studies on Alcohol and Drugs  70(5):683–688, 2009.  PMID: 19737492

Crego, A.; Rodriguez-Holguin, S.; Parada, M., et al. Reduced anterior prefrontal cortex activation in young binge drinkers during a visual working memory task.  Drug and Alcohol Dependence  109(1–3):45–56, 2010.  PMID: 20079980

DeJong, W.; Schneider, S.K.; Towvim, L.G.; et al. A multisite randomized trial of social norms marketing campaigns to reduce college student drinking.  Journal of Studies on Alcohol  67(6):868–879, 2006.  PMID: 17061004

DeJong, W.; Schneider, S.K.; Towvim, L.G.; et al. A multisite randomized trial of social norms marketing campaigns to reduce college student drinking: A replication failure.  Substance Abuse  30(2):127–140, 2009.  PMID: 19347752

Devos-Comby, L., and Lange, JjE. “My drink is larger than yours”? A literature review of self-defined drink sizes and standard drinks.  Current Drug Abuse Reviews  1(2):162–176, 2008.  PMID: 19630715

Elder, R.W.; Lawrence, B.; Ferguson, A.; et al. The effectiveness of tax policy interventions for reducing excessive alcohol consumption and related harms.  American Journal of Preventive Medicine  38(2):217–229, 2010.  PMID: 20117579

Elliott, J.C.; Carey, K.B.; and Bolles, J.R. Computer-based interventions for college drinking: A qualitative review.  Addictive Behaviors  33(8):994–1005, 2008.  PMID: 18538484

Engs, R.C.; Diebold, B.A.; and Hanson, D.J. The drinking patterns and problems of a national sample of college students, 1994.  Journal of Alcohol and Drug Education  41:13–33, 1996.

Fell, J.C.; Fisher, D.A.; Voas, R.B.; et al. The impact of underage drinking laws on alcohol- related fatal crashes of young drivers.  Alcoholism: Clinical and Experimental Research  33(7):1208–1219, 2009.  PMID: 19389192

Fleming, M.F.; Balousek, S.L.; Grossberg, P.M.; et al. Brief physician advice for heavy drinking college students: A randomized controlled trial in college health clinics.  Journal of Studies on Alcohol and Drugs  71(1):23–31, 2010.  PMID: 20105410

Giles, S.M.; Champion, H.; Sutfin, E.L.; et al. Calorie restriction on drinking days: An examination of drinking consequences among college students.  Journal of American College Health  57(6):603–609, 2009.  PMID: 19433398

Gill, J.S. Reported levels of alcohol consumption and binge drinking within the UK undergraduate student population over the last 25 years.  Alcohol and Alcoholism  37(2):109–120, 2002.  PMID: 11912065

Goodwin, D.W. Alcohol amnesia.  Addiction  90(3):315–317, 1995.  PMID: 7735016

Hanson, K.L.; Medina, K.L.; Padula, C.B.; et al. Impact of adolescent alcohol and drug use on neuropsychological functioning in young adulthood: 10-year outcomes.  Journal of Child & Adolescent Substance Abuse  20(2):135–154, 2011.  PMID: 21532924

Hartzler, B., and Fromme, K. Fragmentary and en bloc blackouts: Similarity and distinction among episodes of alcohol-induced memory loss.  Journal of Studies on Alcohol  64(4):547–550, 2003 a .  PMID: 12921196

Hartzler, B., and Fromme, K. Fragmentary blackouts: Their etiology and effect on alcohol expectancies.  Alcoholism: Clinical and Experimental Research  27(4):628–637, 2003 b .  PMID: 12711925

Hingson, R.W.; Heeren, T.; Edwards, E.M.; and Saitz, R. Young adults at risk for excess alcohol consumption are often not asked or counseled about drinking alcohol.  Journal of General Internal Medicine  27(2):179–184, 2012.  PMID: 21935753

Hingson, R.; Heeren, T.; and Winter, M. Lower legal blood-alcohol limits for young drivers.  Public Health Reports  109(6):738–744, 1994.  PMID: 7800781

Hingson, R.; Heeren, T.; Winter, M.R.; and Wechsler, H. Early age of first drunkenness as a factor in college students’ unplanned and unprotected sex attributable to drinking.  Pediatrics  111(1):34–41, 2003 a .  PMID: 12509551

Hingson, R.; Heeren, T.; Winter, M.; and Wechsler, H. Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18-24: Changes from 1998 to 2001.  Annual Review of Public Health  26: 259–279, 2005 a .  PMID: 15760289

Hingson, R.; Heeren, T.; Zakocs, R., et al. Age of first intoxication, heavy drinking, driving after drinking and risk of unintentional injury among U.S. college students.  Journal of Studies on Alcohol  64(1):23–31, 2003 b .  PMID: 12608480

Hingson, R.; Heeren, T.; Zakocs, R.; et al. Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18-24.  Journal of Studies on Alcohol  63(2): 136–144, 2002.  PMID: 12033690

Hingson, R.; McGovern, T.; Howland, J.; et al. Reducing alcohol-impaired driving in Massachusetts: The Saving Lives Program.  American Journal of Public Health  86(6):791–797, 1996.  PMID: 8659651

Hingson, R., and White, A. Magnitude and prevention of college alcohol and drug misuse: U.S. college students ages 18-24. In: Kay, J., and Schwartz, V., Eds.  Mental Health Care in the College Community.  London: John Wiley & Sons, 2010, pp. 289–324.

Hingson, R.W.; Zakocs, R.C.; Heeren, T.; et al. Effects on alcohol related fatal crashes of a community based initiative to increase substance abuse treatment and reduce alcohol availability.  Injury Prevention  11(2):84–90, 2005 b .  PMID: 15805436

Hingson, R.; Zha, W.; and Weitzman, E.R. Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18-24, 1998-2005. Journal of Studies on Alcohol and Drugs (Suppl. 16):12–20, 2009.  PMID: 19538908

Holder, H.D.; Gruenewald, P.J.; Ponicki, W.R.; et al. Effect of community-based interventions on high-risk drinking and alcohol-related injuries.  JAMA: Journal of the American Medical Association  284(18):2341–2347, 2000.  PMID: 11066184

Howland, J.; Rohsenow, D.J.; Greece, J.A.; et al. The effects of binge drinking on college students’ next-day academic test-taking performance and mood state.  Addiction  105(4):655–665, 2010.  PMID: 20403018

Ichiyama, M.A.; Fairlie, A.M.; Wood, M.D.; et al. A randomized trial of a parent-based intervention on drinking behavior among incoming college freshmen.  Journal of Studies on Alcohol and Drugs  (Suppl. 16):67–76, 2009.  PMID: 19538914

Jennison, K.M. The short-term effects and unintended long-term consequences of binge drinking in college: A 10-year follow-up study.  American Journal of Drug and Alcohol Abuse  30(3):659–684, 2004.  PMID: 15540499

Johnston, L.D.; O’Malley, P.M.; and Bachman, J.G.  Monitoring the Future National Survey Results on Drug Use, 1975–2000. Volume I: Secondary School Students.  NIH Publication No. 01–4924. Bethesda, MD: National Institute on Drug Abuse, 2001 a .

Johnston L.D.; O’Malley, P.M.; and Bachman, J.G.  Monitoring the Future National Survey Results on Drug Use,1975–2000. Volume II: College Students and Adults Ages 19–40.  NIH Publication No. 01–4925. Bethesda, MD: National Institute on Drug Abuse, 2001 b .

Johnston, L.D.; O’Malley, P.M.; Bachman, J.G.; and Schulenberg, J.E.  Monitoring the Future National Survey Results on Drug Use, 1975–2006. Volume II: College Students and Adults Ages 19–45.  NIH Publication No. 07–6206. Bethesda, MD: National Institute on Drug Abuse, 2007.

Johnston, L.D.; O’Malley, P.M.; Bachman, J.G.; and Schulenberg, J.E.  Monitoring the Future National Survey Results on Drug Use, 1975–2011. Volume II: College Students and Adults Ages 19–50.  Ann Arbor: Institute for Social Research, the University of Michigan, 2012.

Jones, R., and Lacey, J.  Alcohol and Highway Safety 2001: A Review of the State of Knowledge . Report No. DOT HS–809–383. Washington, D.C.: National Highway Traffic Safety Administration, 2001.

Jones, R., and Pitt, N. Health surveys in the workplace: Comparison of postal, email and World Wide Web methods.  Occupational Medicine (London)  49(8):556–558, 1999.  PMID: 10658310

Kaysen, D.; Neighbors, C.; Martell, J.; et al. Incapacitated rape and alcohol use: A prospective analysis.  Addictive Behaviors  31(10):1820–1832, 2006.  PMID: 16446044

Kerr, W.C.; and Stockwell, T. Understanding standard drinks and drinking guidelines.  Drug and Alcohol Review  31(2):200–205, 2012.  PMID: 22050262

Knight, J.R.; Wechsler, H.; Kuo, M.; et al. Alcohol abuse and dependence among U.S. college students.  Journal of Studies on Alcohol  63(3):263–270, 2002.  PMID: 12086126

Koski, A.; Ojanperä, I.; and Vuori, E. Interaction of alcohol and drugs in fatal poisonings.  Human & Experimental Toxicology  22(5):281–287, 2003.  PMID: 12774892

Koski, A,; Vuroi, E.; and Ojanperä, I. Relation of postmortem blood alcohol and drug concentrations in fatal poisonings involving amitriptyline, propoxyphene and promazine.  Human & Experimental Toxicology  24(8):389–396, 2005.  PMID: 16138729

Kraus, C.L.; Salazar, N.C.; Mitchell, J.R.; et al. Inconsistencies between actual and estimated blood alcohol concentrations in a field study of college students: Do students really know how much they drink?  Alcoholism: Clinical and Experimental Research  29(9):1672–1676, 2005.  PMID: 16205367

Krebs, C.P.; Lindquist, C.H.; Warner, T.D.; et al. College women’s experiences with physically forced, alcohol- or drug-enabled, and drug-facilitated sexual assault before and since entering college.  Journal of American College Health  57(6):639–647, 2009.  PMID: 19433402

LaBrie, J.; Earleywine, M.; Lamb, T.; and Shelesky, K. Comparing electronic-keypad responses to paper-and-pencil questionnaires in group assessments of alcohol consumption and related attitudes.  Addictive Behaviors  31(12):2334-2338, 2006.  PMID: 16626878

LaBrie, J.W.; Huchting, K.; Tawalbeh, S.; et al. A randomized motivational enhancement prevention group reduces drinking and alcohol consequences in first-year college women.  Psychology of Addictive Behaviors  22(1):149–155, 2008.  PMID: 18298242

LaBrie, J.W.; Hummer, J.; Kenney, S.; et al. Identifying factors that increase the likelihood for alcohol-induced blackouts in the prepartying context.  Substance Use & Misuse  46(8):992–1002, 2011.  PMID: 21222521

Larimer, M.E., and Cronce, J.M. Identification, prevention and treatment: A review of individual-focused strategies to reduce problematic alcohol consumption by college students.  Journal of Studies on Alcohol  (Suppl. 14):148–163, 2002.  PMID: 12022721

Larimer, M.E., and Cronce, J.M. Identification, prevention, and treatment revisited: Individual-focused college drinking prevention strategies 1999-2006.  Addictive Behaviors  32(11):2439–2468, 2007.  PMID: 17604915

Lee, C.M.; Lewis, M.A.; and Neighbors, C. Preliminary examination of spring break alcohol use and related consequences.  Psychology of Addictive Behaviors  23(4):689–694, 2009.  PMID: 20025375

Liang, L., and Huang, J. Go out or stay in? The effects of zero tolerance laws on alcohol use and drinking and driving patterns among college students.  Health Economics  17(11):1261–1275, 2008.  PMID: 18219708

Litt, D.M.; Lewis, M.A.; Patrick, M.E.; et al. Spring break versus spring broken: Predictive utility of spring break alcohol intentions and willingness at varying levels of extremity.  Prevention Science , 2013 Feb 13. [Epub ahead of print].  PMID: 23404667

Luczak, S.E.; Shea, S.H.; Hsueh, A.C.; et al. ALDH2*2 is associated with a decreased likelihood of alcohol-induced blackouts in Asian American college students.  Journal of Studies on Alcohol  67(3):349–353, 2006.  PMID: 16608143

Lygidakis, C.; Rigon, S.; Cambiaso, S.; et al. A web-based versus paper questionnaire on alcohol and tobacco in adolescents.  Telemedicine Journal and E-Health  16(9):925– 930, 2010.  PMID: 20958200

Mallett, K.A.; Varvil-Weld, L.; Borsari, B.; et al. An update of research examining college student alcohol-related consequences: New perspectives and implications for interventions.  Alcoholism: Clinical and Experimental Research  37(5):709–716, 2013.  PMID: 23241024

McCabe, S.E.; Cranford, J.A; and Boyd, C.J. The relationship between past-year drinking behaviors and nonmedical use of prescription drugs: Prevalence of co-occurrence in a national sample.  Drug and Alcohol Dependence  84(3):281–288, 2006.  PMID: 16621337

McCartt, A.T.; Hellinga, L.A.; and Wells, J.K. Effects of a college community campaign on drinking and driving with a strong enforcement component.  Traffic Injury Prevention  10(2):141–147, 2009.  PMID: 19333826

McCauley, J.L.; Calhoun, K.S.; and Gidycz, C.A. Binge drinking and rape: A prospective examination of college women with a history of previous sexual victimization.  Journal of Interpersonal Violence  25(9):1655–1668, 2010.  PMID: 20068115

Medina, K.L.; McQueeny, T.; Nagel, B.J.; et al. Prefrontal cortex volumes in adolescents with alcohol use disorders: Unique gender effects.  Alcoholism: Clinical and Experimental Research  32(3):386–394, 2008.  PMID: 18302722

Meilman, P.W.; Leichliter, J.S.; and Presley, C.A. Greeks and athletes: Who drinks more?  Journal of American College Health  47(4):187–190, 1999.  PMID: 9919850

Meilman, P.W.; Presley, C.A.; and Cashin, J.R. The sober life at the historically black colleges.  Journal of Blacks in Higher Education  9:98–100, 1995.

Meilman, P.W.; Presley, C.A.; and Lyerla, R. Black college students and binge drinking.  Journal of Blacks in Higher Education  8:70–71, 1994.

Miller, N.S.; and Gold, M.S. Alcohol. New York: Plenum Publishing Company, 1991.

Miron, J.A., AND Tetelbaum, E. Does the minimum legal drinking age save lives?  Economic Inquiry  47(2):317–336, 2009.

Mohler-Kuo, M.; Dowdall, G.B.; Koss, M.P.; and Wechsler, H. Correlates of rape while intoxicated in a national sample of college women.  Journal of Studies on Alcohol  65(1):37–45, 2004.  PMID: 15000502

Moreira, M.T.; Smith, L.A.; and Foxcroft, D. Social norms interventions to reduce alcohol misuse in university or college students.  Cochrane Database of Systematic Reviews  (Online) (3):CD006748, 2009.  PMID: 19588402

Mundt, M.P.; and Zakletskaia, L.I. Prevention for college students who suffer alcohol-induced blackouts could deter high-cost emergency department visits.  Health Affairs (Millwood)  31(4):863–870, 2012.

Mundt, M.P.; Zakletskaia, L.I.; Brown, D.D.; and Fleming, .MF. Alcohol-induced memory blackouts as an indicator of injury risk among college drinkers.  Injury Prevention  18(1):44–49, 2012.  PMID: 21708813

Naimi, T.S.; Nelson, D.E.; and Brewer, R.D. The intensity of binge alcohol consumption among U.S. adults.  American Journal of Preventive Medicine  38(2):201–207, 2010.  PMID: 20117577

Nash, R.A., and Takarangi, M.K. Reconstructing alcohol-induced memory blackouts.  Memory  19(6):566–573, 2011.  PMID: 21919584

National Institute on Alcohol Abuse and Alcoholism (NIAAA).  Alcohol Policy Information System, 2010.  Available at  http://www.alcoholpolicy.niaaa.nih.gov/ . Accessed February 16, 2010.

NIAAA.  NIAAA Newsletter, Winter 2004,  Number 3. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services (DHHS), 2004. Available at:  http://pubs.niaaa.nih.gov/publications/Newsletter/winter2004/Newsletter_Number3.pdf

NIAAA.  Harmful Interactions: Mixing Alcohol with Medicines.  Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services (DHHS), revised 2007 a  (NIH Publication No. 07-5329). Available at:  http://pubs.niaaa.nih.gov/publications/Medicine/medicine.htm

NIAAA.  Parents – Spring Break Is Another Important Time to Discuss College Drinking.  Bethesda, MD: National Institutes of Health, DHHS, 2007 b  (NIH Publication No. 05-5642).

NIAAA. Task Force of the National Advisory Council on Alcohol Abuse and Alcoholism.  A Call to Action: Changing the Culture of Drinking at U.S. Colleges.  Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services (DHHS), 2002 (NIH Publication No. 02–5010).

NIAAA.  What Colleges Need to Know Now: An Update on College Drinking Research.  Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services (DHHS), 2007 c  (NIH Publication No. 07–5010).

National Research Council Institute of Medicine of the National Academies.  Reducing Underage Drinking: A Collective Responsibility.  Washington, DC: The National Academies Press, 2004.

Neighbors, C.; Lee, C.M.; Lewis, M.A.; et al. Internet-based personalized feedback to reduce 21st-birthday drinking: A randomized controlled trial of an event-specific prevention intervention.  Journal of Consulting and Clinical Psychology  77(1):51–63, 2009.  PMID: 19170453

Neighbors, C.; Lee, C.M.; Atkins, D.C.; et al. A randomized controlled trial of event-specific prevention strategies for reducing problematic drinking associated with 21st birthday celebrations.  Journal of Consulting and Clinical Psychology  80(5):850–862, 2012.  PMID: 22823855

Nelson, E.C.; Heath, A.C.; Bucholz, K.K.; et al. Genetic epidemiology of alcohol-induced blackouts.  Archives of General Psychiatry  61(3):257–263, 2004.  PMID: 14993113

Norberg, K.E.; Bierut, L.J.; and Grucza, R.A. Long-term effects of minimum drinking age laws on past-year alcohol and drug use disorders.  Alcoholism: Clinical and Experimental Research  33(12):2180–2190, 2009.  PMID: 19775322

Northcote, J., and Livingston, M. Accuracy of self-reported drinking: Observational verification of ‘last occasion’ drink estimates of young adults.  Alcohol and Alcoholism  46(6):709–713, 2011.  PMID: 21949190

O’Brien, M.C.; McCoy, T.P.; Champion, H.; et al. Single question about drunkenness to detect college students at risk for injury.  Academic Emergency Medicine  13(6):629– 636, 2006.  PMID: 16614453

O’Hare, T.M. Drinking in college: Consumption patterns, problems, sex differences and legal drinking age.  Journal of Studies on Alcohol  51(6):536–541, 1990.  PMID: 2270062

Oster-Aaland, L.; Lewis, M.A.; Neighbors, C.; et al. Alcohol poisoning among college students turning 21: Do they recognize the symptoms and how do they help?  Journal of Studies on Alcohol and Drugs  (Suppl 16):122–130, 2009.  PMID: 19538920

Parada, M.; Corral, M.; Caamaño-Isorna, F.; et al. Binge drinking and declarative memory in university students.  Alcoholism: Clinical and Experimental Research  35(8):1475– 1484, 2011.  PMID: 21575014

Parada, M.; Corral, M.; Mota, N. et al. Executive functioning and alcohol binge drinking in university students.  Addictive Behaviors  37(2):167–172, 2012.  PMID: 21996093

Paschall, M.J.; Antin, T.; Ringwalt, C.L.; and Saltz, R.F. Effects of AlcoholEdu for College on alcohol-related problems among freshmen: A randomized multicampus trial.  Journal of Studies on Alcohol and Drugs  72(4):642–650, 2011 a .  PMID: 21683046

Paschall, M.J.; Antin, T.; Ringwalt, C.L.; and Saltz, R.F. Evaluation of an internet-based alcohol misuse prevention course for college freshmen: Findings of a randomized multi-campus trial.  American Journal of Preventive Medicine  41(3):300–308, 2011 b .  PMID: 21855745

Paschall, M.J., and Freisthler, B. Does heavy drinking affect academic performance in college? Findings from a prospective study of high achievers.  Journal of Studies on Alcohol  64(4):515–519, 2003.  PMID: 12921193

Patrick, M.E.; Lewis, M.A.; Lee, C.M.; and Maggs, J.L. Semester and event-specific motives for alcohol use during Spring Break: Associated protective strategies and negative consequences.  Addictive Behaviors  38(4):1980–1987, 2013.  PMID: 23384451

Perry, P.J.; Argo, T.R.; Barnett, M.J.; et al. The association of alcohol-induced blackouts and grayouts to blood alcohol concentrations.  Journal of Forensic Sciences  51(4):896– 899, 2006.  PMID: 16882236

Powell, L.A.; Williams, J.; and Wechsler, H. Study habits and the level of alcohol use among college students.  Education Economics  12(2):135–149, 2004.

Presley, C.A.; Leichliter, J.S.; and Meilman, P.W.  Alcohol and Drugs on American College Campuses: A Report to College Presidents. Third in a Series: 1995, 1996, and 1997 , Carbondale, IL: Core Institute, Southern Illinois University, 1998.

Presley, C.A.; Meilman, P.W.; and Cashin, J.R.  Alcohol and Drugs on American College Campuses: Use, Consequences, and Perceptions of the Campus Environment. Volume IV: 1992-94.  Carbondale, IL: The Core Institute, 1996 a .

Presley, C.A.; Meilman, P.W.; Cashin, J.R.; and Lyera, R.  Alcohol and Drugs on American College Campuses: Use, Consequences, and Perceptions of the Campus Environment. Volume III: 1991-93.  Carbondale, IL: The Core Institute, 1996 b .

Presley, C.A.; Meilman, P.W., and Leichliter, J.S. College factors that influence drinking.  Journal of Studies on Alcohol  (Suppl 14):82–90, 2002.  PMID: 12022732

Presley, C.A., and Pimentel, E.R. The introduction of the heavy and frequent drinker: A proposed classification to increase accuracy of alcohol assessments in postsecondary educational settings.  Journal of Studies on Alcohol  67(2):324–331, 2006.  PMID: 16562416

Preusser, D.; Ulmer, R.; and Preisser, C.  Obstacles to Enforcement of Youthful (Under 21) Impaired Driving.  Washington, DC: National Highway Traffic Safety Administration, 1992 (DOT HS 807–878).

Read, J.P.; Beattie, M.; Chamberlain, R.; and Merrill, J.E. Beyond the “Binge” threshold: Heavy drinking patterns and their association with alcohol involvement indices in college students.  Addictive Behaviors  33(2):225–234, 2008.  PMID: 17997047

Reboussin, B.A.; Song, E.Y.; and Wolfson, M. The impact of alcohol outlet density on the geographic clustering of underage drinking behaviors within census tracts.  Alcoholism: Clinical and Experimental Research  35(8):1541–1549, 2011.  PMID: 21463343

Rutledge, P.C.; Park, A.; and Sher, K.J. 21st birthday drinking: Extremely extreme.  Journal of Consulting and Clinical Psychology  76(3):511–516, 2008.  PMID: 18540744

Saltz, R.F.; Welker, L.R.; Paschall, M.J.; et al. Evaluating a comprehensive campus-community prevention intervention to reduce alcohol-related problems in a college population.  Journal of Studies on Alcohol and Drugs  (Suppl. 16):21–27, 2009.  PMID: 19538909

Schaus, J.F.; Sole, M.L.; McCoy, T.P.; et al. Alcohol screening and brief intervention in a college student health center: A randomized controlled trial.  Journal of Studies on Alcohol and Drugs  (Suppl. 16):131–141, 2009.  PMID: 19538921

Schulenberg, J.; Maggs, J.L.; Long, S.W.; et al. The problem of college drinking: Insights from a developmental perspective.  Alcoholism: Clinical and Experimental Research  25(3):473–477, 2001.  PMID: 11290861

Schweinsburg, A.D.; McQueeny, T.; Nagel, B. J.; et al. A preliminary study of functional magnetic resonance imaging response during verbal encoding among adolescent binge drinkers.  Alcohol  44(1):111–117, 2010.  PMID: 20113879

Scribner, R.A.; Mason, K.E.; Simonsen, N.R.; et al. An ecological analysis of alcohol outlet density and campus-reported violence at 32 U.S. colleges.  Journal of Studies on Alcohol and Drugs  71(2):184–191, 2010.  PMID: 20230715

Scribner, R.; Mason, K.; Theall, K.; et al. The contextual role of alcohol outlet density in college drinking.  Journal of Studies on Alcohol and Drugs  69(1):112–120, 2008.  PMID: 18080071

Scribner, R.A.; Theall, K.P.; Mason, K.; et al. Alcohol prevention on college campuses: The moderating effect of the alcohol environment on the effectiveness of social norms marketing campaigns.  Journal of Studies on Alcohol and Drugs  72(2):232-239, 2011.  PMID: 21388596

Shults, R.A.; Elder, R.W.; Sleet, D.A.; et al. Reviews of evidence regarding interventions to reduce alcohol-impaired driving.  American Journal of Preventive Medicine  21(Suppl. 4):66-88, 2001.  PMID: 11691562

Singleton, R.A. Collegiate alcohol consumption and academic performance.  Journal of Studies on Alcohol and Drugs  68(4):548–555, 2007.  PMID: 17568960

Singleton, R.A. Jr., and Wolfson, A.R. Alcohol consumption, sleep, and academic performance among college students.  Journal of Studies on Alcohol and Drugs  70(3):355– 363, 2009.  PMID: 19371486

Smith, G.S.; Branas, C.C.; and Miller, T.R. Fatal nontraffic injuries involving alcohol: A metaanalysis.  Annals of Emergency Medicine  33(6):659–668, 1999.  PMID: 10339681

Squeglia, L.M.; Spadoni, A.D.; Infante, M.A.; et al. Initiating moderate to heavy alcohol use predicts changes in neuropsychological functioning for adolescent girls and boys.  Psychology of Addictive Behaviors  23(4):715–722, 2009.  PMID: 20025379

Squeglia, L.M.; Sorg, S.F.; Schweinsburg, A.D.; et al. Binge drinking differentially affects adolescent male and female brain morphometry.  Psychopharmacology (Berlin)  220(3):529–539, 2012.  PMID: 21952669

Straus, R., and Bacon, S. D. (1953).  Drinking in college.  New Haven, CT: Yale University Press.

Substance Abuse and Mental Health Services Administration (SAMHSA).  The DAWN Report: Trends in Emergency Department Visits Involving Underage Alcohol Use: 2005 to 2009.  Rockville, MD, Substance Abuse and Mental Health Services Administration, 2011.

Substance Abuse and Mental Health Services Administration (SAMHSA).  Results from the 2001 National Household Survey on Drug Abuse: Volume 1: Summary of National Findings.  Rockville, MD: Substance Abuse and Mental Health Services Administration, 2002 (DHHS Publication No. SMA 02–3758, 2002).

Substance Abuse and Mental Health Services Administration (SAMHSA).  Results from the 2005 National Survey on Drug Use and Health: National Findings.  Rockville, MD: Substance Abuse and Mental Health Services Administration, 2006 (DHHS Publication No. SMA 06–4194).

Substance Abuse and Mental Health Services Administration (SAMHSA).  Results from the 2007 National Survey on Drug Use and Health: National Findings.  Rockville, MD: Substance Abuse and Mental Health Services Administration, 2008 (NSDUH Series H-34, DHHS Publication No. SMA 08–4343).

Substance Abuse and Mental Health Services Administration (SAMHSA).  Summary of Findings of the 1999 National Household Survey on Drug Abuse.  Rockville, MD: Substance Abuse and Mental Health Services Administration, 2000 (DHHS Publication No. SMA 00–3466).

Tanaka, E. Toxicological interactions between alcohol and benzodiazepines.  Journal of Toxicology. Clinical Toxicology  40(1):69–75, 2002.  PMID: 11990206

Testa, M., and Livingston, J.A. Alcohol consumption and women’s vulnerability to sexual victimization: Can reducing women’s drinking prevent rape?  Substance Use & Misuse  44(9-10):1349–1376, 2009.  PMID: 19938922

Thombs, D.L.; Olds, R.S.; Bondy, S.J.; et al. Undergraduate drinking and academic performance: A prospective investigation with objective measures.  Journal of Studies on Alcohol and Drugs  70(5):776–785, 2009.  PMID: 19737503

Timberlake, D.S.; Hopfer,C.J.; Rhee, S.H.; et al. College attendance and its effect on drinking behaviors in a longitudinal study of adolescents.  Alcoholism: Clinical and Experimental Research  31(6):1020–1030, 2007.  PMID: 17403064

Treno, A.J.; Gruenewald P.J.; Lee, J.P.; and Remer, L.G. The Sacramento Neighborhood Alcohol Prevention Project: Outcomes from a community prevention trial.  Journal of Studies on Alcohol and Drugs  68(2):197–207, 2007.  PMID: 17286338

Turner, C.F.; Ku, L.; Rogers, S.M.; et al. Adolescent sexual behavior, drug use, and violence: Increased reporting with computer survey technology.  Science  280(5365):867– 873, 1998.  PMID: 9572724

Turrisi, R.; Larimer, M.E.; Mallett, K.A.; et al. A randomized clinical trial evaluating a combined alcohol intervention for high-risk college students.  Journal of Studies on Alcohol and Drugs  70(4):555–567, 2009.  PMID: 19515296

Upcraft, M.L.  Today’s First-Year Students and Alcohol.  Paper prepared for the Task Force on College Drinking, National Advisory Council on Alcohol Abuse and Alcoholism, Bethesda, MD, 2000.

Varvil-Weld, L.; Mallett, K.A.; Turrisi, R.; et al. Are certain college students prone to experiencing excessive alcohol-related consequences? Predicting membership in a high-risk subgroup using pre-college profiles.  Journal of Studies on Alcohol and Drugs  74(4):542–551, 2013.  PMID: 23739017

Voas, R.B., and Williams, A.F. Age differences of arrested and crash-involved drinking drivers.  Journal of Studies on Alcohol  47(3):244–248, 1986.  PMID: 3724162

Voas, R.B.; Tippetts, A.S.; and Fell, J. The relationship of alcohol safety laws to drinking drivers in fatal crashes.  Accident Analysis and Prevention  32(4):483–492, 2000.  PMID: 10868751

Wagenaar, A.C., and Toomey, T.L. Effects of minimum drinking age laws: Review and analyses of the literature from 1960 to 2000.  Journal of Studies on Alcohol  (Suppl. 14):206–225, 2002.  PMID: 12022726

Wagenaar, A.C.; Murray, D.M.; and Toomey T.L. Communities Mobilizing for Change on Alcohol (CMCA): Effects of a randomized trial on arrests and traffic crashes.  Addiction  95(2):209–217, 2000.  PMID: 10723849

Wagenaar, A.C.; O’Malley, P.M.; and LaFond, C. Lowered legal blood alcohol limits for young drivers: Effects on drinking, driving, and driving-after-drinking behaviors in 30 states.  American Journal of Public Health  91(5):801–804, 2001.  PMID: 11344892

Wagenaar, A.C.; Salois, M.J.; and Komro, K.A. Effects of beverage alcohol price and tax levels on drinking: A meta-analysis of 1003 estimates from 112 studies.  Addiction  104(2):179–190, 2009.  PMID: 19149811

Wagenaar, A.C.; Erickson, D.J.; Harwood, E.M.; and O’Malley, P.M. Effects of state coalitions to reduce underage drinking: A national evaluation.  American Journal of Preventive Medicine  31(4):307–315, 2006.  PMID: 16979455

Wang, Y.C.; Lee, C.M; Lew-Ting, C.Y.; et al. Survey of substance use among high school students in Taipei: Web-based questionnaire versus paper-and-pencil questionnaire.  Journal of Adolescent Health  37(4):289–295, 2005.  PMID: 16182139

Wechsler, H.; Davenport, A.; Dowdall, G.; et al. Health and behavioral consequences of binge drinking in college: A national survey of students at 140 campuses.  JAMA: Journal of the American Medical Association  272(21):1672–1677, 1994.  PMID: 7966895

Wechsler, H.; Davenport, A.E.; Dowdall, G.W.; et al. Binge drinking, tobacco, and illicit drug use and involvement in college athletics. A survey of students at 140 American colleges.  Journal of American College Health  45(5):195–200, 1997.  PMID: 9069676

Wechsler, H.; Dowdall, G.W.; Davenport, A.; and Castillo, S. Correlates of college student binge drinking.  American Journal of Public Health  85(7):921–926, 1995.  PMID: 7604914

Wechsler, H.; Dowdall, G.W.; Davenport, A.; and Rimm, E.B. A gender-specific measure of binge drinking among college students.  American Journal of Public Health  85(7):982– 985, 1995.  PMID: 7604925

Wechsler, H.; Dowdall, G.W.; Maenner, G.; et al. Changes in binge drinking and related problems among American college students between 1993 and 1997. Results of the Harvard School of Public Health College Alcohol Study.  Journal of American College Health  47(2):57–68, 1998.  PMID: 9782661

Wechsler, H., and Kuo, M. Watering down the drinks: The moderating effect of college demographics on alcohol use of high-risk groups.  American Journal of Public Health,  93(11):1929–1933, 2003.  PMID: 14600068

Wechsler, H.; Kuh, G.; and Davenport, A.E. Fraternities, sororities and binge drinking: Results from a national study of American colleges.  NASPA Journal  46(3):395–416, 2009.

Wechsler, H.; Lee, J.E.; Kuo, M., et al. 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.  Journal of American College Health  50(5):203– 217, 2002.  PMID: 11990979

Wechsler, H.; Lee, J.E.; Kuo, M.; and Lee, H. College binge drinking in the 1990s: A continuing problem. Results of the Harvard School of Public Health 1999 College Alcohol Survey.  Journal of American College Health  48(5):199–210, 2000.  PMID: 10778020

Wechsler, H., and Nelson, T.F. What we have learned from the Harvard School of Public Health College Alcohol Study: Focusing attention on college student alcohol consumption and the environmental conditions that promote it.  Journal of Studies on Alcohol and Drugs  69(4): 481–490, 2008.  PMID: 18612562

Wechsler, H., and Nelson, T. F. Binge drinking and the American college students: What’s five drinks?  Psychology of Addictive Behaviors,  15(4), 287–291, 2001.  PMID: 11767258

Weitzman, E.R.; Folkman, A; Folkman, M.P.; and Wechsler, H. The relationship of alcohol outlet density to heavy and frequent drinking and drinking-related problems among college students at eight universities.  Health & Place  9(1):1–6, 2003.  PMID: 12609468

Wetherill, R.R., and Fromme, K. Acute alcohol effects on narrative recall and contextual memory: An examination of fragmentary blackouts.  Addictive  Behaviors 36(8):886– 889, 2011.  PMID: 21497445

Wetherill, R.R.; Schnyer, D.M.; and Fromme, K. Acute alcohol effects on contextual memory BOLD response: Differences based on fragmentary blackout history.  Alcoholism: Clinical and Experimental Research  36(6):1108–1115, 2012.  PMID: 22420742

White, A.M. What happened? Alcohol, memory blackouts, and the brain.  Alcohol Research & Health  27(2):186-196, 2003.  PMID: 15303630

White, A.M.; Hingson, R.W.; Pan, I.J.; and Yi, H.Y. Hospitalizations for alcohol and drug overdoses in young adults ages 18-24 in the United States, 1999-2008: Results from the Nationwide Inpatient Sample.  Journal of Studies on Alcohol and Drugs  72(5):774– 786, 2011.  PMID: 21906505

White, A.M.; Jamieson-Drake, D.W.; and Swartzwelder, H.S. Prevalence and correlates of alcohol–induced blackouts among college students: Results of an e–mail survey.  Journal of American College Health  51(3):117–119; 122-131, 2002.  PMID: 12638993

White, A.M.; Kraus, C.L.; Flom, J.D.; et al. College students lack knowledge of standard drink volumes: Implications for definitions of risky drinking based on survey data.  Alcoholism: Clinical and Experimental Research  29(4):631–638, 2005.  PMID: 15834229

White, A.M.; Kraus, C.L.; McCracken, L.A.; and Swartzwelder, H.S. Do college students drink more than they think? Use of a free-pour paradigm to determine how college students define standard drinks.  Alcoholism: Clinical and Experimental Research  27(11):1750–1756, 2003.  PMID: 14634490

White, A.M.; Kraus, C.L.; and Swartzwelder, H. Many college freshmen drink at levels far beyond the binge threshold.  Alcoholism: Clinical and Experimental Research  30(6):1006-1010, 2006.  PMID: 16737459

White, A.M.; Signer, M.L.; Kraus, C.L.; and Swartzwelder, H.S. Experiential aspects of alcohol–induced blackouts among college students.  American Journal of Drug and Alcohol Abuse  30(1):205–224, 2004.  PMID: 15083562

White, A.M., and Swartzwelder, H.S. Inbound college students drink heavily during the summer before their freshman year: Implications for education and prevention efforts.  American Journal of Health Education  40:909–96, 2009.

Williams, J.; Powell, L.M.; and Weschler, H. Does alcohol consumption reduce human capital accumulation? Evidence from the College Alcohol Study.  Applied Economics  35(10):1227–1245, 2003.

Wolfson, M.; Champion, H.; McCoy, T.P.; et al. Impact of a randomized campus/community trial to prevent high-risk drinking among college students.  Alcoholism: Clinical and Experimental Research  36(10):1767–1778, 2012.  PMID: 22823091

Wood, P.K.; Sher, K.J.; Erickson, D.J.; and DeBord, K.A. Predicting academic problems in college from freshman alcohol involvement.  Journal of Studies on Alcohol  58(2):200– 210, 1997.  PMID: 9065898

Wood, M.D.; Sher, K.J.; and McGowan, A.K. Collegiate alcohol involvement and role attainment in early adulthood: Findings from a prospective high-risk study.  Journal of Studies on Alcohol  61(2):278–289, 2000.  PMID: 10757139

World Health Organization (WHO).  Alcohol and Injuries: Emergency Department Studies in an International Perspective.  Geneva: World Health Organization, 2009.

Zagrosek, A.; Messroghli, D.; Schulz, O.; et al. Effect of binge drinking on the heart as assessed by cardiac magnetic resonance imaging.  JAMA: Journal of the American Medical Association  304(12):1328–1330, 2010.  PMID: 20858877

• Research article
• Open access
• Published: 28 June 2013

Alcohol drinking among college students: college responsibility for personal troubles

• Vincent Lorant 1 ,
• Pablo Nicaise 1 ,
• Victoria Eugenia Soto 1 , 2 &
• William d’Hoore 1  

BMC Public Health volume  13 , Article number:  615 ( 2013 ) Cite this article

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One young adult in two has entered university education in Western countries. Many of these young students will be exposed, during this transitional period, to substantial changes in living arrangements, socialisation groups, and social activities. This kind of transition is often associated with risky behaviour such as excessive alcohol consumption. So far, however, there is little evidence about the social determinants of alcohol consumption among college students. We set out to explore how college environmental factors shape college students' drinking behaviour.

In May 2010 a web questionnaire was sent to all bachelor and master students registered with an important Belgian university; 7,015 students participated (participation = 39%). The survey looked at drinking behaviour, social involvement, college environmental factors, drinking norms, and positive drinking consequences.

On average each student had 1.7 drinks a day and 2.8 episodes of abusive drinking a month. We found that the more a student was exposed to college environmental factors, the greater the risk of heavy, frequent, and abusive drinking. Alcohol consumption increased for students living on campus, living in a dormitory with a higher number of room-mates, and having been in the University for a long spell. Most such environmental factors were explained by social involvement, such as participation to the student folklore, pre-partying, and normative expectations.

Conclusions

Educational and college authorities need to acknowledge universities’ responsibility in relation to their students’ drinking behaviour and to commit themselves to support an environment of responsible drinking.

Peer Review reports

In 2007 one young adult in two has entered university education in Western countries and this proportion is likely to increase in the future [ 1 ]. Many of these young students will be exposed to substantial changes in living arrangements and social activities. This kind of transition is often associated with an increase in heavy and risky alcohol use [ 2 ].

Indeed, it is reckoned that college students are particularly exposed to alcohol during their college years. An international study of alcohol consumption among students found wide geographical variation in the prevalence of risky drinking behaviour, with more than 40% of students aged 17-30 having drunk heavily in the U.S.A. and in several European countries [ 3 ]. Risky drinking has also been found to be a common practice [ 4 ].

Risky alcohol consumption among young people is becoming a key public health priority because of its important health and educational consequences. Among those aged 15-29, alcohol accounts for more than 10% of the overall burden of disease and injury [ 5 ]. In addition to morbidity and mortality, alcohol has a significant important effect on student academic performance and on antisocial behaviour [ 6 , 7 ]. The case for alcohol could be weakened if adolescent drinking patterns became more mature in adulthood. However, a review of cohort studies shows that higher consumption in late adolescence continues into adulthood [ 8 ].

Risky alcohol consumption has first been approached from an individual perspective, with a strong emphasis on individual risk factors, such as gender, age, and psychological factors, and on drinking motives [ 3 , 9 , 10 ]. Adolescents often report drinking for motives such as social enhancement, enjoyment, image enhancement, or coping motives; thus, they may drink because of positive consequences that outweigh, at least in the short term, negative consequences [ 11 – 13 ].

International comparison, however, shows there is wide cross-country variation in the prevalence of risky drinking among college students [ 3 ]. Within the U.S.A., there is compelling evidence that college drinking varies dramatically between colleges [ 14 ]. This indicates that alcohol use may be sensitive to contextual factors. Alcohol use among college students occurs in specific social environments characterised by independent living, reduced parental control, increased social homogeneity, wide availability of alcohol-related social activities such as pre-partying [ 15 ] and student folklore (traditional, extra-curricular, and generally recreational activities managed by student organisations) [ 16 ]. The transition to the college environment brings about changes in adolescents’ adjustment to their social environment, which in turns influence alcohol use [ 2 ]. We thus need to better understand upstream factors that shape drinking at college. With some exceptions [ 10 ], there has, however, been little research into the college-related environmental risk factors affecting drinking by college students in Europe. Moreover, research needs to better understand the contribution of the college and university context to alcohol-drinking behaviour. The European university system and legal provisions related to alcohol consumption differ considerably from those in North America. Thus, research of the kind suggested might indicate opportunities for community health preventive interventions.

The study analyses alcohol consumption among college students from a community health perspective. We aim to understand how the college-related environment shapes students’ drinking behaviour. In particular, we assess the role of living arrangements, college social activities, and social norms in drinking patterns. We explore two questions: (1) does the college-related environment influence alcohol use? (2) How do social and normative factors contribute to these college influences on alcohol use?

Design and participants

This study is part of an important multi-method investigation into alcohol drinking among college students. It was carried out in a Belgian university with two main campuses, one in Louvain-La-Neuve, a town of 20,000 inhabitants, half of whom are students living in dormitories. The other campus, mainly devoted to health sciences, is located in Brussels, 30 km away from the main campus.

A web survey was carried out in May 2010. An e-mail invitation was sent to all bachelor and master students registered with the university (n = 18,137), with a link to a web-survey questionnaire. No financial or material incentive was provided. The students could request a copy of the final report, and 62% of the respondents made such request. The form included 31 questions related to socio-demographics, living arrangements, study programmes, involvement in student activities, alcohol use, injunctive and descriptive norms, and positive and negative consequences of alcohol use. On average, filling in the questionnaire took 12 minutes and very few break-offs were recorded. The study was approved for ethical issues by the Social and Student Affairs review board of the university on the 26 th March 2010.

After up to two reminders, 7,015 students (39%) participated, a rate well above the average web survey participation rate [ 17 ]. Compared with a face-to-face survey, our participation rate may look low. But for a web survey it is a very satisfactory result, as it corresponds to the median web-survey participation [ 18 ]. In addition, there is no evidence that online surveys with lower response rates produce biased estimates in higher education evaluation or surveys [ 19 ] or in surveys in general [ 20 , 21 ]. However, to assess the risk of bias we compared the distribution of our sample with the distribution of the population. Analysis of non-participants suggests that women were a bit more likely to participate (OR = 1.10) than men; no differences of participation regarding age or year of study were noted. There is thus little evidence of an important bias linked to factors associated with alcohol consumption.

Alcohol consumption measures came from the Eurostat European Health Interview Survey schedule and from the European School Survey Project on Alcohol and Other Drugs (ESPAD) questionnaire [ 22 ]. We modelled the weekly average number of drinks in the last year, the monthly frequency of drinking, and the monthly frequency of abusive drinking (more than 6 drinks on one occasion [ 23 ]). A drink was defined as a glass of any alcoholic beverage (beer, wine, spirits, other), assuming that a standardised glass of beer, wine, or spirit contains a similar quantity of alcohol (from 10 to 13 g).

College environmental factors included curricular and extra-curricular features. The former consisted of the number of years the student had been studying and the study programme (a student class within a curriculum). The study programme factor was expected to capture the peer effect linked to the culture of alcohol consumption specific to faculties. The extra-curricular features were: living arrangements (living in a dormitory or with parents), living on the campus (yes or no), and the number of room-mates (0 for staying with parents).

Social involvement was measured by involvement in traditional student folklore, pre-partying, and being a student representative. Student folklore shares some similar features with the sororities and fraternities in the U.S.A. It has long played a traditional role in European university social life: traditional students’ organisations contribute to welcoming freshmen and to rites of passage; they organise parties and other recreational activities that may or may not involve drinking. Some student associations also manage student accommodation and sit on consultative bodies related to student social affairs. Involvement in this kind of traditional student folklore was measured by a score ranging from a low of 0 to a high of 3 according to rites of passage or positions of responsibility in student folklore. One point was given for each of the following: participation in hazing activities at the beginning of the academic year, after which one is labelled “baptisé”; participation in another traditional activity that upgrades the student’s prestige and allows him/her to wear a ritual cap called a “calotte”; and participation in the folklore organisation. The score was categorised in three groups (0 = none, 1 = medium, 2-3 = high). Finally, the university provides students with many curricular or extra-curricular social organisations. We asked the students whether they were members of any organisation of that kind.

Pre-partying was defined as the consumption of alcohol with friends while preparing to go out for the night. Pre-partying helps to improve sociability and conviviality, easing the discomfort associated with meeting new people at a party [ 15 , 24 – 26 ]. Students were requested to report their pre-partying frequency per month.

The normative factors included descriptive and injunctive norms. Alcohol injunctive norms were covered by a four-item questionnaire measuring approval by friends of four kinds of drinking behaviour: drinking every weekend, daily, after driving, and enough to be drunk [ 27 ]. Each item had a score ranging from 0 (strong disapproval) to 4 (strong approval). The overall sum of the four items ranged between 0 and 16 and measures “permissiveness”. Descriptive norms measure the perceived drinking behaviour of referent others and were assessed by the Drinking Norm Rating Forms, which ask the student to estimate the average daily number of drinks individuals of three different reference groups consume (students in general, same-sex students, and friends) [ 27 ]. According to social comparison theory proximal comparisons are more relevant than distal comparisons, so we expected that friends’ average consumption would have a greater influence than typical same-sex student consumption [ 28 ].

In order to also include experiential reporting, students’ positive drinking consequences were registered via the Positive Drinking Consequences Questionnaire, a 14-item scale [ 29 ]. This scale measures actual and past perceived positive consequences of alcohol use and differs from expectations. The scale mainly records consequences of drinking in terms of improved social interaction (11 items out of 14) such as social enhancement and stress reduction. This seemed relevant for young people in transition to adulthood and experiencing a dramatic change in their living conditions. We counted the number of times students reported a positive consequence of drinking over the last year.

Data analysis

The analysis was in two stages, according to our two research questions. First, we investigated the role of socio-demographics and college environmental factors. Second, we added to the analysis social-involvement, normative, and experiential factors that might contribute to the influence of college environmental factors. However, cross-sectional analysis of drinking behaviour is vulnerable to selection bias: unobserved heterogeneity across individuals may explain why some vulnerable individuals self-select into an at-risk college environment, as predicted by the theory of increased heterogeneity [ 2 ]. We assessed this kind of bias by sensitivity analysis: we checked the robustness of the models by including age at first drink, a factor strongly linked to poor executive function and an individual risk factor for subsequent drinking and drug abuse [ 30 ]. Because number of drinks and frequency of abusive drinking are not normally distributed and because of over-dispersion (a minority may never drink), we used a negative binomial mixed regression model. All models included a random component capturing the intra-study programme correlation. Statistical procedures were carried with SAS 9.2.

On average, students were aged 21.5 (std = 3.3), and mainly female (Table  1 ). Women were slightly younger compared with men (21.4 vs 21.8, F = 21.5, p < 0.01) but there was no significant association between gender and study year ( χ 2 =1.18, p  = 0.28). On average students have been attending the University for about 2.8 years (std = 1.7) and were pursuing bachelor degrees. A majority of students were staying on the campus (66.9%) and in a dormitory (64%), with an average of 4.4 room-mates (std = 4.2). A minority of the students (12.3%) was highly involved in traditional student folklore with a score of 2 to 3. Most students pre-party (67%), with an average of 2.3 pre-parties per month (std = 3.3).

There were some socio-demographic differences between our sample and the population. Compared with the overall University population, our sample had a higher frequency of females (sample: 57.3%; population: 54.6%), was younger (21.5 y vs 21.9 y), and had a higher proportion of undergraduates (62% vs 59%). Overall, these differences were small and do not indicate a systematic tendency towards more or less frequent drinking: women generally drink less than men and undergraduates generally drink more than postgraduates.

On average, students had their first drink at the age of 15.7 (std = 1.8), while only a small percentage had never drink alcohol (6%). In Belgium, the legal drinking age is 16. On average, a student drank seven times a month (std = 6.6), had 1.7 drinks a day (std = 21), and 2.8 episodes of abusive drinking per month (std = 4.4). Over the last year, the students acknowledged on average 5 positive consequences (std = 3.1). The three most frequent consequences were to “approach a person that I probably wouldn’t have spoken to otherwise” (68%), to “find it easy to engage in a conversation in a situation in which I would usually have stayed quiet” (65%), and to feel “like I had enough energy to stay out all night partying or dancing” (64%).

College students overestimated what a typical student drinks; this overestimation decreased for closer-reference students: 4.2 (std = 4.7) daily drinks for students in general, 3.9 (std = 4.9) for same-sex students, 3.5 (std = 4.4) for friends (to be compared with a self-declared 1.7). College students overestimated their friends’ drinking by 2 drinks a day.

Overall socio-demographic variables played a more important role for abusive drinking and number of drinks than for the frequency of drinking (Table  2 , Model 1). Men drank more, more frequently, and drank abusively more often than women. But the gender difference was somewhat lower for frequency of drinking (OR = 1.58) and higher for abusive drinking (OR = 2.29). Older students were less likely to drink and, in particular, less likely to engage in abusive drinking. For each additional year of age, the frequency of abusive drinking decreased by 9% and the frequency of drinking decreased by 2%.

Higher exposure to college environmental factors meant, in most cases, more frequent, and more abusive drinking (Table  2 , Model 1). These risk factors were, in general, more important for excessive drinking than for frequency of drinking. For each additional year spent at the university, drinking became more frequent and the frequency of abusive drinking increased (OR = 1.11). Compared with not living on the campus, living on the campus meant more frequent and more abusive drinking behaviour (OR = 1.56). The greater the number of room-mates, the higher the risk of frequent and abusive drinking behaviour. Each additional room-mate increased the frequency of abusive drinking by 6%. There was one exception to these college environmental factors: staying in a dormitory was associated with less frequent drinking behaviour. This could be due to the collinearity with living on the campus and the number of room-mates: as 93% of those living in dorms were on the campus, it was difficult to disentangle the campus effect from the dormitory effect. We checked this issue in two ways. First, we ran Model 1 for the number of drinks per day, by excluding the “living on the campus” variable. We found that, indeed, living in a dormitory was associated with an increased number of drinks compared with living with parents (OR =1.12 95% CI: 1.06-1.18). Second, we compared the two campuses, the one in Louvain-la-Neuve, which is mainly a student town and is known to expose students to numerous drinking opportunities, with the one in Brussels, which has a much more mixed population, controlling for all other variables of Model 1. We found that the Brussels campus had a lower risk (OR = 0.68, 95% CI: 0.60-0.76) compared with the Louvain-La-Neuve campus, suggesting that living on the campus is a more potent predictor of frequent abusive drinking than living in a dormitory.

There was a small intra-class correlation linked to the study programme and this was more important for abusive drinking (0.23) than for frequency of drinking (0.03), suggesting a slight programme effect on abusive drinking but not on drinking frequency. We found the Faculty of Engineering and the Faculty of Social Sciences to have a higher number of drinks per day (Engineering mean = 2.2, p  < 0.001; Social Sciences Mean = 2.1, p  < 0.001), with a lower number in the faculties of medicine (1.21, p < 0.001) and psychology (mean = 1.17 NS).

Model 2 adds social-involvement, normative, and experiential factors (Table  2 ). The more a student was involved in traditional student folklore, the more frequent his or her drinking behaviour, even at the intermediate level of involvement. This was particularly obvious for abusive drinking (OR = 2.11), with a somewhat lower risk for drinking frequency (OR = 1.46). More frequent pre-partying was associated with increased drinking: one additional monthly occasion of pre-partying increased abusive drinking by 8%. However, not all university involvement increased drinking frequency. Being elected as a student representative was associated with a lower risk of drinking, particularly of abusive drinking (OR = 0.84).

Drinking was more frequent as the number of positive consequences increased and as drinking norms became more favourable to drinking. The more a student thought his friends were drinking, the more and the more frequently he drank (OR = 1.02). Likewise, the more a student thought his friends were permissive regarding drinking, the higher the risk of all drinking behaviour, particularly for drinking frequency (OR = 1.08). Drinking frequency or quantity increased by at least 10% for each additional positive consequence a college student experienced.

In most cases, controlling for social engagement, normative, and experiential factors led to a reduction in the risk associated with the college environment. The effect of the number of years attending the University on abusive drinking decreased from OR = 1.11 to OR = 1.05, while the effect of the number of room-mates decreased from 1.06 to 1.02. The effect of living arrangements became insignificant or very small.

The model’s robustness was checked by including age at first drink, a factor likely to capture individual vulnerability. In most cases, the ORs were only slightly affected: the effect of time attending the university on abusive drinking decreased from 1.11 (Model 1, without controlling for age at first drink) to 1.109 (Model 1, with control for age at first drink); the effect of living on the campus on abusive drinking frequency decreased from 1.56 to 1.52; the effect of traditional student folklore from 2.11 to 2.09. Pre-partying frequency was not affected by this kind of sensitivity analysis.

Main findings

This study confirmed that excessive alcohol consumption is common among college students, with an average of 3 episodes of abusive drinking per month. Greater exposure to college environmental factors, such as living on the campus, a longer spell at university meant more frequent drinking. These community risk factors were more pronounced for excessive drinking patterns than for the quantity or frequency of drinking. Time had a double and mixed effect: older students drink less and less excessively than younger students; however, the longer the period a student has spent in the university, the higher his/her risk of drinking. These effects of college environmental factors were partly explained by social-involvement, experiential, and normative expectations: college students drank for the positive consequences, because they over-estimate the drinking of their friends, or because of other normative expectations.

Consistency with previous studies

The role of living arrangements has been shown in previous American [ 31 ], European [ 10 , 32 ], and cross-comparative [ 3 , 33 ] studies in which living with parents, not living on the campus, and not living in fraternity and sorority houses protected against heavy or abusive drinking. We found that living on the campus was a more potent predictor of frequent abusive drinking than living in a dormitory (both in model 1 and model 2). On the surface, this might seem to contradict a previous European review [ 10 ]. However, this is in part because of the strong association between living on the campus and living in a dormitory. This is also consistent with the Harvard School of Public Health college alcohol study which found that living off-campus was a stronger and more significant factor than staying in a dormitory [ 31 ]. The finding that the dormitory became non-significant in model 2 suggests that social-involvement, experiential, and normative expectations contribute to explain college environmental factors of drinking behaviours.

Yet, our study shows that the college environment influences drinking behaviour in a much more complex way that involves not only where students live but also the kind of living arrangements, participation in traditional student folklore, the duration of college training, and the type of faculty in which the student is studying. In particular, living in a dormitory with a high number of room-mates and being highly involved in traditional student folklore also play a role in the frequency of abusive drinking. There is thus not one college environmental risk factor but several that relate to different aspects of student life. This may explain why living away from home had a slightly greater effect on heavy drinking in the American (OR = 1.72) or in the international comparison study (OR = 1.61) than in ours (OR = 1.57). The role of dormitory size needs, in particular, to be emphasized and could be explained by innovation diffusion. As adolescent social network studies have shown, teenagers who have a denser social network are more likely to drink than those with less dense social networks [ 34 ]. The finding on that pre-partying contribution to the relationship between college environmental factors and frequency of abusive drinking supports this hypothesis. As in previous studies [ 15 ], pre-partying was revealed to be a common practice contributing to both drinking behaviour and the influence of community factors on drinking behaviour. College students pre-party to ease the discomfort or awkwardness associated with meeting new people. As hypothesized in a qualitative study, the pre-party is a base to build on when you get to a party, a way to bond with friends, and a social lubricant at a later event to help “hook up” with a partner [ 26 ].

Our study shows that abusive drinking increased with the period attending the college, whereas it decreased with age. These two opposite effects were of similar magnitude: this may explain why previous studies have found no clear relationship between age and drinking behaviour [ 10 ]: it all depends on the time spent in the university. Few studies have controlled for the time spent in college, so that the protective maturing effect of age was confounded by the risk attached to the time spent attending college. One important prospective American study found, moreover, that heavy drinking decreased with age [ 35 ], while there is wide evidence of an association between late adolescent drinking behaviour and subsequent drinking into adulthood [ 8 ]. Why did older students drink less while, at the same time, more years at the University were associated with more drinking? Firstly, the correlation between age in years and number of years attending the university was not very high (correlation coefficient = 0.33), suggesting that not all students follow the same trajectory. Some start a postgraduate programme later in life, while working part-time. These “older” students generally spend a shorter period at university (2-3 years) and, possibly, have less time for student activities involving alcohol. Secondly, age and time at the University capture different risks linked to drinking alcohol: age may also capture a cohort effect and, in particular, changes in drinking habits: older students may not only adapt their consumption but may also have started drinking later than the younger age group. This is supported by our data, as we found a small but significant positive correlation between age and age at first drink (correlation = 0.22, p <0.001), although, with our cross-sectional design, these correlations must be approached with caution. A third possible explication is that a significant proportion of students had studied outside the University for their first undergraduate degree and where thus not exposed to the campus for as long as those who followed both under- and postgraduate programmes on the same campus. Our study suggests that the maturing effect on heavy drinking is modest and depends on the time spent attending the University, leaving one particular group of college students at risk: those starting university at a younger age and studying there for longer periods. But these results should be approached with caution. Truncation may affect our results, as younger students who failed to graduate because of heavy alcohol consumption are less likely to be observed at a later stage; this makes the comparison between younger and older students problematic: the latter are observed if they haven’t dropped out of the University.

We found that students overestimate other students’ average number of daily drinks. To compare our results with previous studies of self-other comparison in drinking, we computed the Z Fisher transformation correlation between self-reported daily number of drinks and friends’ numbers of drinks. Our Z Fisher correlation was 0.36 ( p  < 0.001), which compares quite well a Z fisher value of 0.29 from a previous meta-analytic integration of 23 studies [ 29 ]. The college social environment increases drinking through a combination of social activities and normative and motivational expectations. It puts students at risk of frequent and abusive drinking because students expect positive social consequences, because of social activities such as pre-parties, and because of injunctive and descriptive drinking norms. The role of such social and normative influences, evidenced in previous studies [ 36 , 37 ], may result from two different and complementary processes: social learning, in which drinking behaviour is acquired through social interaction, and social control, which emphasizes the role of social expectations such as norms and peer pressure [ 38 ]. We found that college students overestimate other students’ alcohol consumption and this overestimation decreases with social distance: drinking behaviour was more related to the quantities drunk by friends than to the quantities drunk by students overall. Finally, pre-partying and participation in traditional student folklore, both of which provide strong opportunities for social learning, emerged as strong predictors of drinking behaviour. All this suggests that social learning is a key factor that contributes to the effect of the college social environment on drinking behaviour, as found elsewhere [ 39 ].

Limitations

Our cross-sectional study is vulnerable to reversed causality, so the results need to be interpreted with caution. It could be that involvement in student life and drinking behaviour are confounded by unobserved vulnerability. Extraverted individuals are sensitive to positive social rewards and, thus, more likely to engage in socially-motivated drinking, so the relationship between traditional student folklore and drinking behaviour may be biased upwards. Moreover, the dose-response relationship with involvement in traditional student folklore or with the number of room-mates may downplay this risk of confounding without totally removing it. To assess the risk of confounding we replicated the analysis controlling for the age at which the student reported that he or she started drinking, a factor known to predict a heavy alcohol consumption trajectory [ 40 ]. Our results suggest that this kind of self-selection risk may slightly affect our conclusions.

The second limitation has to do with the setting, which unlike other campuses in Belgium or abroad, is much less socially mixed, giving the college environmental factors more clout while mitigating other social control effects. Our results, nevertheless, are in line with a cross-comparative study such as the College Alcohol study in the U.S.A. [ 23 ] or the European Amsterdam-Antwerp comparison, which showed living arrangements to be a strong predictor of problematic alcohol use [ 33 ]. Finally, it could be that our setting provides a pessimistic picture of community factors and is, in that sense, a good model for reflecting on the community risk factors linked to college drinking behaviour.

Conclusion: relevance for community health promotion

It is foreseen that in the future most young adults will attend university where, our study shows, they will be exposed to frequent and intensive drinking behaviour. That experience will have subsequent and important consequences lasting into adulthood [ 8 ]. Colleges need thus to acknowledge their role in this issue and to commit themselves to lower exposure to excessive alcohol consumption. In particular, they need to combine multi-level strategies: individual, group, and organization-level, from a community health promotion perspective. One danger would be a top-down approach of undertaking community actions in ways that do not consider the realities of student life. A first step would be to involve members of the community in identifying realistic objectives, e.g. limiting excessive consumption, and defining targets, e.g. male students involved in traditional and folklore activities in which hazardous alcohol intake peaks. A second step would be to define interventions, e.g. social-norm interventions that could correct gross miss-perceptions and effectively reduce alcohol consumption [ 41 – 43 ]. Third and fourth steps would be to evaluate what has been implemented, to provide feedback in order to improve and extend interventions, which requires sustained funding, and to analyse gaps between national policies and what is locally feasible. More community-based research is needed to face the problem of hazardous alcohol use, which is persistent and pervasive.

Organisation for Economic Co-operation and Development, Centre for Educational Research and Innovation: Education at a glance 2009. 2009, Paris: OECD indicators, 471-

Google Scholar  

Schulenberg JE, Maggs JL: A developmental perspective on alcohol use and heavy drinking during adolescence and the transition to young adulthood. J Stud Alcohol. 2002, 54-70. 14

Dantzer C, Wardle J, Fuller R, et al: International study of heavy drinking: Attitudes and sociodemographic factors in university students. J Am Coll Health. 2006, 55: 83-89. 10.3200/JACH.55.2.83-90.

Article   PubMed   Google Scholar  

Stock C, Mikolajczyk R, Bloomfield K, et al: Alcohol consumption and attitudes towards banning alcohol sales on campus among European university students. Public Health. 2009, 123: 122-129. 10.1016/j.puhe.2008.12.009.

Article   CAS   PubMed   Google Scholar  

Rehm J, Mathers C, Popova S, et al: Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet. 2009, 373: 2223-2233. 10.1016/S0140-6736(09)60746-7.

Aertgeerts B, Buntinx F: The relation between alcohol abuse or dependence and academic performance in first-year college students. J Adolesc Health. 2002, 31: 223-225. 10.1016/S1054-139X(02)00362-2.

Singleton RA, Wolfson AR: Alcohol Consumption, Sleep, and Academic Performance Among College Students. J Stud Alcohol Drugs. 2009, 70: 355-363.

McCambridge J, McAlaney J, Rowe R: Adult Consequences of Late Adolescent Alcohol Consumption: A Systematic Review of Cohort Studies. PLoS Med. 2011, 8: e1000413-10.1371/journal.pmed.1000413.

Article   PubMed   PubMed Central   Google Scholar  

Kuntsche E, Knibbe R, Gmel G, et al: Who drinks and why? A review of socio-demographic, personality, and contextual issues behind the drinking motives in young people. Addict Behav. 2006, 31: 1844-1857. 10.1016/j.addbeh.2005.12.028.

Wicki M, Kuntsche E, Gmel G: Drinking at European universities? A review of students' alcohol use. Addict Behav. 2010, 35: 913-924. 10.1016/j.addbeh.2010.06.015.

Kuntsche E, Knibbe R, Gmel G, et al: Why do young people drink? A review of drinking motives. Clin Psychol Rev. 2005, 25: 841-861. 10.1016/j.cpr.2005.06.002.

Lee CM, Patrick ME, Neighbors C, et al: Exploring the role of positive and negative consequences in understanding perceptions and evaluations of individual drinking events. Addict Behav. 2010, 35: 764-770. 10.1016/j.addbeh.2010.03.003.

Park CL: Positive and negative consequences of alcohol consumption in college students. Addict Behav. 2004, 29: 311-321. 10.1016/j.addbeh.2003.08.006.

Dowdall GW: College drinking : reframing a social problem. 2009, Westport, Conn: Praeger

Read JP, Merrill JE, Bytschkow K: Before the party starts: risk factors and reasons for "pregaming" in college students. J Am Coll Health. 2010, 58: 461-472. 10.1080/07448480903540523.

Borsari B, Bergen-Cico D, Carey KB: Self-reported drinking-game participation of incoming college students. J Am Coll Health. 2003, 51: 149-154. 10.1080/07448480309596343.

Shih TH, Xitao F: Comparing response rates from web and mail surveys: a meta-analysis. Field Methods. 2008, 20: 249-271. 10.1177/1525822X08317085.

Article   Google Scholar  

Cook C, Heath F, Thompson RL: A meta-analysis of response rates in Web- or internet-based surveys. Educ Psychol Meas. 2000, 60: 821-836. 10.1177/00131640021970934.

Bennett L, Nair CS: A recipe for effective participation rates for web-based surveys. Assess Eval Higher Educ. 2010, 35: 357-365. 10.1080/02602930802687752.

Miller ET, Neal DJ, Roberts LJ, et al: Test-retest reliability of alcohol measures: is there a difference between internet-based assessment and traditional methods?. Psychol Addict Behav. 2002, 16: 56-63.

Groves RM, Couper M: Nonresponse in household interview surveys. 1998, New York: Wiley

Book   Google Scholar  

Hibell B, et al: The ESPAD report 2007. Substance use among students in 35 European countries. 2007, Stockholm: Council for Informaiton on Alcohol and other Drugs, 2009-

Wechsler H, Davenport A, Dowdall G, et al: Health and Behavioral Consequences of Binge-Drinking in College - A National Survey of Students at 140 Campuses. JAMA. 1994, 272: 1672-1677. 10.1001/jama.1994.03520210056032.

Pedersen ER, Labrie J: Partying before the party: examining prepartying behavior among college students. J Am Coll Health. 2007, 56: 237-245. 10.3200/JACH.56.3.237-246.

Borsari B, Boyle KE, Hustad JTP, et al: Drinking before drinking: Pregaming and drinking games in mandated students. Addict Behav. 2007, 32: 2694-2705. 10.1016/j.addbeh.2007.05.003.

DeJong W, DeRicco B, Schneider SK: Pregaming: an exploratory study of strategic drinking by college students in Pennsylvania. J Am Coll Health. 2010, 58: 307-316. 10.1080/07448480903380300.

Neighbors C, O'Connor RM, Lewis MA, et al: The relative impact of injunctive norms on college student drinking: the role of reference group. Psychol Addict Behav. 2008, 22: 576-581.

Borsari B, Carey KB: Descriptive and injunctive norms in college drinking: A meta-analytic integration. J Stud Alcohol. 2003, 64: 331-341.

Corbin WR, Morean ME, Benedict D: The Positive Drinking Consequences Questionnaire (PDCQ): Validation of a new assessment tool. Addict Behav. 2008, 33: 54-68. 10.1016/j.addbeh.2007.06.003.

Brown SA, Mcgue M, Maggs J, et al: A developmental perspective on alcohol and youths 16 to 20 years of age. Pediatrics. 2008, 121: S290-S310. 10.1542/peds.2007-2243D.

Weitzman ER, Nelson TF, Wechsler H: Taking up binge drinking in college: the influences of person, social group, and environment. J Adolesc Health. 2003, 32: 26-35. 10.1016/S1054-139X(02)00457-3.

D'Alessio M, Baiocco R, Laghi F: The problem of binge drinking among Italian university students: A preliminary investigation. Addict Behav. 2006, 31: 2328-2333. 10.1016/j.addbeh.2006.03.002.

Boot CR, Rosiers JF, Meijman FJ, et al: Consumption of tobacco, alcohol and recreational drugs in university students in Belgium and the Netherlands: the role of living situation. Int J Adolesc Med Health. 2010, 22: 527-534.

Ennett ST, Bauman KE, Hussong A, et al: The peer context of adolescent substance use: Findings from social network analysis. J Res Adolesc. 2006, 16: 159-186. 10.1111/j.1532-7795.2006.00127.x.

Sher KJ, Rutledge PC: Heavy drinking across the transition to college: Predicting first-semester heavy drinking from precollege variables. Addict Behav. 2007, 32: 819-835. 10.1016/j.addbeh.2006.06.024.

Borsari B, Carey KB: Peer influences on college drinking: A review of the research. J Subst Abuse. 2001, 13: 391-424. 10.1016/S0899-3289(01)00098-0.

Collins RL, Parks GA, Marlatt GA: Social Determinants of Alcohol-Consumption - the Effects of Social-Interaction and Model Status on the Self-Administration of Alcohol. J Consult Clin Psychol. 1985, 53: 189-200.

Ennett ST, Foshee VA, Bauman KE, et al: The social ecology of adolescent alcohol misuse. Child Dev. 2008, 79: 1777-1791. 10.1111/j.1467-8624.2008.01225.x.

Durkin KF, Wolfe TW, Clark GA: College students and binge drinking: An evaluation of social learning theory. Sociol Spectr. 2005, 25: 255-272. 10.1080/027321790518681.

Maggs JL, Schulenberg JE: Initiation and course of alcohol consumption among adolescents and young adults. Recent Dev Alcohol. 2005, 17: 29-47. 10.1007/0-306-48626-1_2.

Anderson P, Chisholm D, Fuhr DC: Alcohol and Global Health 2 Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet. 2009, 373: 2234-2246. 10.1016/S0140-6736(09)60744-3.

Moreira MT, Smith LA, Foxcroft D: Social norms interventions to reduce alcohol misuse in university or college students. Cochrane Database Syst Rev. 2009, CD006748-

Saltz RF, Paschall MJ, McGaffigan RP, et al: Alcohol risk management in college settings: the safer California universities randomized trial. Am J Prev Med. 2010, 39: 491-499. 10.1016/j.amepre.2010.08.020.

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This research was supported by the Université catholique de Louvain, in particular the Vice-Rector for Student and Social Affairs.

The research was also carried out with the help of students in the Faculty of Public Health: Anémone Bruneau, Alessandra Ausloos, Anne-Sophie Dehanne, Céline Denis, François Leruth, and Sandrine Race.

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Alcohol and Substance Abuse Among College Students

Introduction.

Substance abuse is a health condition that involves a misuse of substances. Most of the time, substance abuse is characterized by repeated use of substances that has become more intense. Substance abuse problems can vary from occasional and mild to long-term and have a significant negative effect on the person’s life. There are many different types of substance abuse. One of the most common is abusing alcohol (Ghasemian & Kumar, 2017). Alcohol is addictive because it is a depressant. A depressant is a drug that makes people feel a slower, drowsy feeling. People who become dependent on alcohol often get used to the low feeling of being drunk and may lose their ability to notice when they are feeling drowsy. The present report indicates that the common factors that lead to substance abuse among university students are high pressure in the academic setting, academic stress, low academic performance, poor relationships with friends, family, and the academic community, mental health issues, and social influences, and personality factors. These factors are associated with various levels of alcohol, cannabis, and tobacco use and can influence all other types of substance use.

Adolescents’ drinking behavior often is associated with early substance abuse, and college students are no exception. Many people in the college era enjoy life and all the advantages of being there. However, this is not the situation for every one of them. In some cases, they are victims of drugs and alcohol, because of which they are not getting what they are hoping for. When students abuse alcohol and other drugs, they often experience Short-term, long-term, and chronic consequences (Walters et al., 2018). Long-term effects can include damage to brain cells, liver damage, and even more serious conditions like alcoholism and drug addiction. Shorter-term effects of abuse can include insomnia, hallucinations, headaches, vomiting, dizziness, paranoia, and hallucinations. This can all be incredibly uncomfortable, especially when they’re in class. Chronic effects can include irritability, aggression, depression, and more. These may be uncomfortable but are also things we’d want to prepare for if they occur. And for this reason, it is vital to know what the effects of drug and alcohol abuse among college students are. Also, how they can deal with it. This is the purpose of the article.

Prevalence/Severity

The use of alcohol and other substances among university students has become a major health concern. In recent years, alcohol has been cited as the main substance consumed by students. Alcohol is one of the most common substances consumed by university students, and the majority of university students have experimented with alcohol in their lifetime (Ghasemian & Kumar, 2017). According to statistics from a study done by the National Center for Drug Abuse, one in eight adolescents and young adults abused alcohol and/or illicit drugs in the year 2020 (National Center for Drug Abuse Statistics, 2022). The study also found out that about 62 percent of twelfth graders have abused alcohol. In addition, approximately 50 percent of teenagers have misused drugs at least once. Approximately 40.9 % of college students in the U.S. experienced depression in Spring 2020, up from 35.7 % in Fall 2019. The figure below illustrates alcohol abuse among the youth in the U.S. throughout 2020.

Figure 1:  Youth Alcohol Abuse

Source: https://drugabusestatistics.org/teen-drug-use/#:~:text=591%2C000%20teenagers%20aged%2012%2D%20to,teens%20have%20tried%20illicit%20drugs.

The lifetime prevalence of illicit drug use for eighth through to twelfth graders in the U.S. is estimated to be 27% (Elfein, 2022). The prevalence of adolescent substance use has increased substantially in recent decades. According to National Center for Drug Abuse Statistics (2022), drug use among the youth went up by 61% from 2016 to 2020.

Alcohol is more than just a social and drinking issue. Substance use among college students has become an issue of concern because of its long-term negative effects. Many studies have shown that alcohol abuse has resulted in significant negative consequences and can be fatal. According to WHO, alcohol use disorders are linked to more than 80 illnesses or conditions that include damage to the heart and brain, liver and pancreas damage, birth defects, and increased rates of injury and death (Sharma, 2019). According to Okafor (2019), Substance use by youth may lead to long-term and far-reaching consequences that can result in severe impairment of physical, mental, and social development, such as addiction, poor academic performance, poor mental health, and school dropout, leading to substance use becoming a significant risk factor in youth delinquency and deaths. The figure below his statistic depicts the predominance of specific substance abuse concerns among college students across the U.S.

Figure 2:  Mental health and substance issues in U.S. college students Fall 2019-Spring 2020

Source: https://www.statista.com/statistics/1184610/share-mental-health-and-substance-use-in-us-college-students-fall-spring/

Adolescent drug abuse disrupts academic performance; and, as a problem, is costly. Substance use is a major risk factor for lower educational achievement. Some of the reasons for this may be that alcohol and tobacco are commonly used by the young to mask symptoms of anxiety, and, as a result, their cognitive development can be impaired. Additionally, drug use and abuse often result in the development of serious health issues. Substance abuse in young people results in chronic medical problems that can be harmful and debilitating. These include the direct effects of smoking on the body (e.g., heart disease, lung disease, cancer, respiratory tract disorders) (Hj Ramli et al., 2018). Substance abuse is closely linked to depression, anxiety, cognitive impairment, and other psychiatric conditions. These may be triggered by stress or by a lack of motivation. This can cause the drug user to behave in a way that seems out of control. It can lead the person to not be aware of the damage being done to their body.

Peers and Family Relationships: The ability to establish and maintain close, positive friendships is a critical component of healthy development. Substance abuse frequently affects the ability to establish and maintain friendships (Okafor, 2019). For example, adolescents who are dependent on alcohol or other drugs are not only more likely to experience social problems but also have an increased risk of being rejected by their peers (Okafor, 2019). Other studies have shown that adolescents who use alcohol and other drugs are more likely to be excluded by their peers. They are also less likely to maintain their friendships with others. Also, substance abuse in young people can disrupt family relationships. This can have a significant negative impact on a young person’s ability to make positive choices. Adolescents who abuse alcohol and other drugs may have difficulty in their relationship with their parents (Hj Ramli et al., 2018).

Delinquency: Substance abusers often continue to use illegal drugs in combination with alcohol and other substances. This combination often leads to violent and crime-related activity. Substance abusers are at greater risk of committing property crimes, such as breaking and entering and vandalism. They are also more likely to commit drug-related offenses (e.g., trafficking, possession of drugs) (Hj Ramli et al., 2018). Young people who use drugs are more likely to be arrested and convicted than young people who do not. Further, drug abuse amongst college students indicates later-life substance abuse issues. Adolescents who begin using drugs at an early age and continue use into adulthood are more likely to be alcohol-dependent than those who begin using drugs at a later age (Okafor, 2019). This is subject to addiction, i.e., when a person has a physical dependence or withdrawal from a drug.

Difficulties in Coping

Substance use is a multifaceted problem. College students are often exposed to a wide variety of drugs and alcohol. It is therefore important to understand the many factors associated with college students’ exposure to alcohol and illicit drugs. A considerable amount of literature has indicated that both genetic and environmental factors are likely to be involved in the development of substance use disorders in adolescence and young adulthood. According to (Taremian et al., 2018), there are also many social, economic, and psychological factors that lead to problematic drinking among students. Family, social, and individual factors play a key role in the process of development and may contribute to future substance use behavior. Among these factors are loneliness and isolation, low socioeconomic status, and negative family and friend relations.

Substance abuse among fellow students (peer pressure) has been found to be a risk factor for college students to initiate substance use. College can really be pressuring. College students often perceive themselves as an “outsider” in society and are often faced with peer pressure to conform to mainstream values and accept societal norms (Whitesell et al., 2013). Therefore, peer pressure from “high” and “low” quality peers can significantly affect students’ decision to consume or not consume various substances. Low-quality friends may be those who have a history of substance use, exhibit aggressive or antisocial behavior or are engaging in risky behaviors. Conversely, high-quality friends have a better perspective on substance use and have healthier behaviors. Previous studies have shown that college students who perceive their friends as low quality, that is, as substance users are more likely to start using alcohol and illicit drugs.

Another factor that contributes to the risk for adolescent substance use is the accessibility of drugs and related paraphernalia. College life is often crowded with after-school leisure activities. Whitesell et al. (2013) note that Adolescents who are involved in leisure activities, such as after-school activities, have a higher risk of alcohol and cigarette use than adolescents who are not involved in after-school activities. The high association found in this study between easy access to drugs and the availability of alcoholic beverages found in other studies is consistent with the hypothesis that easy access is a major predictor of adolescent substance use. It is also possible that having easy access to drugs and alcohol is not a result of availability alone but also a result of the fact that they are made available at school.

A lack of self-control, willpower, and self-esteem: Drugs cause a person to lose their self-control, and they lose it because they enjoy the things that they are doing. So by the time you have lost your self-control, you have already begun abusing drugs. Your willpower is the energy that you have that is used to change your habits, and the one that is the only source of motivation is the drugs. The people who have abused the drugs lose their willpower. People who abuse drugs feel negative when they are in the presence of people, and they think that there is nobody to help them. Das et al. (2016) have demonstrated that family characteristics, such as the family history of addiction or alcohol-related legal problems, parenting skills, and family income, are associated with substance use and other forms of antisocial behavior in youth. Generally, as a college student, not only are you struggling to grow as a person, but you’re also dealing with social, emotional, and financial pressures while you juggle classes and a full-time job. However, these problems are not necessarily a new occurrence.

Intervention

There are many types of interventions that colleges can employ to influence alcohol-related attitudes and behaviors. For instance, they can employ HRE, social marketing campaigns, screening and brief intervention programs, and comprehensive community-based prevention programs. The primary goals of these types of programs are to decrease alcohol-related problems, promote healthy behaviors, and reduce alcohol-related risks.

Social marketing campaigns (SMCs) are designed to stimulate interest and encourage participation in programs. Often they are a cost-effective way to reach many people simultaneously. The types of messages and the channels of delivery employed in a social marketing campaign are tailored to the specific needs of the target audience. One advantage of social marketing campaigns is that they can be focused on specific behaviors and provide information and skills to engage and promote healthy behavior change. Another advantage is that social marketing campaigns are a relatively new means for improving health, and they are not constrained by time and place limitations. They can be implemented at schools, universities, and communities across the world.

Taremian et al. (2018) note that colleges can employ mass media campaigns to alter alcohol-related attitudes. This can be done via social media and various print media outlets. This may take the form of educational messages about the negative consequences of alcohol, with information about safe drinking and the dangers of drinking before driving. In many colleges, campus councils provide educational opportunities for students to discuss alcohol problems and to provide a source of help in prevention programs. In other colleges, programs are available to teach students how to identify students who may have alcohol problems and to take steps to get help for these students. Students who consume alcohol frequently can benefit from health and risk education, which seeks to correct misconceptions about alcohol and provide guidance to alcohol-using students. In addition, schools are required to provide resources and programs to assist alcohol-using students, maintain an open and inviting environment, and prevent alcohol-related problems.

The second campaign colleges can do to have policies that promote responsible drinking. Colleges should develop a culture that encourages responsibility rather than just discouraging drunkenness. According to Weinstock et al. (2017), these policies should include, but not be limited to, the following: Encouraging students to become involved in activities that encourage responsible drinking. Helping students develop or maintain good health habits. Providing opportunities for students to gain experience and education related to drug and alcohol abuse. Making students aware of the problem of alcohol abuse and encouraging them to seek help. Helping students develop a support network of friends and family members who encourage them to be responsible drinkers.

The main principle behind comprehensive community-based prevention programs is that alcohol-related problems are influenced by the community as a whole rather than by specific groups and that communities can take steps to change the social norms and environments that support problems (Weinstock et al., 2017). These comprehensive programs focus on social environments that support drinking. For example, a drinking-venue program is designed to prevent high-risk drinking by restricting the availability of alcoholic beverages in public settings. A problem-behavior-change-centers program aims to reduce alcohol-related problems by promoting social responsibility and creating safe and supportive environments.

According to Das et al. (2016), colleges should intensify school counseling. A significant number of people with mental health problems and substance abuse problems will require the aid of professionals (e.g., physicians, therapists, psychiatrists, counselors) who are specially trained to diagnose and treat these conditions. These services include assessing, treating, monitoring, and following up on clients as needed to help them to recover from addiction. Substance abuse treatment can include counseling, relapse prevention training, family therapy, medication counseling, and more. Also, colleges can make their campuses as alcohol-free as possible. This might call for restrictions on bars. It would make sense for a college campus, as a place of learning, to be a sober place. According to Wendt et al. (2017), limiting the closeness of pubs and liquor stores to campuses is one strategy to reduce abusive and adolescent drinking. Alcohol-related fatalities are more likely in locations where drink promotions are heavily publicized, particularly when targeting college students.

Alcohol and substance abuse are two of the most prevalent behaviors among college students. These patterns of use and abuse begin during the pre-college years and often continue into college. Extensive research has been done in this field. Alcohol use among college students was significantly associated with academic pressure, family economic background, and peer pressure, among others. The most important thing to do in preventing alcohol abuse among college students is to educate and warn them of the dangers. Colleges can make their students aware of peer pressure, alcoholism, addiction, and legal problems associated with alcohol use. It is best for colleges to discourage or even forbid the sale of alcoholic beverages on their campus. Students, parents, and administrators have a collective responsibility for student alcohol-related behavior. Schools must take the issue of campus drinking seriously and work with students, parents, and the general community to take action against excessive drinking. Colleges must promote the health and safety of students and provide clear and comprehensive guidance about drinking at parties while also considering how the drinking behavior of the student body affects the student population as a whole.

Das, J., Salam, R., Arshad, A., Finkelstein, Y., & Bhutta, Z. (2016). Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews.  Journal Of Adolescent Health ,  59 (4), S61-S75. https://doi.org/10.1016/j.jadohealth.2016.06.021

Elflein, J. (2022).  Topic: Adolescent drug use in the U.S.  Statista. Retrieved 1 May 2022, from https://www.statista.com/topics/3907/adolescent-drug-use-in-the-us/#dossierKeyfigures.

Ghasemian, A., & Kumar, G. (2017). Substance Abuse among College Students: Prevalence, Predictors, and Prevention of Students Substance Use.  International Journal Of Social And Economic Research ,  7 (4), 92. https://doi.org/10.5958/2249-6270.2017.00029.0

Hj Ramli, N., Alavi, M., Mehrinezhad, S., & Ahmadi, A. (2018). Academic Stress and Self-Regulation among University Students in Malaysia: Mediator Role of Mindfulness.  Behavioral Sciences ,  8 (1), 12. https://doi.org/10.3390/bs8010012

National Center for Drug Abuse Statistics. (2022).  Teenage Drug Use Statistics [2022]: Data & Trends on Abuse . NCDS. Retrieved 1 May 2022, from https://drugabusestatistics.org/teen-drug-use/#:~:text=591%2C000%20teenagers%20aged%2012%2D%20to,teens%20have%20tried%20illicit%20drugs.

Okafor, I. (2019). Causes and Consequences of Drug Abuse among Youth in Kwara State, Nigeria.  Canadian Journal Of Family And Youth / Le Journal Canadien De Famille Et De La Jeunesse ,  12 (1), 147-162. https://doi.org/10.29173/cjfy29495

Sharma, N. (2019). Prevalence of substance abuse among students of SMS Medical College Jaipur, Rajasthan.  Journal Of Medical Science And Clinical Research ,  7 (7). https://doi.org/10.18535/jmscr/v7i7.141

Taremian, F., Yaghubi, H., Pairavi, H., Hosseini, S., Zafar, M., & Moloodi, R. (2018). Risk and protective factors for substance use among Iranian university students: a national study.  Substance Abuse Treatment, Prevention, And Policy ,  13 (1). https://doi.org/10.1186/s13011-018-0181-2

Walters, K., Bulmer, S., Troiano, P., Obiaka, U., & Bonhomme, R. (2018).  Substance Use, Anxiety, and Depressive Symptoms Among College Students  (pp. 103-111).

Weinstock, J., Farney, M., Elrod, N., Henderson, C., & Weiss, E. (2017). Exercise as an Adjunctive Treatment for Substance Use Disorders: Rationale and Intervention Description.  Journal Of Substance Abuse Treatment ,  72 , 40-47. https://doi.org/10.1016/j.jsat.2016.09.002

Wendt, S., Mohr, C., Wang, M., & Haverly, S. (2017). Proximal Predictors of Alcohol Use among Japanese College Students.  Substance Use &Amp; Misuse ,  53 (5), 763-772. https://doi.org/10.1080/10826084.2017.1365086

Whitesell, M., Bachand, A., Peel, J., & Brown, M. (2013). Familial, Social, and Individual Factors Contributing to Risk for Adolescent Substance Use.  Journal Of Addiction ,  2013 , 1-9. https://doi.org/10.1155/2013/579310

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Peer‐led interventions to reduce alcohol consumption in college students: A scoping review

María lavilla‐gracia.

1 School of Nursing, Community, Maternity and Pediatric Nursing, University of Navarra, Pamplona Spain

María Pueyo‐Garrigues

2 IdiSNA, Navarra Institute for Health Research, Pamplona Spain

Sara Pueyo‐Garrigues

3 San Francisco Javier Mental Health Center, Pamplona Spain

Miren Idoia Pardavila‐Belio

Ana canga‐armayor.

4 School of Nursing, Nursing Care for Adult Patients Department, University of Navarra, Pamplona Spain

Nuria Esandi

Cristina alfaro‐díaz, navidad canga‐armayor, associated data.

Data sharing is not applicable to this article as no new data were created or analysed in this study.

Risky alcohol consumption among college students is a significant public health issue. In the college setting, students can collaborate in the implementation of peer‐led interventions. To date, evidence of peer‐led programmes in reducing harmful alcohol consumption in this population is inconclusive. The aim of the current scoping review is to provide a broad overview by systematically examining and mapping the literature on peer‐led interventions for preventing risky alcohol consumption by college students. The specific aims were to (1) identify the underlying focus of the interventions and assess their (2) effectiveness and (3) feasibility. A comprehensive search was conducted in PubMed, PsycINFO, CINAHL, Cochrane Library, Web of Science, DART‐Europe, RCAAP, Trove and ProQuest. The inclusion criteria were peer‐led interventions that exclusively addressed alcohol consumption, college students as the target population and interventional studies (randomised controlled trials, quasi‐experimental studies, systematic reviews and meta‐analyses of interventions). The methodological quality of the articles was evaluated. From 6654 potential studies, 13 were included. Nine interventions were described within these studies: Voice of Reason programme, Brief Advice sessions, Peer Theatre, Alcohol Education programme, Perceptions of Alcohol Norms intervention, Motivational Intervention, Alcohol Skills Training programme, Lifestyle Management Class and the Brief Alcohol Screening and Intervention for College Students. Only the last showed significant reductions in three of the four outcome measures: quantity and frequency of drinking, estimated peak blood alcohol concentration and alcohol‐related consequences. It did not significantly decrease the number of heavy‐drinking episodes. Peer interventions may be effective in preventing alcohol use among college students, although the evidence is weak and scarce. Further research is needed to strengthen the findings about peer‐led interventions.

What is already known about the topic?

• Alcohol consumption in the college environment has a negative impact on students' health and society.
• Undergraduates can participate actively in alcohol prevention interventions.
• There is a lack of robust evidence regarding the effectiveness of peer‐led interventions for preventing alcohol consumption in the college setting.

What this paper adds?

• This paper identifies peer‐led interventions for reducing risky alcohol consumption among college students.
• BASICS is the only intervention that showed significant reductions in alcohol consumption and alcohol‐related consequences.
• Peer‐led programmes are complex interventions in which feasibility aspects such as peer training, supervision and adherence are essential.

1. INTRODUCTION

Approximately 65% of college students report having consumed alcohol in the past month, and 40% of them report having one binge‐drinking episode (Barry & Merianos,  2018 ; Busse et al.,  2021 ). Therefore, alcohol use among this population is a significant public health issue. Specifically, alcohol consumption is responsible for death and disability relatively early in life. The most recent National Institute on Alcohol Abuse and Alcoholism (NIAAA) statistics estimate that 1519 college students aged 18 to 24 in the United States die from alcohol‐related unintentional injuries (Hingson et al.,  2017 ).

Drinking has acute and immediate effects on young people, in addition to increasing the risk of alcohol‐related problems in adulthood (Grant et al.,  2006 ). Moreover, excessive alcohol consumption is associated with a wide range of negative health, legal, social, psychological and environmental consequences for students, such as decreased cognitive functioning and academic ability (Martinez et al.,  2014 ; Patrick et al.,  2020 ). This behaviour affects the entire campus and broader community environment (Cimini et al.,  2009 ).

College settings, identified as educational institutions for studying an undergraduate degree (Cambridge University Press,  n.d. , Definition 1), are favourable for students to implement peer‐led interventions due to their viability (Eaton et al.,  2018 ). Peers are defined as people who share similar characteristics, circumstances or experiences. Several studies have demonstrated their effectiveness in changing tobacco use behaviours among young people (Bilgiç & Günay,  2018 ; Ford et al.,  2013 ; Mohammadi et al.,  2019 ; Orsal & Ergun,  2021 ). To date, the evidence of the use of peer‐led interventions to prevent alcohol consumption is weak and scarce, as was evidenced in a recent meta‐analysis of peer‐led programmes for alcohol use among youth ages 11 to 21 (Georgie et al.,  2016 ). However, this previous review only included one study that focused on alcohol intake among college students, and brief, multicomponent peer‐led interventions with short follow‐up times were excluded. Therefore, a scoping review was undertaken to obtain an updated overview of existing peer‐led interventions in college students, specifically. The aims of this review were (1) to identify the underlying focus of the identified interventions and to assess their (2) effectiveness and (3) feasibility.

2. MATERIALS AND METHODS

2.1. design.

A scoping review was conducted following the recommendations of Arksey and O'Malley ( 2005 ) and Levac et al. ( 2010 ), which implies a six‐step process: (1) formulation of the research question; (2) identification of relevant studies; (3) study selection; (4) data extraction; (5) analysis of the evidence and (6) result reporting.

2.2. Search methods

The search strategy aimed to locate both published and unpublished studies. Five databases (PubMed, PsycINFO, CINAHL, the Cochrane Library and Web of Science) were searched for published studies. The search for unpublished studies was performed in DART‐Europe, RCAAP, Trove and ProQuest. Third, the reference lists of all identified reports and articles were searched for additional studies.

This process was conducted from November 2020 to January 2021. The time frame was not established because the aim was to collect all the literature. Table  1 shows the search strategy used. Supporting Information  S1 illustrates the complete search strategy in the different databases.

Search strategy in PubMed

The inclusion criteria were as follows: (i) peer‐led interventions (understanding peers as undergraduate students; excluding graduate students); (ii) exclusively addressed alcohol consumption, (iii) targeted college students and (iv) interventional studies (randomised controlled trials [RCTs], quasi‐experimental studies, systematic reviews and meta‐analyses of interventions).

After the removal of duplicate studies, the titles and abstracts were assessed for inclusion following the described criteria. If the inclusion criteria were met or further examination was needed, the full text of the article was retrieved. All the processes were carried out independently by two researchers to minimise the risk of biases. In case of a discrepancy, a senior investigator assessed the articles, and then, all members of the research team examined the included articles.

2.3. Quality appraisal

The scoping study methodological framework (Arksey & O'Malley,  2005 ; Levac et al.,  2010 ) does not involve the critical appraisal of the included studies because the focus of the method is on ‘mapping’ the existing evidence. However, to approximate the quality of the selected studies, JBI tools were used to assess quality (Joanna Briggs Institute,  2017a , 2017b ). The results of the quality evaluation of the studies are shown in Supporting Information  S2 .

2.4. Data abstraction

Data were extracted from the included studies using a predefined table with the following categories: (1) author, year and country; (2) study design; (3) aim; (4) intervention; (5) interventionist; (6) training and supervision; (7) sample; (8) outcomes measured and (9) results. For the evaluation of effectiveness, a Synthesis Without Meta‐Analysis (SWiM) was performed due to the heterogeneity of the studies (Campbell et al.,  2020 ). Mean differences between the intervention and control groups were used as the effect size. Data related to the effectiveness of each intervention were extracted, mean differences for each outcome variable were calculated when possible and graphics were designed to facilitate understanding of the results.

2.5. Synthesis

The data were descriptively analysed, synthesised, and narratively presented according to our guiding research aims. The information was collated and summarised in the form of a descriptive numerical summary and subjected to qualitative thematic analysis. Specifically, the latter step consisted of the familiarisation, aggregation and synthesis of findings to generate a set of statements. Their categorisation was performed following the NIAAA interventions guide (2019) and the Medical Research Council (MRC) framework for complex interventions (Craig et al.,  2008 ). These categories were then subjected to synthesis to produce a single comprehensive set of synthesised findings.

Finally, the results were organised into four categories: characteristics of the studies, underlying approach, effectiveness and feasibility. Regarding the underlying approach, the interventions were organised following the NIAAA guide (2019) into the following three broad categories: education and awareness, cognitive behavioural skill‐based and motivation/feedback‐related approaches. Under the education and awareness approach, the NIAAA included the following programmes: information/knowledge/education alone, normative re‐education and values clarification alone. Under cognitive behavioural skill‐based approach: skills training alcohol focus and skills training alcohol plus general life skills. Last, the motivation/feedback‐related approach included brief motivational intervention, a multicomponent education‐focused programme and personalised feedback intervention.

Effectiveness refers to the effect of the intervention on the outcome variables. It was synthesised following the Synthesis Without Meta‐Analysis reporting guideline by summarising the effect estimated by each study (Campbell et al.,  2020 ).

Finally, feasibility was reviewed by evaluating two areas: acceptability (evaluating participants' satisfaction with the intervention) and implementation (to what extent can a programme be successfully delivered to intended participants; in some, defined by assessing peer counsellors' training, peer supervision and fidelity to the intervention) (Bowen et al.,  2009 ).

3.1. Characteristics of the studies

From a total of 6654 potential studies identified, 13 studies were finally included (Figure  1 ). All of the studies were conducted in the USA and were published between 1994 and 2020. Regarding the study design, 12 were RCTs and 1 was a quasi‐experimental study. Nine different interventions were described as follows: the Voice of Reason (VOR) programme, Brief Advice sessions, a Peer Theatre, an Alcohol Education programme, the Perceptions of Alcohol Norms (PAN) intervention, a Motivational Intervention, the Alcohol Skills Training Programme (ASTP), the Lifestyle Management Class (LMC) and the Brief Alcohol Screening and Intervention for College Students (BASICS). Table  2 summarises the characteristics of the studies.

PRISMA flow diagram of the scoping review selection process (Moher et al.,  2009 ).

Peer‐led interventions for alcohol consumption in college students

Abbreviations: MS, mandated students; RCT, randomised controlled trial; VS, volunteer student.

The studies differed in their target samples: most studies included students participating voluntarily ( n  = 8; Abadi et al.,  2020 ; Kulesza et al.,  2013 ; Larimer et al.,  2001 ; Mastroleo,  2008 ; Mastroleo et al.,  2010 ; Stamper et al.,  2004 ; Tollison et al.,  2013 ; Turrisi et al.,  2009 ), three targeted students who had violated the alcohol policy of the college and were mandated to participate (Borsari et al.,  2012 ; Cimini et al.,  2009 ; Mastroleo et al.,  2014 ) and a minority ( n  = 2) included both voluntary and mandated students (Fromme & Corbin,  2004 ; Palmer et al.,  2010 ). The samples also differed in alcohol intake: seven studies included all students regardless of their typical drinking habits, five addressed students with high‐risk alcohol consumption and only one focused on students with low‐ and high‐risk alcohol consumption. The follow‐up time also varied among studies from 1 week to 12 months. Finally, regarding the number of measurements during follow‐up, most studies ( n  = 9) included a single measurement after receiving the intervention (Abadi et al.,  2020 ; Cimini et al.,  2009 ; Fromme & Corbin,  2004 ; Kulesza et al.,  2013 ; Larimer et al.,  2001 ; Mastroleo,  2008 ; Mastroleo et al.,  2010 ; Stamper et al.,  2004 ; Turrisi et al.,  2009 ), while four studies included more than one measurement (Borsari et al.,  2012 ; Mastroleo et al.,  2014 ; Palmer et al.,  2010 ; Tollison et al.,  2013 ).

3.2. Underlying approach

All the included studies performed individual‐level interventions. Following the NIAAA guide (2019), the interventions were organised into education and awareness, cognitive behavioural skill‐based and motivation/feedback‐related approaches. Within each category, the interventions were further grouped into subcategories based on the specific strategy used. As many interventions had multiple components, the classification was intended to serve as a useful guide to understanding the interventions rather than an absolute categorical model.

3.2.1. Education and awareness programmes

Four interventions were included under this approach (Borsari et al.,  2012 ; Cimini et al.,  2009 ; Stamper et al.,  2004 ); these interventions aimed to provide information about the effects of alcohol on the body, potential consequences of drinking (e.g. financial cost or health problems), social norms, protective behaviours to reduce risk and definitions of a standard drink, blood alcohol concentration and alcohol tolerance (Worsley et al.,  2020 ). Three strategies were identified as follows: informative strategy, normative re‐education and value clarification.

First, two interventions used an informative strategy and focused on information, knowledge and education about alcohol, namely, brief advice sessions (Borsari et al.,  2012 ) and alcohol education programmes (Cimini et al.,  2009 ). The brief advice sessions lasted 15 min and consisted of minimal intervention, addressing risks associated with drinking and providing tips to reduce alcohol consumption (Borsari et al.,  2012 ). The Alcohol Education Programme took 2 h and included an interactive session, where participants were presented with information on the effects of alcohol on the body, definitions of a standard drink, the estimated peak blood alcohol concentration (peak eBAC) and tolerance (Cimini et al.,  2009 ). Peer counsellors in the educational programme also discussed the campus culture of college drinking, potential consequences of drinking and use of protective behaviours to reduce the risk (Cimini et al.,  2009 ).

Second, two interventions used normative re‐education and value clarification strategies: the PAN intervention (Stamper et al.,  2004 ) and Peer Theatre (Cimini et al.,  2009 ). The first strategy was designed to give students accurate information about peer alcohol use and consequences and to modify students' attitudes about the acceptability of their excessive alcohol consumption. The second strategy helped students evaluate their values and goals and incorporate responsible decision‐making about alcohol use into these values and goals (National Institute on Alcohol Abuse and Alcoholism,  2019 ). The PAN intervention lasted approximately 45 min and primarily included interactive presentations focusing on value clarification, the risks of drinking and its consequences, alcohol norms and students' perceptions of their peers' consumption (Stamper et al.,  2004 ). The Peer Theatre intervention took 2 h and consisted of an interactive theatrical presentation representing a range of norms, attitudes and behaviours regarding alcohol use (Cimini et al.,  2009 ).

3.2.2. Cognitive behavioural skill‐based approaches

Three interventions were included under this approach (Abadi et al.,  2020 ; Fromme & Corbin,  2004 ; Palmer et al.,  2010 ), which were aimed at changing thoughts and behaviours (Worsley et al.,  2020 ); all of them combined two strategies: alcohol education and skills training. The first strategy pertained to knowledge, perceptions and beliefs about alcohol, and the second strategy involved providing exercises and training in skills (National Institute on Alcohol Abuse and Alcoholism,  2019 ). These programmes were identified as complex multicomponent interventions (Larimer & Cronce,  2007 ).

The VOR intervention consisted of five 1‐h interactive sessions focused on alcohol behaviour modification, effective communication skills and the promotion of alcohol awareness and protective behavioural strategies through practice conversations with peers (Abadi et al.,  2020 ). The ASTP duration included two 90‐min sessions and involved brief presentations of information by group leaders followed by small‐group discussions. The goal was to change drinking and related lifestyle patterns (Palmer et al.,  2010 ). Finally, the LMC was delivered in two 2‐h group sessions focused on the development of skills for lifestyle management in the college setting. Issues related to health behaviour change, moderate drinking, drinking safety, academics, stress and time management and goal setting were explored through didactic lectures, experiential exercises and group discussions (Fromme & Corbin,  2004 ).

3.2.3. Motivation/feedback‐related approaches

Two interventions were included under this approach (Cimini et al.,  2009 ; Kulesza et al.,  2013 ; Larimer et al.,  2001 ; Mastroleo,  2008 ; Mastroleo et al.,  2010 , 2014 ; Tollison et al.,  2013 ; Turrisi et al.,  2009 ); these interventions were aimed at emphasising the personal responsibility, motivation and self‐efficacy of participants and reducing their ambivalence to change (Li et al.,  2016 ; National Institute on Alcohol Abuse and Alcoholism,  2019 ). They used motivational and feedback strategies.

The motivational intervention consisted of a small‐group 2‐h session that included specific components designed to enhance participants' motivation to reduce their alcohol consumption (Cimini et al.,  2009 ). It incorporated a discussion focused on students' evaluation of their own alcohol consumption and problems associated with alcohol use and how current alcohol use was or was not consistent with their own personal values and goals (Cimini et al.,  2009 ).

BASICS was applied in seven studies (Kulesza et al.,  2013 ; Larimer et al.,  2001 ; Mastroleo,  2008 ; Mastroleo et al.,  2010 , 2014 ; Tollison et al.,  2013 ; Turrisi et al.,  2009 ). The studies differed in the duration of the intervention, ranging from 10 to 60 min. The BASICS intervention involved a motivational session that targeted peer influences through the provision of personalised feedback and the discussion of alcohol norms, alcohol expectancies, negative consequences and protective behavioural strategies and skills (Turrisi et al.,  2009 ).

3.3. Effectiveness

The review aims to examine the effectiveness of peer‐led interventions for preventing alcohol consumption in the college setting. Among the included studies, there were differences in terms of the outcome measures (e.g., typical drinking quantity and frequency, peak eBAC, episodes of heavy drinking, alcohol‐related consequences or problems, alcohol effects and risk behaviours among others), the measurement period (e.g. ranging from 1 week to 12 months) and the evaluation tools (different scales or instruments used).

The most common primary outcomes were the quantity and frequency of drinking, peak eBAC, number of heavy‐drinking episodes and alcohol‐related consequences. The quantity and frequency of drinking were measured in all the included studies; most used the Daily Drinking Questionnaire (Collins et al.,  1985 ). Three studies found a statistically lower amount and frequency of alcohol consumption in the intervention group than in the control group (Figure  2 ; Kulesza et al.,  2013 ; Larimer et al.,  2001 ; Turrisi et al.,  2009 ). Specifically, Kulesza et al. ( 2013 ) found a decrease of 2,5 drinks per week (95% CI = −4.89 to −0.11) in students who received a 50‐min BASICS intervention compared to the control group and a decline of 4.1 drinks per week (95% CI = −6.42 to −1.78) in students who received a 10‐min BASICS intervention compared to the control group. Turrisi et al. ( 2009 ) reported a reduction of 0.89 and 1.12 drinks per week (95% CI = −0.95 to −0.83; −1.17 to −1.06) in participants who attended, respectively, BASICS and the combined intervention compared to the control group. Finally, Larimer et al. ( 2001 ) found a decrease of 5.24 drinks per week (95% CI = −9.73 to −0.75) in students who received BASICS compared to the control group.

Mean differences between intervention and control group in weekly alcohol consumption. Note: BASICS, Brief Alcohol Screening and Intervention for College Students; CG, Control Group; CPA, common practice approach; EAA, evidence‐based approach; LMC, Lifestyle Management Class; n , sample size.

The second most evaluated variable was the peak eBAC. It was measured through a specific ad hoc question, or the Quantity/Frequency/Peak Index (Dimeff et al.,  1999 ). It was evaluated in seven studies, and one of them reported a statistically significant reduction in favour of the IG (Figure  3 ) (Turrisi et al.,  2009 ). Turrisi et al. ( 2009 ) found reductions of 0.015 and 0.026 g/L (95% CI = −0.02 to −0.01 g/L; CI = −0.03 to −0.022 g/L) in students who attended BASICS and the combined intervention, respectively, compared to the control group.

Mean differences between intervention and control group in peak eBAC. Note: BASICS, Brief Alcohol Screening and Intervention for College Students; CG, Control Group; CPA, common practice approach; EAA, evidence‐based approach; n , sample size.

Third, the number of heavy drinking episodes was evaluated in six studies. It was measured through a specific ad hoc question. None of them found a statistically significant reduction in favour of the IG (Figure  4 ).

Mean differences between intervention and control group in heavy‐drinking episodes. Note: BASICS, Brief Alcohol Screening and Intervention for College Students; CG, Control Group; CPA, common practice approach; EAA, evidence‐based approach; LMC, Lifestyle Management Class; n , sample size.

Finally, alcohol‐related consequences include driving under the influence of alcohol, nausea and vomiting, a lack of class attendance, fights or physical aggression and unsafe sex, among others. Eleven studies measured them. The following tools were used: Young Adult Alcohol Consequences Questionnaire (YAACQ), Rutgers Alcohol Problem Index (RAPI), Positive and Negative Consequences Experienced (PNCE) and Young Adult Alcohol Problems Screening Test (YAAPST). Only Turrisi et al. ( 2009 ) reported a statistically significant reduction in favour of the IG (Figure  5 ). They found a decrease of 0.049 and 0.65 in the total consequence score (95% CI = −0.08 to −0.02; CI = −0.68 to −0.62) at 10 months after receiving the intervention in students who attended BASICS and the combined intervention, respectively, compared to the control group. They do not specify which consequences were reduced.

Mean differences between intervention and control group in negative consequences. Note: BASICS, Brief Alcohol Screening and Intervention for College Students; CG, Control Group; CPA, Common Practice Approach; EAA, Evidence‐Based Application; LMC, Lifestyle Management Class; n , sample size.

Thus, the results presented above show that the majority of studies found no differences between intervention and control groups. BASICS was the only programme with statistically significant results for three of the four main alcohol‐related outcomes (Kulesza et al.,  2013 ; Larimer et al.,  2001 ; Turrisi et al.,  2009 ); nevertheless, it failed to reduce alcohol use in various studies (Mastroleo,  2008 ; Mastroleo et al.,  2010 , 2014 ).

Furthermore, only two studies compared the programme effectiveness of peer‐ and professional‐led interventions. While Fromme and Corbin ( 2004 ) indicated similar efficacy for both conditions, Larimer et al. ( 2001 ) found that a peer‐led intervention was more effective than a professional one: those who received the peer‐led programme showed reductions in normal peak eBAC of 0.04 g/L ( p  < 0,05) compared to those who received the professional‐led intervention.

3.3.1. Mediators of intervention effectiveness

Mediator variables were analysed in two of the included studies (Kulesza et al.,  2013 ; Turrisi et al.,  2009 ). They found that alcohol descriptive norms mediated treatment efficacy and that were significant mediators between the intervention and alcohol consumption ( β  = 0.19 p  < 0.05; β  = 0.33 p  < 0.01, respectively). Specifically, participants in the control condition ( M  = 4.04; SD  = 0.87) perceived that other college students consumed more alcohol than they did as compared to those in 50‐min ( M  = 3.22; SD  = 0.71) intervention (Kulesza et al.,  2013 ). This result indicated that the more an individual perceived engagement in heavy drinking among their peers, the more alcohol they consumed. In the same vein, Kulesza et al. ( 2013 ), in accordance with Turrisi et al. ( 2009 ), suggested that if changes occur in drinkers' alcohol descriptive norms following the BASICS intervention, those drinkers are significantly more likely to decrease the amount of alcohol they consume.

Kulesza et al. ( 2013 ) also reported that post‐intervention coping skills mediated the efficacy of the intervention. Therefore, another mediator variable was cognitive behavioural skills ( β  = −0.33 p  < 0.05), so the fewer behavioural coping skills for reducing alcohol consumption a student uses, the more he or she consumes alcohol (Kulesza et al.,  2013 ).

3.4. Feasibility

3.4.1. acceptability.

Acceptability is paramount in the development of complex health‐promoting interventions (Sekhon et al.,  2017 ). Of the included studies, only three assessed participant satisfaction and all of them through questionnaires.

Borsari et al. ( 2012 ) found that satisfaction ratings for the brief advice intervention were very high and reported that 92% of the participants stated they would recommend the intervention. Participants' ratings of the peer counsellor were also high, with 95% reporting that the peer was organised and competent.

Fromme and Corbin ( 2004 ), in addition to assessing this aspect, compared the satisfaction of the participants who received peer intervention with those who received the professional intervention. They found that participants evaluated peers less positively than professionals on nine items, such as ‘I am now more knowledgeable about moderating my use of alcohol and other drugs’.

Finally, Tollison et al. ( 2013 ) did not report the results of the satisfaction questionnaire in the article.

3.4.2. Implementation

Training programmes.

The duration of counsellors' training differed among the studies, with an average of 12 h and a range 8 (Abadi et al.,  2020 ) to 16 h (Fromme & Corbin,  2004 ). In the training workshops, several strategies were applied: in all the studies, counsellors received theoretical information; eight studies provided counsellors with a written manual (Borsari et al.,  2012 ; Kulesza et al.,  2013 ; Mastroleo,  2008 ; Mastroleo et al.,  2010 , 2014 ; Stamper et al.,  2004 ; Tollison et al.,  2013 ; Turrisi et al.,  2009 ); nine involved role play (Borsari et al.,  2012 ; Cimini et al.,  2009 ; Kulesza et al.,  2013 ; Mastroleo,  2008 ; Mastroleo et al.,  2010 , 2014 ; Stamper et al.,  2004 ; Tollison et al.,  2013 ; Turrisi et al.,  2009 ); five had counsellors view exemplary videos (Mastroleo,  2008 ; Mastroleo et al.,  2010 , 2014 ; Tollison et al.,  2013 ; Turrisi et al.,  2009 ); and finally, three used a feedback sheet in training counsellors (Mastroleo,  2008 ; Mastroleo et al.,  2010 , 2014 ). Only Cimini et al. ( 2009 ) evaluated the theoretical content through an exam that students had to pass to become counsellors.

Peer supervision

Eight studies included peer supervision once undergraduates began implementing the programme (Borsari et al.,  2012 ; Cimini et al.,  2009 ; Kulesza et al.,  2013 ; Mastroleo,  2008 ; Mastroleo et al.,  2010 , 2014 ; Tollison et al.,  2013 ; Turrisi et al.,  2009 ). Seven of them specified that peer supervision was weekly. Regarding the type of supervision, two studies used group supervision (Borsari et al.,  2012 ; Cimini et al.,  2009 ), while four studies combined group supervision with individual supervision (Mastroleo,  2008 ; Mastroleo et al.,  2010 , 2014 ; Turrisi et al.,  2009 ).

Three studies compared supervised and unsupervised peers (Mastroleo,  2008 ; Mastroleo et al.,  2010 , 2014 ), showing that the supervised group scored higher on some quality indicators, such as the percentage of complex reflections or percentage of open questions. However, no study found significant differences in the outcome variables of alcohol consumption according to supervision.

Peer adherence to the intervention (fidelity)

Fidelity examines the extent to which an intervention is consistently implemented according to the initial treatment protocol (Lovell et al.,  2008 ). It includes the competence of the subject who performs the intervention (Margison et al.,  2000 ); this aspect was evaluated in 8 of the 13 studies.

The measurement varied depending on the type of intervention. In the brief advice intervention, Borsari et al. ( 2012 ) examined whether peer counsellors discussed the information in the provided booklets. They coded the sessions, checked and summed the topics covered and found that 14 or more of the 16 total topics were addressed in 83% of the intervention meetings.

In the LMC intervention, the authors assessed adherence to the protocol, class participation and group cohesiveness (Fromme & Corbin,  2004 ). These variables were evaluated with a Likert‐type scale, and the authors found that peer counsellors scored lower than professionals. In addition, compared to professionals, peer counsellors included less discussion among students and more lectures and time spent completing forms (Fromme & Corbin,  2004 ).

The studies on motivational interventions evaluated peers' adherence to the principles of motivational interviewing as well as to the protocol of the programme. Three studies used the Motivational Interviewing Treatment Integrity (MITI) instrument (Cimini et al.,  2009 ; Tollison et al.,  2013 ; Turrisi et al.,  2009 ), two used the Peer Proficiency Assessment (PEPA) (Mastroleo,  2008 ; Mastroleo et al.,  2010 ) and one used both instruments (Mastroleo et al.,  2014 ). The MITI instrument evaluates adherence to motivational interviewing principles with five items (evocation, collaboration, support, direction and empathy; Mastroleo et al.,  2014 ). Peer adherence differed in each study: one study found that counsellors scored high in proficiency (Turrisi et al.,  2009 ), two found that counsellors had moderate proficiency scores (Mastroleo et al.,  2014 ; Tollison et al.,  2013 ) and one found that counsellors had low proficiency scores (Cimini et al.,  2009 ).

The PEPA evaluates motivational interviewing microskills by counting open/closed questions and simple/complex reflections. Two studies showed significant differences between the supervised and unsupervised groups in simple and complex reflexes and the proportion of reflections to questions in favour of the supervised group (Mastroleo et al.,  2010 , 2014 ). Mastroleo ( 2008 ) did not find significant differences.

Finally, Larimer et al. ( 2001 ) measured peer counsellors' adherence but did not specify the tool. They reported that peers adhered to the intervention protocol.

3.5. Quality appraisal

Regarding the quality assessment of RCT, all the studies ( n  = 12) received “yes” responses to at least 7 of the 13 questions from the JBI Critical Appraisal tool. Consequently, no study was discarded. The items that scored the lowest were those related to the allocation to treatment groups; treatment group similarity at baseline; and the blinding of participants, investigators and assessors. The quality appraisal of the quasi‐experimental study included four of the nine items. The items were those related to the clarity between cause and effect, multiple measurements of the outcome both pre‐ and postintervention, outcomes measurement in a reliable way and appropriate statistical analysis used.

4. DISCUSSION

This is the first scoping review aimed at providing a broad overview of the existing peer‐led interventions for preventing risky alcohol consumption in college students. The literature on peer‐led interventions is weak and scarce. Only BASICS showed significant reductions in three of the four outcome variables: quantity and frequency of drinking, estimated peak blood alcohol concentration and alcohol‐related consequences. This could be explained because of its preventive focus/foundation following a harm reduction approach, seeking to reduce health and social harms associated with alcohol use without necessarily requiring abstinence (Neighbors et al.,  2006 ). It is known that young people respond better to this type of alcohol prevention approach that is contextually relevant and responsive to the lived experiences of youth (Jenkins et al.,  2017 ). Another possible explanation could be that, as mentioned above, BASICS was the intervention that best fit the needs of the target students, as it combined cognitive and motivational strategies, predominantly the latter (Dimeff et al.,  1999 ; Wagstaff,  2015 ). This is in accordance with the NIAAA, which rates BASICS as the intervention with the highest level of effectiveness (National Institute on Alcohol Abuse and Alcoholism,  2019 ).

These results have important clinical implications as any reduction in peak BAC might decrease a wide variety of risks such as fainting, unconsciousness or traffic accidents (Dimeff et al.,  1999 ; Hingson et al.,  2009 ). Another positive effect of the intervention is the reduction in alcohol‐related negative consequences, such as harm to third parties or unprotected sex. Up to 12% of university students claimed to have been beaten or assaulted by another student who had maintained a risky alcohol consumption pattern (Hingson et al.,  2009 ; National Institute on Alcohol Abuse and Alcoholism,  2020 ). Therefore, offering this type of intervention to reduce risky alcohol consumption in undergraduates is paramount.

This review shows how the underlying approach of the intervention is key for enhancing its effectiveness, as it should be in line with the target population's needs (Miller et al.,  2015 ). In the case of college students, it is known that they lack the knowledge and skills required to reduce alcohol consumption (De Visser & Birch,  2012 ; White & Hingson,  2013 ) and that they need the motivation to change their drinking patterns because of social‐contextual factors (e.g. misperceptions about alcohol use, the need for socialisation and peer pressure; Muli & Lagan,  2017 ; O'Hara et al.,  2015 ). Thus, a combination of both cognitive behavioural skill‐based and motivation/feedback‐related approaches is recommended to address the necessities of the college population, as the lack of knowledge, motivation and skills could affect the programmes' impact (Hwang et al.,  2018 ; Iarussi et al.,  2016 ; Moreno‐Guerrero et al.,  2020 ; Pueyo‐Garrigues et al.,  2019 ).

Furthermore, evaluating mediators provides further guidance to enhance intervention effectiveness (Kazdin & Nock,  2003 ). This work has identified alcohol social norms and cognitive behavioural skills as significant mediators in contrast with a recent systematic review, which only found social norms mediating alcohol consumption among college students (Reid & Carey,  2015 ). This could be because this population tends to overrepresent alcohol consumption among their peers, a belief that is associated with an increase in an individual's own consumption (Lin et al.,  2022 ; Wolter et al.,  2021 ). Therefore, these results suggest that alcohol social norms and cognitive behavioural skills are important active ingredients in reducing drinking among college students.

In line with the aforementioned points, in addition to the effect of the intervention on the participants, we can also highlight the impact on the peer counsellors themselves. It is striking that no included study evaluated this effect despite evidence showing its positive effect, that is, on counsellors' interpersonal communication and self‐esteem (King & Fazel,  2021 ; Newton & Ender,  2010 ). This impact is essential because peer facilitators influence the lives of college members and, moreover, of the community and society in general (Holt & Powell,  2017 ; Suárez‐Reyes et al.,  2019 ). Furthermore, they will become professionals and decision‐makers in organisations, communities and countries (El Ansari et al.,  2011 ). Therefore, it is recommended that future studies evaluate the impact of the intervention on the counsellors themselves since they are part of the target population.

Assessing the feasibility of the programme is important as it provides valuable information on why it does or does not work and how it can be optimised (Moore et al.,  2014 ). Regarding the acceptability (satisfaction) of the intervention, this review found that participants' satisfaction was related to the counsellor's status as a peer, which allowed them to feel confident and understood (Borsari et al.,  2012 ; Simoni et al.,  2011 ). Acceptability was measured in only three studies. This is in contrast with the literature that stresses the importance of its assessment to optimise the intervention (Barnhart et al.,  2020 ; O'Cathain et al.,  2019 ). Consequently, future studies need to assess participants' degree of satisfaction to identify the aspects that need to be changed or improved. In addition, counsellor satisfaction was not evaluated in the studies. It would be interesting to assess counsellor satisfaction to determine specific aspects to improve the intervention (Pueyo‐Garrigues,  2021 ).

Regarding implementation, the first aspect identified as fundamental for the quality of the intervention is peer counsellor training. This could be because peer facilitators lack the skills and knowledge for developing health‐promotion interventions in comparison with professionals (Crozier et al.,  2020 ). The pedagogical strategies used for peer training differed among the included studies. All of them provided theoretical information to peers, and nine studies added other strategies, such as written manuals, role playing and viewing exemplary videos. BASICS, which is the intervention that has been shown to be more effective, uses a combination of these strategies to train peers.

The second aspect analysed in the implementation section was supervision. Findings support its importance, especially for counsellors with deficiencies in motivational interviewing skills after initial training (Mastroleo et al.,  2010 , 2014 ). This is in line with the ‘Evidence‐Based Guidelines for Youth Peer Education’, which recommend conducting supportive supervisory meetings (Family Health International,  2010 ). Regarding the supervision format, most of the interventions combined individual and group supervision. The former contributes to a greater awareness of counsellors' strengths and weaknesses in the implementation of the programme, while the latter favours an environment where counsellors can share ideas, opinions and experiences, as well as strengths and aspects of improvement (Pueyo‐Garrigues,  2021 ). Therefore, future studies should include both supervision formats, as they are vital to ensure motivational interviewing adherence, microskill acquisition and fidelity.

The third implementation topic was adherence of peer counsellors to the intervention. It was evaluated in most of the studies, which corroborates the importance of its assessment in complex interventions (Craig et al.,  2008 ). The way in which an intervention is applied can be a unique and important element of students' change processes (Moyers et al.,  2007 ; Tollison et al.,  2013 ). Although most of the included studies assessed peers´ adherence, the results were inconclusive. A possible explanation could be that the instruments used were heterogeneous, making comparisons between studies difficult. For future investigations, the combination of the Peer Proficiency Assessment (PEPA) and Motivational Interviewing Treatment Integrity (MITI) instruments is recommended since they provide complementary information (Mastroleo et al.,  2014 ).

Finally, it is important to emphasise the moderate methodological quality of the studies included in this review. The majority had an appropriate research design for the research question posed and clearly defined randomisation, allocation and outcome measurement. However, there was a lack of information about the implementation of the intervention and the interventionist characteristics. Therefore, it is recommended for future studies to describe in detail the interventions used and the interventionists' characteristics.

4.1. Limitations and strengths

This study has several strengths and limitations. Regarding the possible limitations, while we are confident that we found most peer‐led intervention studies, some publications were possibly not identified in the literature review. Additionally, although we contacted the original authors to gather details about the intervention, when possible, some data from the reviewed studies were unavailable. Moreover, the investigations were heterogeneous in both the measured outcomes and instruments used; hence, the comparison between them was complicated and sometimes not possible. Despite the limitations, this study has various strengths. A rigorous and comprehensive three‐step process for the search strategy was applied, with the inclusion of published and unpublished studies and the use of the JBI guidelines and the MRC framework as guides for data extraction and synthesis. Additionally, the review was performed by two investigators independently and a third who participated in case of discrepancy. Furthermore, although quality appraisal is not compulsory for a scoping review, a quality appraisal of the included articles was conducted.

5. CONCLUSION

This review provided valuable information on the effectiveness of multicomponent peer‐led interventions for preventing risky alcohol consumption among college students and shows that, despite limited evidence, BASICS is the intervention with the highest effect for this population. A strategic aspect highlighted in this review is the importance of peer training in alcohol and motivational interviewing, in addition to the need for supervision for intervention effectiveness. Such peer‐led interventions can be considered complex interventions, and it is also necessary to evaluate process variables such as feasibility. Finally, future randomised controlled trials are desirable to assess the effectiveness and cost‐effectiveness of peer‐led interventions, as well as to evaluate if undergraduates could be a powerful health asset in the college setting.

AUTHOR CONTRIBUTIONS

MLG (primary author) is a researcher in Health Promotion and Education. This author has participated in the conception and design of the study, acquisition of data, its analysis and interpretation and writing the article. MPG is a researcher in Health Promotion and Education. This author has participated in the conception and design of the study, acquisition of data, analysis and interpretation, and writing the article. SPG is a researcher in Health Promotion and Education. She contributed to the critical reviewing of the manuscript, enhancing the final version and writing the article. MIP is a researcher in Psychology and Health Promotion and Education. She contributed to the critical reviewing of the manuscript, enhancing the final version and writing the article. ACA is a senior researcher in Health Education and Family Health Promotion. She contributed to the critical reviewing of the manuscript, enhancing the final version and writing the article. NE is a researcher in Family Health Promotion. She contributed to the critical reviewing of the manuscript, enhancing the final version and writing the article. CAD is a researcher in Family Health Promotion. She contributed to the critical reviewing of the manuscript, enhancing the final version and writing the article. NCA is a senior researcher in Public Health and Health Promotion and Education. This author has participated in the conception and design of the study, acquisition of data, analysis and interpretation and writing the article. All authors read and approved the final manuscript.

FUNDING INFORMATION

The research that led to these results has been promoted by the Association of Friends of the University of Navarra and Banco Santander.

CONFLICT OF INTEREST

No conflict of interest has been declared by the authors.

ETHICS STATEMENT

Ethical approval was not required for conducting this scoping review.

Supporting information

Acknowledgements.

We thank the Santander University of Navarra for providing a grant and the Association of Friends of the University of Navarra for their financial collaboration in this project.

Lavilla‐Gracia, M. , Pueyo‐Garrigues, M. , Pueyo‐Garrigues, S. , Pardavila‐Belio, M. I. , Canga‐Armayor, A. , Esandi, N. , Alfaro‐Díaz, C. , & Canga‐Armayor, N. (2022). Peer‐led interventions to reduce alcohol consumption in college students: A scoping review . Health & Social Care in the Community , 30 , e3562–e3578. 10.1111/hsc.13990 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

Contributor Information

María Lavilla‐Gracia, @MariaLavilla96 .

María Pueyo‐Garrigues, Email: [email protected] , @MariaPueyoG .

Miren Idoia Pardavila‐Belio, @IdoiaPardavila .

Ana Canga‐Armayor, @acangaarmayor .

Nuria Esandi, @nelarramend .

Cristina Alfaro‐Díaz, @CristinaCalfaro .

Navidad Canga‐Armayor, @NavidadCanga .

DATA AVAILABILITY STATEMENT

• Abadi, M. H. , Shamblen, S. R. , Thompson, K. T. , Richard, B. O. , Parrino, H. , & Hall, M. T. (2020). Peer‐led training to reduce alcohol misuse and related harm among Greek‐affiliated students . Substance Use and Misuse , 55 ( 14 ), 2321–2331. 10.1080/10826084.2020.1811342 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Arksey, H. , & O'Malley, L. (2005). Scoping studies: Towards a methodological framework . International Journal of Social Research Methodology: Theory and Practice , 8 ( 1 ), 19–32. 10.1080/1364557032000119616 [ CrossRef ] [ Google Scholar ]
• Barnhart, D. A. , Semrau, K. , Zigler, C. M. , Molina, R. L. , Delaney, M. M. , Hirschhorn, L. R. , & Spiegelman, D. (2020). Optimizing the development and evaluation of complex interventions: Lessons learned from the better birth program and associated trial . Implementation Science Communications , 1 , 29. 10.1186/s43058-020-00014-8 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Barry, A. E. , & Merianos, A. L. (2018). The impact of protective behavioral strategy use frequency on blood alcohol concentrations among student drinkers Nationwide . American Journal of Health Promotion , 32 ( 1 ), 205–209. 10.1177/0890117116686901 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bilgiç, N. , & Günay, T. (2018). Evaluation of effectiveness of peer education on smoking behavior among high school students . Saudi Medical Journal , 39 ( 1 ), 74–80. 10.15537/smj.2018.1.21774 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Borsari, B. , Hustad, J. T. P. , Mastroleo, N. R. , Tevyaw, T. O. L. , Barnett, N. P. , Kahler, C. W. , Short, E. E. , & Monti, P. M. (2012). Addressing alcohol use and problems in mandated college students: A randomized clinical trial using stepped care . Journal of Consulting and Clinical Psychology , 80 ( 6 ), 1062–1074. 10.1037/a0029902 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Bowen, D. J. , Kreuter, M. , Spring, B. , Cofta‐Woerpel, L. , Linnan, L. , Weiner, D. , Bakken, S. , Kaplan, C. P. , Squiers, L. , Fabrizio, C. , & Fernandez, M. (2009). How we design feasibility studies . American Journal of Preventive Medicine , 36 ( 5 ), 452–457. 10.1016/j.amepre.2009.02.002 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Busse, H. , Buck, C. , Stock, C. , Zeeb, H. , Pischke, C. R. , Fialho, P. , Wendt, C. , & Helmer, S. M. (2021). Engagement in health risk behaviours before and during the COVID‐19 pandemic in German university students: Results of a cross‐sectional study . International Journal of Environmental Research and Public Health , 18 ( 4 ), 1410. 10.3390/ijerph18041410 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cambridge University Press . (n.d.). Cambridge dictionary . Retrieved March 16, 2022, from https://dictionary.cambridge.org/es/diccionario/ingles/college
• Campbell, M. , McKenzie, J. E. , Sowden, A. , Katikireddi, S. V. , Brennan, S. E. , Ellis, S. , Hartmann‐Boyce, J. , Ryan, R. , Shepperd, S. , Thomas, J. , Welch, V. , & Thomson, H. (2020). Synthesis without meta‐analysis (SWiM) in systematic reviews: Reporting guideline . BMJ (Clinical Research ed.) , 368 , l6890. 10.1136/bmj.l6890 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cimini, M. D. , Martens, M. P. , Larimer, M. E. , Kilmer, J. R. , Neighbors, C. , & Monserrat, J. M. (2009). Assessing the effectiveness of peer‐facilitated interventions addressing high‐risk drinking among judicially mandated college students . Journal of Studies on Alcohol and Drugs , 16 , 57–66. 10.15288/jsads.2009.s16.57 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Collins, R. L. , Parks, G. A. , & Marlatt, G. A. (1985). Social determinants of alcohol consumption: The effects of social interaction and model status on the self‐administration of alcohol . Journal of Consulting and Clinical Psychology , 53 , 189–200. 10.1037/0022-006X.53.2.189 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Craig, P. , Dieppe, P. , Macintyre, S. , Michie, S. , Nazareth, I. , Petticrew, M. , & Medical Research Council Guidance . (2008). Developing and evaluating complex interventions: The new Medical Research Council guidance . BMJ (Clinical Research ed.) , 337 , a1655. 10.1136/bmj.a1655 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Crozier, A. , Porcellato, L. , Buckley, B. , & Watson, P. M. (2020). Facilitators and challenges in delivering a peer‐support physical activity intervention for older adults: A qualitative study with multiple stakeholders . BMC Public Health , 20 ( 1 ), 1904. 10.1186/s12889-020-09990-x [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• De Visser, R. O. , & Birch, J. D. (2012). My cup runneth over: Young people's lack of knowledge of low risk drinking guidelines . Drug and Alcohol Review , 31 ( 2 ), 206–212. 10.1111/j.1465-3362.2011.00371.x [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Dimeff, L. A. , Baer, J. S. , Kivlahan, D. R. , & Marlatt, G. A. (1999). Brief alcohol screening and intervention for college students (BASICS): A harm reduction approach . Guilford Press. [ Google Scholar ]
• Eaton, E. M. , Magill, M. , Capone, C. , Cramer, M. A. , Mastroleo, N. R. , Reavy, R. , & Borsari, B. (2018). Mechanisms of behavior change within peer‐implemented alcohol interventions . Journal of Studies on Alcohol and Drugs , 79 ( 2 ), 208–216. 10.15288/jsad.2018.79.208 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• El Ansari, W. , Stock, C. , John, J. , Deeny, P. , Phillips, C. , Snelgrove, S. , Adetunji, H. , Hu, X. , Parke, S. , Stoate, M. , & Mabhala, A. (2011). Health promoting behaviours and lifestyle characteristics of students at seven universities in the UK . Central European Journal of Public Health , 19 ( 4 ), 197–204. 10.21101/cejph.a3684 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Family Health International . (2010). Evidence‐Based Guidelines for Youth Peer Education .
• Ford, P. , Clifford, A. , Gussy, K. , & Gartner, C. (2013). A systematic review of peer‐support programs for smoking cessation in disadvantaged groups . International Journal of Environmental Research and Public Health , 10 ( 11 ), 5507–5522. 10.3390/ijerph10115507 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Fromme, K. , & Corbin, W. (2004). Prevention of heavy drinking and associated negative consequences among mandated and voluntary college students . Journal of Consulting and Clinical Psychology , 72 ( 6 ), 1038–1049. 10.1037/0022-006X.72.6.1038 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Georgie, J. M. , Sean, H. , Deborah, M. C. , Matthew, H. , & Rona, C. (2016). Peer‐led interventions to prevent tobacco, alcohol and/or drug use among young people aged 11‐21 years: A systematic review and meta‐analysis . Addiction (Abingdon, England) , 111 ( 3 ), 391–407. 10.1111/add.13224 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Grant, J. D. , Scherrer, J. F. , Lynskey, M. T. , Lyons, M. J. , Eisen, S. A. , Tsuang, M. T. , True, W. R. , & Bucholz, K. K. (2006). Adolescent alcohol use is a risk factor for adult alcohol and drug dependence: Evidence from a twin design . Psychological Medicine , 36 ( 1 ), 109–118. 10.1017/S0033291705006045 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hingson, R. , Zha, W. , & Smyth, D. (2017). Magnitude and trends in heavy episodic drinking, alcohol‐impaired driving, and alcohol‐related mortality and overdose hospitalizations among emerging adults of college ages 18‐24 in the United States, 1998‐2014 . Journal of Studies on Alcohol and Drugs , 78 ( 4 ), 540–548. 10.15288/jsad.2017.78.540 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hingson, R. W. , Zha, W. , & Weitzman, E. R. (2009). Magnitude of and trends in alcohol‐related mortality and morbidity among U.S. college students ages 18‐24, 1998‐2005 . Journal of Studies on Alcohol and Drugs , ( 16 ), 12–20. 10.15288/jsads.2009.s16.12 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Holt, M. , & Powell, S. (2017). Healthy universities: A guiding framework for universities to examine the distinctive health needs of its own student population . Perspectives in Public Health , 137 ( 1 ), 53–58. 10.1177/1757913916659095 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hwang, H. L. , Kuo, M. L. , & Tu, C. T. (2018). Health education and competency scale: Development and testing . Journal of Clinical Nursing , 27 , 1–10. 10.1111/jocn.14116 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Iarussi, M. M. , Tyler, J. M. , Crawford, S. H. , & Crawford, C. (2016). Counselor training in two evidence‐based practices: Motivational interviewing and cognitive behavior therapy . The Journal of Counselor Preparation and Supervision , 8 ( 3 ), 1–24. 10.7729/83.1113 [ CrossRef ] [ Google Scholar ]
• Jenkins, E. K. , Slemon, A. , & Haines‐Saah, R. J. (2017). Developing harm reduction in the context of youth substance use: Insights from a multi‐site qualitative analysis of young people's harm minimization strategies . Harm Reduction Journal , 14 ( 1 ), 53. 10.1186/s12954-017-0180-z [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Joanna Briggs Institute . (2017a). Checklist for randomized controlled trials (pp. 1–9). Joanne Briggs Institute. http://joannabriggs.org/research/critical‐appraisal‐tools.html [ Google Scholar ]
• Joanna Briggs Institute . (2017b). Checklist for quasi‐experimental studies (pp. 1–7). Joanne Briggs Institute. http://joannabriggs.org/research/critical‐apprasal‐tools.htlm [ Google Scholar ]
• Kazdin, A. E. , & Nock, M. K. (2003). Delineating mechanisms of change in child and adolescent therapy: Methodological issues and research recommendations . Journal of Child Psychology and Psychiatry, and Allied Disciplines , 44 ( 8 ), 1116–1129. 10.1111/1469-7610.00195 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• King, T. , & Fazel, M. (2021). Examining the mental health outcomes of school‐based peer‐led interventions on young people: A scoping review of range and a systematic review of effectiveness . PLoS ONE , 16 ( 4 ), e0249553. 10.1371/journal.pone.0249553 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kulesza, M. , McVay, M. A. , Larimer, M. E. , & Copeland, A. L. (2013). A randomized clinical trial comparing the efficacy of two active conditions of a brief intervention for heavy college drinkers . Addictive Behaviors , 38 ( 4 ), 2094–2101. 10.1016/j.addbeh.2013.01.008 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Larimer, M. E. , & Cronce, J. M. (2007). Identification, prevention, and treatment revisited: Individual‐focused college drinking prevention strategies 1999‐2006 . Addictive Behaviors , 32 ( 11 ), 2439–2468. 10.1016/j.addbeh.2007.05.006 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Larimer, M. E. , Turner, A. P. , Anderson, B. K. , Fader, J. S. , Kilmer, J. R. , Palmer, R. S. , & Cronce, J. M. (2001). Evaluating a brief alcohol intervention with fraternities . Journal of Studies on Alcohol , 62 ( 3 ), 370–380. 10.15288/jsa.2001.62.370 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Levac, D. , Colquhoun, H. , & O'Brien, K. K. (2010). Scoping studies: Advancing the methodology . Implementation Science , 5 ( 1 ), 1–9. 10.1186/1748-5908-5-69 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Li, L. , Zhu, S. , Tse, N. , Tse, S. , & Wong, P. (2016). Effectiveness of motivational interviewing to reduce illicit drug use in adolescents: A systematic review and meta‐analysis . Addiction , 111 ( 5 ), 795–805. 10.1111/add.13285 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lin, C. A. , Christensen, J. L. , & Basaran, A. B. (2022). Know your safe drinking skills: Adaptation strategies for the college effect . Social Sciences , 11 ( 1 ), 18. 10.3390/socsci11010018 [ CrossRef ] [ Google Scholar ]
• Lovell, K. , Bower, P. , Richards, D. , Barham, M. , Sibbald, B. , Roberts, C. , Davies, L. , Rogers, A. , Gellatly, J. , & Hennessy, S. (2008). Developing guided self‐help for depression using the Medical Research Council complex interventions framework: A description of the modelling phase and results of an exploratory randomised controlled trial . BMC Psychiatry , 8 , 91. 10.1186/1471-244X-8-91 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Margison, F. R. , Barkham, M. , Evans, C. , McGrath, G. , Clark, J. M. , Audin, K. , & Connell, J. (2000). Measurement and psychotherapy. Evidence‐based practice and practice‐based evidence . The British Journal of Psychiatry: The Journal of Mental Science , 177 , 123–130. 10.1192/bjp.177.2.123 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Martinez, J. A. , Sher, K. J. , & Wood, P. K. (2014). Drinking consequences and subsequent drinking in college students over 4 years . Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors , 28 ( 4 ), 1240–1245. 10.1037/a0038352 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Mastroleo, N. R. (2008). Comparison of supervision training techniques in a motivational enhancement intervention on college student drinking [doctoral dissertation]. The Pennsylvania State University. [ Google Scholar ]
• Mastroleo, N. R. , Magill, M. , Barnett, N. P. , & Borsari, B. (2014). A pilot study of two supervision approaches for peer‐led alcohol interventions with mandated college students . Journal of Studies on Alcohol and Drugs , 75 ( 3 ), 458–466. 10.15288/jsad.2014.75.458 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Mastroleo, N. R. , Turrisi, R. , Carney, J. L. V. , Ray, A. E. , & Larimer, M. E. (2010). Examination of posttraining supervision of peer counselors in a motivational enhancement intervention to reduce drinking in a sample of heavy‐drinking college students . Journal of Substance Abuse Treatment , 39 ( 3 ), 289–297. 10.1016/j.jsat.2010.06.005 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Miller, T. , Chandler, L. , & Mouttapa, M. (2015). A needs assessment, development, and formative evaluation of a health promotion smartphone application for college students . American Journal of Health Education , 46 , 207–215. 10.1080/19325037.2015.1044138 [ CrossRef ] [ Google Scholar ]
• Mohammadi, M. , Ghaleiha, A. , & Rahnama, R. (2019). Effectiveness of a peer‐led behavioral intervention program on tobacco use‐related knowledge, attitude, normative beliefs, and intention to smoke among adolescents at Iranian public high schools . International Journal of Preventive Medicine , 10 , 111. 10.4103/ijpvm.IJPVM_493_17 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Moher, D. , Liberati, A. , Tetzlaff, J. , Altman, D. G. , & PRISMA Group . (2009). Preferred reporting items for systematic reviews and meta‐analyses: The PRISMA statement . PLoS Medicine , 6 ( 7 ), e1000097. 10.1371/journal.pmed.1000097 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Moore, G. , Audrey, S. , Barker, M. , Bond, L. , Bonell, C. , Cooper, C. , Hardeman, W. , Moore, L. , O'Cathain, A. , Tinati, T. , Wight, D. , & Baird, J. (2014). Process evaluation in complex public health intervention studies: The need for guidance . Journal of Epidemiology and Community Health , 68 ( 2 ), 101–102. 10.1136/jech-2013-202869 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Moreno‐Guerrero, A. J. , Rodríguez‐Jiménez, C. , Gómez‐García, G. , & Ramos Navas‐Parejo, M. (2020). Educational innovation in higher education: Use of role playing and educational video in future Teachers' training . Sustainability , 12 ( 6 ), 2558. 10.3390/su12062558 [ CrossRef ] [ Google Scholar ]
• Moyers, T. B. , Martin, T. , Christopher, P. J. , Houck, J. M. , Tonigan, J. S. , & Amrhein, P. C. (2007). Client language as a mediator of motivational interviewing efficacy: Where is the evidence? Alcoholism, Clinical and Experimental Research , 31 ( 10 ), 40s–47s. 10.1111/j.1530-0277.2007.00492.x [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Muli, N. , & Lagan, B. M. (2017). Perceived determinants to alcohol consumption and misuse: A survey of university students . Perspectives in Public Health , 137 ( 6 ), 326–336. 10.1177/1757913917710569 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• National Institute on Alcohol Abuse and Alcoholism . (2019). Planning alcohol interventions using NIAAA's CollegeAIM . Alcohol Intervention Matrix. Revised and updated. [ Google Scholar ]
• National Institute on Alcohol Abuse and Alcoholism . (2020). Alcohol facts and statistics . https://www.niaaa.nih.gov/sites/default/files/publications/NIAAA_Alcohol_FactsandStats_102020.pdf
• Neighbors, C. , Larimer, M. E. , Lostutter, T. W. , & Woods, B. A. (2006). Harm reduction and individually focused alcohol prevention . The International Journal on Drug Policy , 17 ( 4 ), 304–309. 10.1016/j.drugpo.2006.05.004 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Newton, F. B. , & Ender, S. C. (2010). Students helping students: A guide for peer educators on college campuses (2nd ed.). Jossey‐Bass. [ Google Scholar ]
• O'Cathain, A. , Croot, L. , Duncan, E. , Rousseau, N. , Sworn, K. , Turner, K. M. , Yardley, L. , & Hoddinott, P. (2019). Guidance on how to develop complex interventions to improve health and healthcare . BMJ Open , 9 ( 8 ), e029954. 10.1136/bmjopen-2019-029954 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• O'Hara, R. E. , Armeli, S. , & Tennen, H. (2015). College students' drinking motives and social‐contextual factors: Comparing associations across levels of analysis . Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors , 29 ( 2 ), 420–429. 10.1037/adb0000046 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Orsal, O. , & Ergun, A. (2021). The effect of peer education on decision‐making, smoking‐promoting factors, self‐efficacy, addiction, and behavior change in the process of quitting smoking of young people . Risk Management and Healthcare Policy , 14 , 925–945. 10.2147/RMHP.S280393 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Palmer, R. S. , Kilmer, J. R. , Ball, S. A. , & Larimer, M. E. (2010). Intervention defensiveness as a moderator of drinking outcome among heavy‐drinking mandated college students . Addictive Behaviors , 35 ( 12 ), 1157–1160. 10.1016/j.addbeh.2010.08.009 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Patrick, M. E. , Terry‐McElrath, Y. M. , Evans‐Polce, R. J. , & Schulenberg, J. E. (2020). Negative alcohol‐related consequences experienced by young adults in the past 12 months: Differences by college attendance, living situation, binge drinking, and sex . Addictive Behaviors , 105 , 106320. 10.1016/j.addbeh.2020.106320 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pueyo‐Garrigues, M. , Whitehead, D. , Pardavila, M. I. , Canga‐Armayor, A. , Pueyo‐Garrigues, S. , & Canga‐Armayor, N. (2019). Health education: A Rogerian concept analysis . International Journal of Nursing Studies , 94 , 131–138. 10.1016/j.ijnurstu.2019.03.005 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pueyo‐Garrigues, S. (2021). Diseño, implementación y evaluación de una intervención preventiva sobre el consumo de alcohol, liderada por pares, en estudiantes universitarios. un ensayo exploratorio [Unpublished doctoral dissertation]. University of Navarra. [ Google Scholar ]
• Reid, A. E. , & Carey, K. B. (2015). Interventions to reduce college student drinking: State of the evidence for mechanisms of behavior change . Clinical Psychology Review , 40 , 213–224. 10.1016/j.cpr.2015.06.006 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Sekhon, M. , Cartwright, M. , & Francis, J. J. (2017). Acceptability of healthcare interventions: An overview of reviews and development of a theoretical framework . BMC Health Services Research , 17 ( 1 ), 88. 10.1186/s12913-017-2031-8 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Simoni, J. M. , Franks, J. C. , Lehavot, K. , & Yard, S. S. (2011). Peer interventions to promote health: Conceptual considerations . The American Journal of Orthopsychiatry , 81 ( 3 ), 351–359. 10.1111/j.1939-0025.2011.01103.x [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Stamper, G. A. , Smith, B. H. , Gant, R. , & Bogle, K. E. (2004). Replicated findings of an evaluation of a brief intervention designed to prevent high‐risk drinking among first‐year college students: Implications for social norming theory . Journal of Alcohol and Drug Education , 48 ( 2 ), 53–72. [ Google Scholar ]
• Suárez‐Reyes, M. , Muñoz Serrano, M. , & Van den Broucke, S. (2019). How do universities implement the health promoting university concept? Health Promotion International , 34 ( 5 ), 1014–1024. 10.1093/heapro/day055 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Tollison, S. J. , Mastroleo, N. R. , Mallett, K. A. , Witkiewitz, K. , Lee, C. M. , Ray, A. E. , & Larimer, M. E. (2013). The relationship between baseline drinking status, peer motivational interviewing microskills, and drinking outcomes in a brief alcohol intervention for matriculating college students: A replication . Behavior Therapy , 44 ( 1 ), 137–151. 10.1016/j.beth.2012.09.002 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Turrisi, R. , Larimer, M. E. , Mallett, K. A. , Kilmer, J. R. , Ray, A. E. , Mastroleo, N. R. , Geisner, I. M. , Grossbard, J. , Tollison, S. , Lostutter, T. W. , & Montoya, H. (2009). A randomized clinical trial evaluating a combined alcohol intervention for high‐risk college students . Journal of Studies on Alcohol and Drugs , 70 ( 4 ), 555–567. 10.15288/jsad.2009.70.555 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Wagstaff, J. (2015). Brief alcohol screening and intervention for college students (BASICS): A qualitative study of the experiences of mental health practitioners on the college campus . [Doctoral dissertation]. Virginia Polytechnic Institute and State University. [ Google Scholar ]
• White, A. , & Hingson, R. (2013). The burden of alcohol use: Excessive alcohol consumption and related consequences among college students . Alcohol Research: Current Reviews , 35 ( 2 ), 201–218. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Wolter, C. , Lesener, T. , Thomas, T. A. , Hentschel, A. C. , & Gusy, B. (2021). Finding the right balance: A social norms intervention to reduce heavy drinking in university students . Frontiers in Public Health , 9 , 653435. 10.3389/fpubh.2021.653435 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Worsley, J. , Pennington, A. , & Corcoran, R. (2020). What interventions improve college and university students' mental health and wellbeing? A review of review‐level evidence . National Grey Literature Collection , 1–54. [ Google Scholar ]

The Effect of Alcohol on College Students

This essay will examine the impact of alcohol consumption on college students. It will discuss its effects on academics, health, and social behavior. You can also find more related free essay samples at PapersOwl about Addiction.

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Alcohol abuse among college students has become a major issues and concern. In society today Alcohol abuse in college student are increasing tremendously, this is due to the fact that everyone wants to experience what it is like to be tipsy. With College having different age ranges alcohol abuse is drastically increasing because a lot of people believe that college is stressful, and alcohol is the only way to cope with the stress. Alcohol is an ingrediencies that is found in many beers whine and sprit, which can cause a person to be intoxicated, which can lead to drunkenness.

Alcohol is so dangerous it can slow down our vital functions which can cause us to loss our balance, have slurred speech and causes the inability to react to thing quickly. Alcohol tends to affect a person mind and the way they think for example, a female who is intoxicated may make some poor decision as compare to went she is not intoxicated. It is okay for an individual of age to Consume a small amount of alcohol, but sometimes people tend to overdo which can lead to the abusing of alcohol.

To abuse Alcohol means to constantly engaging in the over consumption of alcohol. Alcohol is mostly abused on college campus, due to frequent parties thrown by other student without the supervision of an older adult, this causes them to drink carelessly and irresponsibly. In this essay I would be discussing the causes and effects of alcohol Abuse, intervention, prevents, solutions, Family history Racial Differences in Alcohol. In order to fully Understand Alcohol Abuse among College Students a person must first understand what the driven force behind a person actions is, and we know that the driven force is mainly stress, peer pressure , family problems and depression, this is due to the fact that students have to dedicate most of their time to studying and taking exams which can bring a toll on the body for example, I have noticed college students drinking more frequently around finals week , for example my friends tents to drink more frequently during this time. College students have a higher rate of alcohol abuse than the general population.

The main purpose of this article “Understanding Alcohol Abuse among College Students: Contributing Factors and Strategies for Intervention” by Iconis, Rosemary. This article discusses the understanding of alcohol Abuse among college students, in this article a study was carried out by Harvard school of Public health examined the behavior of college students. “College Alcohol Study (CAS), consisted of a series of nationwide surveys of approximately 140 institutions of higher education across the United States with 17,592 responses. The CAS found that 44% of students reported binge drinking, which consists of five or more drinks in one sitting for men, and four for women, and almost half of those who were frequent binge drinkers. Frequent binge drinkers were ten times more likely than non-binge drinkers to report trouble with campus police, damage to property, injuries, and unplanned, unprotected sex. The rate of binge drinking among college students has hardly changed”. (Rosemary ,2014).

There are many different factors Associated with Alcohol abuse in college for example, individual, environmental and demographic factors which are associated with the risk of alcohol abuse. “Among college students, individuals are faced with multiple factors that can contribute to alcohol abuse for example a family history of alcoholism, peer pressure and not forgetting, participation in athletics events for example, Football, basketball, baseball, and track and field, are associated with alcohol use. Environmental factors that influence alcohol use among college students include the college size, the distance of bars and clubs and availability of alcohol.” (Rosemary. 2014) a lot of college students consider heavy drinking of alcohol to be a norm part of their college experience. They are also a lot of reasons why students consume alcohol for example wanting to fit in with their peers , being a part of a college athletic team and trying to live up to certain expectations for their peers, another example is getting an injury and being stressed that you won’t be able to continue the season can lead to Alcohol abuse.

“Schools that are known as “party schools” have a reputation as the school popular school where students can binge drink with few consequences. Alcohol consumption during 21st birthday celebrations and pre-gaming drinking before entering a stadium during sporting events have been associated with excessive alcohol consumption” (Rosemary 2014). Bars dance clubs and parties gives students the urge to drink alcohol and use other substances, for example, illegal drugs such as marijuana, heroin and cocaine or other illicit drugs.

In the second articles Excessive Alcohol Consumption and Related Consequences Among College Students by (Aaron White, Ph.D., and Ralph Hingson, Sc.D.) This article discussed the danger of consuming alcohol. Alcohol leads to high health risk factors, injuries, sexual assault, memory lost, overdose, blackout, assault and even death. “Several studies indicate that crossing commonly used binge-drinking thresholds increases a college student’s risk of experiencing negative alcohol-related consequences. For instance, data from the Harvard CAS indicate that students who binge one or two times during a 2-week period are roughly three times as likely as non–binge drinkers to get behind in school work, do something regretful while drinking, experience a memory blackout, have unplanned sex, fail to use birth control during sex, damage property, get in trouble with police, drive after drinking, or get injured”.( White, Hingson, 2013). They are multiple stories of college school students getting into accidents due to drunk driving and, in most cases, drunk drinking ends in fatality. A lot of families are hurting and suffering due to the reckless drinking and driving by college students.

In the third article “Alcohol abuse prevention programs in college students” by (Ickes, Melinda J.; Haider, Taj; Sharma, Manoj). This article discussed ways of intervention to prevent alcohol abuse in college students. Some of the current intervention methods targeting alcohol abused in college students are different for each college.

“Motivational Interventions are the most common and most empirically tested type of alcohol-related programming for college students Generally, BMI consists of one or two sessions lasting from 10 to 60 min providing subjects with a personalized consultation based on their baseline assessment. This individualized consultation can include information on decisional balance, readiness to change, goal setting, and/or a discussion on social norms. Additionally, these sessions can be taught by a trained graduate student or a licensed clinical psychologist. (Melinda, Taj, Manoj 2015).

Another approach, parent-based interventions (PBI), which includes the parents as a focal point. Parent based interventions is usually administered before their children attends their first year of college, when they are still living at home with their parents, the parents are able to provide guidance for their long children that are about the go to college , where they are to meet thousands of other students their age and even older, PBI focuses on prevention and early intervention, as opposed to other forms of alcohol interventions that focus on treatment. Before a student starts college as a freshman a handbook are sent home to parents or guardians “They are asked to read the handbook thoroughly and fill out an evaluation to submit to researchers. The handbooks focus on skill-building, communication skills surrounding alcohol, and strategies for parents to help college students to avoid risky situations”. (Melinda, Taj, Manoj 2015). The different amount of intervention strategies available for alcohol prevention on college campuses, helps to determine a current effective strategies, regarding the general college population. They should be more classes and programs that are mandatory for college students to take in order to advise them of the consequences of alcohol abuse. I remember taking a class called alcohol education in high school and I was able to learn so much from the documentary. The documentary made me very aware of the effect that Alcohol has on a person and mainly how it makes a person’s ability to function difficult. When some of the interventions that the school created in this article it does show that rate of alcohol abused is decreasing. Female has a lower rate of Alcohol abused that men. The article concluded that the intervention of alcohol programs helps college students in many ways in order to limit the amount of alcohol they drink.

In the fourth article by Addictive Behavior of Full-time Students at Masaryk University and Options in Its Prevention by (Kachli?k, Petr) The use of alcoholic beverages by teens is one of the serious long-term issues. Since 2007, incidence of regular beer and spirits drinking among boys and wines and spirits among girls has increased. Frequent heavy drinking which consist of five or more glasses of alcohol three times or more within the last 30 days was admitted by 21% of students in 2011 (27% of boys and 16% of girls); the growth was apparent particularly among boys (Petr,2015). They are a lot of ways to prevent alcohol for example, not keeping alcohol or allowing Alcohol on campus and parents should also not keep Alcohol at home making it easy for their children to access it. College students should also know their limits when it comes to consuming alcohol. College students should always be around peers that are not bad influences on their life, they should try to associate themselves with friends who don’t drink. If college students feel like they are not able to control the amount of alcohol they consume they should seek help which means finding a support group and talking about ways to help each other to get over alcohol abuse. If the groups are not able to help them and they are still turning to Alcohol they should consider Enroll in a treatment program or a rehibition center to get the help they need.

In article five “Racial Differences in Alcohol Use and Abuse Among College Students,” a new study on racial differences in drinking behaviors by American college students, authored by a team of researchers at Florida State University. The study confirms that African-American college students are far less likely than white students to drink alcoholic beverages. Evidence shows that white students tents to have three or four more drinkers than a African American students. “The results of the study, which involved a detailed survey of more than 1,100 students, found that on average whites drank alcohol slightly more than four days a month. African-American college students consumed alcohol on less than three days each month. And when they did drink alcohol, whites were far more likely than blacks to consume a large quantity. When asked how many drinks they had the last time they partied, whites reported an average of 5.39 drinks. Blacks on average had 2.43 drinks. Whites reported binge drinking having five or more alcoholic drinks at one sitting 2.61 times per month.” (journal of Blacks in Higher Education, 2004).

In the book” Family history of alcohol abuse associated with problematic drinking among college students by “(Joseph W. LaBrie, Savannah Migliuri, Shannon R. , Kenney Andrew Lac). “This article discussed the links between family history of alcohol abuse among college students. The current report investigates family history of alcohol abuse and its relationships with alcohol , consumption and consequence and the study found that college students that comes from a family history of alcohol abuse was reported as more higher alcohol abusers, rather than college students that did not come from an alcohol addiction family”. ( LaBrie, Migliuri, Lac,2010). College students that comes from a family that has a history of alcohol abuse does not view drinking as a problem, because they watch various family’s members drink frequently so they don’t see it as a big deal.

In the book, “College Campuses Should Regulate Alcohol Abuse” by (Gruenewald, Paul Saltz, Robert). This book discussed the issues that college campuses are facing due to students abusing alcohol, Reports of alcohol-related tragedies are increasing once again on college campuses. “In October 2004 it was the Harvard University student convicted of manslaughter for stabbing a restaurant worker in a fight following a night of drinking, and two Marshall University football players accused of assaulting a woman in a bar”. ( Paul, Robert ,2007). The book also explained that a student from the University of Delaware was struck and killed by a train on her way home from a fraternity party after she had a blood alcohol concentration three times the legal limit. “A Colorado State University student was found dead Saturday December 11, 2004 in an apparent alcohol-related incident. CSU recently formed a task force on drinking after another student’s death in September 2004. Police said the 19-year-old woman had consumed some 40 beers that evening”. ( Paul, Robert ,2008). College students are at a higher risk for alcohol related problems because they have high rates of heavy consumption, college students tend to drink more recklessly than others, and are heavily targeted by advertising and promotions of the alcoholic beverage industry. Students spend approximately $4.2 billion annually to purchase 430 million gallons of alcoholic beverages. Alcohol is associated with missed classes and poor performance on tests and projects. The number of alcoholic drinks consumed per week is clearly related to lower GPAs.( Paul, Robert, 2008)

In the book The Unforeseen Consequences of Drinking by Snyder Gail , this book discussed the consequences that college students can faced after consuming a lot of alcohol and not knowing the danger that it can cause on the body and brain function. According to Snyder Gail “Teens who drink may also find themselves coping with alcohol dependence, pregnancy and fetal alcohol syndrome, sexually transmitted diseases, sexual violence, depression, and suicidal thoughts. A 1989 report on teenage suicide prepared by the U.S. Alcohol, Drug Abuse and Mental Health Administration tracked cases involving young suicide victims over a period of 10 years and concluded that youths who abused drugs and alcohol were up to eight times more likely to kill themselves than youths who didn’t drink or take drugs” ( Gail, 2004)

In the book “Colleges Should Promote Tougher Policies Against Alcohol Abuse” by (Wechsler, Henry , Nelson, Toben ,Weitzman, Elissa, R). This book explains why colleges should promote tougher alcohol consequences to the abusers for example, Colleges must protect their students from these negative effects of alcohol. One in eight non-binge-drinking students nationwide reported being assaulted physically or having personal property destroyed due to student’s alcohol intake. The everyday effects of binge drinking interrupt the ability for the brain to process information and also making the process of higher education harder.

In conclusion, after reading the articles and books I was able to get a better understanding on why college students seek Alcohol in order to cope with stress and anxiety. The articles and books give excellent consequences that college students face when they abuse alcohol. The excessive amount of alcohol that one can consume can cause a lot of danger to one’s brain and body balance. Alcohol slows down the heart rate; excessive amount of alcohol can also cause alcohol poisoning. The book College Student Alcohol Abuse: A Guide to Assessment, Intervention, and Prevention by Christopher J. Correia , James G. Murphy , Nancy P. Barnett. This book gives a lot of important information how the danger of heavy drinkers impacts there life and their families. Also, there was some intervention and prevention that was mentioned that one can follow in order to prevent alcohol abuse. seeks help is the best way to get over alcohol addiction in college students.

• Iconis, R. (2014). Understanding Alcohol Abuse among College Students: Contributing Factors and Strategies for Intervention. Contemporary Issues in Education Research, 7(3), 243–248.
• White, A., & Hingson, R. (2013). The burden of alcohol use: excessive alcohol consumption and related consequences among college students. Alcohol Research: Current Reviews, (2), 201
• Ickes, M. J., Haider, T., & Sharma, M. (2015). Alcohol abuse prevention programs in college students. Journal of Substance Use, 20(3), 208–227.
• Kachli?k, P. (2016). Addictive Behavior of Full-time Students at Masaryk University and Options in Its Prevention (Vol. 1st edition)
• LaBrie, J. W. . jlabrie@lmu. ed., Migliuri, S. smigliur@lmu. ed., Kenney, S. R. . S. kenney@lmu. ed., & Lac, A. andrew. lac@cgu. ed. (2010). Family history of alcohol abuse associated with problematic drinking among college students. Addictive Behaviors, 35(7), 721–725.
• Racial Differences in Alcohol Use and Abuse among College Students. (2004). The Journal of Blacks in Higher Education, (44).
• Gruenewald, P., & Saltz, R. (2007). College Campuses Should Regulate Alcohol Abuse. In R. D. Lankford (Ed.), At Issue. Alcohol Abuse. Detroit, MI: Greenhaven Press. (Reprinted from Christian Science Monitor, 2004, December 14) .
• Snyder, G. (2004). Chapter 4: The Unforeseen Consequences of Drinking. Teens & Alcohol, 15.
• Wechsler, H., Nelson, T., & Weitzman, E. R. (2003). Colleges Should Promote Tougher Policies Against Alcohol Abuse. Gale.
• Correia, C. J., Murphy, J. G., & Barnett, N. P. (2012). College student alcohol abuse: A guide to assessment, intervention, and prevention. Hoboken, NJ: John Wiley & Sons.

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According to survey carried out in 2009, just over half of American youths between the ages of 12 and 20 claimed that they regularly consumed alcohol (Edwin and Harald 10). Alcohol abuse is a major issue among today’s youth and a solution needs to be found to eradicate the growing problem.

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Home — Essay Samples — Nursing & Health — Alcohol Abuse — Binge Drinking in College Students

Binge Drinking in College Students

• Categories: Alcohol Abuse

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Words: 1374 |

Published: Feb 8, 2022

Words: 1374 | Pages: 3 | 7 min read

Table of contents

What is drunkenness and its consequences, the fight against drunkenness, bibliography.

• College Alcoholism and Binge Drinking. (n.d.). Retrieved from https://www.alcoholrehabguide.org/resources/college-alcohol-abuse/.
• Corte, C. M., & Sommers, M. S. (2005). Alcohol and risky behaviors. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16350769.
• Demographics of Social Media Users and Adoption in the United States. (2019, June 12). Retrieved from https://www.pewinternet.org/fact-sheet/social-media/.
• Lautieri, A. (n.d.). Signs of Alcoholism: Symptoms of Early, Chronic & End Stages. Retrieved from https://americanaddictioncenters.org/alcoholism-treatment/stages.
• Partnership News Service. (n.d.). Text Messages Can Help Reduce Young Adults' Binge Drinking. Retrieved from https://drugfree.org/learn/drug-and-alcohol-news/text-messages-can-help-reduce-young-adults-binge-drinking/.

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University Policies

Drug & alcohol abuse prevention program (daapp) policy.

1.0 Policy Purpose

The purpose of this policy is to comply with the Drug-Free Schools and Communities Act of 1989. It establishes drug and alcohol standards of conduct, describes sanctions, details health risks, and relays drug and alcohol resources available to students and employees.

2.0 To Whom the Policy Applies

This policy applies to students and employees (i.e., faculty and staff), as well as any individual attending or participating in campus and institution-associated programs or activities or off-campus activities sponsored by Brown University (Brown).

3.0 Policy Statement

Brown expects its students and employees to abide by all federal, state, and local laws pertaining to drugs and alcohol.

3.1 Alcohol

Brown prohibits the unlawful possession, use, or distribution of alcohol by students and employees on its property or as part of any of its programs or activities. Students and employees must fulfill their obligations and responsibilities pursuant to institutional policy and federal, state, and local laws and regulations.

It is unlawful for individuals:

• who have not attained the age of 21 to purchase, possess, or consume alcoholic beverages.
• to deliver alcoholic beverages to a person under the age of 21.
• to misrepresent oneself as having attained the age of 21 to procure alcoholic beverages.

The illegal possession, use, manufacture, distribution, provision, sale, or possession with the intent to sell alcohol is prohibited. Students and employees seeking to sponsor activities where alcohol beverages are to be served must have all required Brown approvals and abide by established policies and procedures.

Students: A student who is in violation of Brown’s policies on alcohol shall be subject to discipline in accordance with Brown’s policies and procedures. Refer to the Student Alcohol and Other Drugs Policy for additional alcohol restrictions. Disciplinary action involving alcohol violations by students may result in the imposition of a range of terms as specified in Brown University’s Code of Student Conduct up to and including expulsion, or requiring the student to participate satisfactorily in an approved alcohol assistance or rehabilitation program. Any disciplinary action imposed by Brown may be in addition to any penalty imposed by an off- campus authority. Students are subject to prosecution under applicable local, state, or federal laws.

With respect to student employees, nothing in this policy shall be construed as precluding Brown from disciplining students pursuant to the University’s Code of Student Conduct/policies, or from taking appropriate action against students pursuant to Brown’s emergency powers.

Employees: An employee who is in violation of Brown’s policies on alcohol will be disciplined in accordance with procedures outlined in Brown’s policies and/or the Faculty Rules and Regulations, up to and including termination of employment, or requiring the employee to participate satisfactorily in an approved alcohol assistance or rehabilitation program. Any disciplinary action imposed by the University may be in addition to any penalty imposed by an off-campus authority. Employees are subject to prosecution under applicable local, state, or federal laws.

3.2 Illegal Drugs

Brown prohibits the unlawful possession, use, sale, provision, manufacture, possession with the intent to sell, and distribution of controlled substances, illicit drugs, and/or drug paraphernalia by students and employees on its property or as part of any of its programs or activities. Limited exceptions may be possible for lawful, University-approved research involving cannabis in accordance with the Drug-Free Workplace Policy and related University procedures. Students and employees must fulfill their obligations and responsibilities pursuant to institutional policy and federal, state, and local laws and regulations. Under state and federal law, it is unlawful, except as expressly authorized by law, to manufacture, distribute, dispense, or possess with intent to manufacture, distribute, or dispense a controlled substance or illicit drug. More severe criminal sanctions are assessed in instances where a person 18 years of age or older unlawfully distributes a controlled substance or illicit drug to a person under 21 years of age (federal law) or under 18 years of age (state law). Although the State of Rhode Island and some other jurisdictions have legalized the use of marijuana for adults 21 years of age and older, marijuana remains illegal under federal law and is prohibited by this policy.

Students : A student who is in violation of Brown’s policies on drugs shall be subject to discipline in accordance with Brown’s policies and procedures. Disciplinary action involving illegal drug violations by students may result in the imposition of a range of terms as specified in Brown University’s Code of Student Conduct up to and including expulsion, or requiring the student to participate satisfactorily in an approved drug assistance or rehabilitation program. Any disciplinary action imposed by Brown may be in addition to any penalty imposed by an off-campus authority. Students are subject to prosecution under applicable local, state, or federal laws.

With respect to student employees, nothing in this policy shall be construed as precluding Brown from disciplining students pursuant to the University’s Code of Student Conduct/policies or from taking appropriate action against students pursuant to the University’s emergency powers.

Employees: An employee who is in violation of Brown’s policies on drugs will be disciplined in accordance with procedures outlined in Brown’s policies and/or the Faculty Rules and Regulations , up to and including termination of employment, or requiring the employee to participate satisfactorily in an approved drug assistance or rehabilitation program. Any disciplinary action imposed by the University may be in addition to any penalty imposed by an off-campus authority. Employees are subject to prosecution under applicable local, state, or federal laws.

3.3 Federal, State, and Local Laws and Sanctions

3.3.1 federal drug trafficking penalties.

3.3.2 Federal Trafficking Penalties - Marijuana

* The minimum sentence for a violation after two or more prior convictions for a felony drug offense have become final is not less than 25 years imprisonment and a fine up to $20 million if an individual and $75 million if other than an individual.

3.3.3 RI Controlled Substance Penalties

Any person who manufacturers, delivers, or possesses with the intent to manufacture or deliver a Schedule I or II controlled substance may be imprisoned to a term up to life, and/or fined $10,000 to $500,000. For Schedule III or IV controlled substances, such person may be imprisoned for up to twenty (20) years and/or fined up to $40,000. For Schedule V controlled substances, such person may be imprisoned up to one (1) year and/or fined up to $10,000. Any person who knowingly or intentionally possesses a Schedule I, II, III, IV, or V controlled substance in the absence of a valid prescription may be imprisoned for up to three (3) years, and/or fined $500 to $5,000. R.I.G.L. § 21-28-4.01.

3.3.4 RI Alcoholic Beverages

Sanctions for misrepresentation of age include (i) a mandatory fine of $100 to $500, thirty (30) hours of community service, and suspension of driving privileges for thirty (30) days for the first offense; (ii) a mandatory fine of $500 to $750, forty (40) hours of community service, and suspension of driving privileges for three (3) months for the second offense; and (iii) a mandatory fine of $750 to $1,000, fifty (50) hours of community service, and suspension of driving privileges for one (1) year for the third and subsequent offenses. R.I.G.L. § 3-8-6.

Sanctions for possession of alcoholic beverages by underage persons include thirty (30) hours of community service, minimum sixty (60) day suspension of driving privileges, and (i) fines of $150 to $750 for the first offense, (ii) fines of $300 to $750 for the second offense, and (iii) fines of $450 to $950 for the third and subsequent offenses. R.I.G.L. § 3- 8-10.

Sanctions for furnishing or procuring alcoholic beverages for underage persons include (i) fines of $350 to $1,000 and/or imprisonment up to six (6) months for the first offense, (ii) fines of $750 to $1,000 and/or imprisonment up to one (1) year for the second offense, and (iii) fines of $1,000 to $2,500 and/or imprisonment up to three (3) years for the third or subsequent offenses. R.I.G.L. §§ 3-8-11.1 – 3-8-11.2.

3.3.5 Additional State and Local Laws

Additional criminal penalties for violations of state and local drug and alcohol laws may be found on websites below. There may be other provisions of federal, state, and local laws related to drugs and alcohol that are not included in this list.

Penalties for Violations of Rhode Island’s Drug and Alcohol Laws:

• Title 3 Alcoholic Beverages
• Title 11 Criminal Offenses
• Title 21 Food and Drugs
• Title 31 Motor and Other Vehicles

Penalties for Violations of the City of Providence’s Drug and Alcohol Ordinances:

• https://library.municode.com/ri/providence/codes/code_of_ordinances

3.4 Associated Health Risks

3.4.1 alcohol health risks.

Drinking too much, on a single occasion or over time, can take a serious toll on your health. The following information from the National Institute on Alcohol Abuse and Alcoholism details how alcohol can affect your body:

Brain: Alcohol interferes with the brain’s communication pathways and can affect the way the brain looks and works. These disruptions can change mood and behavior and make it harder to think clearly and move with coordination.

Heart: Drinking a lot, on a single occasion or over time, can damage the heart, causing problems including:

• Cardiomyopathy – Stretching and drooping of heart muscle
• Arrhythmias – Irregular heartbeat
• High blood pressure

Liver: Heavy drinking takes a toll on the liver and can lead to a variety of problems and liver inflammations including:

• Steatosis, or fatty liver
• Alcoholic hepatitis

Pancreas: Alcohol causes the pancreas to produce toxic substances that can eventually lead to pancreatitis, a dangerous inflammation and swelling of the blood vessels in the pancreas that prevents proper digestion.

Cancer: According to the National Cancer Institute: “The evidence indicates that the more alcohol a person drinks—particularly the more alcohol a person drinks regularly over time—the higher their risk of developing an alcohol-associated cancer.” For more information regarding specific types of cancer, please visit the National Cancer Institute Alcohol and Cancer webpage.

Immune System: Drinking too much can weaken your immune system, making your body a much easier target for disease. People who drink chronically are more liable to contract diseases like pneumonia and tuberculosis than people who do not drink too much. Drinking a lot on a single occasion slows your body’s ability to ward off infections – even up to 24 hours after getting drunk.

3.4.2 Drug Health Risks

According to the U.S. Department of Health and Human Services the most commonly used illicit drug is marijuana. Marijuana or cannabis has both short- and long-term effects on the brain. If a person chooses to use cannabis, it is essential to understand the potential risks and recognize that cannabis, like any other drug, can be addictive.

Short term risks include:

• Increased heart rate
• Elevated blood pressure
• Slowed reaction time and/or motor functioning
• Impaired short-term memory
• Difficulty thinking or problem solving
• Altered senses
• Poor perception of time
• Changes in mood (i.e., depression, anxiety, panic, paranoia)

Long term risks include:

• Memory and Learning - Regular cannabis use can impair the ability to focus, sustain, remember information and shift attention.
• Physical Health - Cannabis smoke irritates the lungs and can lead to problems such as daily cough and phlegm, more frequent lung illness, and a higher risk of lung infections.
• Mental Health - There may be a link between long-term cannabis use and the worsening or development of mental health problems such as depression, anxiety, psychosis, and schizophrenia.
• Other Unintended Effects - Long term cannabis use may lead to lower life satisfaction, more relationship problems, less academic and career success, and more accidents and injuries.
• Substance Use Disorder - 30% of cannabis users develop a cannabis use disorder. People who begin using cannabis before age 18 are more likely than adults to develop a cannabis use disorder. Withdrawal symptoms that make quitting difficult include: irritability, insomnia, decreased appetite, anxiety and cravings.

Many other drugs can alter a person’s thinking and judgment and can lead to health risks, including addiction, drugged driving, infectious disease, and adverse effects on pregnancy. Information on commonly used drugs with the potential for misuse or addiction can be found on the National Institute on Drug Abuse website . 

3.5 Drug and Alcohol Resources Available to Students and Employees

3.5.1 on-campus for students - care related to substance use or abuse resources.

The following services are available to all students for individual care related to substance use or abuse:

Counseling and Psychological Services (CAPS): Confidential individual appointments. Visit www.brown.edu/caps for more information or call 401-863-3476 to schedule appointments.

BWell Health Promotion: For a follow-up appointment, email [email protected] or click the "Confidential Appointments" link on the BWell webpage .

Dean for Recovery and Substance-Free Student Initiatives: Offers support groups, sub-free events, and individual meetings for those affected by their own, or another’s substance use. To schedule a meeting, call 401-863-9800 or email [email protected] , and for more information visit brown.edu/go/donovan .

Student Support Services: Are available to assist students with a wide range of issues and concerns that might arise during their time at Brown. To schedule an appointment, call 401-863-3145 or email [email protected] .

Health Services : Medical providers are available for appointments by calling 401-863-3953. The laboratory and pharmacy are also open during specified hours. Visit brown.edu/campus-life/health/services/ for more information.

3.5.2 On-Campus for Students - Proactive Education and Prevention Programs

The following proactive education and prevention programs are available to all students for alcohol and other drugs: 

Pre-arrival Course: All incoming undergraduate students complete an online course that addresses alcohol use with a diverse and comprehensive opportunity for health and wellness educational empowerment. 

Orientation Course: The Culture of Consent and Community Care orientation class meeting, required for all incoming undergraduate students, includes video content and several student testimonials addressing alcohol use and highlighting positive actions students can take to care for themselves and each other, as well as speaking to the experiences of students who are substance free and/or in recovery. This class meeting lays a foundation of what Brown students expect from one another in a caring community. The BWell Orientation Committee comprised of student and staff reviews this programming and makes suggestions for improvements each year. 

3.5.3 On-Campus for Students - Ongoing Initiatives

BWell Health Promotion: Uses population-based health behavior interventions that empower students with information and access to pro-health skills through in person and social media outreach as well as curriculum-based workshops. This includes: 

• Public Health Messaging : Print and social media with alcohol education and information on campus resources are distributed regularly throughout campus with a focus on residence halls and program houses. 
• Education : Evidence-based workshops covering alcohol physiology led by a BWell facilitator are conducted throughout the year within community settings on campus. 
• Campus Life Advisory Board on Alcohol and Other Drugs : Comprised of staff, faculty and students who come together to compile and analyze relevant data and emerging research to ensure Brown is using evidence-informed practices and aligning policy and educational interventions with outcomes that can be measured through a variety of data inputs. 

3.5.4 On-Campus for Employees – Employee Assistance Program

The following service is available to Brown employees related to substance use or abuse:

Employee Assistance Plan (EAP) : 855-629-0554. The EAP is a benefit designed to help employees and their families handle personal problems. It provides confidential problem assessment and, in many cases, referral for a specific course of treatment. To access the program directly, employees or their immediate family members may call or  email the provider and indicate that they are covered by the Brown contract.

3.4.5 Students and Employees - Local and National Resources

The following local and national resources are available to everyone, including students and employees: 

Alcoholics Anonymous: 401-438-8860. Anonymous twelve-step recovery program. 

Butler Hospital: 1-800-433-6888 (inside RI) or 1-800-272-9699 (outside RI). When you or someone you know is ready to commit or re-commit to recovery, the patient assessment team at Butler can assist in finding the right program. 

Narcotics Anonymous: 866-624-3578. 12 step recovery program that focuses on the disease of addiction rather than any particular drug. 

The Rhode Island Department of Behavioral Health Care, Developmental Disabilities and Hospitals (BHDDH): This site offers a listing of licensed substance use treatment agencies throughout Rhode Island. List includes agencies licensed to provide detox, residential, outpatient, and medication-assisted treatment services. 

Rhode Island’s Hope & Recovery Support Line: 401-942-STOP (7867). This support line connects people to treatment and recovery services 24 hours/day, 7 days/week, 365 days/year. 

SAMHSA’s National Helpline: 1-800-662-HELP (4357), TTY: 1-800-487-4889. This Helpline provides 24-hour, free and confidential treatment referral and information about mental and/or substance use disorders, prevention, and recovery in English and Spanish. 

ZenCare: Allows you to review local (Providence and Boston area) therapists. You can filter options by selecting alcohol, substance use or recovery focuses. You can also filter by insurance accepted and schedule a phone consultation to see if it is the right fit. 

4.0 Definitions:

5.0 responsibilities.

All individuals to whom this policy applies are responsible for becoming familiar with and following this policy. University supervisors and employees with student oversight duties are responsible for promoting the understanding of this policy and for taking appropriate steps to help ensure and enforce compliance with it, and ensuring that the disciplinary sanctions describe in this policy are consistently enforced.

In addition to responsibilities already assigned in this policy, the following offices will accomplish additional actions.

Health and Wellness :

• Complete a biennial review of the alcohol and other drug program and make changes to the program and this policy, as needed.

University Human Resources :

• Provide notice of this policy to every employee annually in writing and in a manner that ensures all employees receive it.
• Provide inputs to the biennial review, as needed.

Student Conduct and Community Standards:

• Provide notice of this policy to every student annually in writing and in a manner that ensures all students receive it.

6.0 Consequences for Violating this Policy

In addition to consequences and discipline already directed in this policy, failure to comply with this and related policies is subject to disciplinary action up to and including expulsion for students, and suspension without pay or termination of employment or association with the University for employees, in accordance with applicable (e.g., staff, faculty, student) disciplinary procedures, or for non-employees may result in the suspension or revocation of the user’s relationship with Brown University. The University may also refer violators of this policy for prosecution.

7.0 Related Information

Brown University is a community in which individuals are encouraged to share concerns with University leadership. Additionally, Brown’s Anonymous Reporting Hotline allows anonymous and confidential reporting on matters of concern online or by phone (877-318-9184).

The following information complements and supplements this document. The information is intended to help explain this policy and is not an all-inclusive list of policies, procedures, laws and requirements.

7.1 Related Policies

• Alcoholic Beverages Policy
• Drug-Free Workplace Policy
• Student Alcohol and Other Drugs Policy
• Code of Student Conduct
• Faculty Rules and Regulations

7.2 Related Procedures

• Student Conduct Procedures

7.3 Related Forms

7.4 frequently asked questions:, 7.5 other related information:.

• Alcohol and cancer information
• Alcohol’s effect on the body
• Commonly used drugs with the potential for misuse or addiction
• DEA Drugs of Abuse

Policy Owner and Contact(s)

Policy owner: vice president for campus life & student services and vice president for human resources, policy approved by: president, contact information:, policy history, policy issue date: august 22, 2024, policy effective date: august 22, 2024, policy update/review summary:.

DAAPP information was previously contained in the Annual Security Report. 

170 Alcoholism Essay Topic Ideas & Examples

🏆 best alcoholism topic ideas & essay examples, 💡 interesting topics to write about alcoholism, 📑 good research topics about alcoholism, 📌 simple & easy alcoholism essay titles, 👍 good essay topics on alcoholism, ❓ research questions about alcohol addiction.

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• Do Alcoholic People Interact Differently? The mode of interaction of alcoholics is different from that of non-alcoholics because the two categories of people operate in different states of mind.
• Alcohol Abuse by Quentin McCarthy The aim of MAST is to determine the extent of alcohol consumption based on responses provided and formulate strategies of helping the agent with regard to excess consumption of alcohol.
• Alcohol Abuse Among Elderly The effects of moderate consumption of alcohol are more beneficial to the elderly than to the younger generations. Thus, in the body of this report contains a deeper discussion of the causes, effects and solutions […]
• Reducing Drug and Alcohol Abuse: Europe vs. USA For instance, the needle and syringe exchange program has helped to reduce the rate of HIV infection among the injection drug users in the UK, which is the pioneer of needle and syringe exchange program.
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• Definition of Alcohol Misuse (Alcohol Abuse and Addiction) in Youth Population Age 18-29 Analyzing the article of Jiang, it is possible to define the alcohol misuse simply as the excessive consumption of alcohol where a number of the young drinkers is higher than any other group of age […]
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• Social Influences on Behavior: Towards Understanding Depression and Alcoholism Based on Social Situations According to Smith & Mackie, dispositional variables entails the personalities, values, worldviews, and attitudes of the people that are interacting in a group, while situational variables comprise of the particular characteristics of the situation that […]
• Motivational Program and Alcoholics Anonymous The success or failure of AA recovery program can arguably be attributed to the strength of an individual to undergo total change in the way of thinking.
• Alcohol Abuse and the Contribution of Economists to Solving This Issue Analyzing the impact of a shift in supply, the researcher should consider the elasticity of demand as if the demand is elastic the price may be changed depending on the number of existing products at […]
• Alcoholism-Nature vs. Nurture Debate The analysis on physiological physiology regarding alcohol shows that, alcohol displays feelings of superiority and fearless behavior and also, it reduces an individual’s fear.
• Alcoholism: The Rough Road I was the only family he had and he had to move in with me in my apartment. Ken had nothing and he was willing to try anything to put his life back together.
• Alcoholism Disease or Self Will Alcoholism as a disease has serious physical effects to the body because it affects organs and systems such as the liver, the heart, and the nervous system amongst other critical organs in the body. Alcoholism […]
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IvyPanda. (2024, March 2). 170 Alcoholism Essay Topic Ideas & Examples. https://ivypanda.com/essays/topic/alcoholism-essay-topics/

"170 Alcoholism Essay Topic Ideas & Examples." IvyPanda , 2 Mar. 2024, ivypanda.com/essays/topic/alcoholism-essay-topics/.

IvyPanda . (2024) '170 Alcoholism Essay Topic Ideas & Examples'. 2 March.

IvyPanda . 2024. "170 Alcoholism Essay Topic Ideas & Examples." March 2, 2024. https://ivypanda.com/essays/topic/alcoholism-essay-topics/.

1. IvyPanda . "170 Alcoholism Essay Topic Ideas & Examples." March 2, 2024. https://ivypanda.com/essays/topic/alcoholism-essay-topics/.

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IvyPanda . "170 Alcoholism Essay Topic Ideas & Examples." March 2, 2024. https://ivypanda.com/essays/topic/alcoholism-essay-topics/.

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