A systematic review of college student-athlete drinking: Prevalence rates, sport-related factors, and interventions

A Culturally Sensitive Approach to Treating Substance Abuse in Athletes Using Evidence-Supported Methods

Substance abuse in athletes is both prevalent and dangerous, leading to its international recognition as a public health concern. In recent controlled trials, behavioral prevention programs have been shown to reduce alcohol use in collegiate student athletes who are at-risk for alcohol abuse, with outcomes appearing to be enhanced when family members are prescriptively involved. However, no interventions have been found to decrease alcohol or drug use frequency in controlled trials involving athletes who have been diagnosed with substance abuse, and no prescribed clinical interventions for substance abuse have been tailored to accommodate the unique needs of competitive athletes. As an initial step in this development, we review an evidenced-supported behavioral treatment program modified for use with athletes. Optimizing the support of significant others, this innovative treatment approach comprehensively targets multiple areas of mental health while emphasizing cultural enlightenment. Recommendations are offered, including the great need for controlled treatment outcome research specific to substance abuse in athletes.

Transitions into and out of intercollegiate athletic involvement and risky drinking

OBJECTIVE

Cross-sectional data show that college athletes consume more alcohol and experience more general alcohol-related problems than those not participating in athletics. To our knowledge, the current study is the first to use a longitudinal design to examine the extent to which the course of drinking and alcohol-related problems relates to involvement in intercollegiate athletics, including transitioning into and out of athletic involvement.

METHOD

Participants were drawn from a sample of 3,720 college students from the Intensive Multivariate Prospective Alcohol College-Transitions Study who completed a survey every semester through their fourth year. Four groups were created based on athletic involvement status at baseline (freshman year) and follow-up (senior year): nonathlete, nonathlete (no reported athletic involvement at either time point), nonathlete, athlete (nonathlete at freshman year, athlete at senior year), athlete, nonathlete (athlete at freshman year, nonathlete at senior year), and athlete, athlete (athlete at freshman year, athlete at senior year).

RESULTS

A series of repeated measures analyses were then conducted to test for developmental differences among the athlete groups involving alcohol consumption and alcohol-related problems. Although findings differed as a function of alcohol outcome and comparison among various groups with differing athletic involvement, the general pattern of results showed that individuals who were more athletically involved demonstrated sharper increases in problem drinking (i.e., heavy drinking, frequency of intoxication, alcohol-related problems) during the college years.

CONCLUSIONS

These findings highlight the apparent risk associated with participation in intercollegiate athletics on college drinking.

Sociocultural and Mental Health Adjustment of Black Student-Athletes: Within-Group Differences and Institutional Setting

Research has shown that African American college students have a difficult time adjusting at predominately White institutions (PWIs) in comparison with historically Black colleges and universities (HBCUs) with regard to both general and race-related stressors (Neville, Heppner, Ji, & Thye, 2004; Prillerman, Myers, & Smedley, 1989; Sedlacek, 1999). For college student-athletes, the campus environment can challenge their capacity to ft in and adhere to academic and social expectations, perhaps especially for Black student-athletes (BSA). The current study therefore examined the sociocultural and mental health adjustment of 98 BSA based on their perceived social support, perceived campus racial climate, team cohesion, and life events using latent profle analysis (LPA). Results indicated three distinct profile groups: Low Social Support/Cohesion, High Minority Stress, and High Social Support/Cohesion. Profiles were predictive of adjustment concerns and campus setting (PWIs vs. HBCUs), highlighting within-group differences among BSA. Implications for interventions to facilitate and support healthy adjustment and success for BSA are discussed.

The relationship between baseline drinking status, peer motivational interviewing microskills, and drinking outcomes in a brief alcohol intervention for matriculating college students: a replication

The purpose of this study was to replicate and extend previous findings (Tollison et al., 2008) on the association between peer facilitator adherence to motivational interviewing (MI) microskills and college student drinking behavior. This study used a larger sample size, multiple follow-up time-points, and latent variable analyses allowing for more complex models to be tested in a sample with different characteristics than Tollison et al. Matriculating students who participated in high school sports (N=327) took part in a Brief Alcohol Screening and Intervention for College Students led by peer facilitators trained in motivational interviewing (MI). Participants were assessed pre- and immediately postintervention on contemplation to change, as well as pre-, 5months, and 10months postintervention on drinking quantity. Independent coders used the Motivational Interviewing Treatment Integrity scale (Moyers, Martin, Manuel, & Miller, 2003) to evaluate therapist MI adherence. Contrary to our previous study, results indicated that a higher number of open questions was positively related to increases in drinking, especially for heavier drinkers. Congruent with the previous study, more simple reflections was positively related to increases in drinking. Finally, this study revealed that heavier baseline drinking was associated with more simple reflections. There were no significant results found for changes in contemplation. Results corroborate previous findings that the excessive use of simple reflections may be indicative of countertherapeutic outcomes while raising questions about the relationship between the frequency of open questions and therapeutic outcomes.

Is beer consumption related to measures of abdominal and general obesity? A systematic review and meta-analysis

A systematic review was conducted to assess the evidence linking beer consumption to abdominal and general obesity. Following a systematic search strategy, 35 eligible observational studies and 12 experimental studies were identified. Regarding abdominal obesity, most observational data pointed towards a positive association or no association between beer intake and waist circumference or waist-to-hip ratio in men, whereas results for women were inconsistent. Data from a subset of studies indicated that beer intake > 500 mL/day may be positively associated with abdominal obesity. Regarding general obesity, most observational studies pointed towards an inverse association or no association between beer intake and body weight in women and a positive association or no association in men. Data from six experimental studies in men, in which alcoholic beer was compared with low-alcoholic beer, suggested that consumption of alcoholic beer (for 21-126 days) results in weight gain (0.73 kg; P < 0.0001), but data from four studies comparing intake of alcoholic beer with intake of no alcohol did not support this finding. Generally, experimental studies had low-quality data. In conclusion, the available data provide inadequate scientific evidence to assess whether beer intake at moderate levels (<500 mL/day) is associated with general or abdominal obesity. Higher intake, however, may be positively associated with abdominal obesity.

Drink-driving in community sports clubs: adopting the Good Sports alcohol management program

Throughout the developed world, community sports clubs are a high-risk setting for alcohol-impaired driving. The Good Sports program accredits community sports clubs to encourage implementation of alcohol-focussed harm-reduction and safe-transport strategies. This study tested for associations between participation in the Good Sports program and reduced rates of drink-driving amongst club members. Multilevel modelling indicated that for each season a club was in the program there was an 8% reduction in the odds of drink-driving. These findings may arise due to clubs with lower rates of alcohol use maintaining longer involvement in the program. However, the findings are also compatible with the intention of the Good Sports program to reduce the risk that club members will drive whilst alcohol impaired.

Adolescent elite athletes' cigarette smoking, use of snus, and alcohol

The purpose was to examine cigarette smoking, use of snus, alcohol, and performance-enhancing illicit drugs among adolescent elite athletes and controls, and possible gender and sport group differences. First-year students at 16 Norwegian Elite Sport High Schools (n = 677) and two randomly selected high schools (controls, n = 421) were invited to participate. Totally, 602 athletes (89%) and 354 (84%) controls completed the questionnaire. More controls than athletes were smoking, using snus, and drinking alcohol. Competing in team sports was associated with use of snus [odds ratio = 2.8, 95% confidence interval (CI) 1.6 to 4.7] and a similar percentage of male and female handball (22.2% vs 18.8%) and soccer players (15.7% vs 15.0%) reported using snus. For controls, not participating in organized sport was a predictor for smoking (odds ratio = 4.9, 95% CI 2.2 to 10.9). Female athletes were more prone to drink alcohol than males (46.3% vs 31.0%, P < 0.001). Only, 1.2% athletes and 2.8% controls reported use of performance-enhancing illicit drugs. In conclusion, use of legal drugs is less common among athletes, but this relationship depends on type of sport and competition level. The association between team sports and use of snus suggests that sport subcultures play a role.

Measurement equivalence of the brief comprehensive effects of alcohol scale in a multiethnic sample of college students

OBJECTIVES

This study examined the measurement equivalence of the Brief Comprehensive Effects of Alcohol scale (B-CEOA; Ham et al., 2005)--a measure that assesses alcohol outcome expectancies (AOE) and expectancy evaluations-across ethnic groups and genders among multiethnic college student samples.

METHOD

Undergraduates provided self-report data in two multisite studies (Study 1: N = 1,536, 75.5% women, Mage = 19.6 years old, 56.4% European American, 9.8% African American, 7.6% Asian American, and 26.2% Hispanic/Latino American; Study 2: N = 7,767, 72.6% women, Mage = 19.8 years old, 63.3% European American, 7.9% African American, 14.3% Asian American, and 14.5% Hispanic/Latino American).

RESULTS

Exploratory and confirmatory factor analyses supported a positive and negative 4-factor model. Positive and negative AOE and expectancy evaluations were positively associated with hazardous alcohol use. Measurement equivalence of the B-CEOA across ethnicities and genders was largely supported.

CONCLUSIONS

This study provides support for the utility of the B-CEOA in college students of different ethnicities and genders in assessment and prevention.

Review of risk and protective factors of substance use and problem use in emerging adulthood

This review examines the evidence for longitudinal predictors of substance use and abuse in emerging adulthood. Nationally representative data from the 2007 National Survey on Drug use and Health suggest that many substance use problems reach their peak prevalence during emerging adulthood (usually defined as the period from age 18 to age 26). This stage of development is characterized by rapid transitions into new social contexts that involve greater freedom and less social control than experienced during adolescence. Concurrent with this newfound independence is an increase in rates of substance use and abuse. Understanding the risk and protective factors associated with emerging adult substance use problems is an important step in developing interventions targeting those problems. While multiple reviews have examined risk and protective factors for substance use during adolescence, and many of these earlier predictors may predict emerging adult substance use, few studies have focused primarily on the emerging adult outcomes examining predictors from both adolescence and emerging adulthood. This review used the databases PubMed and PsycInfo to identify articles pertaining to longitudinal predictors of substance use problems in emerging adulthood, building from the conceptual framework presented in a review on risk and protective factors for adolescent substance abuse by Hawkins and colleagues (Hawkins, Catalano, & Miller, 1992). Predictors identified as predictors of substance use in adolescence, sometimes decreased in strength and in one case reversed direction. Unique predictors in emerging adulthood were also identified. Implications for prevention science during adolescence and emerging adulthood are discussed as well as suggestions for future research.

Interventions in sports settings to reduce alcohol consumption and alcohol-related harm: a systematic review protocol

INTRODUCTION

Alcohol consumption is a primary cause of physical, psychological and social harm to both the user and others. At both the professional and non-professional level, sports players and fans report consuming alcohol at greater levels than people not involved in sports. Limited systematic reviews have been conducted assessing interventions targeting alcohol consumption behaviour and related harms in the sporting context.

METHODS AND ANALYSIS

The review aims to determine if interventions implemented in the sport setting decrease alcohol consumption and related harms. Participants may include all persons regardless of age or other characteristics. Studies will be included which have implemented interventions within the sport setting and have either measured: alcohol consumption, excessive alcohol consumption or intoxication or alcohol-related injury or violence. Randomised controlled trials, staggered enrolment trials, stepped-wedged trials, quasi-randomised trials, quasi-experimental trials and natural experiments will be included. Studies without a parallel comparison group will be excluded. Data will be sourced from a range of electronic databases and sources of grey literature. Two authors will independently screen all titles and abstracts of papers identified through the search strategy. Two authors will independently examine the full text of all remaining papers to determine eligibility. Two authors will independently extract data from eligible studies and independently assess risk of bias by assessing the adequacy of study characteristics. Where studies are sufficiently homogeneous, trial results will be synthesised using a fixed-effects meta-analysis. Standardised mean differences will be used for continuous outcomes and RRs will be used for binary outcomes.

DISSEMINATION

The findings of this study will be disseminated widely through mechanisms including peer-reviewed publications and conference presentations.

The culture of high-risk alcohol use among club and intramural athletes

OBJECTIVE

The purpose of this study was to examine the drinking patterns of club and intramural college athletes and compare their alcohol consumption, perceived norms around the excessive use of alcohol, experience of negative consequences, and employment of protective strategies with those of campus varsity athletes.

PARTICIPANTS

A total of 442 undergraduate students attending a private, suburban institution in the Northeast participated in the American College Health Association National College Health Assessment-II Web survey in spring 2011. Thirty-five students identified themselves as varsity athletes, 76 identified as club sport athletes, and 196 students identified themselves as intramural athletes.

METHODS

Survey responses were analyzed using Statistical Package for the Social Sciences. The Pearson's correlation coefficient and test for independence were applied to identify significant relationships between athlete status and identified variables related to alcohol use.

RESULTS

Results indicated that there were significant correlations between athlete status and all variables, to varying degrees.

CONCLUSIONS

These findings have implications for campus health promotion professionals and athletics program coordinators seeking to address high-risk alcohol use among college athletes.

Do coaches make a difference off the field? The examination of athletic coach influence on early college student drinking

Coaches can exert a considerable influence on the lives of their athletes. However, little is known about the influence of athletic coaches on athlete drinking behaviors. This study extends research on drinking influences in student-athletes. The relationship between athletic coaches and athlete drinking behaviors were examined. First-year college students (N=362) who had played high school sports were assessed on their relationships with their coaches as well as their alcohol use and problems. Findings revealed significant associations among the approval of and relationship with their athletic coaches and student drinking behaviors. These findings are discussed in the context of involving coaches in comprehensive strategies to reduce athlete drinking.

Recreational substance use among elite Australian athletes

INTRODUCTION AND AIMS

The study aimed to investigate the prevalence of illicit drug use among elite Australian athletes with a focus upon cannabis, ecstasy, meth/amphetamine, cocaine, GHB and ketamine; explore perceptions concerning the extent of drug use among this group; ascertain opinions regarding specific drugs of concern; and investigate predictors of recent drug use.

DESIGN AND METHODS

Data were taken from surveys with 974 elite athletes.

RESULTS

One-third of the sample had been offered or had the opportunity to use illicit drugs in the past year; despite this, the self-reported prevalence of all six drugs under investigation was lower than that reported by the general population. Sixteen per cent of athletes believed that there was a drug of concern in their sport, with ecstasy, cocaine and alcohol being nominated. Knowing other athletes who use illicit drugs, being offered or having the opportunity to use drugs and identifying as a 'full-time athlete' were significant predictors of recent drug use.

DISCUSSION AND CONCLUSIONS

The present study found that one-third of the athlete sample had been offered or had the opportunity to use illicit drugs in the past year; despite this, there was low self-reported drug use. Despite media discussion regarding alcohol use in sport, alcohol was nominated as a drug of concern only by a small proportion of athletes, and further research investigating this issue may be warranted.

Predictors of alcohol-related outcomes in college athletes: the roles of trait urgency and drinking motives

Research has shown that college students participating in athletics drink more than other students, yet relatively few studies have examined variables that are associated with alcohol-related outcomes among this population. The purpose of this study was to examine the relationships among trait urgency, general drinking motives and sport-related drinking motives, and both alcohol use and alcohol-related problems. Data were collected from 198 college students participating in either intercollegiate or recreational athletics at three U.S. universities. Structural equation modeling was used to examine a series of theoretically derived explanatory models. All variables included in the model were directly associated with alcohol use and/or alcohol-related problems. The specific patterns of relationships differed across the motives and trait urgency variables. Sport-related coping motives, sport-related positive reinforcement motives, and general enhancement motives had direct relationships with alcohol use, while trait urgency, general coping motives, and sport-related positive reinforcement motives had direct relationships with alcohol-related problems. Several indirect effects on alcohol use and alcohol-related problems were also found. This study suggests that general drinking motives, sport-related drinking motives, and trait urgency all serve as important predictors of alcohol-related outcomes in college athletes.

Combined effects of chronic alcohol consumption and physical activity on bone health: study in a rat model

Chronic alcohol consumption may be deleterious for bone tissue depending on the amount of ethanol consumed, whereas physical activity has positive effects on bone. This study was designed to analyze the effects of moderate alcohol consumption on bone in trained rats. 48 male Wistar rats were divided into four groups: control (C), alcohol (A), exercise (E) and alcohol + exercise (AE). A and AE groups drank a solution composed of water and ethanol. E and AE groups were trained for 2 months (treadmill: 40 min/day, 5 times/week). Body composition and bone mineral density (BMD) were assessed by dual X-ray absorptiometry and microarchitectural parameters using micro-computed tomography. Serum osteocalcin and CTx were determined by ELISA assays. The body weight and lean mass gain were lower in group A, while the fat mass gain was lower in exercised groups. BMD and BMC were higher with alcohol after body weight adjustment. Trabecular thickness was significantly higher in AE and A groups compared to C and E; cross-sectional area was larger in A and C groups compared to AE and E. CTx levels were higher in A compared to C and in AE and E versus C and A. Osteocalcin levels were significantly greater in AE and E groups versus C and A. In conclusion, the light to moderate alcohol consumption over a short period increased the trabecular thickness, BMC and BMD in A and AE groups. However, we observed alterations in bone remodeling and body composition with alcohol, at the end of the protocol, which did not appear when alcohol was combined to exercise.

Is reducing drinking always the answer to reducing consequences in first-year college students?

OBJECTIVE

Pre-college drinking has been shown to be a predictor of risky drinking and harmful outcomes in college. By contrast, less is known about how pre-college alcohol consequences influence subsequent consequences during the freshman year. The present study examined pre-college drinking and consequences in relationship to consequences experienced during the freshman year to better understand alcohol-related problems in this population.

METHOD

Incoming freshmen (N = 340, 58% female) were randomly selected and completed measures of drinking quantity, alcohol-related consequences, and drinking style behaviors at pre-college baseline and at 10-month follow-up.

RESULTS

Pre-college consequences demonstrated a unique relationship with consequences at 10-month follow-up controlling for both pre-college and freshman-year alcohol consumption. Furthermore, precollege consequences moderated the relationship between pre-college drinking and consequences at 10-month follow-up. For individuals who reported above-average pre-college consequences, no differences in 10-month follow-up consequences were observed across different levels of drinking. Finally, drinking style significantly mediated the relationship between the interaction between pre-college drinking and consequences and consequences at follow-up.

CONCLUSIONS

The findings demonstrate the need to identify students who are at an increased risk of experiencing alcohol-related problems during their freshman year based on their history of consequences before college. Interventions aimed at these students may benefit from examining the usefulness of increasing protective behaviors as a method to reduce consequences in addition to reducing drinking quantity.

Social Influences, Alcohol Expectancies, and Hazardous Alcohol Use Among College Athletes

Research has shown that college student-athletes are at increased risk for hazardous alcohol use. As such, this study examined social and cognitive influences on athletes’ alcohol consumption by exploring the association between injunctive norms (parental, teammate, and coach approval) and hazardous alcohol use among college athletes, and testing whether alcohol expectancy outcomes and valuations would mediate this association. College student-athletes (n = 301; mean age = 19.4, SD = 1.3) completed self-report questionnaires assessing their drinking behaviors and perceptions of alcohol use in their social environment. Structural equation modeling revealed, in all but one case, a direct association between each of the injunctive norms variables and hazardous alcohol use. In addition, negative expectancy valuations mediated the association between teammate approval and hazardous alcohol use. Injunctive norms emerged as an important factor in student-athletes’ alcohol use. Implications for alcohol intervention programming among student-athletes are discussed.

Age of drinking onset as a moderator of the efficacy of parent-based, brief motivational, and combined intervention approaches to reduce drinking and consequences among college students

BACKGROUND

The current study tested age of onset as a moderator of intervention efficacy on drinking and consequence outcomes among a high-risk population of college students (i.e., former high school athletes).

METHODS

Students were randomized to one of four conditions: assessment only control, combined parent-based intervention (PBI) and brief motivational intervention (BMI), PBI alone, and BMI alone. Participants (n = 1,275) completed web-administered measures at baseline (summer before starting college) and 10-month follow-up.

RESULTS

Overall, the combined intervention demonstrated the strongest and most consistent reductions across all outcomes, particularly with the youngest initiators. Participants who initiated drinking at the youngest ages had significantly lower peak drinking, typical weekly drinking, and reported consequences at follow-up when they received the combined intervention when compared to the control group. The BMI and PBI groups, when examined independently, demonstrated significant effects across outcomes but were inconsistent across the different age groups.

CONCLUSION

Results suggest the combination of a PBI and a peer-delivered BMI is an appropriate and efficacious way to reduce drinking and related consequences among individuals who initiated drinking earlier in adolescence and are at an increased risk of experiencing alcohol problems.

Relationship of high school and college sports participation with alcohol, tobacco, and illicit drug use: a review

This study provides an exhaustive review of 34 peer-reviewed quantitative data-based studies completed on high school and college sports involvement and drug use. The studies reviewed suggest that participation in sport is related to higher levels of alcohol consumption, but lower levels of both cigarette smoking and illegal drug use. Additional research is needed in this domain to further elucidate the relationship between these variables.

Waterpipe and cigarette smoking among college athletes in the United States

PURPOSE

Tobacco use using a waterpipe is an emerging trend among college students. Although cigarette smoking is low among college athletes, waterpipe tobacco smoking may appeal to this population. The purpose of this study was to compare cigarette and waterpipe tobacco smoking in terms of their associations with organized sport participation.

METHODS

In the spring of 2008, we conducted an online survey of 8,745 college students at eight institutions as part of the revised National College Health Assessment. We used multivariable regression models to assess the associations between tobacco use (cigarette and waterpipe) and organized sports participation.

RESULTS

Participants reported participation in varsity (5.2%), club (11.9%), and intramural (24.9%) athletics. Varsity athletes and individuals who were not varsity athletes had similar rates of waterpipe tobacco smoking (27.6% vs. 29.5%, p=.41). However, other types of athletes were more likely than their counterparts to have smoked waterpipe tobacco (35.1% vs. 28.7%, p < .001 for club sports and 34.8% vs. 27.7%, p < .001 for intramural sports). In fully-adjusted multivariable models, sports participants of any type had lower odds of having smoked cigarettes, whereas participants who played intramural sports (odds ratio=1.15, 95% confidence interval=1.03, 1.29) or club sports (odds ratio=1.15, 95% confidence interval=1.001, 1.33) had significantly higher odds of having smoked waterpipe tobacco.

CONCLUSIONS

College athletes are susceptible to waterpipe tobacco use. In fact, compared with their nonathletic counterparts, club sports participants and intramural sports participants generally had higher odds of waterpipe tobacco smoking. Allure for waterpipe tobacco smoking may exist even for individuals who are traditionally considered at low risk for tobacco use.

Is Substance Use a Team Sport? Attraction to Team, Perceived Norms, and Alcohol and Marijuana Use Among Male and Female Intercollegiate Athletes

This research examined the role of attraction to one's team in predicting alcohol and marijuana use among intercollegiate athletes. Attraction to team and alcohol-related information were collected via an online survey and marijuana use-related information was gathered in a live setting. We investigated the influence of attraction to one's team above and beyond the influence of gender and perceived norms, and attraction to team as a moderator of these relationships. Attraction to one's team accounted for significant variance in marijuana use, and alcohol-related consequences after controlling for alcohol consumption. Regression analyses revealed significant interactions between gender, attraction to team, and norms in predicting alcohol and marijuana use. Stronger attraction to one's team may increase alcohol use but decrease marijuana use among male athletes, suggesting the importance of attraction to team when developing interventions for athletes.

A randomized clinical trial evaluating a combined alcohol intervention for high-risk college students

OBJECTIVE

The current study is a multisite randomized alcohol prevention trial to evaluate the efficacy of both a parenting handbook intervention and the Brief Alcohol Screening and Intervention for College Students (BASICS) intervention, alone and in combination, in reducing alcohol use and consequences among a high-risk population of matriculating college students (i.e., former high school athletes).

METHOD

Students (n = 1,275) completed a series of Web-administered measures at baseline (in the summer before starting college) and follow-up (after 10 months). Students were randomized to one of four conditions: parent intervention only, BASICS only, combined (parent and BASICS), and assessment-only control. Intervention efficacy was tested on a number of outcome measures, including peak blood alcohol concentration, weekly and weekend drinking, and negative consequences. Hypothesized mediators and moderators of intervention effect were tested.

RESULTS

The overall results revealed that the combined-intervention group had significantly lower alcohol consumption, high-risk drinking, and consequences at 10-month follow-up, compared with the control group, with changes in descriptive and injunctive peer norms mediating intervention effects.

CONCLUSIONS

The findings of the present study suggest that the parent intervention delivered to students before they begin college serves to enhance the efficacy of the BASICS intervention, potentially priming students to respond to the subsequent BASICS session.

The prognostic power of normative influences among NCAA student-athletes

This study evaluated the predictive power of perceived descriptive and injunctive norms on intercollegiate student-athlete alcohol consumption and attitudes toward drinking-related behaviors. The sample consisted of 594 NCAA student-athletes from two geographically opposite sites. Norms variables utilized a school and gender-specific athletic peer reference group. Results indicate that respondents reported greater perceived injunctive norms than actual attitudes, and greater perceived descriptive norms than actual alcohol use. Further, after accounting for demographics and alcohol motivations, perceived injunctive norms were the strongest predictors of athletes' attitudes with the final model explaining 54% of the variance. Similarly, perceived descriptive norms were among the strongest predictors of alcohol use with the final model explaining 69% of the variance. Future research may want to use both of these perceived norms constructs to create a more salient and targeted social norms intervention aimed at reducing risky behavior and permissive alcohol-related attitudes among this population. Utilizing this strong peer reference group as well as targeting both injunctive and descriptive norms may increase the power and saturation of prevention and intervention strategies.

Binge drinking in college-aged women: framing a gender-specific prevention strategy

PURPOSE

To provide an overview of binge drinking in college-aged women and to suggest strategies for nurse practitioners (NPs) to assist women in preventing the negative consequences associated with this behavior.

DATA SOURCES

Original research articles and comprehensive review articles identified through Medline, CINAHL, and OVID databases.

CONCLUSIONS

Researchers have shown that the rates of binge drinking in college-aged women are increasing, which places these women at increased risk for the long-term complications associated with alcohol use.

IMPLICATIONS FOR PRACTICE

NPs must be aware of this phenomenon and carefully screen women for high-risk alcohol use. Prevention strategies are reviewed and include the use of brief motivational interviews delivered during individual client encounters as well as through Web-based programs.

Drinking by professional Australian Football League (AFL) players: prevalence and correlates of risk

OBJECTIVES

To examine self-reported patterns of alcohol consumption and experience of alcohol-related harms among professional Australian Football League (AFL) players.

DESIGN, SETTING AND PARTICIPANTS

Cross-sectional survey of player alcohol consumption and self-reported alcohol-related harms among members of all 16 professional AFL clubs. Data relating to the 2006 football year were collected between 25 July and 30 August 2006 at regular football training sessions using a self-administered structured questionnaire.

MAIN OUTCOME MEASURES

Risky/high-risk drinking for long- and short-term harm at different times of the year; Alcohol Use Disorders Identification Test (AUDIT) score.

RESULTS

582 AFL players completed the questionnaire (an 83% response rate). Alcohol consumption varied at different times of the year. During the playing season (approximately 22 weeks), the level of risky/high-risk consumption for long-term harm in AFL players (11/564 [2%]) was typically lower than in age-matched Australian men in the general population (15%). However, risky/high-risk consumption for long-term harm was higher in AFL players during the end-of-season period (approximately 2 weeks) (303/561 [54%]) and vacation period (6-8 weeks) (231/559 [41%]) than in age-matched Australian men. Risky/high-risk drinking for short-term harm on a monthly basis was frequent at all times of the year (eg, 395/560 [71%] in the pre-season period). The mean AUDIT score was 8.8 (95% CI, 8.4 to 9.1; range, 0 to 36). Reports of harmful effects of drinking and negative consequences, such as getting involved in a fight (physical or verbal) while drinking (146/556 [26%]), were common. Risky/high-risk consumption for short-term harm on a monthly basis was associated with a variety of player characteristics, such as usually drinking in public locations (odds ratio, 1.55 [95% CI, 1.02 to 2.35]). AUDIT score was associated with variables such as marital status, with married players scoring more than two points lower (95% CI, - 3.58 to - 0.58) than single players. Formal club rules on alcohol consumption had little effect on outcome measures.

CONCLUSIONS

Drinking among AFL players is intricately related to time of year. This seasonal drinking pattern requires the development of specific club and league strategies to minimise drinking-related harms to players.

Risk for excessive alcohol use and drinking-related problems in college student athletes

There is compelling evidence that college student athletes engage in frequent episodes of heavy drinking and are prone to negative consequences resulting from such use. This study sought to identify risk and protective factors associated with student-athlete drinking and determine if student-athlete risk factors differed from those of non-athletes. Athletes compared to non-athletes reported more exaggerated perceptions of peer heavy drinking and lower sensation seeking and coping and enhancement motives for drinking, suggesting a risk profile distinct from non-athletes. In the overall sample, higher sensation seeking, overestimation of peer heavy drinking, non-use of protective behaviors while drinking, and higher enhancement and coping drinking motives were associated with greater frequency of heavy episodic drinking and more negative drinking consequences. In athletes compared to non-athletes, sensation seeking was more strongly associated with heavy episodic drinking and drinking to cope was more strongly associated with negative alcohol-related consequences. Overall, the results suggest that already proven brief intervention strategies, with minor adaptations related to the roles of sensation seeking and drinking to cope, may be helpful for student athletes.

Competitiveness and Alcohol Use Among Recreational and Elite Collegiate Athletes

Large-scale, national research studies have consistently indicated that college students participating in athletics consume more alcohol than nonathletes. Theorists have speculated that a number of risk factors could be associated with heavy drinking among this group, although research in the area has been sparse. The purpose of the current study was to assess the relationship between one possible risk factor, competitiveness, in a sample of recreational and elite college athletes to determine whether competitiveness was related to alcohol use among these athletes. Data were collected from a sample of 298 undergraduates from a large university in the northeastern United States. Results showed that competitiveness was associated with higher amounts of alcohol consumption. Clinical implications and future research directions are discussed.

Alcohol expectancies and context-specific drinking behaviors among female college athletes

Alcohol expectancies have been associated with drinking behaviors among college students. Few studies, however, have focused on researcher-labeled "positive" and "negative" expectancies as well as the valuations (i.e., desirability) of these expectancies. Moreover, research on the correlates of heavy drinking among female college athletes remain relatively sparse, despite the prevalence of elevated alcohol use in this population. We examined the associations of expectancies and valuations with frequency of heavy drinking and context-specific drinking behaviors. The sample consisted of 145 female college athletes (mean age=19.6; range=17 to 22) who completed self-report surveys and indicated alcohol use in the past 30 days. Regression analyses indicated that favorable valuations of negative expectancies were related to heavy drinking, and that valuations accounted for significant proportions of variance in the model. Elevated endorsement of negative expectancies was also associated with the perceived likelihood of heavy use in convivial and personal-social drinking contexts, and favorable valuations of these expectancies accounted for significant variance in these models. These findings highlight the relevance of negative expectancies and valuations with respect to heavy drinking and context-specific drinking behaviors among female college athletes. The perception of "negative" effects of alcohol as "positive" could help explain the high rates of problematic drinking among female athletes. Future research considerations and potential implications for assessment and prevention efforts are discussed.

Alcohol consumption: the good, the bad, and the indifferent

Dietary ethanol (alcohol) is the most widely consumed drug worldwide. High levels of mortality, morbidity, and social malaise are associated with abuse of alcohol, and increasing numbers of women and youth are abusing alcohol. However, strong epidemiological data demonstrate a U- or J-shaped relationship between volume of alcohol consumed and all-cause mortality or disease burden. Moderate alcohol consumption is associated with a lower risk of all-cause mortality and disease burden than are abstinence and immoderate drinking. A brief review of the absorption, distribution, metabolism, and excretion of ethanol is provided with a discussion of the impact of gender differences. Potential mechanisms by which ethanol, ethanol metabolites, and (or) phytochemicals, as associated with different types of ethanol-containing beverages, are discussed in regards to the beneficial and detrimental impacts they may have on physiological system functioning and mortality or disease burden. Per capita consumption of ethanol-containing beverages varies across geo-political regions worldwide. A more recent research focus is the impact of consumption patterns on consumption volumes as they relate to disease and mortality. Certain drinking patterns moderate overall volume of ethanol consumption. Thus, an emerging approach to the study of alcohol consumption in populations is to consider both the volume and pattern of consumption as they relate to mortality and disease burden. Alcohol consumption patterns among athletes are discussed; physiological implications of alcohol abuse in this population are outlined. Current guidelines for the consumption of alcohol are reviewed. Alcohol consumption guidelines reflect the current scientific understanding of both the benefits of moderate alcohol consumption and the detriments of immoderate alcohol consumption.

Factors associated with herb and dietary supplement use by young adults in the United States

BACKGROUND

Little is known about the association between use of herbs and dietary supplements (HDS) and lifestyle/behavior factors in young adults in the US.

METHODS

Analyzing the 2002 National Health Interview Survey (NHIS), we examined the patterns of HDS (excluding vitamins/minerals) use among young adults in the United States using descriptive statistics and logistic regression.

RESULTS

In our sample of 18 to 30 year olds (n = 6666), 26% were current smokers, 24% were moderate/heavy drinkers, 43% had high physical activity, and 54% and 76% use prescription and over the counter (OTC) medications respectively. Non-vitamin, non-mineral HDS was used by 17% of the overall sample in the last 12 months. In the multivariable analysis, the lifestyle and behavioral factors associated with HDS use include: current smoking (odds ratio 1.41 95% CI [1.16-1.72]); being a former smoker (1.50 [1.15-1.95]); moderate/heavy alcohol use (2.02 [1.53-2.65]); high physical activity levels (2.45 [1.98-3.03]); and prescription medication use (1.51 [1.26-1.81]). Among HDS users, only 24% discussed their use with a health care professional.

CONCLUSION

Nearly one in five young adults report using non-vitamin/non-mineral HDS.