Secondhand effects of student alcohol use reported by neighbors of colleges: the role of alcohol outlets

A national assessment of on-premise drinking establishments near public universities: Drink prices, drink specials, indoor tobacco use, and state-level alcohol laws

BACKGROUND

Inexpensive drinks and price promotions increase alcohol consumption and have been observed at on-premise drinking establishments near large colleges. Some bars may sell tobacco products and allow indoor tobacco use to encourage patrons to stay and drink more. This study examined drink prices/specials and associated practices of on-premise drinking establishments including tobacco sales and policies regarding tobacco use.

METHODS

In 2018, telephone calls about prices/practices were made to 403 randomly selected bars/nightclubs within 2 miles of large residential universities in each U.S. state. The Alcohol Policy Information System provided data on state-level alcohol laws. Multivariable linear and logistic regression models examined associations between alcohol prices/specials, state laws, and establishment practices.

RESULTS

The average price for the least expensive draft beer and a vodka shot at each location were $3.62 (SD = $1.15) and $4.77 (SD = $1.16), respectively. Most establishments (65%) had happy hour specials, 6% had 2-for-1 specials, 91% sold food, 9% sold cigarettes, 8% allowed smoking indoors, and 18% permitted electronic cigarette (e-cigarette) use indoors. Allowing e-cigarette use indoors (b = -0.54) and selling cigarettes (b = -0.79) were associated with lower vodka prices; allowing cigarette smoking indoors (b = -0.46) was associated with lower beer prices. Lower beer prices (OR = 1.38), selling food (OR = 2.97), and no state law banning happy hour specials altogether (OR = 4.24) or with full-day price reduction exemptions (OR = 12.74) were associated with higher odds of having happy hour specials. Allowing e-cigarette use indoors was associated with having 2-for-1 specials (OR = 6.38).

CONCLUSION

In bars near large public universities, beers and shots were often available for less than $5 and drink specials were prevalent. Further, some establishments allowed tobacco use indoors and/or sold cigarettes. Laws that increase alcohol taxes, set minimum drink prices, and ban the sale and indoor use of tobacco products at on-premise drinking locations are important harm reduction tools.

Where's the party? A mixed method study investigating characteristics, motivations, and harms of attending off-campus (over on-campus) parties

ObjectiveWe examined the characteristics, motivations, and harms associated with celebrating events at off-campus parties (OCPs), including a particularly harmful off-campus block party compared to on-campus parties (CPs). Participants and Method: Survey with a representative sample of 491 students in Canada. Three focus groups with a total of 14 students who have attended the OCBP and one focus group with community members affected by the OCBP (n = 10). Results: 14.3% of students attended OCPs. OCPs were significantly more likely to be associated with harms. Focus groups revealed that students attend the OCBP as it is cheaper to consume alcohol compared to CPs. Improved music was the most common solution to improve CP. Community members identified 16 potential solutions to mitigate the harms and prevent the OCBP. Conclusion: Reducing costs and improving the experience may increase likelihood of students attending CPs and minimize harms of OCPs.

Perceived Gambling Availability and Adolescent Gambling Behavior: the Moderating Role of Self-Efficacy

Geographic accessibility has been linked to gambling behavior, but little is known about whether the perception of gambling availability in both offline and online venues is prospectively associated with adolescent gambling behavior. Further, relatively few studies have analyzed the interaction between environmental and individual factors in explaining adolescent gambling and problem gambling. This prospective study examined the association between perceived gambling availability, gambling frequency, and problem gambling among 554 adolescents aged 13–17 years (mean = 15.1, female 47.4%) and explored the moderating role of self-efficacy to control gambling in these associations. Participants completed assessments of perceived gambling availability and gambling self-efficacy at baseline. Gambling frequency and problem gambling were measured at follow-up. Two separate hierarchical regression models were applied to analyze the relationship of perceived gambling availability with gambling behavior and the moderating role of gambling self-efficacy. Results showed that a greater perception of gambling availability was associated with a higher gambling frequency and more problem gambling in adolescents. The impact of perceived gambling availability on gambling frequency and problem gambling was lower among participants with moderate gambling self-efficacy in comparison with participants with low gambling self-efficacy. In those adolescents with high self-efficacy to control gambling, perceived gambling availability was not associated either with gambling frequency or problem gambling. These results suggest the usefulness of implementing regulatory policies aimed at reducing gambling availability in adolescents, and the design of preventative interventions aimed at enhancing self-efficacy to control gambling.

Maternal working hours and smoking and drinking in adolescent children: based on the Korean National Health and Nutrition Examination Survey VI and VII

Background

Adolescent smoking and drinking are influenced by parental supervision. This study aimed to investigate the gap in adolescent smoking and drinking experience rates and age at initiation according to maternal working hours.

Methods

Data from 1,580 adolescents aged 12–18 years and 1,172 working mothers of double-parent or single-mother households were selected from the Korean National Health and Nutrition Examination Survey (KNHANES) VI & VII data. Figures on adolescents' smoking and drinking rates and their ages at imitation were used. Maternal working hours were divided into < 40 hours, 40–52 hours, and > 52 hours to analyze whether smoking and drinking experience rates and age at initiation differ according to maternal working hours and by the child's sex. Maternal age, education level, household income, occupation, shift work, current smoking status, monthly drinking frequency and child's obesity, stress recognition and depressive mood were adjusted for in the statistical analyses.

Results

The odds for adolescents' smoking behavior were significantly higher with increasing maternal working hours in boys but not in girls. The odds for adolescents' drinking behavior were not significantly higher in both boys and girls. Regardless of the child's sex, there were no significant differences in the age of smoking and drinking initiation according to maternal working hours.

Conclusions

Adolescents of mothers who work long hours are at a higher risk of being exposed to smoking. Thus, our society needs to share the burden of raising children, which is concentrated on women, and employers and governments should support policies that can help prevent long working hours.

Effects of the COVID-19 Mitigation Measures on Alcohol Consumption and Binge Drinking in College Students: A Longitudinal Survey

To "flatten the curve" of COVID-19 contagion, several countries ordered lockdowns amid the pandemic along with indications on social distancing. These social isolation measures could potentially bring alterations to healthy behavior, including to alcohol consumption. However, there is hardly any scientific evidence of the impact of such measures on alcohol consumption and binge drinking (BD) among young adults, and how they relate to alcohol craving, stress, anxiety, and depression levels. We addressed these questions by conducting a longitudinal study with 146 Portuguese college students-regular binge drinkers (regular BDs), infrequent binge drinkers (infrequent BDs) and non-binge drinkers (non-BDs)-in three moments: before the pandemic (Pre-Lockdown), during lockdown (Lockdown) and 6 months after (Post-Lockdown). Results revealed that regular BDs decreased alcohol use during Lockdown, a change in behavior that was even greater during Post-Lockdown, when regular BDs displayed similar levels of consumption to infrequent/non-BDs. Additionally, alcohol craving and living with friends were predictive of alcohol use during Lockdown, whereas stress, anxiety, and depression symptoms did not contribute to explain changes in drinking behavior. Collectively, the results suggest that BD in young Portuguese college students can be stopped when the contexts in which alcohol intake usually takes place are suppressed, which may have important implications for future prevention and intervention strategies.

Drinking Motives and Drinking Consequences across Days: Differences and Similarities between Moderate, Binge, and High-Intensity Drinking

BACKGROUND

The current study examined the extent to which within-person variation in drinking motives differentiates moderate, binge, and high-intensity drinking; and independent associations of motives and drinking intensity with alcohol use consequences in a sample of young adult drinkers from across the United States.

METHODS

Participants were past 30-day drinkers in the U.S. nationally representative Monitoring the Future 12th grade sample in 2018, who also reported alcohol use during a 14-day data collection burst 1 year later (N = 484 people, mean age 19.3 [SD 0.40], 43% female; N = 1042 drinking days) as part of the Young Adult Daily Life Study in 2019. Weighted multilevel modeling estimated within- and between-person associations of drinking motives, drinking intensity (i.e., moderate [women 1-3, men 1-4 drinks], binge [women 4-7, men 5-9 drinks], and high-intensity drinking [women 8+, men 10+ drinks]), and number of positive and negative alcohol consequences.

RESULTS

On days participants reported greater enhancement and social motives, they were more likely to engage in high-intensity (vs. binge) drinking and binge (vs. moderate) drinking and experience more positive alcohol consequences. On days participants reported greater enhancement and coping motives, they experienced more negative alcohol consequences. Binge (vs. moderate) drinking on a given day was associated with more positive and negative alcohol consequences; high-intensity (vs. binge) drinking on a given day was associated with more negative alcohol consequences that day. Moderation analyses indicated that social motives were associated with high-intensity (vs. binge) drinking only among college students.

CONCLUSIONS

Stronger drinking motives on a given day were associated with drinking intensity (enhancement and social motives) and negative consequences (enhancement and coping). High-intensity (vs. binge or moderate) drinking was associated with more negative consequences but not more positive consequences. These results underscore that high-intensity drinking and consequences vary across days and time-varying, occasion-specific risks such as current motivational context are appropriate targets for intervention.

Negative alcohol-related consequences experienced by young adults in the past 12 months: Differences by college attendance, living situation, binge drinking, and sex

PURPOSE

This study estimated the prevalence of negative consequences associated with alcohol use in a national sample of young adults one or two years after graduating from high school, focusing on differences by college attendance, living situation, binge drinking, and sex.

METHODS

A subsample (N = 1068) of U.S. nationally representative Monitoring the Future study 12th grade students from 2006 to 2016 cohorts was followed-up at modal age 19 or 20 (in 2008-2017) and asked about negative consequences related to their own alcohol use during the past 12 months. Differences in prevalence were estimated and multivariable models examined associations with college attendance, living situation, binge drinking, and sex.

RESULTS

Half of surveyed U.S. 19/20 year-old alcohol users (a third of non-binge drinkers and almost three-quarters of binge drinkers) experienced negative consequences in the past year. The likelihood of experiencing several consequence types was significantly associated with college attendance prior to controlling for living situation. In multivariable models controlling for living situation, unsafe driving due to drinking remained more likely for students attending 2-year colleges or vocational/technical schools than for 4-year college students or non-attenders. In general, negative consequence risk was elevated among young adults not living with parents (vs. those living with parents) and women (vs. men).

CONCLUSION

Negative consequences from alcohol use are prevalent among young adults and differ by college attendance, living situation, binge drinking, and sex. Students at 2-year/vocational/technical schools are at particular risk for unsafe driving, warranting specific research attention and targeted intervention.

Association between state-level alcohol availability and taxation policies on the prevalence of alcohol-related harms to persons other than the drinker in the USA, 2000-2015

INTRODUCTION AND AIMS

Alcohol-related harms to others (AHTO) are consequences of alcohol use borne by persons other than the drinker. This study assessed whether the odds of experiencing AHTO are associated with alcohol availability and taxation policies.

DESIGN AND METHODS

This study pooled data from four waves of the National Alcohol Survey (n = 20656 adults). We measured past-year AHTO exposure using three binary variables: physical (pushed/hit/assaulted or property damage by someone who had been drinking), family or financial (family/marital problems or financial harms by someone who had been drinking) and driving AHTO (riding in a vehicle with a drink-driver or being in a drink-driving crash). Policies included bar and off-premise alcohol outlet density (separately), alcohol retail hours, beer and spirits taxes (separately) and monopoly on retail/wholesale alcohol purchases.

RESULTS

Monopolies were associated with 41.2% lower odds of physical harms [adjusted odds ratio (aOR) = 0.59, 95% confidence interval (CI) 0.45, 0.77, q < 0.001 correcting for multiple analyses], and a 10% increase in bar density was associated with a 1.2% increase in odds of driving-related harms ( e ^{ln(1.1) * β} =1.01, 95% CI 1.00, 1.02, q = 0.03). Among men, beer taxes were associated with lower odds of physical harms ( e^{ln(1.1) * β} =0.93, 95% CI 0.88, 0.98 q = 0.03) and monopolies were associated with lower odds of physical (aOR = 0.45, 95% CI 0.35, 0.59, q < 0.001) and driving harms (aOR = 0.66, 95% CI 1.00, 1.02, q = 0.03).

DISCUSSION AND CONCLUSIONS

Monopolies, taxes and outlet density are associated with odds of some AHTO. Future longitudinal research should test whether physical availability and taxation policies may be protective for bystanders as well as drinkers.

Gender Equality, Drinking Cultures and Second-Hand Harms from Alcohol in the 50 US States

BACKGROUND

Gender inequality and cultures of binge drinking may increase the risk of second-hand harms from alcohol.

METHODS

Using the 2014-2015 National Alcohol Survey and 2015 National Alcohol's Harm to Others Survey (N = 7792), we examine associations of state-level gender equality measures (contraceptive access, abortion rights, women's economic equality) and binge drinking cultures (rates of men's and women's binge drinking) with individual-level indicators of second-hand harms by drinking strangers and partners/spouses.

RESULTS

In main effects models, only male binge drinking was associated with greater odds of harms from drinking strangers. There were significant interactions of gender equality with male binge drinking: High male binge drinking rates were more strongly associated with stranger-perpetrated harms in states low on contraceptive access or abortion rights compared to states high on these measures. Conversely, male binge drinking was more strongly associated with spouse/partner-perpetrated second-hand harms in states with more economic equality, compared to states lower on this measure.

CONCLUSIONS

Detrimental effects of high male binge drinking rates may be modified by gender equality. Targeted interventions may reduce alcohol-related harms experienced by women in states with high rates of male binge drinking. Restrictions in access to contraception and abortion may exacerbate harms due to men's drinking.

Harm from other people's drinking among college students in India

INTRODUCTION AND AIMS

There is a paucity of studies on the harms experienced by college students from India due to others' drinking, despite their increased risk. We studied the prevalence and correlates of harm from others' drinking among college students in the state of Kerala, India.

DESIGN AND METHODS

A total of 5784 students from 58 colleges completed a self-administered questionnaire, which included the World Health Organization-Thai Health Harm to Others from Drinking Master Protocol and other structured instruments to assess correlates. The frequencies of various harms were determined and a mixed effect multivariable negative binomial regression model was used to identify the factors responsible for harms.

RESULTS

Of the 4487 valid responses, 68.3% were females. The mean age of the sample was 19.5 years. Harm from others' drinking was reported by 68.7% of respondents. Among various harm domains, psychological harm was reported by 65.7%, physical by 15.2%, financial by 20.9%, and property harm by 5.0%. Strangers were the most common perpetrators. Being male and having a part-time job increased harms. Increasing age, urban residence, and staying in a hostel were correlated with psychological-but not physical-harm. Subjects who reported harm had higher odds of reporting alcohol use and psychological distress. 'Any harm' or psychological harm was associated with suicidal thoughts; only physical harm was correlated with suicidal attempts.

DISCUSSION AND CONCLUSIONS

The high prevalence of harms from others' drinking and its negative correlates underscore the need for colleges to focus on second-hand effects in programs for tackling alcohol use.

Collateral damage from college drinking: A conceptual framework for alcohol's harms to others among US college students

BACKGROUND

A growing literature shows that drinkers can harm bystanders through alcohol-related harms to others (HTO). The burden of HTO is particularly consequential in college environments, where heavy alcohol consumption and related harms are highly prevalent. A key limitation to the current literature on HTO among college students is that the determinants of HTO in college settings are not well-described.

OBJECTIVE

This article presents an evidence- and theory-based conceptual framework of HTO among United States college students.

METHODS

This study used a literature review in Embase, PsycInfo, PubMed, and Web of Science to determine the prevalence of HTO among college students and literature gaps. Researchers supplemented college HTO literature with broader HTO literature to develop a conceptual framework.

RESULTS

Prevalence estimates for HTO among college populations range from 59% to 84%. Literature on HTO among college students is mostly confined to brief sections of larger surveys. The college HTO literature lacks the level of detail necessary to support methodologically rigorous research.

CONCLUSIONS

HTO are prevalent among college populations but their prevalence and etiology are not well understood. This likely leads to systematic undercounting of the impact of alcohol in college settings, exacerbating the "translation" gap between what the research says is effective and what colleges actually do. Better understanding of HTO mechanisms through which drinkers harm those around them would inform alcohol research and policy on college campuses, and lead to more accurate assessments of the degree to which stronger alcohol policies could benefit all students, regardless of their drinking patterns.

Assessing Campus Alcohol Policies: Measuring Accessibility, Clarity, and Effectiveness

BACKGROUND

Excessive alcohol consumption poses significant hazards to health and safety on college campuses. While substantial research exists regarding effective policies for preventing alcohol-related problems in the communities surrounding campuses, on-campus alcohol policies have received far less attention.

METHODS

Official campus alcohol policies (CAPs) were retrieved from the websites of the 15 member schools of the Maryland Collaborative to Reduce College Drinking and Related Problems, a voluntary statewide collaborative. CAPs were assessed for accessibility, clarity, and effectiveness. In addition to assessing whether campuses were in compliance with federal regulations for comprehensiveness of policies, a measure of likely policy effectiveness was developed through the use of 2 Delphi panels drawing on alcohol policy researchers and on-campus and community practitioners, respectively. The panels rated 35 potential policies and 13 possible sanctions; lists of policies and sanctions were compiled primarily from what was already in existence at 1 or more member schools.

RESULTS

For most campuses, the CAPs could be located within 30 seconds, but tended to be spread across multiple web pages. Language used to communicate the policies tended to be complex and above the reading level of someone with a high school education. At least half of the schools had less than half of the possible policies rated most or somewhat effective by the Delphi panels. Schools were more likely to employ the most effective sanctions, but somewhat and ineffective sanctions were also not uncommon.

CONCLUSIONS

CAPs are an important element in reducing negative consequences of alcohol consumption on college campuses. A higher level of research scrutiny is warranted to understand the extent to which CAPs are associated with excessive drinking, but this research describes an evidence- and expert-informed assessment approach that colleges can use to regularly analyze and update their CAPS.

A Causal Model of Binge Drinking Among University Students in Northern Thailand

Binge drinking, an extreme drinking pattern and the most common form of hazardous alcohol consumption among university students, has remained a public health concern with physical, psychological, academic, and social problems. Tracking multiple factors is needed to find ways to deal with such hazardous drinking patterns and their adverse consequences. In Thailand, the particular factors leading to binge drinking patterns among university students are still not recognized. Four hundred thirteen university students in Northern Thailand self-administered a Web-based survey about the causal factors. The survey was based on a hypothesized model from the Social Ecological Model and from empirical studies. There were four factors that were hypothesized to directly increase binge drinking behavior: attitudes toward drinking, peer influence, physical environments of drinking, and alcohol advertisements. However, there were another four factors that were hypothesized to directly decrease binge drinking behavior: drinking refusal self-efficacy, university alcohol regulations, alcohol public policies, and knowledge. Through testing of the hypothesized model by Structural Equation Modeling, the causal model of binge drinking among Thai university students revealed "binge drinking refusal self-efficacy" (β = -.22, p < .001) and "peer influence" (β = -.14, p < .05) as significant negative factors and "physical environments" (β = .18, p < .001) as a positive predictor regarding binge drinking. The study shows how healthcare providers may be able to lessen binge drinking by designing effective prevention programs centering on an intrapersonal factor (binge drinking refusal self-efficacy), an interpersonal factor (peer influence), and a community factor (physical environments).

Psychometric evaluation of the drinking refusal self-efficacy scale - revised with college students in the United States

Drinking refusal self-efficacy has recently emerged as a potential factor related to reduced alcohol consumption and alcohol-related negative consequences in college students. The Drinking Refusal Self-Efficacy Questionnaire-Revised (DRSEQ-R) has been commonly used to assess for drinking refusal self-efficacy. However, psychometric evaluation of the measure with college students from the United States is needed to enhance its research and clinical utility. The goal of the present study was to confirm the factor structure of the DRSEQ-R with a sample of traditional aged college students from the United States as well as assess the measurement invariance of the factor structure across sex and race and the measure's convergent validity with other common alcohol use measures. Traditional age college students (n = 1683, 73% women; 63% White, non-Hispanic) completed measures of drink refusal self-efficacy, protective behavioral strategies, weekly alcohol use, hazardous drinking, and alcohol-related negative consequences. Using exploratory factor analysis and multi-group confirmatory factor analyses, a three-factor structure was identified, but, unlike the DRSEQ-R, one item loaded onto the opportunistic relief factor instead of the social pressure factor. The proposed model registered more reliable internal consistencies across the subscales, was invariant across sex and race, and demonstrated acceptable convergent validity with other commonly used alcohol measures. The proposed model for the DRSE-R may be a more psychometrically sound way to assess for drinking refusal self-efficacy among college students in the United States. Implications, limitations, and future research directions are discussed.

Hazardous Drinking among Students over a Decade of University Policy Change: Controlled Before-and-After Evaluation

Background: Responding to high levels of alcohol-related harm among students, a New Zealand university deployed a security and liaison service, strengthened the Student Code of Conduct, increased its input on the operation of alcohol outlets near campus, and banned alcohol advertising on campus. We estimated the change in the prevalence of alcohol consumption patterns among students at the university compared with other universities. Methods: We conducted a controlled before-and-after study with surveys in residential colleges at the target university in 2004 and 2014, and in random samples of students at the target university and three control universities in 2005 and 2013. The primary outcome was the prevalence of recent intoxication, while we analysed drinking per se and drinking in selected locations to investigate mechanisms of change. Results: The 7-day prevalence of intoxication decreased from 45% in 2004 to 33% in 2014 (absolute difference: 12%; 95% CI: 7% to 17%) among students living in residential colleges, and from 40% in 2005 to 26% in 2013 (absolute difference: 14%; 95% CI: 8% to 20%) in the wider student body of the intervention university. The intervention effect estimate, representing the change at the intervention university adjusted for change at other universities (aOR = 1.30; 95% CI: 0.89 to 1.90), was consistent with a benefit of intervention but was not statistically significant (p = 0.17). Conclusion: In this period of alcohol policy reform, drinking to intoxication decreased substantially in the targeted student population. Policy reforms and coincidental environmental changes may each have contributed to these reductions.

Addressing College Drinking as a Statewide Public Health Problem: Key Findings From the Maryland Collaborative

Excessive drinking among college students is a serious and pervasive public health problem. Although much research attention has focused on developing and evaluating evidence-based practices to address college drinking, adoption has been slow. The Maryland Collaborative to Reduce College Drinking and Related Problems was established in 2012 to bring together a network of institutions of higher education in Maryland to collectively address college drinking by using both individual-level and environmental-level evidence-based approaches. In this article, the authors describe the findings of this multilevel, multicomponent statewide initiative. To date, the Maryland Collaborative has succeeded in providing a forum for colleges to share knowledge and experiences, strengthen existing strategies, and engage in a variety of new activities. Administration of an annual student survey has been useful for guiding interventions as well as evaluating progress toward the Maryland Collaborative's goal to measurably reduce high-risk drinking and its radiating consequences on student health, safety, and academic performance and on the communities surrounding college campuses. The experiences of the Maryland Collaborative exemplify real-world implementation of evidence-based approaches to reduce this serious public health problem.

The Age-Varying Association of Student Status with Excessive Alcohol Use: Ages 18 to 30 Years

BACKGROUND

There is a well-known link between attending college and engaging in excessive alcohol use. This study examines in a national sample how the association between student status and excessive alcohol use changes from late adolescence through young adulthood and whether the association of student status with excessive alcohol use is different for students residing with versus away from parents during the school year.

METHODS

This study used cross-sectional data from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of noninstitutionalized civilian adults residing in the United States. Our analyses included nonhigh school young adults who were ages 18 to 30 years (n = 8,645). Excessive alcohol use included past-year (i) high-intensity drinking (men: ≥10 standard drinks; women: ≥8) and (ii) exceeding weekly drinking guidelines (men: >14 drinks per week; women: >7). Students who resided away from their parents and students who lived with their parents during the school year were compared to nonstudents.

RESULTS

Analyses using time-varying effect modeling showed that the relationship of student status with excessive alcohol use varied as a function of age. Overall student status lost its association with excessive alcohol use in the early 20s, after controlling for demographics and other adult social roles. The association between student status and excessive alcohol use also varied considerably across age and depending on whether the student was residing with or away from parents.

CONCLUSIONS

The association of student status with excessive alcohol use is heterogeneous in terms of both age and living arrangements, suggesting opportunities for interventions targeting problematic alcohol use. Future research should examine additional sources of heterogeneity of students in their risk for excessive alcohol use.

Distress and alcohol-related harms from intimates, friends, and strangers

Alcohol's harms to others (AHTO) has gained increased research and policy attention, yet little information is available on different social relationships involved in such harms or consequences of harms perpetrated by various types of drinkers. Using data from the 2014-15 U.S. National Alcohol Survey (N=5,922), we present analyses comparing frequency and impacts of eight past-year harms from other drinkers. In this sample (53% female; 66% White/Caucasian, 13% Black/African American, and 15% other race; 15% Hispanic/Latino of any race; mean age=47 years), 19% reported at least one harm in the prior 12 months, 8% reported more than one harm, 4.9% reported a family perpetrator, 3.5% a spouse perpetrator, 6.1% a friend perpetrator, and 8.1% a stranger perpetrator. Controlling for basic demographics, the number of harms in the past year and harms perpetrated by known others (but not strangers) were significantly associated with recent distress. When comparing specific harms, financial problems due to a family member's or a spouse/partner's drinking each were associated with significantly greater distress, as were feeling threatened or afraid of family members, spouses/partners or friends who had been drinking. These new data shed light on possible intervention points to reduce negative impacts of AHTO in the U.S.

Intoxication and binge and high-intensity drinking among US young adults in their mid-20s

BACKGROUND

Alcohol use is a key risk factor for young adult mortality and disease, but limited research has focused on high-risk alcohol use among individuals moving from early young adulthood into building and maintaining an initial structure of adult life. This study estimated the prevalence of a range of alcohol use behaviors among US young adults aged 25/26, examined evidence for historical change in prevalence rates, and estimated associations between alcohol use and key demographic, substance use, and adult social role characteristics.

METHODS

Data were obtained from 3542 individuals selected for follow-up from the nationally representative 12th-grade student Monitoring the Future study. Respondents self-reported alcohol use behaviors at age 25/26 during calendar years 2005-2014.

RESULTS

Two fifths (39.9%) of young adults aged 25/26 reported being intoxicated at least once in the past 30 days; 25.6% reported usually experiencing a sustained high of 3 or more hours when drinking alcohol. Past-2-week binge drinking (5+ drinks in a row) was reported by 36.3% of respondents. Past-2-week high-intensity drinking (10+ drinks in a row) was reported by 12.4%. These age 25/26 alcohol use prevalence rates remained stable over the 10 years of data examined, in contrast to significant declines over historical time in alcohol prevalence rates among these same individuals at age 18. High-risk drinking was particularly associated with being male, white, unmarried, employed, a nonparent, and an alcohol user before finishing high school.

CONCLUSIONS

Among US young adults in their mid-20s, alcohol use was highly normative and frequently included participation in high-risk drinking behaviors. High-risk alcohol use prevention approaches developed specifically to reach young adults in their mid-20s are needed, as well as efforts to increase proactive clinician screening to identify young adults participating in high-risk alcohol use.

A New Neighborhood Every Fall: Aging in Place in a College Town

Older adults who live in residential neighborhoods adjacent to college and university campuses have a unique experience that makes them vulnerable to marginalization and displacement. As these neighborhoods become increasingly dominated by college students living in rental properties, older adults find themselves in the minority in a neighborhood where they have lived for many years. In addition, these neighborhoods are attractive to universities, city governments, and private companies for their development potential, which can result in gentrification. A year-long ethnographic study of a campus-adjacent neighborhood in a small US college town that is home to a medium-sized public university sheds light on the relationships between members of 5 stakeholder groups that have a vested interest in the neighborhood. The study highlights the need for additional research on different types of neighborhoods and their effects on aging in place in addition to outlining social work interventions in campus-adjacent neighborhoods that are designed to enhance these intergenerational spaces.

Underage Drinking: A Review of Trends and Prevention Strategies

Underage drinking and its associated problems have profound negative consequences for underage drinkers themselves, their families, their communities, and society as a whole, and contribute to a wide range of costly health and social problems. There is increased risk of negative consequences with heavy episodic or binge drinking. Alcohol is a factor related to approximately 4,300 deaths among underage youths in the U.S. every year. Since the mid-1980s, the nation has launched aggressive underage drinking prevention efforts at the federal, state, and local levels, and national epidemiologic data suggest that these efforts are having positive effects. For example, since 1982, alcohol-related traffic deaths among youth aged 16-20 years have declined by 79%. Evidence-based or promising strategies for reducing underage drinking include those that limit the physical, social, and economic availability of alcohol to youth, make it illegal for drivers aged <21 years to drive after drinking, and provide mechanisms for early identification of problem drinkers. Strategies may be implemented through a comprehensive prevention approach including policies and their enforcement, public awareness and education, action by community coalitions, and early brief alcohol intervention and referral programs. This paper focuses on underage drinking laws and their enforcement because these constitute perhaps the most fundamental component of efforts to limit youth access to and use of alcohol.

Pregaming, Drinking Duration, and Movement as Unique Predictors of Alcohol Use and Cognitions Among Mandated College Students

BACKGROUND

Pregaming is a common phenomenon among college students and is associated with increased risks such as heavy drinking, alcohol-related consequences, and violating campus alcohol policies. However, the mechanism by which pregaming increases student risk is unclear.

OBJECTIVES

The current study aimed to delineate the role of personal endorsement of pregaming, duration of an entire drinking episode on the night of an alcohol violation, and movement from one location to another in predicting alcohol use and violation-related cognitions.

METHODS

Participants (N = 113) were college students who had received an alcohol violation. Hierarchical multiple regressions were conducted to investigate the predictive value of pregaming endorsement, duration of drinking, and movement on drinking behaviors [number of drinks consumed and estimated blood alcohol content (eBAC)] on the night of the alcohol violation as well as violation-related cognitions (responsibility, aversiveness).

RESULTS

Pregaming and duration of drinking were significant predictors of alcohol consumption and eBAC on the night of the violation, whereas movement was not. Duration of the drinking episode was significantly related to increased perceived responsibility for the alcohol violation.

CONCLUSIONS/IMPORTANCE

Self-reported pregaming and the duration of the drinking episode appear to be better targets than movement for prevention and intervention efforts addressing pregaming on college campuses. Interventions should continue focusing on reducing pregaming and its associated consequences, especially for those who report a longer duration of drinking following a pregaming episode.

First- and second-hand consequences of alcohol in college: Differential associations with later alcohol use

INTRODUCTION

College students are at increased risk of experiencing a variety of consequences as result of their own as well as others' alcohol consumption. The current study examined the differential associations between both first-hand consequences (resulting from one's own drinking) and second-hand consequences (resulting in victimization as a result of others' drinking) and subsequent alcohol consumption across the first year of college.

METHOD

First year students (n = 253) from a large northeastern U.S. university were randomly selected to participate and surveyed at the end of the first semester of college (time 1) and during the first semester of the second year of college (time 2).

RESULTS

Results showed a significant, positive relationship between first-hand consequences and subsequent weekend drinking (β = .16, p < .05) and heavy episodic drinking (β = .49, p < .01), after controlling for individual and friend drinking. A negative association between second-hand consequences and later heavy episodic drinking was also observed (β = -.16, p < .05).

DISCUSSION AND CONCLUSIONS

The findings provided partial support for both a positive association hypothesis and a negative association hypothesis. The importance of personal alcohol consumption and peers' drinking in relation to first- and second-hand consequences are discussed.

Do neighborhood attributes moderate the relationship between alcohol establishment density and crime?

Although numerous studies have found a positive association between the density of alcohol establishments and various types of crime, few have examined how neighborhood attributes (e.g., schools, parks) could moderate this association. We used data from Minneapolis, MN with neighborhood as the unit of analysis (n = 83). We examined eight types of crime (assault, rape, robbery, vandalism, nuisance crime, public alcohol consumption, driving while intoxicated, underage alcohol possession/consumption) and measured density as the total number of establishments per roadway mile. Neighborhood attributes assessed as potential moderators included non-alcohol businesses, schools, parks, religious institutions, neighborhood activism, neighborhood quality, and number of condemned houses. Using Bayesian techniques, we created a model for each crime outcome (accounting for spatial auto-correlation and controlling for relevant demographics) with an interaction term (moderator × density) to test each potential moderating effect. Few interaction terms were statistically significant. The presence of at least one college was the only neighborhood attribute that consistently moderated the density-crime association, with the presence of a college attenuating the association between the density and three types of crime (assaults, nuisance crime, and public consumption). However, caution should be used when interpreting the moderating effect of college presence because of the small number of colleges in our sample. The lack of moderating effects of neighborhood attributes, except for presence of a college, suggests that the addition of alcohol establishments to any neighborhood, regardless of its other attributes, could result in an increase in a wide range of crime.

Exploring Alcohol Policy Approaches to Prevent Sexual Violence Perpetration

Sexual violence continues to be a significant public health problem worldwide with serious consequences for individuals and communities. The implementation of prevention strategies that address risk and protective factors for sexual violence at the community level are important components of a comprehensive approach, but few such strategies have been identified or evaluated. The current review explores one potential opportunity for preventing sexual violence perpetration at the community level: alcohol policy. Alcohol policy has the potential to impact sexual violence perpetration through the direct effects of excessive alcohol consumption on behavior or through the impact of alcohol and alcohol outlets on social organization within communities. Policies affecting alcohol pricing, sale time, outlet density, drinking environment, marketing, and college environment are reviewed to identify existing evidence of impact on rates of sexual violence or related outcomes, including risk factors and related health behaviors. Several policy areas with initial evidence of an association with sexual violence outcomes were identified, including policies affecting alcohol pricing, alcohol outlet density, barroom management, sexist content in alcohol marketing, and policies banning alcohol on campus and in substance-free dorms. We identify other policy areas with evidence of an impact on related outcomes and risk factors that may also hold potential as a preventative approach for sexual violence perpetration. Evidence from the current review suggests that alcohol policy may represent one promising avenue for the prevention of sexual violence perpetration at the community level, but additional research is needed to directly examine effects on sexual violence outcomes.

Statistical Validation of a Web-Based GIS Application and Its Applicability to Cardiovascular-Related Studies

PURPOSE

There is abundant evidence that neighborhood characteristics are significantly linked to the health of the inhabitants of a given space within a given time frame. This study is to statistically validate a web-based GIS application designed to support cardiovascular-related research developed by the NIH funded Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) Data Coordinating Center (DCC) and discuss its applicability to cardiovascular studies.

METHODS

Geo-referencing, geocoding and geospatial analyses were conducted for 500 randomly selected home addresses in a U.S. southeastern Metropolitan area. The correlation coefficient, factor analysis and Cronbach's alpha (α) were estimated to quantify measures of the internal consistency, reliability and construct/criterion/discriminant validity of the cardiovascular-related geospatial variables (walk score, number of hospitals, fast food restaurants, parks and sidewalks).

RESULTS

Cronbach's α for CVD GEOSPATIAL variables was 95.5%, implying successful internal consistency. Walk scores were significantly correlated with number of hospitals (r = 0.715; p < 0.0001), fast food restaurants (r = 0.729; p < 0.0001), parks (r = 0.773; p < 0.0001) and sidewalks (r = 0.648; p < 0.0001) within a mile from homes. It was also significantly associated with diversity index (r = 0.138, p = 0.0023), median household incomes (r = -0.181; p < 0.0001), and owner occupied rates (r = -0.440; p < 0.0001). However, its non-significant correlation was found with median age, vulnerability, unemployment rate, labor force, and population growth rate.

CONCLUSION

Our data demonstrates that geospatial data generated by the web-based application were internally consistent and demonstrated satisfactory validity. Therefore, the GIS application may be useful to apply to cardiovascular-related studies aimed to investigate potential impact of geospatial factors on diseases and/or the long-term effect of clinical trials.

Drinking Patterns and Behavioral Consequences: A Cross-Sectional Study among Romanian University Students

Background

Alcohol/binge drinking among university students has become a major public health problem. Many of young students will be exposed to substantial changes in living arrangements, socialization groups and social activities during the transitional period.

Aim

The aim of this study was to analyse the alcohol consumption in Romanian university students, and to describe the behaviours occurring after drinking.

Methods

A cross-sectional study was conducted on 468 undergraduate students, from a university for medicine and law. Of these students, 35.5% were males and 64.5% were females. The mean age of students was 21.9 ± 3.22 years. Validated anonymous paper questionnaires were completed voluntary by the students. Questionnaires contained demographic items, six questions for determining the level of alcohol consumed in terms of quantity and frequency, and 19 statements or problems resulting from drinking.

Results

The findings of the study showed that males drunk more units of alcohol/week than females (p<0.001). The prevalence of abstainers was 10.8% in males and 17.6% in women. Heavy drinkers (drinking 5 or more drinks more than once a week) were more common among male (19.3%) than among female students (16.2%). Most frequently, drinking behaviours are related to academic performance, and the possible link between poor academic performance and alcohol consumption appears tenuous and merits further investigation.

Conclusion

Effective intervention strategies should be implemented to prevent students’ alcohol consumption and adverse health and social consequences resulting from this behaviour.

A Review of the Statistical and Quantitative Methods Used to Study Alcohol-Attributable Crime

Modelling the relationship between alcohol consumption and crime generates new knowledge for crime prevention strategies. Advances in data, particularly data with spatial and temporal attributes, have led to a growing suite of applied methods for modelling. In support of alcohol and crime researchers we synthesized and critiqued existing methods of spatially and quantitatively modelling the effects of alcohol exposure on crime to aid method selection, and identify new opportunities for analysis strategies. We searched the alcohol-crime literature from 1950 to January 2014. Analyses that statistically evaluated or mapped the association between alcohol and crime were included. For modelling purposes, crime data were most often derived from generalized police reports, aggregated to large spatial units such as census tracts or postal codes, and standardized by residential population data. Sixty-eight of the 90 selected studies included geospatial data of which 48 used cross-sectional datasets. Regression was the prominent modelling choice (n = 78) though dependent on data many variations existed. There are opportunities to improve information for alcohol-attributable crime prevention by using alternative population data to standardize crime rates, sourcing crime information from non-traditional platforms (social media), increasing the number of panel studies, and conducting analysis at the local level (neighbourhood, block, or point). Due to the spatio-temporal advances in crime data, we expect a continued uptake of flexible Bayesian hierarchical modelling, a greater inclusion of spatial-temporal point pattern analysis, and shift toward prospective (forecast) modelling over small areas (e.g., blocks).

Those harmed by others' drinking in the US population are more depressed and distressed

INTRODUCTION AND AIMS

Harms from second-hand smoke were instrumental in enacting tobacco controls. Documenting negative impacts of harms from others' drinking (also called second-hand effects of drinking) is vital to increase political will for optimal alcohol policies. We assessed associations between harms from others' drinking and depression in a national sample of US adults.

DESIGN AND METHODS

Using the landline sample from the 2010 National Alcohol Survey (n = 5388), weighted logistic regression models adjusting for alcohol problems in family of origin, respondent drinking pattern (volume and heaviest drinking), poverty and other demographics were used to analyse associations between experiencing harms from others' drinking in the last 12 months with mild to moderate depression (8-item Center for Epidemiologic Studies Depression scale; alpha = 0.92; using cut point ≥8) and current distress.

RESULTS

Past 12 month family/marital harms, financial troubles, assaults, and vandalised property attributed to others' drinking were each associated with higher depression scores (all P < 0.001). In a combined model, all harms other than assaults remained highly significant. Similar patterns were found for current distress, but with some specific differences because of measurement and analytic approaches chosen also evident.

DISCUSSION

Findings suggest recently experiencing particular harms from others' drinking significantly affects mental health (both depression and distress). This confirms in a US population results recently reported in Australasian samples.

CONCLUSIONS

Studies that quantify the extent to which heavy drinkers victimise others are important for alcohol policy. [Greenfield TK, Karriker-Jaffe KJ, Kerr WC, Ye Y, Kaplan LM. Those harmed by others' drinking in the US population are more depressed and distressed. Drug Alcohol Rev 2015;●●:●●-●●].

An applied test of the social learning theory of deviance to college alcohol use

Several hypotheses about influences on college drinking derived from the social learning theory of deviance were tested and confirmed. The effect of ethnicity on alcohol use was completely mediated by differential association and differential reinforcement, whereas the effect of biological sex on alcohol use was partially mediated. Higher net positive reinforcements to costs for alcohol use predicted increased general use, more underage use, and more frequent binge drinking. Two unexpected finding were the negative relationship between negative expectations and negative experiences, and the substantive difference between nondrinkers and general drinkers compared with illegal or binge drinkers. The discussion considers implications for future campaigns based on Akers's deterrence theory.

'What a man can do, a woman can do better': gendered alcohol consumption and (de)construction of social identity among young Nigerians

BACKGROUND

The misuse of alcohol and other drugs among young people, especially students, is a growing global phenomenon. In traditional Nigerian society, different locally-produced alcoholic beverages served complex roles but were mainly consumed among adult males for pleasure. Though adult females in some communities consumed alcohol, the practice of drinking was culturally controlled. In contemporary Nigeria, available quantitative studies reveal changing patterns of alcohol use amongst youth but fail to unravel the social variables that motivate alcohol use among this group.

METHODS

Qualitative data were collected through in-depth interviews with 31 (22 males and 9 females, aged 19-23 years) undergraduate students attending a university located in a metropolitan city in Anambra State, south-eastern Nigeria. Data were collected and analysed to generate themes with the aid of Nvivo 10 software.

RESULTS

There appears to be a resilient socio-cultural belief in which men see alcohol as 'good for males' while the females in contrast believe that alcohol does not discriminate according to gender and should be drunk by both males and females. Findings also point to the ways in which male-gendered drinking behaviours, such as heavy or fast drinking are employed by women to develop social capital.

CONCLUSIONS

These results do suggest how gendered constructions of alcohol consumption create risks for both men and women, how they negotiate and ameliorate those risks, and how women challenge gender roles through their use of alcohol. Some focus on formulating evidence-based policies and comprehensively evaluated campaigns are needed to disseminate information about the risks and potential consequences of heavy alcohol consumption in order to promote safer alcohol use by young people.

Twenty Years of Neighborhood Effect Research: An Assessment

This paper reviews the magnitude and empirical findings of social epidemiological neighborhood effects research. An electronic keyword literature search identified 1369 empirical and methodological neighborhood effects papers published in 112 relevant journals between 1990 and 2014. Analyses of temporal trends were conducted by focus, journal type (e.g., epidemiology, public health, or social science), and specific epidemiologic journal. Select papers were then critically reviewed. Results show an ever-increasing number of papers published, notably since the year 2000, with the majority published in public health journals. The variety of health outcomes analyzed is extensive, ranging from infectious disease to obesity to criminal behavior. Papers relying on data from experimental designs are thought to yield the most credible results, but such studies are few and findings are inconsistent. Papers relying on data from observational designs and multilevel models typically show small statistically significant effects, but most fail to appreciate fundamental identification problems. Ultimately, of the 1170 empirically focused neighborhood effects papers published in the last 24 years, only a handful have clearly advanced our understanding of the phenomena. The independent impact of neighborhood contexts on health remains unclear. It is time to expand the social epidemiological imagination.

Effects of the Campus Watch intervention on alcohol consumption and related harm in a university population

BACKGROUND

High levels of drinking and alcohol-related problems are pervasive among university students in New Zealand and other high-income countries, where controls on alcohol availability and promotion are typically weak. Environmental interventions to reduce hazardous drinking and harm have shown promise in general populations, but require further evidence of effectiveness in university settings. The aim of this study was to estimate the effect of a community liaison and security program, Campus Watch, on drinking patterns and alcohol-related harm among university students.

METHODS

The study used a quasi-experimental design with non-equivalent control sites using before (2005) and after (2009) observations. Participants were full-time students aged 17-25 years selected randomly from the enrolment lists of six New Zealand universities. Changes in scores on the alcohol use disorders identification consumption scale (AUDIT-C) and alcohol-related harms at the intervention campus were compared with those at control campuses using linear and logistic regression models.

RESULTS

Compared to control campuses, AUDIT-C scores decreased in students at the intervention campus (β=-0.5, 95% CI: -0.6 to -0.3). Campus Watch was associated with reductions in some harms (independent of its effect on drinking), such as aggression (aOR 0.66, 95% CI: 0.46 to 0.94), but not other harms, e.g., blackouts (aOR 1.06, 95% CI: 0.89 to 1.27).

CONCLUSION

While not being focused on alcohol per se, Campus Watch reduced alcohol consumption and some related harms. Such programs may be useful in similar environments where controls on alcohol availability and promotion cannot be affected and where informal controls are weak.

Neighbourhood availability of alcohol outlets and hazardous alcohol consumption in New Zealand

The socio-spatial arrangement of alcohol retailers is potentially important in understanding the relationship between neighbourhood context and 'excessive' alcohol consumption. This New Zealand study examines whether the availability of alcohol products is associated with individual-level alcohol consumption. Measures capturing the availability of alcohol retailers were calculated for neighbourhoods across the country and then appended to a national health survey. At the national level there was no evidence for an association between hazardous consumption and alcohol outlet access. However, there was evidence of associations with neighbourhood retailing for younger Māori and Pacific peoples males; younger European females; middle-aged European men; and older men. The findings provide evidence that 'alcogenic' environments are associated with excessive drinking in New Zealand, albeit that the associations are restricted to particular vulnerable groups.

A spatial analysis of student binge drinking, alcohol-outlet density, and social disadvantages

BACKGROUND AND OBJECTIVES

This paper examined whether and how student binge drinking at the individual level was influenced by population disadvantages, community instability, alcohol-outlet density, and protective factors generated by community and school.

METHODS

We used a dataset collected in 2002 by the Alabama Department of Mental Health, with additional materials generated by the 2000 Census and from the Alabama State Department of Education. School-catchments were employed as geographic units of analysis. The final sample comprised 78,138 public-school students in grades 6-12 who attended schools located in the 566 school-catchments.

RESULTS

We hypothesized the presence of spatial processes that, once identified, would enhance understanding of student binge drinking. Our results confirmed that student binge drinking in a focal area was affected by that area's structural factors and also by individual-level risk and protective factors. The results did not support the hypothesized impact of surrounding areas' characteristics on student binge drinking in the focal area.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

The results of our study clearly indicate that both environment-based factors and individual-level risk and protective factors are important in explaining student binge drinking in Alabama.

Gender differences in associations of neighbourhood disadvantage with alcohol's harms to others: a cross-sectional study from the USA

INTRODUCTION AND AIMS

To examine whether alcohol's harms to others are more prevalent in socioeconomically disadvantaged neighbourhoods and whether men or women are at differential risk in these neighbourhoods.

DESIGN AND METHODS

Cross-sectional survey data from 2000 and 2005 National Alcohol Surveys were linked to geo-referenced indicators of neighbourhood disadvantage from the US 2000 Decennial Census. The pooled sample included 10,121 adults (54% female; average age 44.4 years; 69% White; 13% African-American; 13% Hispanic). A dichotomous indicator denoted neighbourhoods based on the top quartile on a five-item measure of disadvantage (alpha = 0.90). We examined past-year family problems due to someone else's drinking (marriage difficulties and/or financial trouble) and victimisation by someone who had been drinking (having property vandalised and/or being pushed, hit or assaulted).

RESULTS

During the prior 12 months, 6% of women and 3% of men experienced family problems from someone else's drinking, and 4% of women and 7% of men reported being victimised by drinkers. Multivariate logistic regression models adjusting for individual-level socioeconomic status and other demographic characteristics showed the relationship between neighbourhood disadvantage and harms from someone else's drinking was moderated by gender, with significantly higher odds of family problems in disadvantaged neighbourhoods for men but not for women, as well as significantly higher odds of crime victimisation in disadvantaged neighbourhoods for women but not men.

DISCUSSION AND CONCLUSIONS

Experiences of harms from someone else's drinking in disadvantaged neighbourhoods vary for men and women. Targeted intervention strategies are needed to reduce alcohol's harm to others.

Alcohol-selling outlets and mortality in Switzerland--the Swiss National Cohort

AIM

To examine the association of alcohol-related mortality and other causes of death with neighbourhood density of alcohol-selling outlets for on-site consumption.

DESIGN, SETTING AND PARTICIPANTS

Longitudinal study of the adult Swiss population (n = 4 376 873) based on census records linked to mortality data from 2001 to 2008.

MEASUREMENTS

Sex-specific hazard ratios (HR) for death and 95% confidence intervals (95%CI) were calculated using Cox models adjusting for age, educational level, occupational attainment, marital status and other potential confounders. The density of alcohol-selling outlets within 1000 m of the residence was calculated using geocodes of outlets and residences.

FINDINGS

Compared with >17 outlets within 1000 m the HR for alcohol-related mortality in men was 0.95 (95%CI: 0.89-1.02) for 8-17 outlets, 0.84 (95%CI: 0.77-0.90) for 3-7 outlets, 0.76 (95%CI: 0.68-0.83) for 1-2 outlets and 0.60 (95%CI: 0.51-0.72) for 0 outlets. The gradient in women was somewhat steeper, with a HR comparing 0 with >17 outlets of 0.39 (95%CI: 0.26-0.60). Mortality from mental and behavioural causes and lung cancer were also associated with density of alcohol-selling outlets: HRs comparing 0 outlets with >17 outlets were 0.64 (95%CI: 0.52-0.79) and 0.79 (95%CI: 0.72-0.88), respectively, in men and 0.46 (95%CI: 0.27-0.78) and 0.63 (95%CI: 0.52-0.77), respectively, in women. There were weak associations in the same direction with all-cause mortality in men but not in women.

CONCLUSIONS

In Switzerland, alcohol-related mortality is associated with the density of outlets around the place of residence. Community-level interventions to reduce alcohol outlet density may usefully complement existing interventions.

Correlates of heavy alcohol consumption at Rhodes University

OBJECTIVE

To establish the extent to which students typically overestimate normative drinking and to determine whether these estimates are uniquely implicated in alcohol consumption over and above the role of the various demographic and family variables.

METHOD

An online survey was used to obtain a sample of 2 177 students who completed the AUDIT questionnaire along with other items, including three adapted from the AUDIT asking respondents to estimate the descriptive drinking norms of their typical same-sex student. A hierarchical regression analysis was performed to determine the relative contributions of these variables towards individual student's own consumption scores. Three blocks of variables were entered in temporal sequence, starting with demographic variables, then family variables, followed by the normative estimates.

RESULTS

Most students overestimate how frequently their same-sex peers go drinking and how much alcohol they consume on these drinking occasions and how often they consume six or more drinks on one occasion. These normative estimates account for a significant portion of the variance over and above that accounted for by the demographic and family variables.

CONCLUSIONS

The university should attempt to correct inflated normative estimates of how many drinks a typical same-sex peer has on a typical day when drinking.

Is the density of alcohol establishments related to nonviolent crime?

OBJECTIVE

We examined the associations between the density of alcohol establishments and five types of nonviolent crime across urban neighborhoods.

METHOD

Data from the city of Minneapolis, MN, in 2009 were aggregated and analyzed at the neighborhood level. We examined the association between alcohol establishment density and five categories of nonviolent crime: vandalism, nuisance crime, public alcohol consumption, driving while intoxicated, and underage alcohol possession/consumption. A Bayesian approach was used for model estimation accounting for spatial auto-correlation and controlling for relevant neighborhood demographics. Models were estimated for total alcohol establishment density and then separately for off-premise establishments (e.g., liquor and convenience stores) and on-premise establishments (e.g., bars and restaurants).

RESULTS

We found positive associations between density and each crime category. The association was strongest for public consumption and weakest for vandalism. We estimated that a 3.3%-10.9% increase across crime categories would result from a 20% increase in neighborhood establishment density. Similar results were seen for on- and off-premise establishments, although the strength of the associations was lower for off-premise density.

CONCLUSIONS

Our results indicate that communities should consider the potential increase in nonviolent crime associated with an increase in the number of alcohol establishments within neighborhoods.

Magnitude of the problem of drinking alcohol on college campuses, commentary on "Structuring a college alcohol prevention program on the low level of response to alcohol model: a pilot model"

BACKGROUND

The objective of this commentary is to discuss the significance of the study entitled, "Structuring a College Alcohol Prevention Program on the Low Level of Response to Alcohol Model: A Pilot Model" by Schuckit and colleagues (2012) published in this issue of the Alcoholism: Clinical and Experimental Research. The work by Schuckit and colleagues emphasizes the importance of personalizing an alcohol prevention program for college students.

METHODS

This pilot model is the result of over 30 years of clinical translational research on an individual's level of response to alcohol. The prevention program is efficient, simple, safe, cost-effective and self-directed.

RESULTS

The results indicate the computerized intervention was associated with decreases in drinking overall and students with a low level of response to alcohol showed greater decreases when the prevention program is personalized to focus on how level of response is affected by peer influence, alcohol expectancies, and stress management. It concludes that college students with a low level of response to alcohol will benefit from a prevention program that is personalized to this well documented endophenotype.

CONCLUSIONS

The findings provide the foundation for developing future longitudinal studies of the proposed prevention program with a larger sample size on diverse campuses. In addition, as mentioned in the Discussion section, future studies could also evaluate the effectiveness of other easily measured clinical endophenotypes known to be associated with alcohol use such as impulsivity, negative effect, and maximum number of drinks per occasion.

Alcohol use and crime: findings from a longitudinal sample of U.S. adolescents and young adults

BACKGROUND

A positive relationship between alcohol use and criminal activity has been well documented among adults, but fewer studies explore this relationship among adolescents.

METHODS

Using data from 4 waves of the National Longitudinal Study of Adolescent Health (Add Health), we examine alcohol use patterns and criminal activity from adolescence to young adulthood. Fixed-effects models partially address the potential endogeneity of alcohol use, and, because numerous studies indicate that males are more likely than females to engage in drinking and criminal activity, the analyses are segmented by gender.

RESULTS

We find a strong positive relationship between alcohol consumption, the commission of crimes, and criminal victimization for both genders. Various sensitivity analyses and robustness checks support this core finding.

CONCLUSIONS

Our results have important policy implications, as public policy tools that aim to reduce drinking among adolescents could also reduce criminal activity. Moreover, effective alcohol abuse treatment may indirectly reduce delinquency and thus have greater long-term economic benefits than previously estimated.

Undergraduate student drinking and related harms at an Australian university: web-based survey of a large random sample

Background

There is considerable interest in university student hazardous drinking among the media and policy makers. However there have been no population-based studies in Australia to date. We sought to estimate the prevalence and correlates of hazardous drinking and secondhand effects among undergraduates at a Western Australian university.

Method

We invited 13,000 randomly selected undergraduate students from a commuter university in Australia to participate in an online survey of university drinking. Responses were received from 7,237 students (56%), who served as participants in this study.

Results

Ninety percent had consumed alcohol in the last 12 months and 34% met criteria for hazardous drinking (AUDIT score ≥ 8 and greater than 6 standard drinks in one sitting in the previous month). Men and Australian/New Zealand residents had significantly increased odds (OR: 2.1; 95% CI: 1.9-2.3; OR: 5.2; 95% CI: 4.4-6.2) of being categorised as dependent (AUDIT score 20 or over) than women and non-residents. In the previous 4 weeks, 13% of students had been insulted or humiliated and 6% had been pushed, hit or otherwise assaulted by others who were drinking. One percent of respondents had experienced sexual assault in this time period.

Conclusions

Half of men and over a third of women were drinking at hazardous levels and a relatively large proportion of students were negatively affected by their own and other students' drinking. There is a need for intervention to reduce hazardous drinking early in university participation.

Trial registration

ACTRN12608000104358

State Patty's Day: College Student Drinking and Local Crime Increased on a Student-constructed Holiday

College student alcohol consumption is a major concern, and is known to increase during the celebration of special events. This study examined a student-constructed holiday, State Patty's Day, at a university with a dominant drinking culture using three sources of data - coded data from Facebook groups, daily web surveys from first-year students (N= 227, 51% male, age 18 to 20; 27.3% Hispanic/Latino; of non-Hispanic/Latino, 26.9% of sample European American/White, 19.4% Asian American/Hawaiian/Pacific Islander, 15.9% African American/Black, 10.6% more than one race), and criminal offense data from police records. Results indicated that messages about State Patty's Day on Facebook focused on drinking and social aspects of the holiday, such as the social context of drinking, a sense of belonging to a larger community, and the social norms of drinking. These messages were rarely about consequences and rarely negative. On State Patty's Day, 51% of students consumed alcohol, compared to 29% across other sampled weekend days. Students consumed more drinks (M = 8.2 [SD = 5.3] drinks per State Patty's Day drinker) and were more likely to engage in heavy drinking on State Patty's Day, after controlling for gender, drinking motives, and weekend, demonstrating the event-specific spike in heavy drinking associated with this holiday. The impact of this student-constructed holiday went beyond individual drinking behavior; alcohol-specific and other crime also peaked on State Patty's Day and the day after. Event-specific prevention strategies may be particularly important in addressing these spontaneous, quickly-constructed, and dynamic events.

Alcohol prevention on college campuses: the moderating effect of the alcohol environment on the effectiveness of social norms marketing campaigns

OBJECTIVE

Evaluations of social norms marketing campaigns to reduce college student drinking have produced conflicting results. This study examines whether the effectiveness of such campaigns may be moderated by on-premise alcohol outlet density in the surrounding community.

METHOD

Multilevel analyses were conducted of student survey responses (N= 19,838) from 32 U.S. colleges that took part in one of two 4-year randomized, controlled trials completed for the Social Norms Marketing Research Project (SNMRP). In the models, students by year were nested within treatment (n = 16) and control group (n = 16) campuses, which were characterized by the on-premise outlet density in their surrounding community. The moderating effect of outlet density was introduced into the models as an interaction between the treatment effect (i.e., the effect of the social norms marketing campaigns over time) and outlet density. The models were also stratified by campus alcohol outlet density (high vs. low) to examine the effect of the intervention in each type of setting.

RESULTS

There was a significant interaction between the treatment effect and on-premise alcohol outlet density for one of the drinking outcomes targeted by the SNMRP intervention, the number of drinks when partying, and marginal evidence of interaction effects for two other outcomes, maximum recent consumption and a composite drinking scale. In stratified analyses, an intervention effect was observed for three of the four outcomes among students from campuses with lower on-premise alcohol outlet density, whereas no intervention effect was observed among students from campuses with higher on-premise alcohol outlet density.

CONCLUSIONS

The findings suggest that the campus alcohol environment moderates the effect of social norms marketing interventions. Social norms marketing intervention may be less effective on campuses with higher densities of on-sale alcohol outlets.