Participation in Drinking Games and Predrinking Among University Students in Argentina, Australia, Canada, and New Zealand

A national study on pregaming motives, frequency, consumption, and negative alcohol consequences among university students in the United States

BACKGROUND

Pregaming, or drinking before going out, is a commonly practiced risky behavior. Drinking motives are well-established predictors of alcohol use and negative alcohol consequences. Given the influence of context on drinking practices, motives specific to pregaming may affect pregaming behaviors and outcomes above and beyond general drinking motives. Thus, we examined how pregaming motives are related to pregaming behaviors and negative alcohol consequences.

METHODS

Using data from two national cross-sectional online studies, the current study included undergraduates who pregamed at least once in the past month (n=10,200, Mage=19.9, women=61%, white=73.6%; 119 U.S. universities). Participants completed assessments of demographics, general drinking motives, pregaming motives, pregaming frequency/consumption, and negative alcohol consequences. Data were analyzed using hierarchical linear models accounting for nesting of participants within sites.

RESULTS

When controlling for demographic factors and general drinking motives, interpersonal enhancement motives and intimate pursuit motives were positively associated with pregaming frequency, pregaming consumption, and negative alcohol consequences. Situational control motives were negatively associated with pregaming consumption and negative alcohol consequences. Barriers to consumption motives were negatively associated with pregaming frequency but positively associated with negative alcohol consequences.

CONCLUSIONS

Students who pregame to make the night more fun or to meet potential dating partners appear to be at particular risk for negative alcohol consequences. Motives may be modifiable, particularly via cognitive/behavioral strategies. Findings suggest that specific motives may be appropriate intervention targets when trying to reduce pregaming behaviors and negative alcohol consequences.

Risky business: an examination of drinking games in college settings and their impact: a systematic review

This systematic review explores the prevalence and impact of Drinking Games (DG) among college students. DGs involve social drinking with the goal of heavy alcohol consumption and are associated with risky behaviours. The review aims to quantify the relationship between DG participation, alcohol consumption, and negative outcomes. It also investigates gender moderation and unexplored motivational factors for DG engagement. Following PRISMA guidelines, 34 studies were included after screening 317 records. The studies comprised n = 34,197 participants and were analysed for various variables, including gender dynamics, motivations, and associated negative consequences. Gender convergence in DG participation was noted, emphasizing the importance of gender-specific interventions. Participants were aware of risks but often perceived negative outcomes as a badge of honour. Motivations for DGs were linked to social interaction and a sense of belonging. Personality traits like sensation seeking and identification with college drinking culture played significant roles in DG engagement and outcomes. The review underscores the need for targeted interventions to address shifting perceptions of negative consequences and consider personality traits when designing preventive measures. It also highlights the significance of gender-specific strategies. However, variations in DG measurement and possible selection bias among heavy drinkers participating in DGs remain limitations. This systematic review provides insights into DG prevalence and its link to negative outcomes among college students. The findings stress the importance of tailored interventions and further research to mitigate risk factors and promote healthier drinking behaviours in this demographic.

Prologue to the special issue on predrinking and drinking game behaviors among adolescents and young adults in the United States and across the globe: Definitions and overview of prevalence rates

Predrinking and drinking games (DGs) are common risky drinking practices among adolescents and young adults in many different countries around the world. However, most studies on these behaviors have been conducted with university student samples in a limited number of countries. Despite the risks of negative alcohol-related consequences associated with predrinking and DGs, these activities are quite prevalent among young people. In this prologue, we provide definitions for predrinking and DGs and an extensive overview of the known prevalence rates of predrinking and DGs among young people around the world. This special issue addresses known gaps in the literature by including articles which (a) use differing methodologies to examine predrinking or DGs behavior, (b) consider psychosocial and contextual factors that influence these behaviors, and (c) examine young people's perceptions of alcohol policies and interventions. Taken together this Special Issue offers an international view on how and why young people around the world engage in these risky drinking practices, and potential ways to address these behaviors.

Preloading, exit intoxication related to energy drink usage, and gender differences within night-time entertainment districts for young people

BACKGROUND

Governments frequently introduce legislation to reduce drunkenness and violence in night-time entertainment districts (NEDs). However, there is no study which has looked at inebriation of a large sample of young people exiting a NED. We investigated Breath Approximated Blood Alcohol Concentration (BrAC; grams per decilitre, g/dl) levels as people left Brisbane (Australia) NEDs and measured the effects of preloading, energy drink usage, time of night and gender differences on exit intoxication.

METHODS

We systematically assessed patrons between November 2015 to March 2019 by administering surveys and breathalysing them as they exited the NEDs. We then analysed only those under the age of 26 years old (n = 3,211) as there was a natural break in the data on energy drink usage for those aged over 25 years old.

FINDINGS

This study found that young drinkers leave the NED with an average BrAC of 0.094 g/dl. Consistent with hypotheses, the exit BrAC was significantly and meaningfully higher in preloaders (medium effect size). These preloaders also came into the NEDs later but stayed for the same length of time as non-preloaders. BrAC levels did not significantly differ for those who did or did not use energy drinks during the night. As predicted, gender was not associated with a meaningful difference in alcohol intoxication and consumption. The time of night that patrons were interviewed was positively associated with inebriation levels, however, this association was small (r ≈ 0.1).

DISCUSSION

With preloading being such a strong predictor for end of night intoxication, and length of time spent in the NED equal between those who do or do not preload, we suggest that to have people less inebriated, they should be encouraged into the NED earlier rather than focusing on their leaving time.

"It Breaks the Ice": A Qualitative Examination of Drinking Game Motives, Harms and Protective Behavioral Strategies among University Students in Australia

Background: Most research on drinking games (DG) behaviors and cognitions has been conducted among university students from the United States. Understanding why DGs are played, consequences and protective behavioral strategies (PBS) to reduce negative consequences is needed among Australian students. Objectives: In Australia, five focus groups (n=3-8) were held with 27 university students (63% female) aged 18-24 years who had played a DG in the past month. The study aimed to identify motives for playing DGs, consequences and adoption of PBS. Results: Four themes were identified: (1) social lubrication and conformity: playing to fit in; (2) community and camaraderie (perceived social benefits of DGs); (3) a means to an end (where getting drunk/predrinking was the goal and avoidance of PBS was prevalent); and (4) it is not a levelled playing field, which highlights that the risks are not equal for everyone. Conclusions: The interplay between DG motives, PBS and associated harms was identified. Expanding measurement of pre-existing DG motives and PBS is recommended, as well as the potential of DG motives to inform proposed interventions.

A mobile-based pregaming drinking prevention intervention for college students: study protocol for a randomized controlled trial

BACKGROUND

Pregaming is a high-drink context popular among college students that often leads to elevated blood alcohol levels and negative consequences. Over 15 years of research studies have demonstrated that pregaming represents one of the riskiest known behaviors among college students, yet no pregaming-specific interventions have been developed to help prevent this behavior. General brief interventions for students do not reduce pregaming behavior and may not be appropriate, as they do not help students develop skills unique to the pregaming context that could help them drink less. We developed a brief, mobile-based intervention that is proposed to prevent heavy drinking during pregaming for college students, with the ultimate goal that behavioral reductions in this risky practice will ultimately affect global drinking and prevent consequences.

METHODS/DESIGN

The intervention, Pregaming Awareness in College Environments (PACE), was developed by combining two innovations to facilitate behavior change: (1) a mobile-based application that increases accessibility, is easy and engaging to use, and broadens the reach of the intervention content and (2) personalized pregaming-specific intervention content with harm reduction and cognitive behavioral skills proven to be mechanisms preventing and reducing heavy drinking among college students. After a develop and beta-test phase, we propose to test the efficacy of PACE in a preliminary randomized controlled trial with 500 college students who pregame at least once per week. Pregaming, general drinking, and alcohol-related consequences outcomes will be examined in the immediate (2 weeks post-intervention) and short-terms (six and 14-week post-intervention). We will also evaluate moderator effects for age, sex, and heaviness of drinking to allow for more refined information for a planned larger test of the intervention to follow this initial trial of PACE.

DISCUSSION

This pregaming intervention clinical trial, if found to be efficacious, will culminate with an easily-disseminated mobile-based intervention for college student drinkers. It has the potential to reach millions of college students, perhaps as a clinical tool used by college counseling centers as an adjunct to formal care or as a preventive tool for first-year students or other high-risk groups on campus.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier NCT04016766.

Stay Home, Drink at Home? A Daily Diary Study on College Students' Alcohol and Social Media Use during the COVID-19 Pandemic

BACKGROUND

COVID-19 and measures to contain it may have impacted college students' behavior, including their drinking behavior. Students' drinking may have decreased-for example, due to the closure of bars-but problematic drinking may have increased-for example, due to (solitary) drinking at home. Another behavior that has increased due to COVID-19 and the accompanying social isolation is students' social networking site (SNS) use. This is worrisome because students' SNS use has been shown to increase their alcohol use. Nevertheless, little research has investigated these behaviors and the possible link between them during a lockdown. Therefore, this study aimed to examine (1) whether students engaged in drinking during a lockdown, (2) whether they displayed their drinking behavior on SNSs, and (3) whether exposure to and posting of alcohol-related content was linked to their daily alcohol use.

METHODS

337 college students (M_age = 20.63 years, SD_age = 1.55 years; 50.3% male) participated in a two-week daily diary study. Descriptive statistical analyses and generalized linear mixed modeling (GLMM) were deployed.

RESULTS

Descriptive analysis results showed that during the week, students' drinking occurred with friends in dormitories, while in the weekend, this behavior shifted to drinking with friends and parents at home. Moreover, students mostly saw visual and posted textual posts of this drinking on SNSs. Furthermore, GLMM revealed associations between exposure to alcohol postings, sharing of alcohol postings, and students' probability of drinking on the same day.

CONCLUSION

This study provides important insights into students' alcohol use and its underlying mechanisms during health crises.