Correlates and motives of pre-drinking with intoxication and harm around licensed venues in two cities

How is alcohol consumption and heavy episodic drinking spread across different types of drinking occasion in Great Britain: An event-level latent class analysis

BACKGROUND

This paper aimed to (i) update a previous typology of British alcohol drinking occasions using a more recent and expanded dataset and revised modelling procedure, and (ii) estimate the average consumption level, prevalence of heavy drinking, and distribution of all alcohol consumption and heavy drinking within and across occasion types.

METHODS

The paper uses a cross-sectional latent class analysis of event-level diary data that includes characteristics of 43,089 drinking occasions in 2019 reported by 17,821 adult drinkers in Great Britain. The latent class indicators are characteristics of off-trade only (e.g. home), on-trade only (e.g. bar) and mixed trade (e.g. home and bar) drinking occasions. These describe companions, locations, purpose, motivation, accompanying activities, timings, consumption volume in units (1 UK unit = 8g ethanol) and beverages consumed.

RESULTS

The analysis identified four off-trade only, eight on-trade only and three mixed-trade occasion types (i.e. latent classes). Mean consumption per occasion varied between 4.4 units in Family meals to 17.7 units in Big nights out with pre-loading. It exceeded ten units in all mixed-trade occasion types and in Off-trade get togethers, Big nights out and Male friends at the pub. Three off-trade types accounted for 50.8% of all alcohol consumed and 51.8% of heavy drinking occasions: Quiet drink at home alone, Evening at home with partner and Off-trade get togethers. For thirteen out of fifteen occasion types, more than 25% of occasions involved heavy drinking. Conversely, 41.7% of Big nights out and 16.4% of Big nights out with preloading were not heavy drinking occasions.

CONCLUSIONS

Alcohol consumption varies substantially across and within fifteen types of drinking occasion in Great Britain. Heavy drinking is common in most occasion types. However, moderate drinking is also common in occasion types often characterised as heavy drinking practices. Mixed-trade drinking occasions are particularly likely to involve heavy drinking.

Drinking before sporting events in Australia: An ecological momentary assessment study

This study investigates the individual and event-level correlates of drinking prior to attending Australian Football League (AFL) games among a sample of Australian spectators.

A total of 30 adults (20% female, mean age = 32) completed a series of questionnaires (n = 417) before, during, and after an AFL match on a Friday, Saturday, or Sunday. Cluster-adjusted regression analyses were conducted to examine the impact of individual-level (age, gender, drinking habits) and event-level factors (time and day of game, location of viewing the game, viewing with friends or family) on drinking prevalence and the number of drinks consumed prior to the game.

41.4% of participants engaged in drinking before attending an AFL match with a mean of 2.3 drinks consumed by those who reported pre-game consumption. Those aged 30 and over were significantly more likely to engage in pre-game consumption (OR = 14.44, p = 0.024) and consumed significantly more pre-game (B = 1.39, p = 0.030). Drinking before the game was significantly more likely before night games than daytime games (OR = 5.24, p = 0.039). Those who watched the game on-premise consumed significantly more before the game than those who watched the game at a private residence or at home (B = 1.06, p = 0.030). Those who watched games with family also drank significantly less prior to the game than those who attended without family (B=-1.35, p = 0.010).

Addressing the contextual factors associated with drinking before the sporting events, such as the time of the game, may assist with efforts to reduce risky alcohol consumption and related harm.

Impulsivity, masculine norms and patron pre-drinking levels in Queensland

Pre-drinking is a common practice for young people prior to entering a night-time entertainment precinct (NEP), and is associated with numerous harms, such as increased experience of physical aggression and drink driving. The relationship between both impulsivity traits such as negative urgency, positive urgency and sensation seeking and conformity to masculine norms, and number of pre-drinks remains under-researched. The current study aims to explore whether level of negative urgency, positive urgency, sensation seeking, or conformity to masculine norms is associated with the number of pre-drinks consumed prior to entering a NEP. Participants included patrons aged under 30 years that were systematically selected for street surveys in Fortitude Valley and West End NEPs, Brisbane, Australia; and completed a follow-up survey in the week following (n = 312). Generalized structural equation modelling was used to fit five separate models with a negative binomial regression using a log link function, adjusting for age and sex. Postestimation tests were conducted to identify any indirect effects via an association between pre-drinking and enhancement motives. The standard errors were bootstrapped for the indirect effects. We found direct effects for sensation seeking. Indirect effects were present for Playboy norms, Winning norms, positive urgency and sensation seeking. While these findings provide some evidence that impulsivity traits can influence the number of pre-drinks an individual consumes, the findings suggest that some traits are more likely to be related to overall alcohol consumption and that pre-drinking is a unique type of alcohol consumption with distinct predictors that require further investigation.

A cross-national study of predrinking motives in Spain and the UK: Cross-sectional associations with risk-taking and alcohol consumption

This study contrasts young people's predrinking in two European cultural contexts: Spain and the UK. Whilst UK predrinking typically occurs amongst small groups of individuals who already know one another, the distinctive Spanish context of the Botellón details a far larger gathering in which participants may be less likely to know each other. As such, predrinking motives which drive consumption and risk-taking may be expected to vary between these cultures. An online questionnaire (N = 397; UK = 167, Spain = 230) was used to examine a variety of drinking behaviours and associated beliefs/motivations including predrinking motivations, drinking behaviour, and risk taking. Path analysis was used to analyse both direct and indirect relationships between the measures with the aim of predicting problem alcohol consumption with the most parsimonious model. Varying (in)direct paths were observed between predrinking motives and alcohol consumption between the cultures. Most notably and pointing towards inconsistency in the drivers of young adults' drinking, fun predrinking motives featured prominently among Spanish respondents and predicted their reported consumption (not so in the UK), while conviviality was a more prevalent predrinking motive in the UK sample and associated with alcohol consumption (not the case in Spain). Further, (personal) risky behaviour and risk-taking predicted consumption in both samples, suggesting the importance of group norms and behaviours in predrinking activity, irrespective of alcohol consumption. These findings highlight the potential importance of the environment in which young people predrink. Given their importance in shaping alcohol consumption and risk taking in young people, cultural differences in predrinking contexts and motives warrant further investigation.

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.

This is the rhythm of the night: Examining the phases of a night-out on preloading motivations and intentions to backload

BACKGROUND

Field research into the preloading phenomena has rarely examined how patrons move and transition into target events. We conceptualised three phases of the night (PotN) - entering, within and leaving - which a patron can be intercepted by a research group. Our research tested the differences between the PotN on preloading, preloading motivations and alcohol consuming behaviours in a popular night-time entertainment district (NED).

METHODS

The sample comprised 1,585 young-adult patrons (934 Men, 651 Women; ages 18-27 years) collected in a cross-sectional design over three PotN. We measured the patron's preloading motivations, current alcohol intoxication and backloading intentions between three different phases of a night-out on Thursday, Friday and Saturday nights, from 9:00p.m. - 4:00 a.m. in Brisbane NEDs (Queensland, Australia).

RESULTS

The phases contributed to a difference in preloading rates - one that decreased over the night (p <.001). Between the phases, the motivation of 'saving money' (≈45%) decreased as a reason for preloading and to 'socialise' (≈20%) increased. Enhancement-based preloading motivations (i.e., 'enjoy the feeling' and 'get drunk') were related to increased alcohol intoxication and backloading intentions at different PotN. However, 'saving money' motivations were also associated with a decrease in alcohol intoxication and backloading intentions (i.e., planning to return home to continue alcohol consumption).

CONCLUSIONS

Preloading is valued highly by patrons when proximal to the actual preloading. There is a difference between the PotN on preloading rates, preloading motivations, intentions to backload and drinking outcomes as patrons shift from preloading, to entering the NED, to eventually leaving.

Changing trends and characteristics of one punch deaths in Australia (2012-2018)

One-punch assaults also known as 'coward punches', are characterised by a single severe blow to the head causing the victim to lose consciousness, resulting in a secondary impact between the head and surrounding environment. Such impacts may result in brain injury leading to fatality or permanent neurological impairment. In a previous publication, there were 90 one punch deaths around Australia between 2000 and 2012, mostly involving young men drinking alcohol at a licensed venue at the weekend. This prompted a surge of public education and awareness campaigns around Australia, in addition to regulatory and legislative changes aimed at curbing social violence. This retrospective descriptive study aimed to examine one punch deaths since 2012 in Australia to determine if there has been a decrease in deaths, and whether the demographics and circumstances of these deaths have changed. A search of the National Coronial Information System was undertaken for all closed coronial cases between 1 January 2012 and 31 December 2018. Additional information was collected from medicolegal reports including toxicology, pathology and coronial findings. There were 80 one punch fatalities in Australia, almost exclusively involving males. The median age was 43.5 (range 18-71) years and there was a decreasing trend in the number of deaths annually. Most fatal assaults occurred in the state of New South Wales (28.8%) followed by Queensland (23.8%), and in metropolitan locations (64.6%) rather than regional areas (35.4%). Alcohol was the most commonly detected drug, found in 47 cases of the 71 cases where toxicology results were available (66%), with a median concentration of 0.14 and 0.19 g/100 mL in antemortem and postmortem samples, respectively (range 0.005-0.32 g/100 mL). Five deaths reported methylamphetamine, with THC detected in 21.1% of cases. Assaults more commonly occurred on a footpath or roadside (41.3%), followed by a home or dwelling (32.5%). 8.8% of assaults occurred inside hotels, bars or other licenced venues. Most transpired on a weekday, which differed from the pre-2012 period when these assaults occurred mainly on the weekend. While some trends are positive, there has been a shift in the victim demographic as well as the typical environment for fatal one punch assaults, highlighting the importance of public health surveillance in providing a current evidence base to inform policy and practice.

Where to next? An exploration of 'night-out' location progression and propensity to experience violence in night -time entertainment precincts

BACKGROUND

Alcohol related violence in night-time entertainment precincts (NEPs) is a significant public health concern. Studies suggest characteristics including venue density, bar hopping and permissive social norms facilitate violence in NEPs. Yet, we have a limited understanding of how individual drinking occasions progress within NEPs and how location sequence is associated with the propensity to experience violence in these spaces.

METHODS

In this study we apply sequence analysis and logistic regression to examine the association between location sequences and experiences of violence among a sample of NEP patrons (N=387).

RESULTS

We find that individuals who stay out longer and visit a greater number of unique location types are more likely to experience a violent event. We also find that attending a 'non-venue' pre-event such as a private party, gathering, sporting or celebratory event, is associated with elevated risk experiencing violence during a night out.

CONCLUSION

The findings offer important insights into the dynamic context in which risky drinking occasions may emerge and suggest that the context and location in which pre-drinking occurs should be considered in future research.

Drink for drink: measurement of preloading motivations for field and survey research with correlates of alcohol related harms

Field researchers often use categorical systems to record primary preloading motivations, while survey researchers use continuous systems to examine preloading motivation ratings. We tested the psychometric properties of the two systems for measuring preloading motivations. Six hundred and eight-one undergraduate students and social media recruited participants (178 males; 503 females) completed an online survey pertaining to their last preloading experience. We measured preloading motivations by the categorical and continuous systems, general drinking motivations, estimations of preloaded standard drinks and harm. Measurements of preloading motivations by categorical (primary motivation) and continuous systems (motivation ratings) were concordant. The continuous system of preloading motivations held mix concurrence with general drinking motivations, implying conceptual differences between the two constructs. ‘Enhancement-based’ preloading motivations had strong relationships with estimations of preloaded standard drinks, while general drinking motivations for ‘coping’ were strong correlates of harm. Preloading motivations can be measured through either categorical or continuous systems. Implications for future psychometric measurement development is discussed.

Side-loading prevalence and intoxication in the night-time economy

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A substantial minority of the ambient population in the night-time economy had engaged in side-loading.

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Unlike pre-drinking, side-loading was not statistically significantly associated with greater levels of intoxication (as measured by breath alcohol content).

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Side-loading might not be used as a method for drinkers to enhance intoxication, but instead as a means of sustaining a target level of intoxication.

Although pre-drinking has attracted considerable research interest, side-loading (any drinking occurring outside of licensed premises during a night out, and excluding drinking at home) is comparatively under-studied. In this paper, we investigate the prevalence of side-loading behaviour and intoxication in the night-time economy of Hamilton, New Zealand’s fourth-largest city. Using a street-intercept survey conducted over six nights (n = 469) in March and April 2019, we found that 17.5% of research participants (82/469), and 19.9% of drinkers (82/413), had engaged in side-loading. Of those engaging in side-loading, the majority did so in a car (61.0%), with smaller proportions engaging in side-loading in the street (17.1%), a carpark (12.2%), or somewhere else (13.4%). Men were significantly more likely than women to engage in side-loading behaviour (p = 0.001). In linear models controlling for time of the night, day of the week, and demographic variables, side-loading was not statistically significantly associated with breath alcohol content. This contrasts with pre-drinking, which was associated with statistically significantly higher breath alcohol content. Our results suggest that side-loading might not be used as a method for drinkers to enhance intoxication, but instead as a means of sustaining a target level of intoxication during an evening.

The association of childhood physical abuse, masculinity, intoxication, trait aggression with victimization in nightlife districts

BACKGROUND

High-risk intoxication, trait aggression and conformity to masculine norms are associated with increased risk of barroom aggression; however, less is understood regarding the factors associated with victimization in the night-time environment.

OBJECTIVE

This study aimed to explore the influence of childhood physical abuse, high-risk intoxication, conformity to masculine norms and trait aggression on physical and/or verbal victimization in the night-time environment.

PARTICIPANTS AND SETTING

A sample of N = 490 patrons aged 18-50 years (M = 23.02, SD = 5.89, 58.8% female) were recruited in Fortitude Valley and West End district, Queensland.

METHOD

Participants completed a street interview, including breathalyser, and a follow-up online survey asking about experiences of aggression on the night of interview, experiences of childhood physical abuse and psychosocial correlates.

RESULTS

For males, but not females, childhood physical abuse (OR = 3.98) increased the risk of physical and/or verbal victimization. Conformity to the masculine norm of Winning (OR = 0.21) was protective against physical and/or verbal victimization for males, and trait aggression (OR = 1.51) was significantly associated with increased risk of physical and/or verbal victimization for females.

CONCLUSIONS

These findings add to the growing literature surrounding the long-term impacts of childhood physical abuse, demonstrating experiences of childhood physical abuse are significantly associated with victimization in the night-time economy. The current findings should be taken into consideration when constructing public policy or directed interventions, to help reduce aggression and violence in the night-time economy.

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

AIMS

The limited existing research on drinking games and predrinking among university students in Argentina, Australia, Canada, and New Zealand suggests that participation in these risky drinking practices is relatively widespread among this population. Drinking norms and alcohol use can vary across countries and in different regions of the globe. The measurement of drinking games and predrinking participation between studies also differs, making cross-country comparisons difficult. The present study explored differences in past month participation in drinking games and predrinking among university students from a large public university in Argentina, Australia, Canada, and New Zealand.

METHODS

The data analytic sample consisted of 1134 university students (ages 18-25, Mage = 20.2 years; 72.6% women) from Argentina (n = 349), Australia (n = 280), Canada (n = 262), and New Zealand (n = 243) who reported weekly alcohol consumption. Students completed a confidential survey on drinking attitudes and behaviors.

RESULTS

Controlling for age, gender, and weekly drink consumption, there were no cross-country differences in past month participation in predrinking. In contrast, university students from Canada and New Zealand were more likely to have played a drinking game in the past month than students from Australia and Argentina.

CONCLUSIONS

The present finding suggest that university students from Argentina, Australia, Canada, and New Zealand are equally likely to participate in predrinking regardless of country; however, the likelihood of playing drinking games differs as a function of country site.

The impact of changes to alcohol policy on patron drinking behaviours in Queensland

INTRODUCTION

On 1 July 2016, stage 1 of the Tackling Alcohol-Fuelled Violence (TAFV) policy was introduced in Queensland, Australia and included restricted alcohol service to 03:00 in dedicated entertainment precincts (safe night precincts or SNPs). During stage 2 (from 1 February 2017), the number of extended trading permits (i.e. trading until 05:00) per venue were reduced; and during stage 3 (from 1 July 2017), networked identification scanners were mandated for late-night venues. We aim to examine whether patron drinking behaviours in two key SNPs changed significantly following stages 2 and 3.

METHODS

The study design was repeated cross-sectional, with three data collection (policy) stages. Patrons street surveys were conducted in Fortitude Valley (n = 2066) and Cairns (n = 1021) SNPs between July 2016 and November 2018. Linear or negative binomial regressions were conducted to examine changes in three key outcomes: blood alcohol concentration (BAC) reading, proportion of pre-drinkers and number of pre-drinks.

RESULTS

We found no significant difference in BAC reading, proportion of pre-drinkers or number of pre-drinks at stages 2 and 3 of the policy compared to baseline in Fortitude Valley. In Cairns, we found significant reductions in patron BAC at stage 3 of the policy, and female BAC at stages 2 and 3 compared to baseline; while the proportion of females pre-drinking significantly reduced by half in stage 2.

DISCUSSION AND CONCLUSIONS

Despite evidence of some reductions in alcohol consumption, high levels of intoxication remain, suggesting harm reduction may be more difficult to achieve in these drinkers.

Queensland Alcohol-related violence and Night-time Economy Monitoring (QUANTEM): Rationale and overview

This commentary introduces the special section on the outcomes of the Queensland Alcohol-related violence and Night-time Economy Monitoring project and outlines the political and policy context of the interventions put in place under the Queensland government's Tackling Alcohol-Fuelled Violence strategy. The development of the strategy was informed by alcohol policy initiatives trialled in other major Australian cities over the past two decades. The articles in this special section examine the impact of the Tackling Alcohol-Fuelled Violence policy stages on alcohol-related harms and local economies across selected entertainment precincts (Safe Night Precincts). A rich array of data were utilised, including administrative health and justice data, data reflective of nightlife trading (i.e. foot traffic data, ID scanner data and live music performances) and street surveys. Findings have implications for research, policy and practice and demonstrate the need for comprehensive evaluations that can accommodate the complexities of modern alcohol policy in Australia.

The Impact of Liquor Restrictions on Serious Assaults across Queensland, Australia

Aims: This study aimed to explore the relationship between a 00:00 liquor restriction, introduced on 1 July 2016, and alcohol-related harm by examining its impact on serious assault numbers during high-alcohol hours (20:00-6:00 Friday and Saturday night), from 1 January 2009 to 30 June 2018. Methods: Two types of locations only impacted by the liquor restriction were identified: designated safe night precincts (SNPs) and other local government areas (LGAs). A times series autoregressive integrated moving average analysis was used to estimate the influence of liquor restrictions on police-recorded serious assaults in the two years following the policy introduction, for SNPs and LGAs separately. Results: Contrarily to our predictions, monthly police-recorded serious assaults did not significantly change within SNPs or LGAs following the introduction of liquor restrictions. Conclusion: The implementation of the Queensland liquor restriction did not result in a clear, unique reduction in serious assault trends. Further investigation should consider the impact of liquor restrictions in conjunction with other policy changes as public perception of restrictions and their cumulative impact may produce varied outcomes.

The Role of Sex and Age on Pre-drinking: An Exploratory International Comparison of 27 Countries

Aims

This exploratory study aims to model the impact of sex and age on the percentage of pre-drinking in 27 countries, presenting a single model of pre-drinking behaviour for all countries and then comparing the role of sex and age on pre-drinking behaviour between countries.

Methods

Using data from the Global Drug Survey, the percentages of pre-drinkers were estimated for 27 countries from 64,485 respondents. Bivariate and multivariate multilevel models were used to investigate and compare the percentage of pre-drinking by sex (male and female) and age (16–35 years) between countries.

Results

The estimated percentage of pre-drinkers per country ranged from 17.8% (Greece) to 85.6% (Ireland). The influence of sex and age on pre-drinking showed large variation between the 27 countries. With the exception of Canada and Denmark, higher percentages of males engaged in pre-drinking compared to females, at all ages. While we noted a decline in pre-drinking probability among respondents in all countries after 21 years of age, after the age of 30 this probability remained constant in some countries, or even increased in Brazil, Canada, England, Ireland, New Zealand and the United States.

Conclusions

Pre-drinking is a worldwide phenomenon, but varies substantially by sex and age between countries. These variations suggest that policy-makers would benefit from increased understanding of the particularities of pre-drinking in their own country to efficiently target harmful pre-drinking behaviours.

Pregaming: A Field-Based Investigation of Alcohol Quantities Consumed Prior to Visiting a Bar and Restaurant District

BACKGROUND

Investigations examining the association between pregaming, or the consumption of alcohol prior to attending a social gathering or drinking establishment, and blood alcohol concentrations have primarily relied on estimations (i.e., Widmark equation), rather than objective biologic samples, such as breath alcohol concentration (BrAC).

OBJECTIVES

The current study assessed: (1) pregaming, using quantity-based measures, among a sample of college and non-college affiliated bar patrons, (2) associations between pregaming intensity/status and participant intoxication (BrAC), and (3) whether participants who pregamed were more likely to identify as a hazardous drinker.

METHODS

548 bar patrons provided data on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and a single pregaming item assessing quantity of alcohol consumed prior to visiting a bar/restaurant district in 2015. BrAC samples were collected post interview. We used hierarchical linear regression models, respectively, to assess whether pregaming significantly impacted BrAC and whether presence of hazardous drinking predicted pregaming behavior.

RESULTS

After controlling for sex, race/ethnicity, age, student status, and Greek affiliation, the linear regression model explained 32.3% (R² = .323) of the variance of BrAC levels (F(12) = 21.162, p < .001), with 4.30% of the variance explained solely by pregaming (β = 0.014; p < .001). The linear regression model to assess if harzardous drinking behavior (AUDIT-C) significantly predicted pregaming explained 31.2% (R² = .312) of the variance of pregaming behavior (F(18) = 13.276, p < .001), with 4.2% of the variance explained solely by AUDIT-C scores (β = 0.280; p < .001).

CONCLUSION

Findings further highlight pregaming as a harmful risk behavior linked to elevated levels of hazardous drinking and intoxication.

Public self-consciousness, pre-loading and drinking harms among university students

BACKGROUND

Social anxiety and self-consciousness are associated with alcohol-related problems in students. The practice of pre-loading is one avenue for exploration regarding this relationship. Individuals may pre-load to reduce social anxiety and feel more confident when socializing, which could lead to the increased harms experienced. The current study aimed to explore reasons for pre-loading, and whether public and private self-consciousness and social anxiety were related to pre-loading, increased drinking, and harms.

OBJECTIVES

Prospective study with four-week follow up of 325 UK students aged 18--30 years old. Participants completed measures of private and public self-consciousness, social anxiety, alcohol consumption, alcohol-related harms, and pre-loading.

RESULTS

Financial motives and mood-related reasons, such as gaining confidence were reported as reasons for pre-loading. Pre-loading predicted hazardous alcohol consumption, but social anxiety, and public and private self-consciousness did not. However, pre-loading, public self-consciousness, and social anxiety predicted alcohol-related harms. Furthermore, public self-consciousness mediated the relationship between pre-loading and harms in a positive direction and this appeared to be more relevant in high-risk (AUDIT 8+) than low-risk drinkers.

CONCLUSIONS

Students who scored higher in public self-consciousness appeared to be at greater risk of harms from pre-loading. Further research should examine this relationship with particular attention to high-risk drinkers, and explore which aspects of a night out are related to heightened self-consciousness. Interventions could incorporate measures to reduce public self-consciousness, in order to reduce the negative impacts of pre-loading.

An intercept study to measure the extent to which New Zealand university students pre-game

OBJECTIVE

We aimed to quantify the degree to which students pre-gamed in New Zealand, using self-report and breathalysers.

METHODS

A total of 569 New Zealand undergraduate students were interviewed (men = 45.2%; first year = 81.4%) entering three university-run concerts. We asked participants to report how many drinks they had consumed, their self-reported intoxication and the duration of their pre-gaming session. We then recorded participants' Breath Alcohol Concentration (BrAC; µg/L) and the time they arrived at the event.

RESULTS

The number of participants who reported consuming alcohol before the event was 504 (88.6%) and the number of standard drinks consumed was high (M=6.9; median=6.0). A total of 237 (41.7%) participants could not have their BrAC recorded due to having consumed alcohol ≤10 minutes before the interview. The remaining 332 participants (57.3%) recorded a mean BrAC of 288.8µg/L (median=280.0 µg/L). Gender, off-campus accommodation, length of pre-gaming drinking session, and time of arrival at the event were all associated with increased pre-gaming. Conclusion and implications for public health: Pre-gaming was the norm for students. Universities must take pre-gaming into account; policy implications include earlier start times of events and limiting students' access to alcohol prior to events.

Nature versus intensity of intoxication: Co-ingestion of alcohol and energy drinks and the effect on objective and subjective intoxication

BACKGROUND

We report a series of studies examining the effect of alcohol mixed with energy drinks (AmEDs) versus alcohol on objective intoxication (breath alcohol concentration; BrAC), intensity, and nature of intoxication. We also aimed to disentangle the role of energy drink (ED) ingredients in any effects.

METHOD

Three within-subject double-blind placebo-controlled studies measured BrAC, subjective intoxication and impairment ('intensity of intoxication'), stimulation and sedation ('nature of intoxication') following administration of ED, Cola, Caffeine+Sugar, and Placebo with alcohol (Study 1, n=18); ED, Caffeine-only, Sugar-only and Placebo with alcohol (Study 2, n=20); and ED and Placebo with alcohol (Study 3, n=27).

RESULTS

Significant moderate-to-large magnitude BrAC decrements and delayed time to peak BrAC were observed after ED administration versus Placebo. However, no meaningful BrAC differences between ED and other active conditions were observed in Study 1 and 2. After BrAC adjustment, moderate-to-large magnitude reductions in intoxication and impairment ratings were observed after ED versus Placebo on the ascending limb in all studies and at peak in Study 2 and 3. No meaningful differences were observed in intoxication and impairment ratings between ED and Caffeine+Sugar and Cola conditions (Study 1); ratings were lower after ED versus Sugar-only (Study 2). Stimulation and sedation ratings did not differ between ED and Placebo.

CONCLUSION

Reductions in objective intoxication and perceived intensity of intoxication, but not nature of intoxication, were observed after AmED consumption. However, effects may be common to alcohol mixers containing sugars (objective intoxication) and caffeine (intensity of intoxication) and specific to a laboratory setting.

Violence involvement among nightlife patrons: The relative role of demographics and substance use

The nightlife setting is a risk context for violence involvement that ultimately may cause severe injuries and fatalities. Few studies have examined associations between alcohol and illicit substance use with physical violence involvement among nightlife patrons. The aim of the current study was to investigate the relative role of demographics and substance use characteristics for nightlife violence involvement among Norwegian nightlife patrons. A cross-sectional self-completion survey was conducted outside 12 licensed premises in Oslo (n = 1099, response rate = 76%) and each respondent's BAC level was measured by a breathalyzer and registered on the questionnaire. A total of 103 individuals (10%) reported that they had been involved in physical violence when they were consuming alcohol in the nightlife setting during the last 12 months. Uni-variate results showed that patrons who had been involved in violence were more likely to present a BAC level above 1.00‰ than those who had not been involved. The prevalence of last year illicit substance use was overall high, especially in the violence-involved group. The most important factors associated with violence involvement in multivariate analysis were a high frequency of last year alcohol intoxication and last year illicit substance use. Women and those with high education had a lower risk of violence involvement. The implications for preventive initiatives are that these need to focus on factors additional to alcohol restrictions. Preventive efforts targeted to specific patron groups and measures targeting patrons who are more likely to use illicit substances may hold promise. Aggr. Behav. 43:398-407, 2017. © 2017 Wiley Periodicals, Inc.

Correlates of verbal and physical aggression among patrons of licensed venues in Australia

INTRODUCTION AND AIMS

The current study aimed to examine the association between patron demographics and substance use, and experiences of verbal and physical aggressive incidents within the last 3 months among patrons of night-time entertainment precincts (NEP) in Australia.

DESIGN AND METHODS

Patron interviews (n = 4216) were conducted around licensed venues in the NEPs of five Australian cities. Seven correlates of verbal and physical aggressive incidents were examined: gender, age, occupation, blood alcohol concentration, pre-drinking, energy drink use and illicit drug use in the current session.

RESULTS

A total of 7.5% and 8.2% of respondents reported involvement in a verbally and physically aggressive incident in the past 3 months, respectively. Multivariate logistic regression models indicated men and people <25 years old were significantly more likely to report both verbal and physical aggressive incidents. A significant occupation effect showed lower levels of both verbal and physical aggression in managers/professionals compared with non-office workers. The likelihood of being involved in a verbally aggressive incident significantly increased with energy drink consumption, while the likelihood of being involved in a physically aggressive incident significantly increased with blood alcohol concentration, energy drink consumption and illicit drug use.

DISCUSSION AND CONCLUSIONS

This study highlights the different correlates of verbal and physical aggression within NEPs, suggesting they should be viewed as distinct types of violence, rather than points on a continuum. Major modifiable correlates with verbal and physical aggression included intoxication, energy drink consumption, and illicit drug use, suggesting the need for further interventions and policy development to address these key issues. [Hyder S, Coomber K, Pennay A, Droste N, Curtis A, Mayshak R, Lam T, Gilmore W, Chikritzhs T, Miller PG. Correlates of verbal and physical aggression among patrons of licensed venues in Australia. Drug Alcohol Rev 2018;37:6-13].

Demographic and Substance Use Factors Associated with Non-Violent Alcohol-Related Injuries among Patrons of Australian Night-Time Entertainment Districts

This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries.

Observable characteristics associated with alcohol intoxication within licensed entertainment venues in Australia

BACKGROUND

The aim of the current study was to assess correlates of intoxication in licensed venues in Australia.

METHODS

Covert observations of licensed venues and venue patron in night-time entertainment districts of five Australian cities were conducted. In total, 828 unique cross-sectional observations were completed across 62 bars, nightclubs, and large mainstream pubs. Venues were selected from the main entertainment district of smaller cities and the busiest entertainment districts of larger cities. Outcomes were the estimated percentage of patrons showing any signs of alcohol intoxication and the overall level of intoxication ('high' versus 'none to medium'). Seven predictors of patron intoxication were examined: hour of observation; estimated percentage of male patrons; estimated percentage of patrons <25 years old; venue crowding; presence of observable alcohol promotions; type of alcoholic beverage consumed by the majority of patrons; and, venue type.

RESULTS

Time of night (coefficient=11.71, p<.001; OR=9.61, p<.001), percentage of patrons aged <25 (coefficient=0.14, p<.001; OR=1.01, p=.031), and venue crowding (coefficient=4.40, p<.001; OR=1.39, p=.009) had significant positive associations with both signs of intoxication and high levels of intoxication. Nightclubs had a lower percentage of signs of intoxication compared to pubs (coefficient=-10.73, p=.021). Increased percentage of male patrons was associated with increased odds of high-level intoxication (OR=1.05, p=.020).

CONCLUSION

Time of night and proportion of younger patrons had a strong association with patron intoxication adding further support for the strong body of evidence that ceasing service of alcohol earlier in the evening will reduce intoxication levels.