Person and environment predictors of blood alcohol concentrations: a multi-level study of college parties

The Naturalistic Cannabis Administration Protocol (NCAP): A Proof-of-Concept Study

Lab-based studies examining the effects of cannabis administration on human behavior compromise ecological validity due to the influence of set and setting. Contextual factors of clinical settings have long been recognized as producing measurable changes in physiology, emotionality, and cognition. Among people who use drugs, these settings may be associated with higher levels of perceived stigma and stereotype threat which may meaningfully confound the effects of cannabis on outcomes of interest. Recent liberalization of cannabis regulation may allow novel and more ecologically valid approaches to assessing the acute effects of cannabis. The Naturalistic Cannabis Administration Protocol (NCAP) is a novel paradigm for the study of acute cannabis effects in an ecologically valid manner. Two independent studies demonstrated the safety and feasibility of the NCAP. Participants (N= 79; Mage = 25.44, SD = 5.67) self-administered the cannabis of their choice in their home and then (Study 1; n= 47) engaged in a leisure activity or (Study 2; n= 32) underwent cognitive assessment remotely via videoconference following cannabis administration. The NCAP was well tolerated across samples with no reported adverse events. These findings provide a rationale for the adoption of the NCAP to reduce research barriers and develop our research capabilities to fit the landscape of cannabis use today.

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.

Event-level contextual predictors of high-intensity drinking events among young adults

BACKGROUND

Drinking events are characterized by social and physical contexts that are associated with level of alcohol consumption. Ecologically valid data is needed to delineate aspects of the drinking context that are most likely to precipitate excessive alcohol consumption.

METHODS

We utilized event-level data from a longitudinal study that included repeated daily surveys administered in two 28-day bursts. Data from 341 college student past-month alcohol and cannabis users (Mage=19.79; 53 % women; 74 % White) produced a total of 4107 alcohol use days. Generalized linear mixed effects models were used to predict drinking level (moderate: 1-3/1-4 for women/men; heavy-episodic drinking (HED): 4-7/5-9; high-intensity drinking (HID), 8+/10+) by social (e.g., with friends) and physical (e.g., at a party) contexts. We conducted analyses for the first and last drink reported, controlling demographic and study characteristics.

RESULTS

Being at a party, friend's house, or with strangers at the last drink reported were associated with HID compared to HED, while being at home, alone, or with family were protective for HID. No first drink contexts were associated with HID relative to HED. Witnessing others who were intoxicated was consistently associated with HID.

CONCLUSIONS

Social settings such as parties and those with intoxicated persons were associated with risk for HID. The context of drinks at the end of an event are salient signals of level of alcohol consumption. Preventive interventions, particularly those that deliver strategies in real time, should consider accounting for contextual risk factors to reduce harms associated with excessive alcohol consumption.

Is bringing one's own alcohol to parties protective or risky? A prospective examination of sexual victimization among first-year college women

ObjectiveThis study assessed whether college women who bring their own alcohol to parties (BYOB) are less vulnerable to sexual victimization (SV). Participants: Participants were 652 female freshmen (M age = 18.04 years) at a large, public university. Methods: Women were recruited by email to complete online surveys of their drinking-related behaviors and sexual experiences in September (T1) and November (T2) of their first college semester. Results: Approximately 47% of our sample reported BYOB. Women who reported BYOB more frequently at T1 were more likely to report SV at T2 when accounting for risk factors, including prior SV, heavy episodic drinking, and hookups. Specifically, BYOB predicted contact and rape, but not coercion. Conclusions: Findings suggested BYOB does not prevent college SV, but rather may increase risk. We encourage college health professionals and researchers to target BYOB to better understand this common behavior and help students recognize potential for associated harm.

Combinations of Drinking Occasion Characteristics Associated with Units of Alcohol Consumed among British Adults: An Event-Level Decision Tree Modeling Study

BACKGROUND

Alcohol consumption is influenced by the characteristics of drinking occasions, for example, location, timing, or the composition of the drinking group. However, the relative importance of occasion characteristics is not yet well understood. This study aims to identify which characteristics, and combinations of characteristics, are associated with units consumed within drinking occasions. It also tests whether accounting for occasion characteristics improves the prediction of consumption compared to using demographic information only.

METHODS

The data come from a cross-sectional, nationally representative, online market research survey. Our sample includes 18,409 British drinkers aged 18 + who recorded the characteristics of 46,072 drinking occasions using 7-day retrospective drinking diaries in 2018. We used decision tree modeling and nested linear regression to predict units consumed in occasions using information on drinking location/venue, occasion timing, company, occasion type (e.g., a quiet night in), occasion motivation, drink type and packaging, food eaten and entertainment/ other activities during the occasion. We estimated models separately for 6 age-sex groups and controlled for usual drinking frequency, and social grade in nested linear regression models. Open Science Framework preregistration: https://osf.io/42epd.

RESULTS

Our 6 final models accounted for between 55% and 71% of the variance in drinking occasion alcohol consumption. Beyond demographic characteristics (1 to 9%) and occasion duration (24 to 60%), further occasion characteristics and combinations of characteristics accounted for 31 to 70% of the total explained variance. The characteristics most strongly associated with heavy alcohol consumption were long occasion duration, drinking spirits as doubles, and drinking wine. Spirits were also consumed in light occasions, but as singles. This suggests that the serving size is an important differentiator of light and heavy occasions.

CONCLUSIONS

Combinations of occasion duration and drink type are strongly predictive of alcohol consumption in adults' drinking occasions. Accounting for characteristics of drinking occasions, both individually and in combination, substantially improves the prediction of alcohol consumption.

Contextual characteristics of adults' drinking occasions and their association with levels of alcohol consumption and acute alcohol-related harm: a mapping review

BACKGROUND AND AIMS

There is a growing literature using event-level methods to estimate associations between contextual characteristics of drinking occasions, consumption levels and acute harms. This literature spans many research traditions and has not been brought together as a whole. This mapping review aimed to identify and describe the theoretical approaches to conceptualizing drinking occasions, study designs, predictors and outcome measures used in existing research with a view to identifying dominant approaches, research gaps and areas for further synthesis.

METHODS

Eligible papers studied adults' drinking occasions using quantitative event-level methods and considered one or more contextual characteristics (e.g. venue, timing or company) and at least one event-level consumption or acute alcohol-related harm outcome. We systematically searched Ovid MEDLINE, PsycInfo and the Web of Science Social Sciences Citation Index, extracting data on studies' theoretical approach, data collection methods, settings, populations, drinking occasion characteristics and outcome measures.

RESULTS

Searches identified 278 eligible papers (from 1975 to 2019), predominantly published after 2010 (n = 181; 65.1%). Most papers reported research conducted in the United States (n = 170; 61.2%) and half used student participants (n = 133; 47.8%). Papers typically lacked a stated theoretical approach (n = 203; 73.0%). Consistent with this, only 53 (19.1%) papers studied three or more occasion characteristics and most used methods that assume occasion characteristics do not change during an occasion (n = 189; 68.0%). The most common outcome type considered was consumption (n = 224; 80.6%) and only a few papers studied specific acute harm outcomes such as unprotected sex (n = 24; 8.6%), drink driving (n = 14; 5.0%) or sexual violence (n = 9; 3.2%).

CONCLUSIONS

Studies from 1975 to 2019 using event-level methods to estimate associations between contextual characteristics of drinking occasions, consumption levels and acute harms were largely focused on students and consumption outcomes, and most have considered a limited range of contextual characteristics.

Social and Situational Party Characteristics Associated With High-Intensity Alcohol Use Among Youth and Young Adults

BACKGROUND

Rates of high-intensity drinking, which is alcohol consumption that exceeds standard heavy drinking levels, have increased in recent years and peak in young adulthood. To identify modifiable environmental targets for prevention of high-intensity drinking, we identified characteristics of parties attended by youth and young adults that were associated with high-intensity drinking and the consequences of this excessive form of drinking.

METHODS

Data are from 15- to 20-year-old participants in an online survey (n = 2,442; 55.4% female, 74.8% White) who resided in 24 communities across 7 states that were a part of a community randomized intervention trial to reduce the incidence and consequences of underage drinking parties. We used multinomial logistic regression to predict level of drinking by 6 party characteristics (size, location, age and gender composition, supervision, others' drinking behavior), and to predict 6 consequences (hangover, not remember event, passed out, punished by parents, broke something/got in fight, and sex against will) from level of drinking. We tested study hypotheses in 2 models, one that used a single binge drinking threshold (below binge vs. at or above binge level) and one that additionally used a high-intensity drinking level (below binge, 1 to 2 times binge, 2+ times binge level).

RESULTS

We found that larger party size and a mostly male composition were unique predictors of high-intensity drinking when compared to those who consumed 1 to 2 times the binge drinking level. Odds of passing out, not remembering the drinking event, breaking/damaging property, or getting in a fight were more than double for high-intensity drinkers compared to standard binge level drinkers.

CONCLUSIONS

Results from this study indicate there are unique precursors and consequences of high-intensity alcohol consumption among youth and young adults. These environmental factors associated with high-risk drinking contexts can be used to develop prevention strategies to mitigate the harms associated with excessive alcohol consumption.

The contexts of heavy drinking: A systematic review of the combinations of context-related factors associated with heavy drinking occasions

Background

The amount of alcohol consumed during an occasion can be influenced by physical and social attributes of the setting, characteristics and state of individuals, and the interactions of these components. This systematic review identifies and describes the specific combinations and sequences of context-related factors that are associated with heavy drinking occasions.

Materials and methods

We conducted a systematic literature search of MEDLINE, Embase and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Eligible articles were event-level and event-based studies that quantitatively analysed associations of sequences or combinations of context-related factors with event-level alcohol consumption. We extracted information on study design, sample, variables, effect estimates and analytical methods. We compiled a list of combinations and sequences associated with heavier drinking (i.e., ‘risky contexts’) and with lighter drinking (‘protective contexts’). The review protocol was registered with PROSPERO (registration number: CRD42018089500).

Results

We screened 1902 retrieved records and identified a final sample of 65 eligible studies. Daily mood, day of week, location and drinking group characteristics are important drivers of whether an individual engages in a heavy drinking occasion. The direction and magnitude of some associations differed by gender, age, personality and motives, such that in particular social or physical contexts, some people may feel compelled to drink more while others are compelled to drink less. Very few sequences of factors were reported as being associated with event-level alcohol consumption.

Conclusions

Contexts or factors are experienced in specific sequences that shape the broader drinking context and influence drinking behaviours and consequences but are under-studied. Event-level studies such as those using ecological momentary assessment can harness new technologies for data collection and analysis to improve understandings of why people engage in heavy drinking. Continued event-level research will facilitate public health interventions and policies that reduce heavy drinking and alcohol-related harms.

Risk Factors for Distortion Product Otoacoustic Emissions in Young Adults

Young adults with normal hearing may exhibit risk factors for hearing loss. The purpose of this study was to evaluate how self-reported personal music (PM) system volume use, preferred listening level, and self-reported alcohol use affects distortion product otoacoustic emissions (DPOAEs). Two-hundred, sixteen young adults, 161 women and 55 men, participated. Questionnaire data included the PM system and alcohol use. DPOAEs were obtained from 1–6 kHz and collapsed into 1/3rd octave bands and a probe microphone was used to determine preferred listening level. Alcohol was defined as drinks per month (DPM), categorized as No, Light (≤14), and Heavy (>14). Men who reported loud/very loud volume use had statistically significant lower DPOAEs at 1.5, 2, and 3 kHz than men who reported lower volume use. Light and Heavy DPM men had lower DPOAEs at 1.5, 2, and 3 kHz than no DPM men, but this was not statistically significant. There were no DPOAE differences for either variable in women and there was no association between preferred listening level and DPOAEs for women or men. Men who reported loud/very loud volume use and any DPM had poorer mid-frequency DPOAEs. There was not an association for volume use or DPM and DPOAEs in women.

Exploring the Use of Smartphone Geofencing to Study Characteristics of Alcohol Drinking Locations in High-Risk Gay and Bisexual Men

BACKGROUND

Geofencing offers new opportunities to study how specific environments affect alcohol use and related behavior. In this study, we examined the feasibility of using geofencing to examine social/environmental factors related to alcohol use and sexual perceptions in a sample of gay and bisexual men (GBM) who engage in heavy drinking and high-risk sex.

METHODS

HIV-negative GBM (N = 76) completed ecological momentary assessments for 30 days via a smartphone application and were prompted to complete surveys when inside general geofences set around popular bars and clubs. A subset (N = 45) were also asked to complete surveys when inside personal geofences, which participants set themselves by identifying locations where they typically drank heavily.

RESULTS

Approximately 49% of participants received a survey prompted by a general geofence. Among those who identified at least 1 personal drinking location, 62.2% received a personal geofence-prompted survey. Of the 175 total location-based surveys, 40.2% occurred when participants were not at the location that was intended to be captured. Participants reported being most able to openly express themselves at gay bars/clubs and private residences, but these locations were also more "sexualized" than general bars/clubs. Participants did not drink more heavily at gay bars/clubs, but did when in locations with more intoxicated patrons or guests.

CONCLUSIONS

Geofencing has the potential to improve the validity of studies exploring environmental influences on drinking. However, the high number of "false-positive" prompts we observed suggests that geofences should be used carefully until improvements in precision are more widely available.

A Control-Theoretic Assessment of Interventions During Drinking Events

This paper employs control-theoretic tools to provide guidelines for in-situ interventions aimed at reducing high-risk alcohol consumption at drinking events. A dynamical directed network model of a drinking event with external intervention, suitable for mathematical analysis and parameter estimation using field data is proposed, with insights from pharmacokinetics and psychology. Later, a characterization of a bound on blood alcohol content (BAC) trajectories is obtained via Lyapunov stability analysis, and structural controllability guarantees are obtained via a graph-theoretic method. We use the degree of controllability, given to be the trace of the system's controllability Gramian, as a metric to compare the viability of network nodes for intervention based on theoretic and heuristic centrality measures. Results of numerical examples of bars and parties, informed by field data, and the stability and controllability results, suggest that intervening in the environment in wet bars, while targeting influential individuals with high alcohol consumption motivations in private parties efficiently yield lower peak BAC levels in individuals at the drinking events.

Effects of Sexual Arousal and Alcohol Cues on Acute Motivation for Alcohol

Reward-related stimuli can induce motivation to obtain rewards both within and across domains. We tested within- and cross-domain effects of environmental context (mock bar vs. laboratory) and sexually arousing stimuli (pornography vs. nature film) on acute motivation for alcohol as measured by a state-based alcohol purchase task in 109 male and female college students. Our results showed significant effects of both sexual arousal and environmental context on acute motivation for alcohol. A limited subsample analysis (N = 84) revealed significant effects of both sexual arousal and environmental context conditions on elasticity. Consistent with hypotheses, the presence of either sex- or alcohol-related cues increased acute motivation for alcohol and decreased sensitivity to costs of drinking. Furthermore, there was a significant video × laboratory condition interaction in the elasticity analysis. Our findings suggest that both sexually arousing stimuli and incidental environmental alcohol cues may significantly increase the effort one will expend to consume alcohol and thus the potential for risky drinking behavior. We believe this is the first experiment to use demand curves to present evidence of cross-domain effects of sexually arousing stimuli on acute motivation for alcohol.

Characterizing conditioned reactivity to sequential alcohol-predictive cues in well-trained rats

Implicit learning about antecedent stimuli and the unconditional stimulus (US) properties of alcohol may facilitate the progressive loss of control over drinking. To model this learning, Cofresí et al. (2017) developed a procedure in which a discrete, visual conditional stimulus (houselight illumination; CS) predicted the availability of a retractable sipper that rats could lick to receive unsweetened alcohol [Alcoholism: Clinical and Experimental Research, 41, 608-617]. Here we investigated the possibility that houselight illumination, sipper presentation, and oral alcohol receipt might each exert control over alcohol seeking and drinking. We also determined the relationship between ingested dose and blood alcohol concentration, in order to validate the idea that the US is a post-ingestive action of alcohol. Finally, we tested a major prediction from the conditioning account of problematic drinking [Tomie, A., & Sharma, N. (2013). Current Drug Abuse Reviews, 6, 201-219], which is that once learned, responses elicited by a CS will promote drinking. We found that despite having constrained opportunities to drink alcohol during the conditioning procedure, ingested doses produced discriminable blood concentrations that supported cue conditioning. Based on our analysis of the dynamics of cue reactivity in well-trained rats, we found that houselight illumination triggered conditioned approach, sipper presentation evoked licking behavior, and alcohol receipt promoted drinking. Reactivity to these cues, which varied in terms of their temporal proximity to the alcohol US, persisted despite progressive intoxication or satiety. Additionally, rats with the greatest conditioned reactivity to the most distal alcohol cue were also the fastest to initiate drinking and drank the most. Our findings indicate that the post-ingestive effects of alcohol may condition multiple cues simultaneously in adult rats, and these multiple cues help to trigger alcohol seeking and drinking. Moreover, identification and characterization of these cues should be helpful for designing interventions that attenuate the power of these cues over behavior.

Daily associations between alcohol and sexual behavior in young adults

We tested within-person effects of alcohol on sexual behavior among young adults in a longitudinal burst design (N = 213, 6,487 days) using data collected from a previously published parent study. We differentiated effects of alcohol on likelihood of sexual activity versus use of protection against sexually transmitted diseases (STDs) or pregnancy on intercourse occasions by testing a multilevel multinomial model with 4 outcomes (no sex, oral sex without intercourse, protected intercourse, and unprotected intercourse). At the within-person level, effects of alcohol were hypothesized to be conditional upon level of intoxication (i.e., curvilinear effect). We also tested effects of four between-person moderators: gender, typical length of relationship with sexual partners, and two facets of self-control (effortful control and reactivity). Consistent with our hypothesis, low-level intoxication was associated with increased likelihood of engaging in oral sex or protected intercourse (relative to no sex) but was not related to likelihood of unprotected intercourse. The effect of intoxication on unprotected versus protected intercourse was an accelerating curve, significantly increasing likelihood of unprotected intercourse at high levels of intoxication. Between-person factors moderated associations between intoxication and sexual behavior. Effects of intoxication on both protected and unprotected intercourse were diminished for individuals with more familiar sexual partners. Effortful control exhibited a protective effect, reducing the effects of intoxication on likelihood of unprotected intercourse. Hypothesized effects of reactivity were not supported. Intoxication was a stronger predictor of oral sex and protected intercourse (but not unprotected intercourse) for women relative to men. Results highlight the inherent complexities of the alcohol-sexual behavior nexus. (PsycINFO Database Record

Dynamics of Metabolism and Decision Making During Alcohol Consumption: Modeling and Analysis

Heavy alcohol consumption is considered an important public health issue in the United States as over 88 000 people die every year from alcohol-related causes. Research is being conducted to understand the etiology of alcohol consumption and to develop strategies to decrease high-risk consumption and its consequences, but there are still important gaps in determining the main factors that influence the consumption behaviors throughout the drinking event. There is a need for methodologies that allow us not only to identify such factors but also to have a comprehensive understanding of how they are connected and how they affect the dynamical evolution of a drinking event. In this paper, we use previous empirical findings from laboratory and field studies to build a mathematical model of the blood alcohol concentration dynamics in individuals that are in drinking events. We characterize these dynamics as the result of the interaction between a decision-making system and the metabolic process for alcohol. We provide a model of the metabolic process for arbitrary alcohol intake patterns and a characterization of the mechanisms that drive the decision-making process of a drinker during the drinking event. We use computational simulations and Lyapunov stability theory to analyze the effects of the parameters of the model on the blood alcohol concentration dynamics that are characterized. Also, we propose a methodology to inform the model using data collected in situ and to make estimations that provide additional information to the analysis. We show how this model allows us to analyze and predict previously observed behaviors, to design new approaches for the collection of data that improves the construction of the model, and help with the design of interventions.

Examining the social ecology of a bar-crawl: An exploratory pilot study

Many of the problems associated with alcohol occur after a single drinking event (e.g. drink driving, assault). These acute alcohol problems have a huge global impact and account for a large percentage of unintentional and intentional injuries in the world. Nonetheless, alcohol research and preventive interventions rarely focus on drinking at the event-level since drinking events are complex, dynamic, and methodologically challenging to observe. This exploratory study provides an example of how event-level data may be collected, analyzed, and interpreted. The drinking behavior of twenty undergraduate students enrolled at a large Midwestern public university was observed during a single bar crawl event that is organized by students annually. Alcohol use was monitored with transdermal alcohol devices coupled with ecological momentary assessments and geospatial data. “Small N, Big Data” studies have the potential to advance health behavior theory and to guide real-time interventions. However, such studies generate large amounts of within subject data that can be challenging to analyze and present. This study examined how to visually display event-level data and also explored the relationship between some basic indicators and alcohol consumption.

Individual, interpersonal, and contextual factors associated with discrepancies between intended and actual spring break drinking

The purpose of the present paper was to examine the extent to which college students underestimate the quantity of alcohol they will consume during Spring Break (SB), and whether individual, interpersonal, and contextual factors may be related to underestimation of SB drinking and drinking consequences. College students participated in web-based surveys prior to and after SB (N=603; 57% women). Overall, results indicated that individual factors (being male, being a member of a fraternity or sorority, previously experiencing more alcohol-related consequences, and intending to drink less during SB), interpersonal factors (reporting friends encourage getting drunk), and contextual factors (going on a SB trip with friends and receiving drinks from others) predicted underestimating peak drinks consumed during SB. Underestimating the peak number of drinks to be consumed on SB was associated with experiencing a greater number of alcohol-related consequences. Targeted interventions designed specifically to focus on underestimation of college student drinking and the impact of SB contextual and interpersonal factors may be an important area of study to reduce negative consequences of alcohol use during SB.

Predictors of breath alcohol concentrations in college parties

Background

Alcohol use and subsequent consequences are harmful for individual college students. Other students and the university can also be negatively impacted by the consequences of alcohol use.

Method

A field-based study was used to assess the alcohol use environment at college parties. Researchers replicated a previous study by driving and walking a route to identify parties primarily on Thursday, Friday, and Saturday evenings between 9:00 PM and 1:00 AM across an academic year. Parties were randomly sampled. Hosts were asked for permission to enter the party at each sampled location. A census of partygoers was attempted at each party. Participants were asked to complete a brief survey and give a breath sample. All participants were recruited into a follow-up survey. Bivariate and multivariate analyses of individual-level and party-level factors associated with intoxication are presented.

Results

The research team identified 29 parties: 16 were approached, and 12 were surveyed. Overall, 112 participants were surveyed for a response rate of approximately 28.7% of partygoers. Controlling for demographic characteristics, consumption of shots of liquor/spirits was significantly associated with a five times greater risk for intoxication. Notably, drinking games were protective of breath alcohol concentration (BrAC) risk in this model. Individuals who reported engaging in drinking games were 74% less likely to report a BrAC above the U.S. legal limit, while controlling for underage drinking in the model. Several party characteristics were identified that increased overall BrAC at the parties, including whether the party was themed, if it was a Greek life party, and whether there were illicit drugs present. Notably, when intoxication is examined by gender and party theme, women are significantly more likely to be intoxicated at themed parties: 75% were above 0.08 at themed parties compared to 35% above 0.08 at non-themed parties.

Conclusions

Field-based data collection methods can, and should, be modified to conduct needs assessment and evaluation of prevention programs on college campuses. The findings on this campus were different than the originally sampled campus. Prevention programs should target unique risks identified on each campus, and to respond to problematic party behaviors with comprehensive programming rather than policy-level bans.

Drinking with mixed-gender groups is associated with heavy weekend drinking among young adults

AIMS

To investigate how gender composition of the drinking group affects young adults' alcohol consumption on weekend evenings over and above the effect of drinking-group size.

DESIGN

Using the internet-based cellphone-optimized assessment technique (ICAT), participants completed online questionnaires on their cell phones every hour from 8 p.m. to midnight on Thursday, Friday and Saturday evenings during five consecutive weekends.

SETTING

French-speaking Switzerland.

PARTICIPANTS

Convenience sample of 183 young adults (53.0% female, mean age = 23.1) who completed a total of 4141 hourly assessments.

MEASUREMENTS

Alcohol consumption and number of male and female friends present assessed at 8 p.m., 9 p.m., 10 p.m., 11 p.m. and midnight.

FINDINGS

Results of three-level negative binomial regression analyses showed that women consumed significantly more drinks per hour when drinking in mixed-gender groups (Z-values ranging from 2.9 to 5.3, all P < 0.01) and significantly fewer drinks when drinking with men only (Z = -2.7, P < 0.01), compared with drinking with women only. Men reported consuming more drinks per hour in mixed-gender groups of equal gender composition (Z = 2.4, P < 0.05) or mixed-gender groups with men in the majority (Z = 2.2, P < 0.05) and fewer hourly drinks when drinking with women only (Z = -4.9, P < 0.001), compared with drinking with men only. Drinking-group size predicted the hourly number of drinks for women (Z = 6.0, P < 0.001) and men (Z = 5.5, P < 0.001).

CONCLUSIONS

Drinking-group gender composition is associated with number of drinks consumed per hour, over and above the impact of the drinking-group size. Young adults report consuming more drinks per hour when drinking with mixed-gender groups than with same-gender groups.

Postretrieval Extinction Attenuates Alcohol Cue Reactivity in Rats

BACKGROUND

Conditioned responses to alcohol-associated cues can hinder recovery from alcohol use disorder (AUD). Cue exposure (extinction) therapy (CET) can reduce reactivity to alcohol cues, but its efficacy is limited by phenomena such as spontaneous recovery and reinstatement that can cause a return of conditioned responding after extinction. Using a preclinical model of alcohol cue reactivity in rats, we evaluated whether the efficacy of alcohol CET could be improved by conducting CET during the memory reconsolidation window after retrieval of cue-alcohol associations.

METHODS

Rats were provided with intermittent access to unsweetened alcohol. Rats were then trained to predict alcohol access based on a visual cue. Next, rats were treated with either standard extinction (n = 14) or postretrieval extinction (n = 13). Rats were then tested for long-term memory of extinction and susceptibility to spontaneous recovery and reinstatement.

RESULTS

Despite equivalent extinction, rats treated with postretrieval extinction exhibited reduced spontaneous recovery and reinstatement relative to rats treated with standard extinction.

CONCLUSIONS

Postretrieval CET shows promise for persistently attenuating the risk to relapse posed by alcohol cues in individuals with AUD.

Subjective alcohol responses in a cross-sectional, field-based study of adolescents and young adults: Effects of age, drinking level, and dependence/consequences

BACKGROUND

Adolescents are physically, cognitively, socially, and emotionally different than adults in ways that may partially explain why alcohol misuse typically develops during this period. Ample animal-science evidence and nascent ecological evidence points toward developmentally limited differences in sensitivity to alcohol's stimulatory and sedative effects. Field-based research methods were used to test for such age-related differences in a sample of adolescents through young adults. Potential moderating influences of estimated blood alcohol content (eBAC), as well as typical consumption and level of dependence/consequences were explored.

METHODS

Subjective alcohol responses were collected from 1,364 participants, aged 17 to 32 years, recruited outside of venues where drinking takes place in a small metropolitan bar district.

RESULTS

Self-reports of stimulatory response to alcohol were age-related, such that younger participants reported increased subjective stimulation at the time of data collection relative to older participants. Age-related differences in stimulatory responses were more pronounced at lower eBACs and among younger participants who typically drank more heavily. Stimulatory responses generally diminished among older than younger participants, although individuals with greater dependence/consequences consistently reported greater stimulation from drinking. Contrastingly, age, typical consumption, and dependence/consequences were not related to sedation in this sample.

CONCLUSIONS

This research provides cross-sectional evidence to support age-, consumption-, and dependence/consequences-related differences in stimulatory alcohol responses among adolescents and young adults assessed within a bar-area context. While cross-sectional, the results of this field-based study provide support for the theory that addiction liability is developmentally linked and associated, in part, with age-related differences in subjective alcohol responses.

Modeling and Analysis of Group Dynamics in Alcohol-Consumption Environments

High-risk drinking is considered a major concern in public health, being the third leading preventable cause of death in the United States. Several studies have been conducted to understand the etiology of high-risk drinking and to design prevention strategies to reduce unhealthy alcohol-consumption and related problems, but there are still major gaps in identifying and investigating the key components that affect the consumption patterns during the drinking event. There is a need to develop tools for the design of methodologies to not only identify such dangerous patterns but also to determine how their dynamics impact the event. In this paper, based on current empirical evidence and observations of drinking events, we model a human group that is in an alcohol-consumption scenario as a dynamical system whose behavior is driven by the interplay between the environment, the network of interactions between the individuals, and their personal motivations and characteristics. We show how this mathematical model complements empirical research in this area by allowing us to analyze, simulate, and predict the drinking group behaviors, to improve the methodologies for field data collection, and to design interventions. Through simulations and Lyapunov stability theory, we provide a computational and mathematical analysis of the impact of the model parameters on the predicted dynamics of the drinking group at the drinking event level. Also, we show how the dynamical model can be informed using data collected in situ and to generate information that can complement the analysis.

Sexually Selected Sex Differences in Competitiveness Explain Sex Differences in Changes in Drinking Game Participation

Drinking games are a risk factor for behavioral and health problems among university students. Previous cross-sectional research by Hone, Carter, and McCullough (2013) replicated well-established sex differences in drinking game behaviors (i.e., that men are more active drinking game participants than are women) and university drinking problems more generally. Hone et al. (2013) also found that these male-specific behavioral patterns are attributable in part to the fact that men's generally unrestricted sexual strategies, plus their social competitiveness, motivate them to participate in drinking games to display their fortitude and compete with same-sex rivals. Here, the authors conducted a study to evaluate with greater causal rigor whether sex differences in sexual restrictedness and social competitiveness—and sex differences in motivations for participating in drinking games in particular—are partially responsible for the sex differences in university students' drinking game behaviors and drinking problems. Sex differences in changes in frequency of drinking game participation were partially mediated by competitive motivations for participating in drinking games and by the effects of social competitiveness on competitive drinking game motivation. These findings lend additional support to the proposition that participation in drinking games is motivated in part by their suitability as a venue for sexual competition in university students' day-to-day lives.

A Multilevel Study of Students in Vietnam: Drinking Motives and Drinking Context as Predictors of Alcohol Consumption

BACKGROUND

This study used multi-level analysis to estimate which type of factor explains most of the variance in alcohol consumption of Vietnamese students.

METHODS

Data were collected among 6011 students attending 12 universities/faculties in four provinces in Vietnam. The three most recent drinking occasions were investigated per student, resulting in 12,795 drinking occasions among 4265 drinkers. Students reported on 10 aspects of the drinking context per drinking occasion. A multi-level mixed-effects linear regression model was constructed in which aspects of drinking context composed the first level; the age of students and four drinking motives comprised the second level. The dependent variable was the number of drinks.

RESULTS

Of the aspects of context, drinking duration had the strongest association with alcohol consumption while, at the individual level, coping motive had the strongest association. The drinking context characteristics explained more variance than the individual characteristics in alcohol intake per occasion.

CONCLUSIONS

These findings suggest that, among students in Vietnam, the drinking context explains a larger proportion of the variance in alcohol consumption than the drinking motives. Therefore, measures that reduce the availability of alcohol in specific drinking situations are an essential part of an effective prevention policy.

Interactions Between Drinking Motives and Friends in Predicting Young Adults' Alcohol Use

While drinking motives are well-established proximal predictors of alcohol use, less is known about their role in event-level drinking behavior. The present study examines whether the interaction between individuals' drinking motives and the number of friends present at a given moment can predict alcohol consumption over the course of the evening. Using the Internet-based cell phone-optimized assessment technique (ICAT), 183 young adults (53.0 % female, mean age = 23.1) in French-speaking Switzerland completed cell phone questionnaires every Thursday, Friday, and Saturday evening over five weekends. A total of 7205 questionnaires completed on 1441 evenings were analyzed. Drinking motives and gender were assessed at baseline, while the hourly alcohol consumption rate and number of friends present were assessed at 8 p.m., 9 p.m., 10 p.m., 11 p.m., and midnight. Multilevel growth curve models with time-invariant and time-varying covariates were estimated for men and women separately. Among women, enhancement motives were associated with an increase in the hourly alcohol consumption rate over the course of the evening (b = .025; p < .05). The impact of the number of friends present on the hourly consumption rate was stronger among those women who scored high on coping motives at baseline (b = .028; p < .05). Among men, drinking motives were found to have no moderating effects. Results highlight the role of drinking motives and their interactions with situational characteristics in determining event-level drinking, especially among women. Strategies to prevent risky weekend drinking should focus on both the social environment in which drinking takes place (e.g., the drinking group) and individual drinking motives.

Day-to-day variations in high-intensity drinking, expectancies, and positive and negative alcohol-related consequences

High-intensity drinking (i.e., women/men consuming 8+/10+ drinks in a day) is prevalent and associated with negative consequences. Occasions of high-intensity drinking have markedly high risk; however, previous research has not examined the predictors of these high-risk drinking days. The current study was designed to examine to what extent positive and negative alcohol expectancies predict high-intensity drinking and whether high-intensity drinking on a given day was associated with drinking consequences and their evaluations that day. Frequently drinking college students (N=342) participated in an intensive longitudinal study of drinking behaviors (N=4645 drinking days). Days with greater positive and negative expectancies were associated with high-intensity drinking. Days with high-intensity drinking were associated with reporting more positive and negative consequences and with evaluating positive consequences more favorably and evaluating negative consequences less favorably, compared to drinking days without high-intensity drinking. Given this, prevention and intervention efforts may consider specifically targeting high-intensity drinking events as a unique phenomenon.

Lifetime nonmedical use of prescription medications and socioeconomic status among young adults in the United States

BACKGROUND

Despite decreases in the use of illicit drugs in the United States, prescription medications have become a major category of substances used by young adults.

OBJECTIVE

This study examines the relationship between the socioeconomic status (SES) of young adult respondents (ages 24-32) and their history of nonmedical use of prescription medications (NUPM).

METHOD

A secondary analysis was conducted with nationally representative data gathered from several waves (n = 15 701) of the National Longitudinal Study of Adolescent Health (Add Health). Four categories of NUPM were examined: (i) sedatives; (ii) tranquilizers; (iii) stimulants; and (iv) pain killers. SES was defined by several measures in the Add Health survey. Given the complex sampling plan of the Add Health, all analyses were weighted appropriately.

RESULTS

Results indicated higher levels of personal SES, such as having health insurance or not experiencing a financial hardship in the past year, decreased the likelihood of reporting lifetime NUPM. In contrast higher levels of parent SES (e.g. parental education) were associated with an increased likelihood of reporting lifetime use of NUPM tranquilizers and stimulants.

CONCLUSIONS

The results of this study suggest parental SES may have a stronger influence over NUPM than personal levels of SES, particularly for the categories of tranquilizers and stimulants. Furthermore, these findings indicate more research is needed on this subject to better understand the NUPM epidemic in order to effectively develop comprehensive clinical, public health, and policy-related intervention and prevention approaches.

Party Characteristics, Drinking Settings, and College Students' Risk of Intoxication: A Multi-Campus Study

We examined party characteristics across different college drinking settings, associations between party characteristics and likelihood of drinking to intoxication, and the mediating role of perceived prevalence of intoxicated partygoers. Students (N = 6903) attending 14 public universities in California during the 2010 and 2011 fall semesters completed surveys on individual and party characteristics in six unique settings (e.g., residence hall). We used descriptive statistics to examine party characteristics by setting. We estimated multilevel logistic regression models to identify party characteristics associated with drinking to intoxication, and we used RMediation to determine significance of mediating effects. Individual and party characteristics varied by drinking context. Greater time at a party was associated with drinking to intoxication at five of six settings, while larger party size was significant only for outdoor settings. Enforcing the legal drinking age and refusing to serve intoxicated patrons were associated with lower likelihood of intoxication at Greek and off-campus parties. The presence of a keg was associated with drinking to intoxication at Greek, off-campus and outdoor parties; at bars, cover charges and drink promotions were positively associated with drinking to intoxication. In four of six settings, we found evidence of significant mediating effects through perceived prevalence of intoxicated partygoers. Findings highlight risk and protective characteristics of parties by drinking setting, and have prevention implications.

Towards the development of laboratory methods for studying drinking games: initial findings, methodological considerations, and future directions

BACKGROUND

Drinking games are prevalent among college students and are associated with increased alcohol use and negative alcohol-related consequences. There has been substantial growth in research on drinking games. However, the majority of published studies rely on retrospective self-reports of behavior and very few studies have made use of laboratory procedures to systematically observe drinking game behavior.

OBJECTIVES

The current paper draws on the authors' experiences designing and implementing methods for the study of drinking games in the laboratory.

RESULTS

The paper addressed the following key design features: (a) drinking game selection; (b) beverage selection; (c) standardizing game play; (d) selection of dependent and independent variables; and (e) creating a realistic drinking game environment.

CONCLUSIONS

The goal of this methodological review paper is to encourage other researchers to pursue laboratory research on drinking game behavior. Use of laboratory-based methodologies will facilitate a better understanding of the dynamics of risky drinking and inform prevention and intervention efforts.

'Wide-awake drunkenness'? Investigating the association between alcohol intoxication and stimulant use in the night-time economy

AIMS

We tested whether patrons of the night-time economy who had co-consumed energy drinks or illicit stimulants with alcohol had higher blood alcohol concentration (BAC) levels than patrons who had consumed only alcohol.

DESIGN

Street intercept surveys (n = 4227) were undertaken between 9 p.m. and 5 a.m. over a period of 7 months.

SETTING

Interviews were undertaken with patrons walking through entertainment precincts, queuing to enter venues or exiting venues in five Australian cities.

PARTICIPANTS

The response rate was 92.1%; more than half the study sample was male (60.2%) and the median age was 23 years (range 18-72).

MEASUREMENTS

Data were collected on demographics, length of drinking session, venue types visited, types and quantity of alcohol consumed and other substance use. A BAC reading was recorded and a subsample of participants was tested for other drug use.

FINDINGS

Compared with the total sample (0.068%), illicit stimulant consumers (0.080%; P = 0.004) and energy drink consumers (0.074%; P < 0.001) had a significantly higher median BAC reading, and were more likely to engage in pre-drinking (65.6, 82.1 and 77.6%, respectively, P < 0.001) and longer drinking sessions (4, 5 and 4.5 hours, respectively, P < 0.001). However, stimulant use was not associated independently with higher BAC in the final multivariable model (illicit stimulants P = 0.198; energy drinks P = 0.112). Interaction analyses showed that stimulant users had a higher BAC in the initial stages of the drinking session, but not after 4-6 hours.

CONCLUSIONS

While stimulant use does not predict BAC in and of itself, stimulants users are more likely to engage in prolonged sessions of heavy alcohol consumption and a range of risk-taking behaviours on a night out, which may explain higher levels of BAC among stimulants users, at least in the initial stages of the drinking session.

Predictors of at-risk intoxication in a university field setting: social anxiety, demographics, and intentions

OBJECTIVE

The determinants of alcohol consumption among university students were investigated in a downtown field setting with blood alcohol content (BAC) as the dependent variable.

PARTICIPANTS

In total, 521 participants completed a brief survey and had their BAC assessed during April 2013.

METHODS

Between 10:00 pm and 2:00 am, teams of researchers recruited passersby at 3 heavy-drinking locations near a university campus. Before the BAC assessment, participants completed a questionnaire regarding their drinking intentions, drinking group, and social anxiety.

RESULTS

The average BAC of drinking students was 0.107 g/dL, which was 0.033 g/dL higher than their intended BAC. Males and members of a Greek-life organization consumed significantly more alcohol than their demographic counterparts. A significant positive curvilinear relationship was observed between social anxiety and BAC.

CONCLUSIONS

University students achieve high levels of intoxication, often exceeding their intended BAC. Social anxiety may be an informative predictor of alcohol consumption in this setting.

Diagnostic accuracy study of three alcohol breathalysers marketed for sale to the public

OBJECTIVES

To assess the diagnostic accuracy of three personal breathalyser devices available for sale to the public marketed to test safety to drive after drinking alcohol.

DESIGN

Prospective comparative diagnostic accuracy study comparing two single-use breathalysers and one digital multiuse breathalyser (index tests) to a police breathalyser (reference test).

SETTING

Establishments licensed to serve alcohol in a UK city.

PARTICIPANTS

Of 222 participants recruited, 208 were included in the main analysis. Participants were eligible if they were 18 years old or over, had consumed alcohol and were not intending to drive within the following 6 h.

OUTCOME MEASURES

Sensitivity and specificity of the breathalysers for the detection of being at or over the UK legal driving limit (35 µg/100 mL breath alcohol concentration).

RESULTS

18% of participants (38/208) were at or over the UK driving limit according to the police breathalyser. The digital multiuse breathalyser had a sensitivity of 89.5% (95% CI 75.9% to 95.8%) and a specificity of 64.1% (95% CI 56.6% to 71.0%). The single-use breathalysers had a sensitivity of 94.7% (95% CI 75.4% to 99.1%) and 26.3% (95% CI 11.8% to 48.8%), and a specificity of 50.6% (95% CI 40.4% to 60.7%) and 97.5% (95% CI 91.4% to 99.3%), respectively. Self-reported alcohol consumption threshold of 5 UK units or fewer had a higher sensitivity than all personal breathalysers.

CONCLUSIONS

One alcohol breathalyser had sensitivity of 26%, corresponding to false reassurance for approximately three people in four who are over the limit by the reference standard, at least on the evening of drinking alcohol. The other devices tested had 90% sensitivity or higher. All estimates were subject to uncertainty. There is no clearly defined minimum sensitivity for this safety-critical application. We conclude that current regulatory frameworks do not ensure high sensitivity for these devices marketed to consumers for a decision with potentially catastrophic consequences.

Not just fun and games: a review of college drinking games research from 2004 to 2013

Drinking games are a high-risk social drinking activity consisting of rules and guidelines that determine when and how much to drink (Polizzotto et al., 2007). Borsari's (2004) seminal review paper on drinking games in the college environment succinctly captured the published literature as of February 2004. However, research on college drinking games has grown exponentially during the last decade, necessitating an updated review of the literature. This review provides an in-depth summary and synthesis of current drinking games research (e.g., characteristics of drinking games, and behavioral, demographic, social, and psychological influences on participation) and suggests several promising areas for future drinking games research. This review is intended to foster a better understanding of drinking game behaviors among college students and improve efforts to reduce the negative impact of this practice on college campuses.

The relationship between group size, intoxication and continuing to drink after bar attendance

OBJECTIVE

The present study was undertaken to explore multilevel determinants of planning to continue to drink alcohol after leaving public drinking events. We assessed whether individual-level factors, group-related factors, or event-level bar characteristics were associated with post-bar drinking.

METHOD

We recruited a total of 642 participants from 30 participating bars in urban Southern California. Groups who arrived to patron a bar were interviewed upon their entrance and exit. Given data nesting, we employed a multilevel modeling approach to data analysis.

RESULTS

More than one-third (40%) of our sample reported the intention to continue drinking as they exited the bar. Results of our multilevel model indicated eight individual-level variables significantly associated with intending to continue to drink. Time of night moderated the relationship between BrAC change and intentions to continue to drink. Although none of the group factors were significant in our model, a significant cross-level interaction between BrAC change and number of group members indicated the effect of intoxication on planning to continue to drink increases as group members increase. At the bar level, the presence of temporary bars and server offers of non-alcoholic drinks significantly decreased intentions to continue to drink.

CONCLUSIONS

Given the large percentage of participants who reported the intention to continue drinking after exiting a bar, this study draws attention to the fact that field studies of drinking behavior may assess drinking mid-event rather than at the end of a drinking event.

The Role of Context-Specific Norms and Group Size in Alcohol Consumption and Compliance Drinking During Natural Drinking Events

Using experience sampling methods we examined how group size and context-specific drinking norms corresponded to alcohol consumption and compliance with drinking offers during natural social drinking events. For 30 days, 397 college students reported daily on their alcohol consumption during social events, the size of the group they were with, the average alcohol consumption of its' members, and the number of drinks they accepted that came directly from the group they were with during these social drinking events. Larger groups corresponded with greater alcohol consumption, but only when context-specific norms were high. Furthermore, larger groups increased compliance with drinking offers when context-specific norms were high, but decreased compliance with drinking offers when context-specific norms were low. Thus, subtle features of the social-context may influence not only overall consumption behavior, but also compliance with more overt forms of social influence.

Integrating field methodology and web-based data collection to assess the reliability of the Alcohol Use Disorders Identification Test (AUDIT)

Field methodologies offer a unique opportunity to collect ecologically valid data on alcohol use and its associated problems within natural drinking environments. However, limitations in follow-up data collection methods have left unanswered questions regarding the psychometric properties of field-based measures. The aim of the current study is to evaluate the reliability of self-report data collected in a naturally occurring environment - as indexed by the Alcohol Use Disorders Identification Test (AUDIT) - compared to self-report data obtained through an innovative web-based follow-up procedure. Individuals recruited outside of bars (N=170; mean age=21; range 18-32) provided a BAC sample and completed a self-administered survey packet that included the AUDIT. BAC feedback was provided anonymously through a dedicated web page. Upon sign in, follow-up participants (n=89; 52%) were again asked to complete the AUDIT before receiving their BAC feedback. Reliability analyses demonstrated that AUDIT scores - both continuous and dichotomized at the standard cut-point - were stable across field- and web-based administrations. These results suggest that self-report data obtained from acutely intoxicated individuals in naturally occurring environments are reliable when compared to web-based data obtained after a brief follow-up interval. Furthermore, the results demonstrate the feasibility, utility, and potential of integrating field methods and web-based data collection procedures.

Drinking plans and drinking outcomes: examining young adults' weekend drinking behavior

This study examined relationships among drinking intentions, environments, and outcomes in a random sample of 566 undergraduate college students. Telephone interviews were conducted with respondents before and after a single weekend assessing drinking intentions for the coming weekend related to subsequent drinking behaviors. Latent class analyses found evidence for four distinct drinking environments distinguished by private/public setting and presence of few/many intoxicated people. There was evidence that the drinking environment mediated the relationship between drinking intentions and heavy episodic drinking in this young adult sample. Future research might focus on examining person/environment interactions as they relate to heavy episodic drinking.

No fear, just relax and play: social anxiety, alcohol expectancies, and drinking games among college students

OBJECTIVE

The authors examined the association between social anxiety and drinking game (DG) involvement as well as the moderating role of social anxiety-relevant alcohol outcome expectancies (AOE) in social anxiety and DG involvement among college students.

PARTICIPANTS

Participants were 715 students (74.8% women, Mage = 19.46, SD = 1.22) from 8 US colleges.

METHODS

Data were collected via self-report survey from Fall 2005 to Spring 2007.

RESULTS

Tension Reduction and Liquid Courage AOE moderated the association between social anxiety and DG participation. Tension Reduction AOE and DG participation were positively related among those with high social anxiety, but were associated negatively for those with low social anxiety. Liquid Courage AOE were associated with increased DG participation for those with low social anxiety, but not for those with high social anxiety.

CONCLUSIONS

Findings suggest that social anxiety acts as a protective or a risk factor for DG participation among college students, depending upon AOE.

Drinking game participation among undergraduate students attending National Alcohol Screening Day

OBJECTIVES, PARTICIPANTS, METHODS: Drinking game participation has increased in popularity among college students and is associated with increased alcohol consumption and alcohol-related problems. The current study investigated drinking game participation among 133 undergraduates attending National Alcohol Screening Day (NASD) in April of 2007.

RESULTS

A large percentage of the sample reported lifetime (77%) and recent (52%) drinking game participation. Males were more likely to report recent participation and reported higher levels of consumption while playing drinking games. Drinking game participants were more likely to experience a range of alcohol-related problems, and the relationship between drinking game participation and alcohol-related problems was mediated by weekly alcohol consumption.

CONCLUSIONS

These results suggest that drinking game participation is a risk factor for elevated levels of alcohol consumption and alcohol-related problems. Programs should be developed to educate students about the risks of drinking game participation, and prevention programs like NASD should address drinking games.

Blood alcohol concentrations among bar patrons: A multi-level study of drinking behavior

This paper presents data from a study that collected observational data, survey data, and breath samples to estimate blood alcohol concentrations (BrAC) from patrons attending 30 bars. The study examines: (1) drinking behavior and settings prior to going to a bar; (2) characteristics of the bar where respondents are drinking; (3) person and environmental predictors of BrAC change (entrance to exit). Purposive sampling of bars that cater to young adults gave a sample of 30 bars. Patrons were randomly selected from bars (n=839). Approximately half of the sample was female (48.7%). Nearly three-quarters of participants reported drinking before attending the bar. Serving practices of the bars were observed; majority of bars served excessive amounts of alcohol in short periods of time. On average, those who drank before attending the bar had BrACs at approximately half the legal limit. Implications for responsible beverage service coupled with law enforcement strategies are discussed.

Event-specific analyses of poly-drug abuse and concomitant risk behavior in a college bar district in Florida

OBJECTIVE

The authors describe the epidemiology of risk behavior associated with poly-drug use in a college bar district of a large campus community.

PARTICIPANTS

A total of 469 bar patrons participated in the study.

METHODS

The authors used self-report data and biological measures collected from patrons outside bars in July and August of 2007.

RESULTS

The mean breath alcohol concentration of the exiting patrons was 0.09. Illicit and prescription drug use on the nights of data collection and in the recent past were significant features of the profile of patron risk behavior. About one-quarter of the patrons using only alcohol reported an intention to drive a vehicle within 60 minutes of leaving an establishment, compared with almost one-half of those using both alcohol and marijuana.

CONCLUSIONS

A substantial amount of high-risk behavior was generated from the bar district on 4 typical nights. College bar districts should be a priority focus for prevention efforts.

Three exploratory studies of college theme parties

INTRODUCTION AND AIMS

The objectives of this exploratory research were to (1) explore the characteristics and risks associated with college theme parties, (2) assess differences in risk associated with college theme parties compared to non-theme parties and (3) to assess differences in risk associated with risqué theme parties as compared to non-risqué theme parties.

DESIGN AND METHODS

We used a mixed methods design. Results are presented from three exploratory studies of alcohol consumption in college theme parties: (1) four qualitative focus groups of students who have attended such events, (2) a web-based survey and (3) a multi-level (observational, survey, breath blood alcohol samples) study of 226 college parties, 29 of which were themed events. Focus group participants included a convenience sample of 17 college students aged 18-24 years; participants for the web survey included a convenience sample of 407 college students; participants for the multi-level study of college parties included 1725 randomly selected individuals at college parties.

RESULTS

Themes tended to be highly sexualized. Compared to non-themed parties, theme parties have been observed to be more rowdy, louder, involve drinking games, feature kegs and feature hard liquor.

DISCUSSION AND CONCLUSIONS

Themed parties are associated with heavy drinking and are consistent with environments sought by heavy drinkers. As a result, themed parties are marked by a greater number of alcohol-related problems. Further research is needed to understand more clearly the risks involved in themed and risqué themed events.