Changes in undergraduate student alcohol consumption as they progress through university

Are health behaviors associated with academic performance among tertiary education students? A systematic review of cohort studies

OBJECTIVE

To evaluate the association between health behaviors with academic performance among tertiary education students.

METHODS

Six databases were searched until July 2020 for prospective cohort studies evaluating the association between health behavior(s) (dietary intake, physical activity, sedentary behavior, alcohol intake, sleep, smoking or illicit drug use) and academic performance.

RESULTS

Thirty-four studies were included (18 assessed sleep, 16 alcohol intake, 12 illicit drug use, 10 physical activity, 8 diet, 4 smoking, 2 sedentary behavior). A consistent negative association with academic performance was demonstrated for sleep (12/18 studies), alcohol intake (13/16) and illicit drug use (9/12). Most (7/10) studies found no association between physical activity and academic performance.

CONCLUSION

Findings suggest interventions to mitigate the influence of poor sleep, high alcohol intake, and illicit drug use on academic performance may be needed. Further research of other health behaviors, along with their co-occurrence, with academic performance, is required.

Comparing self-affirmation manipulations to reduce alcohol consumption in university students

Objective: Self-affirmation theory proposes that defensive processing prevents people from accepting health-risk messages, which may explain university students' dismissal of risk-information about binge drinking. SA-interventions may encourage non-biased processing of such information through impacting on interpersonal feelings and self-esteem. This study compared two self-affirmation manipulations on interpersonal feelings, self-esteem, message processing, message acceptance and subsequent alcohol consumption.Participants: UK university students (N = 454).Methods: Participants were randomly allocated to one of three conditions (Self-affirmation Implementation Intention, Kindness Questionnaire, Control) before reading health-risk information about binge drinking. This was followed by measures of interpersonal feelings, self-esteem, message processing, acceptance and behavioral intentions. Alcohol consumption was assessed one week later.Results: The self-affirmation manipulations had non-significant effects on all outcome variables.Conclusion: Consistent with previous research, the results indicate that self-affirmation interventions are not effective for reducing alcohol consumption in university students.

Student drinking cultures in tertiary education residential accommodation: A contextual research study

Background: In Australia, harmful drinking among students aged 18-24 years in tertiary education residential accommodation (TRA) remains high, placing students at higher risk of harms than non-TRA and university peers. Aim: The aim of this study was to identify the context-specific factors distinctive to TRAs that supported a heavy drinking culture among students. Conducted across three sites in Melbourne, Australia, the purpose of the study was to inform the development of context-specific harm reduction interventions for these sites. Methods: Five focus groups were conducted with 32 students to examine their lived experience of drinking within the distinctive environments of their TRAs. The data were examined using thematic data analysis. Results: Three themes were identified: (1) routine drinking in TRAs; (2) drinking for social inclusion in the TRA; and (3) TRA alcohol governance and students' self-regulation. The data show that factors contributing to these TRA drinking cultures included: liberty to store alcohol and drink on campus; freshers' belief that admission to the TRA was conditional on "partying hard"; students' belief that staff supported the TRA drinking culture; and poor dissemination and operationalisation of TRA alcohol policy. Collectively, these factors fostered an environment that enabled frequent and heavy alcohol consumption among residents. Conclusions: The TRA drinking cultures were supported by social and regulatory factors specific to these institutions and, in particular, by a liberal approach to TRA alcohol governance and poorly disseminated alcohol policy that made widespread heavy drinking possible. Drinking cultures in TRAs can be changed through appropriate interventions that include nuanced policy and effective governance.

Factors associated with changing alcohol consumption during the first UK lockdown

Background

In response to COVID-19 there have been lockdowns and restrictions to hospitality services. Drinking behaviours often change in response to traumatic events and changes in the drinking environment, and this is influenced by a range of factors. This study explores self-reported changes in alcohol consumption in the third month of the UK lockdown, associations with socio-demographics factors and with COVID-19-related concerns, and mental health and wellbeing.

Methods

The COVID-19 Psychological Wellbeing Study was a longitudinal, online, three-wave survey of 1958 UK adults. Data were collected during the first UK lockdown; wave 1 launched 23 March 2020, wave 2 was 1 month after and wave 3 2 months after completion of wave 1A hierarchical multinomial regression model was estimated to investigate factors associated with changes in perceived alcohol consumption in the third month of the lockdown.

Results

The majority of participants reported changes in drinking (62%) with over one-third indicating increased consumption. Student status and worries about the financial implications of COVID-19 were associated with lower odds of decreased alcohol consumption. Those with above average income and those with children in the household had lower odds of increased alcohol consumption, while younger adults had higher odds of increased alcohol consumption.

Conclusions

This study adds to the growing body of research showing changes in alcohol consumption behaviours during the COVID-19 lockdown restrictions, and identifies risk and protective factors which can aid in targeting intervention at those most in need of support.

Patterns of Alcohol Consumption and Use of Health Services in Spanish University Students: UniHcos Project

The aim of the study was to examine the association of alcohol consumption patterns (hazardous alcohol use and binge drinking) and the use of emergency services and primary care consultations in university students. An observational, descriptive, cross-sectional study was conducted at eleven Spanish universities collaborating within the uniHcos Project. University students completed an online questionnaire that assessed hazardous alcohol use and binge drinking using the AUDIT questionnaire and evaluated the use of emergency services and primary care. A descriptive analysis of the data was performed, as well as the chi-squared test and Student’s t-test and nonconditional logistic regression models to examine this association. Results: There were 10,167 participants who completed the questionnaire. The prevalence of hazardous alcohol use was 16.9% (95% CI: 16.2−17.6), while the prevalence of binge drinking was 48.8% (95% CI: 47.9−49.8). There were significant differences in the use of emergency services in those surveyed with hazardous alcohol use (p < 0.001) or binge drinking pattern (p < 0.001). However, no significant differences were observed in terms of attendance during primary care visits in individuals with hazardous alcohol use (p = 0.367) or binge drinking pattern (p = 0.755). The current study shows the association between university students with a pattern of hazardous alcohol use or binge drinking and greater use of emergency services. However, no significant association was observed between the said consumption patterns and the use of primary care services.

"If You Don't Drink at University, You're Going to Struggle to Make Friends" Prospective Students' Perceptions around Alcohol Use at Universities in the United Kingdom

BACKGROUND

New students arrive at university with pre-determined perceptions around how alcohol can be used as a tool to overcome anxieties and secure new friendships, which in turn influences students' drinking behaviors. From a health promotion perspective, the transition to university may present a unique yet understudied opportunity to challenge and reframe situated drinking norms. This paper explores prospective university students' perceptions of the role that alcohol plays at university and the influence that these perceptions have on behavior.

METHOD

Focus groups with 46 prospective university students (aged 16-20 years) recruited from colleges and sixth forms in the North West of England.

RESULTS

Through various sources of information, new students arrive at university with pre-conceived perceptions of a heavy student drinking culture and knowledge around how alcohol can be used to aid successful integration with new peers. Alcohol was viewed by new students as a social lubricant which is key to accruing social capital. Cultural presentations of the student drinker identity led prospective students to formulate negative connotations of those students who transgress from the norms of drinking.

CONCLUSIONS

The findings provide new insights into how young people conceptualize alcohol at university and the impact that these perceptions have on shaping ideology and influencing drinking behavior. Breaking down these norms presents real challenges for those trying to address excessive drinking in universities, therefore, early intervention which challenges, re-frames and modifies perceptions before students arrive on campus may help to reduce the pressure and expectations to drink in social situations.

Risk factors for hazardous drinking in university students from South Africa and Belgium: a cross-cultural comparison study

Background

Previous studies have associated certain risk factors with hazardous drinking in students. However, big cultural and geographical differences exist regarding alcohol use.

Objectives

To determine whether or not there was a difference in hazardous drinking between Belgian and South African university students and to establish the risk factors that contribute to hazardous drinking in university students (calculated using the AUDIT-C) from a developing country (South Africa) and a developed country (Belgium).

Methods

An online survey assessing hazardous drinking among university students in South Africa (University of KwaZulu-Natal, UKZN) and Belgium (University of Antwerp, UoA) was conducted, using the shortened version of the Alcohol Use Disorder Identification Test (AUDIT-C). Risk factors in males and females for hazardous drinking were explored using multivariate logistic regression analysis.

Results

In total, 499 students were included in the study (250 UoA and 249 UKZN students). A significant higher amount of male (94.8%) as well as female (92.4%) UoA students drank alcohol in the last year compared to the male (66.2%) and female (67.8%) UKZN students (p<0.001). Additionally, a significant higher amount of UoA students were hazardous drinkers, compared to the UKZN students (p<0.001). Multivaiate analysis showed that male UoA students were almost 6 times more likely to be hazardous drinkers than male UKZN students (OR=5.611, p=0.005). Female UoA students were more than twice as likely to be hazardous drinkers than female UKZN students (OR=2.371, p=0.016).

Conclusion

This study found a significant difference in hazardous drinking between Belgian and South African university students.

Adolescent Behavioral Characteristics Mediate Familial Effects on Alcohol Use and Problems in College-Bound Students

BACKGROUND

Studies suggest a broad spectrum of behaviors associated with drinking. Consequently, it is unclear whether patterns of familial risk for psychopathology are directly or indirectly related to patterns of alcohol use and problems in late adolescence or mediated by behavioral characteristics, such as temperament, mood.

OBJECTIVES

We examined direct and indirect effects of perceived family history of psychopathology on pre-collegiate alcohol use and problems via the Transmissible Liability Index (TLI).

METHODS

Participants (N = 302; 29.6% male) provided self-report data on age of onset of drinking, past 90-day frequency of alcohol use and problems (AUP), family history of internalizing and alcohol and illicit substance use, and TLI.

RESULTS

Approximately 21% of participants reported having at least one relative with a history of regular and/or problematic alcohol use, compared to 12% for illicit substance use, and -55% for internalizing problems. Higher TLI scores were associated with increased family history of substance use, alcohol use, and internalizing problems, as well as earlier age of onset of drinking. Family history of internalizing problems was the most robust indicator of AUP (β = 0.20 [95% CI = 0.04-0.36], P = .01). Path analyses suggested that the individual-level behaviors that comprise TLI mediate the effects of family history on age of initiation and regular alcohol consumption.

CONCLUSIONS

Family history of internalizing, drinking, and illicit substance use reflect generalized risk for a broad set of behaviors associated with risk for alcohol initiation and use during the transition from high school to college.

ELSA 2014 Cohort: Risk Factors Associated With Heavy Episodic Drinking Trajectories in Argentinean College Students

Heavy episodic drinking (HED) is highly prevalent in college students. In Argentina, there is a notable lack of longitudinal studies examining drinking trajectories. The present study identified HED trajectories in Argentinean college students during the first 3 years of college (seven waves) and examined the association between risk factors for alcohol use and HED trajectories. The sample was composed of 1,240 college students [63.1% women, aged 18–25 years (M = 19.1 ± 1.7)] who completed at least three waves (the first data collection and ≥2 follow-ups). For 3 years, participants completed seven surveys that measured HED frequency, age of drinking onset, drunkenness occurrence, trait impulsivity, family history of alcohol abuse, stressful life events, and perceived peer’s drinking. Latent Class Growth Analysis (LCGA) and Multinomial Logistic Regression (MLR) were used to identify the pattern and number of HED trajectories and to explore which risk factors better distinguished between the trajectories, respectively. Six HED trajectories were identified: Heavy Stable Frequency, Moderate Stable Frequency, Moderate Decreasing Frequency, Stable Infrequent, Decreasing Infrequent, and No-HED. Younger age of drinking onset, alcohol intoxication, greater perception of peer drinking frequency and higher levels of impulsivity (i.e., sensation seeking, lack of premeditation, and positive urgency) increased the probability of belonging to the trajectories with more frequent HED. These trajectories partially coincide with those identified in studies from other cultures. Unlike previous studies, we did not find a trajectory with increasing/ascending HED frequency. This may be related to contextual/cultural variables unique to Argentina, like differences in the age when the peak in alcohol consumption is reached or the legal minimum age to buy alcoholic beverages in this country, and the idiosyncratic elements that characterize college life in Argentina. This work represents a step forward in the identification of risk factors differentiating between different HED trajectories, and help understand changes in alcohol use during college, in an understudied population.

Relationship between Alcohol Consumption and Drinking Refusal Self-Efficacy among University Students: The Roles of Sports Type and Gender

The present study examines the relationship between drinking behaviour and drinking refusal self-efficacy among university students, with a focus on the influential roles of sports type and gender. A total of 354 students from Seoul National University of Science and Technology volunteered and participated in this study. The Korean Alcohol Use Disorders Identification Test (AUDIT-K), the Korean Drinking Refusal Self-Efficacy (DRSE) Questionnaire-Revised, and a questionnaire measuring participation in sports activities were administered to measure students’ alcohol drinking behaviours, refusal self-efficacy and sport-related activities, respectively. The data were analysed using descriptive statistics, two-way ANOVAs, correlation analysis, and regression analysis. The subdomains of DRSE had significant influences on binge drinking. Specifically, low DRSE in situations involving social pressure played a key role in predicting increased binge drinking. There was also a significant relationship between sports type and drinking behaviour, but only for male students. Those who participated in individual sports binge drank less than those who participated in team sports. Finally, gender differences were also revealed in drinking behaviour. Male students were more likely to binge drink compared to their female counterparts. This study offers a foundation for practical interventions to help control problematic drinking behaviour among university students.

Population Attributable Fraction of Early Age of Onset of Alcohol Use in Alcohol Abuse and Dependence: A 3-Year Follow-Up Study in University Students

BACKGROUND

we aimed to determine the risk factors and associated population attributable fractions (PAFs) for the age of onset of alcohol use and also to identify protective factors.

METHODS

we analyzed follow-up data collected between autumn 2011 and spring 2016 (n = 5170) from the first two cohorts (2011, 2012) of the Spit for ScienceTM project. The dependent variables were alcohol abuse and dependence, and the independent variables were age of drinking onset, residence, ethnicity, religiosity, sexual orientation and work status. We determined the odds ratios (OR) using multilevel logistic regression for repeated measures in SPSSv.20.

RESULTS

the early onset of alcohol use was associated with an increased risk of alcohol abuse and dependence among females (OR = 14.98; OR = 11.83) and males (OR = 7.41; OR = 6.24). The PAFs for the early onset of alcohol use in alcohol abuse and dependence were respectively 80.9% and 71.7% in females and 71.0% and 63.5% in males. Among females, being white (OR = 1.58; OR = 1.51), living off-campus (OR = 1.73; OR = 2.76) and working full-time (OR = 1.69; OR = 1.78) were also risk factors. Strong religious beliefs were found to protect males from alcohol abuse (OR = 0.58), while same-gender sexual orientation increased the risk among females (OR = 2.09).

CONCLUSION

delaying the age of onset by one year would reduce alcohol abuse among young adults.

Alcohol Consumption, Drinking Patterns, and Cognitive Performance in Young Adults: A Cross-Sectional and Longitudinal Analysis

Long-term alcohol abuse is associated with poorer cognitive performance. However, the associations between light and moderate drinking and cognitive performance are less clear. We assessed this association via cross-sectional and longitudinal analyses in a sample of 702 Dutch students. At baseline, alcohol consumption was assessed using questionnaires and ecological momentary assessment (EMA) across four weeks (‘Wave 1’). Subsequently, cognitive performance, including memory, planning, and reasoning, was assessed at home using six standard cognition tests presented through an online platform. A year later, 436 students completed the four weeks of EMA and online cognitive testing (‘Wave 2’). In both waves, there was no association between alcohol consumption and cognitive performance. Further, alcohol consumption during Wave 1 was not related to cognitive performance at Wave 2. In addition, EMA-data-based drinking patterns, which varied widely between persons but were relatively consistent over time within persons, were also not associated with cognitive performance. Post-hoc analyses of cognitive performance revealed higher within-person variance scores (from Wave 1 to Wave 2) than between-person variance scores (both Wave 1 and Wave 2). In conclusion, no association was observed between alcohol consumption and cognitive performance in a large Dutch student sample. However, the online cognitive tests performed at home may not have been sensitive enough to pick up differences in cognitive performance associated with alcohol consumption.

Prevalence of alcohol consumption and related factors among students of higher education centers in one of the northeastern cities of Iran

Introduction

Knowing the prevalence and the factors associated with alcohol abuse among students can be an important step in initiating preventive measures. The purpose of this study was to determine the prevalence of alcohol consumption and its related factors in students of higher education centers in one of the northeastern cities of Iran in 2017.

Methods

This descriptive-analytical study was performed on 668 students from 7 higher education centers. The samples were selected by stratified random sampling. The valid researcher-made questionnaires were issued to the subjects, and were collected immediately after being filled out. The obtained data were analyzed using appropriate statistical tests.

Results

Ninety-two (13.77%) students had history of alcohol consumption, with 55.6% continued to drink alcohol. The mean age of the consumers was 23.92 years, of whom 77.41% were male, 75% were single, 55.43% were non-indigenous, and 74.46% had history of smoking. 81.52% of the subjects were undergraduates, while 36.95% studied mathematics and engineering. There was a significant relationship between alcohol consumption and age, gender, GPA, being non-indigenous, personal residence, smoking, history of alcohol consumption in family and friends, satisfaction with academic major and city in which they study (p < 0.05).

Conclusion

The findings showed that alcohol consumption was relatively high in students of higher education centers and many variables (ten out of fifteen studied variables) were involved in this process. Therefore, careful planning and serious measures are needed to prevent this problem.

Is Involvement a Good Thing? The Undesirable Consequences of Topical and Conversational Involvement in the Context of Alcohol Consumption

Whereas there is evidence that interpersonal communication, or conversation, influences predictors of alcohol consumption, the role of involvement in conversation effects remains unclear. This study explored how three aspects of involvement (topical relevance, or how relevant the topic of alcohol is; conversational relevance, or how relevant a conversation about alcohol is; and conversational effort, or how much effort people put into such a conversation), influence conversation effects. After assessing topical relevance, 46 same-sex dyads were requested to talk about the negative consequences of heavy drinking. Within each dyad, one participant was asked to take on an active talking role and the other participant a passive listening role. Next, conversational relevance, effort, and predictors of heavy drinking were measured. Results showed that participants who drank more alcohol found the topic of heavy drinking more relevant. This topical relevance increased conversational relevance and conversational effort. Conversational effort further increased when a talking role was assigned. Furthermore, participants who put more effort in the conversation and found it more relevant had more positive norms, identified more strongly with alcohol, and had higher intentions to drink. These findings suggest that more involvement in an alcohol-related conversation does not always lead to desirable outcomes.

The Impact of History of Aggression and Alcohol Use on Aggressive: Responding in the Laboratory

The current study examines how different levels of past aggression combined with self-reported levels of alcohol use impacted lab-based aggressive responding. Data were collected from 160 male undergraduate college students. Participants completed online measures of drinking (Alcohol Use Disorders Identification Test) and past aggression (Buss Perry Aggression Questionnaire) prior to a lab session assessing aggressive responding [Point Subtraction Aggression Paradigm (PSAP)]. Regression analyses revealed participants with “high” levels of past alcohol use and a history of “high” aggression were more likely to respond aggressively on the PSAP, a trend primarily driven by those with a history of physical aggression. For proactively aggressive participants, the risk for aggressive responding is greater in individuals with a history of physically aggressive behavior as they report higher alcohol use, relative to those “low” in past aggression. The interaction of alcohol use and past aggression was associated with continued aggressive behavior.

'A Healthy CIT': An Investigation into Student Health Metrics, Lifestyle Behaviours and the Predictors of Positive Mental Health in an Irish Higher Education Setting

Higher Education Institutions (HEIs) are potent health promotion settings, uniquely positioned to aid societal efforts to combat non-communicable diseases (NCDs). International evidence suggests that health metrics and lifestyle behaviours of higher education students are sub-optimal, yet a dearth of contemporary Irish data exists. This study aimed to examine sex differences in student lifestyle behaviours and identify significant predictors of positive mental health in an Irish HEI setting. An online questionnaire instrument distributed to all registered students (n = 11,261) gathered data regarding a multitude of health and lifestyle domains. Many items were adapted from previous Irish research. Further validated scales included the Alcohol Use Disorders Identification Test (AUDIT), Mental-Health Index 5 (MHI-5) and the Energy and Vitality Index (EVI). Self-reported height/body mass were also recorded. In total, 2267 responses were analysed (51.7% female, 48.3% male). Both sexes demonstrated poor sleeping patterns, hazardous drinking and sub-optimal fruit and vegetable intake. The calculated prevalence of overweight/obesity was 38.2%. Both sexes underestimated obesity. Males underestimated and females overestimated overweight. Males displayed riskier behavioural patterns with regard to illicit substances, drinking, and sexual partners. Females reported greater psychological distress. Multivariate linear regression identified 8 variables as predictors of positive mental health, accounting for 37% of the variance in EVI scores. In conclusion, HEI students would benefit from sex-specific multi-level health promotion initiatives to remove macro-level barriers to healthier lifestyles.

Alcohol consumption among university students in the night-time economy in the UK: A three-wave longitudinal study

BACKGROUND

Excessive alcohol consumption is commonly reported in university/college students, and contributes to emerging peer-group relations.

PURPOSE

This study aimed to provide up-to-date longitudinal data on students' alcohol consumption patterns, and predictors of this, across a single academic year.

METHODS

A 3-wave study was conducted at a university in the UK. Participants reported their alcohol consumption patterns, along with perceptions of the social norms and behavioral expectations associated with attending licensed venues where alcohol is sold (the "night time economy"). Participants also reported their social identification with this environment.

RESULTS

Around half of participants overall fell into the three higher alcohol-risk categories (moderate, high or hazardous drinking). A modest reduction in consumption was observed across the study. At each assessment point, males reported greater alcohol consumption in the preceding two months than females, while Year 4 students and those on graduate-entry programs reported the lowest consumption. Excessive alcohol consumption was regarded as largely normative within the night time economy, both descriptively ("what others do") and injunctively ("what others approve of"). Social identification and norm perceptions, along with gender, year group, and intoxication and socialising expectations, were significantly associated with higher alcohol consumption at baseline. However, baseline consumption was the only variable significantly associated with alcohol use at the end of the academic year.

CONCLUSIONS

Many students drink alcohol at potentially harmful levels, and norms and expectations supporting this consumption are prominent and stable. The findings support a targeted approach to intervention that accounts for heterogeneity in the student population.

Assessing Heavy Episodic Drinking: A Random Survey of 18 to 34-Year-Olds in Four Cities in Four Different Continents

Background: Heavy episodic drinking (HED) can have health and social consequences. This study assesses the associations between HED and demographic, socioeconomic, motivation and effects indicators for people aged 18–34 years old living in four cities in different regions of the world. Method: Multistage random sampling was consistent across the four cities (Ilorin (Nigeria), Wuhan (China), Montevideo (Uruguay) and Moscow (Russia)). The questionnaire was forward/back translated and face-to-face interviewing was undertaken. A total of 6235 interviews were undertaken in 2014. Separate univariable and multivariable modelling was undertaken to determine the best predictors of HED. Results: HED prevalence was 9.0%. The best predictors differed for each city. The higher probability of HED in the final models included beliefs that they have reached adulthood, feeling relaxed as an effect of drinking alcohol, and forgetting problems as an effect of drinking alcohol. Lower probability of HED was associated with not being interested in alcohol as a reason for limiting alcohol, and the belief that drinking alcohol is too expensive or a waste of money. Conclusion: Although some indicators were common across the four cities, the variables included in the final models predominantly differed from city to city. The need for country-specific prevention and early intervention programs are warranted.

DRUG CONSUMPTION, KNOWLEDGE ON THE CONSEQUENCES OF CONSUMPTION AND ACADEMIC PERFORMANCE AMONG COLLEGE STUDENTS IN SAN SALVADOR, EL SALVADOR

ABSTRACT Objective: determine the relationship among drug consumption, knowledge on the consequences of consumption and academic performance, for alcohol cocaine and marijuana, among undergraduate students of social sciences and health of San Salvador, El Salvador. Method: the used method was a cross-sectional survey, with a convenience sample of 250 university students. A modified version of the combination of two instruments was applied evaluating the variables for the knowledge on the consequences, pursuing the knowledge of a student about the adverse effects of the biological, psychological and social categories related to consumption of the drugs under study. Drug consumption was evaluated by consulting the student whether or not they used drugs at any time or in the last 3 months. Academic performance was evaluated by consulting students on the average in which they are applied on a scale of 1 to 10. Results: the results showed that 88.1% of the survey participants have a broad knowledge on the consequences of consuming alcoholic beverages; 45.5% on the consequences of marijuana use and 55.7% know the consequences of cocaine consumption. While 28.4% have consumed alcohol in the last year, 6.5% have consumed marijuana and 1.7% cocaine. The relationship of alcohol consumption with the knowledge on each of the consequences reflected a very low influence, while the larger is the knowledge obtained from these consequences caused by the use of the drugs under study, the lower is the consumption. Conclusion: the use of alcohol, cocaine and marijuana is not related to academic performance, indicating very low positive and negative correlations according to each case.

Trends in alcohol use among young people according to the pattern of consumption on starting university: A 9-year follow-up study

AIM

To identify differences in Risky Consumption (RC) and Binge drinking (BD) trends in students who already followed these patterns of alcohol consumption on starting university and those who did not, and also to try to understand what leads students to engage in these types of behaviour at university.

MATERIAL AND METHODS

Cohort study among university students in Spain (n = 1382). BD and RC were measured with the Alcohol Use Disorders Identification Test at ages 18, 20, 22, 24 and 27 years. Multilevel logistic regression for repeated measures was used to calculate the adjusted Odds Ratios (ORs).

RESULTS

The prevalence rates of RC and BD were lower throughout the study in students who did not follow these patterns of consumption at age 18. For RC and BD, the differences at age 27 years, expressed as percentage points (pp), were respectively 24 pp and 15 pp in women and 29 pp and 25 pp in men. Early age of onset of alcohol use increased the risk of engaging in RC and BD patterns at university, for men (OR = 2.91 & 2.80) and women (OR = 8.14 & 5.53). The same was observed in students living away from the parental home for BD (OR = 3.43 for men & 1.77 for women). Only women were influenced by having positive expectancies for engaging in RC (OR = 1.82) and BD (OR = 1.96).

CONCLUSIONS

The prevalence rates of both RC and BD at age 27 years were much higher among university students who already followed these patterns of consumption at age 18 years, with the differences being proportionally higher among women. Focusing on the age of onset of alcohol consumption and hindering access to alcohol by minors should be priority objectives aimed at preventing students from engaging in these patterns of alcohol consumption at university.

Alcohol and other substance use among medical and law students at a UK university: a cross-sectional questionnaire survey

PURPOSE OF THE STUDY

To examine the use of alcohol and other substances among medical and law students at a UK university.

STUDY DESIGN

Anonymous cross-sectional questionnaire survey of first, second and final year medical and law students at a single UK university.

RESULTS

1242 of 1577 (78.8%) eligible students completed the questionnaire. Over half of first and second year medical students (first year 53.1%, second year 59.7%, final year 35.9%) had an Alcohol Use Disorders Identification Test (AUDIT) score suggestive of an alcohol use disorder (AUDIT≥8), compared with over two-thirds of first and second year law students (first year 67.2%, second year 69.5%, final year 47.3%). Approximately one-quarter of medical students (first year 26.4%, second year 28.4%, final year 23.7%) and over one-third of first and second year law students (first year 39.1%, second year 42.4%, final year 18.9%) reported other substance use within the past year. Over one-third of medical students (first year 34.4%, second year 35.6%, final year 46.3%) and approximately half or more of law students (first year 47.2%, second year 52.7%, final year 59.5%) had a Hospital Anxiety and Depression Scale anxiety score suggestive of a possible anxiety disorder.

CONCLUSIONS

Study participants had high levels of substance misuse and anxiety. Some students' fitness to practice may be impaired as a result of their substance misuse or symptoms of psychological distress. Further efforts are needed to reduce substance misuse and to improve the mental well-being of students.

Perceived determinants to alcohol consumption and misuse: a survey of university students

Aim:

Before an attempt is made to develop any population-specific behavioural change programme, it is important to know what the factors that influence behaviours are. The aim of this study was to identify what are the perceived determinants that attribute to young people’s choices to both consume and misuse alcohol.

Method:

Using a descriptive survey design, a web-based questionnaire based on the Theory of Triadic Influence was administered to students aged 18–29 years at one university in Northern Ireland.

Results:

Out of the total respondents ( n = 595), knowledge scores on alcohol consumption and the health risks associated with heavy episodic drinking were high (92.4%, n = 550). Over half (54.1%, n = 322) cited the Internet as their main source for alcohol-related information. The three most perceived influential factors of inclination to misuse alcohol were strains/conflict within the family home ( M = 2.98, standard deviation ( SD) = 0.18, 98.7%, n = 587), risk taking/curiosity behaviour ( M = 2.97, SD = 0.27, 97.3%, n = 579) and the desire not to be socially alienated ( M = 2.94, SD = 0.33, 96%, n = 571). Females were statistically significantly more likely to be influenced by desire not to be socially alienated than males (  p = .029). Religion and personal reasons were the most commonly cited reasons for not drinking.

Conclusion:

Future initiatives to reduce alcohol misuse and alcohol-related harms need to focus on changing social normative beliefs and attitudes around alcohol consumption and the family and environmental factors that influence the choice of young adult’s alcohol drinking behaviour. Investment in multi-component interventions may be a useful approach.

Heavy episodic drinking and alcohol-related injuries: An open cohort study among college students

AIM

The objective of this study is to assess the effects of Heavy Episodic Drinking (HED) on the incidence of alcohol-related injuries among university students in Spain, taking sex into consideration.

METHODS

We carried out an open cohort study among college students in Spain (992 women and 371 men). HED and alcohol-related injuries were measured by question 3rd and 9th of Alcohol Use Disorders Identification Test to every participant at the ages of 18, 20, 22, 24 and 27. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for alcohol and cannabis use.

RESULTS

The incidence rate of alcohol-related injuries was 0.028year^-1 for females and 0.036year^-1 for males. The multivariate analysis showed that among females a high frequency of HED and use of cannabis are risk factors for alcohol-related injuries (Odds Ratio [OR]=2.64 and OR=3.68), while being more than 23 is a protective factor (OR=0.34). For males, bivariate analysis also showed HED like risk factor (OR=4.69 and OR=2.51). Finally, the population attributable fraction for HED among females was 37.12%.

CONCLUSIONS

HED leads to an increase of alcohol-related injuries in both sexes and being over 23 years old acts as a protective factor among women. Our results suggest that about one third of alcohol-related injuries among women could be avoided by removing HED.

Risky drinking among Norwegian students: Associations with participation in the introductory week, academic performance and alcohol-related attitudes

Aims

Substantial increase in heavy drinking upon transition from high school to college is common. Norwegian universities and university colleges arrange yearly introductory weeks to welcome new students. It has been questioned whether these events are too centered on alcohol. We aimed to investigate whether participation in the introductory week is associated with risky drinking (RD). We further aimed to investigate whether RD is associated with academic performance. Finally, we investigated whether alcohol-related attitudes are associated with both RD and introductory week participation.

Design

Data from the Norwegian study of students' health and well-being (SHoT, 2014, n=13,663) were used. The odds ratio (OR) of RD was calculated for individuals having participated in the introductory week compared to others. Different measures of academic performance (having failed exams, study progression and study-related self-efficacy (SRSE)) were compared between individuals reporting RD compared to others. The association between attitudes and participation in the event and RD was investigated.

Results

Individuals having participated in the introductory week are more likely to report RD (OR (95%CI) = 2.41 (2.12-2.74)). Individuals reporting RD report lower SRSE and are more likely to have failed exams more than once. Study progression is unassociated with RD. Liberal alcohol-related attitudes are associated with participation in the event and RD.

Conclusions

RD among students is associated with participation in the introductory week and with poorer academic performance. The university introductory week might be in danger of excluding individuals who do not drink much, or of promoting an unhealthy drinking culture among students.

Identifying Predictors and Prevalence of Alcohol Consumption among University Students: Nine Years of Follow-Up

AIM

To evaluate the prevalence of alcohol consumption among university students during late adolescence and young adulthood and to identify the associated factors.

MATERIAL AND METHODS

Cohort study among university students in Spain (n = 1382). Heavy Episodic Drinking (HED) and Risky Consumption (RC) were measured with the Alcohol Use Disorders Identification Test (AUDIT) at ages 18, 20, 22, 24 and 27 years. Data on potential factors associated with alcohol use were obtained with an additional questionnaire. Multilevel logistic regression for repeated measures was used to obtain adjusted OR (Odds Ratios).

RESULTS

The rates of prevalence of RC were lower, but not statistically significant, in women. The age-related changes in these rates were similar in both genders, and the prevalence of RC peaked at 20 years. By contrast, the prevalence of HED was significantly lower in women and peaked at 18 years in women and at 22 years in men. Multivariate models showed that early age of onset of alcohol use (OR = 10.6 and OR = 6.9 for women; OR = 8.3 and OR = 8.2 for men) and positive expectations about alcohol (OR = 7.8 and OR = 4.5 for women; OR = 3.6 and OR = 3.3 for men) were the most important risk factors for RC and HED. Living away from the family home was also a risk factor for both consumption patterns among women (OR = 3.16 and OR = 2.34), while a high maternal education level was a risk factor for RC among both genders (OR = 1.62 for women; OR = 2.49 for men).

CONCLUSIONS

Alcohol consumption decreases significantly at the end of youth, with higher rates of prevalence and a later peak among men. Prevention strategies should focus on beliefs and expectations about alcohol and on delaying the age of onset. Women are at particular risk for these consumption patterns if they live away from their parents. Belonging to a high-income family is a strong risk factor for RC.

Different pathways explain alcohol-related problems in female and male college students

OBJECTIVES

Comprehensive models elucidating the intricate associations of depressive symptoms, coping motives, alcohol use, alcohol-related problems (ARPs), and gender among young adults have been scarcely examined. This study investigated relationships among these variables and the effect of gender on these pathways.

METHODS

College students (N = 163; 49.7% female) completed self-report measures on alcohol consumption, depressive symptoms, coping motives, and ARPs.

RESULTS

Structural equation modeling showed that the association between depressive symptoms and ARPs was mediated by coping motives in both females and males. However, frequency of heavy alcohol use mediated the association between depressive symptoms and ARPs in females but not in males.

CONCLUSIONS

Different models explain the association between depressive symptoms and ARPs in male and female college students. Prevention programs aimed at reducing ARPs should focus on increasing alcohol screening among students with depressive symptoms, teaching coping skills, and emphasizing moderation in alcohol consumption.

Alcohol consumption among university students: a Sino-German comparison demonstrates a much lower consumption of alcohol in Chinese students

BACKGROUND

Alcohol use is reported in university students with discrepancy between countries. The study objectives were to assess prevalence and associated factors of alcohol consumption among university students in Germany and China.

METHODS

Data used were from 1853 Chinese and 3306 German university students. Alcohol consumption frequency was measured by a question "How often did you drink alcohol in the last three months?" with six possible responses, which were later collapsed into three categories of "At least once a week", "Less than once a week" and "Never". Problem drinking was measured by the CAGE test and defined as a CAGE score of two or more (four as the maximum). Simple and multivariable logistic regressions were used for association analyses.

RESULTS

German students reported more often "At least once a week" drinking (59.8 vs. 9.0 %). Among Germans, women drank less often "At least once a week" (OR = 0.40, 0.30-0.53). Among Chinese, a higher BMI was associated with drinking "At least once a week" (OR = 1.09, 1.02-1.18). Age revealed a positive association with "At least once a week" drinking in Chinese (1.33, 1.21-1.46) but a negative association in Germans (OR = 0.97, 0.94-0.99). Having a father with high educational level was positively related to "At least once a week" drinking in both countries (OR = 4.25, 2.67-6.78 for Chinese; OR = 1.32, 1.01-1.72 for Germans). Doing less than once a week physical exercise was negatively associated with "At least once a week" drinking in Chinese and German students (OR = 0.27, 0.15-0.48 for Chinese; OR = 0.69, 0.49-0.96 for Germans). Among the German students, 20.3 % reported problem drinking. Being a female (OR = 0.32, 0.26-0.40) and performing less than once a week physical activity (OR = 0.73, 0.56-0.95) were negatively associated with problem drinking, while having a father with high educational level (OR = 1.32, 1.09-1.60) and experiencing higher level of perceived stress (OR = 1.08, 1.04-1.13) were positively related to problem drinking.

CONCLUSIONS

Country-specific strategies for reducing alcohol consumption, e.g. educational awareness programmes of alcohol use on Chinese campuses and alcohol prevention schemes among German youth before entering university, are sensible.

Dyslexia and Substance Use in a University Undergraduate Population

BACKGROUND

A number of cognitive deficits are associated with dyslexia. However, only a limited amount of research has been performed exploring a putative link between dyslexia and substance use. As substance use is thought to involve a cognitive component, it is possible that the pattern of substance use would be different for dyslexic participants, when compared to nondyslexic controls. During the current study, a guiding hypothesis was that people with dyslexia would demonstrate less substance use than nondyslexic controls. Theories of memory activation, automaticity, and attentional bias in substance use suggest that cognitive components of substance use are important in the development and maintenance of continued substance use and it is thought that, at least some of these components, would be impaired in a dyslexic population.

OBJECTIVES

If the cognitive deficits displayed by dyslexics somehow impair the development of cognitive components of substance use, substance use for dyslexic participants may be less pronounced. This paper therefore examines this hypothesis by comparing substance use within dyslexic and nondyslexic participants, from an undergraduate population.

METHODS

This was an exploratory questionnaire-based study. Dyslexic participants (n = 35) were compared to control participants (n = 62) on a series of questions designed to measure their substance use history.

RESULTS

The results provided preliminary evidence of a difference between dyslexic and nondyslexic substance use. Dyslexics reported a substance use history that was significantly lower than nondyslexic controls.

CONCLUSIONS/IMPORTANCE

These results are interpreted in terms of cognitive deficits within dyslexia and with reference to the cognitive model of substance use.

Alcohol Brief Intervention in a university setting: A small-scale experimental study

Alcohol misuse among university students is commonplace. This study aimed to assess whether Alcohol Brief Intervention would be effective in reducing hazardous alcohol consumption in students compared to an alcohol information leaflet. Participants ( n = 125) assessed as higher risk drinkers using the Alcohol Use Disorders Identification Test Consumption were randomly assigned to receive an Alcohol Brief Intervention ( n = 67) or an information leaflet ( n = 58), with 82 (66%) completing a follow-up assessment. Alcohol consumption ( F(1, 80) = 14.52, p < 0.001) and the Alcohol Use Disorders Identification Test Consumption scores ( F(1, 80) = 23.63, p < 0.001) significantly decreased in both groups post-intervention; however, the groups did not significantly differ. Further research is recommended.

Impulsivity as a Multifaceted Construct Related to Excessive Drinking Among UK Students

AIMS

A substantial number of university students exceed alcohol guidelines. Impulsivity has been repeatedly implicated in heavy alcohol use, yet despite knowledge that impulsivity is multifaceted, there have previously been few studies applying multiple measures of self-report and behavioural impulsivity to examine the relationship with excessive student drinking. This results in a limited understanding of the relationship of various facets of impulsivity to student drinking.

METHODS

Participants completed a comprehensive battery of impulsivity measures: the Barratt Impulsiveness Scale as a self-report index and the Stop Signal Task, Information Sampling Task and Monetary Choice Questionnaire as behavioural measures of three facets of impulsivity. Participants who exceeded UK drinking guidelines were compared to those who did not on measures of impulsivity. Hierarchical linear regression was then employed to test whether indices of impulsivity were associated with the average units consumed per week.

RESULTS

Participants who exceeded UK guidelines reported increased impulsivity in facets of self-report impulsivity. They also displayed performance deficits in normal adjustment of Go responses on the Stop Signal Task. In the regression model, nonplanning impulsivity on the Barratt Impulsiveness Scale was seen to predict quantity of alcohol consumed per month.

CONCLUSIONS

The study applies a comprehensive selection of behavioural and self-report measures of impulsivity and indicates that excessive drinkers are more impulsive in some but not all aspects. The results indicate that the wide range of deficits apparent in alcohol-dependent individuals are not evident in this younger, heavy drinking population, but that specific performance and self-identified deficits are already apparent.

“Social Stuff” and Institutional Micro-Processes

The literature on alcohol consumption among university and residential college students in Australia and comparable countries shows a high incidence of heavy and/or frequent drinking. In this article, we report the findings from a study on alcohol consumption among undergraduate university students living in residential colleges in Australia. The aim of the study was to examine residents’ alcohol use as part of a broader set of institutional practices in higher education that are constructed as central to the student experience. The data were collected through in-depth semistructured interviews with 29 students from seven residential colleges. We found that inclusion of alcohol in many students’ social and extracurricular activities while residing in college is associated with heavy and/or frequent drinking. We suggest that the use of alcohol among students is shaped by the colleges’ institutional micro-processes, leading to a tension between college managements’ aim to foster alcohol citizenship and students’ liberty to engage in frequent and/or heavy drinking.

Drinking behavior and drinking refusal self-efficacy in Korean college students

The prevalence of drinking behavior and sex differences were examined. A possible relationship between drinking behavior and drinking refusal self-efficacy (DRSE) also was investigated among a convenience sample of 582 Korean college students (309 men, 273 women). A drinking habit scale (from AUDIT-K) and drinking refusal self-efficacy questionnaire (DRSEQ-R) were administered. Results indicated 74.4% of the students drank alcohol and 80.1% of the students were regular drinkers (> 2 to 4 times per month). There were significant differences in drinking behavior by sex and in the DRSE constructs for current drinking statuses. Drinking behavior was significantly associated with sex and DRSE. The present study offers more information about practical interventions aimed at reasonably controlling the drinking behavior of Korean college students in a university setting. The findings may provide better understanding of Korean students' drinking behavior.

[Data quality in surveys on alcohol consumption among university students]

Different survey modalities have been developed to assess alcohol consumption and related problems. Research that compares data quality between survey modalities is scarce in Latin America. The aim of this study was to assess data quality in three survey modalities on alcohol consumption: self-administered online, self-administered hard-copy, and face-to-face interviews. Data were obtained from three probabilistic samples of students (n = 60 each) from the National University of Mar del Plata, Argentina, using the same questionnaire. Data quality was measured for each modality by overall response rate, item response rate, and accuracy. Data accuracy was evaluated as the percentage of self-reported binge drinking, positive results on AUDIT, and internal consistency of AUDIT for each modality. The overall and item response rates were lower in the online modality and similar between the other two. No differences were found between modalities in the accuracy of responses.

The impact of alcohol on health-related quality of life in Belgrade University students

OBJECTIVE

The aim of this study was to assess alcohol drinking patterns and its influence on health-related quality of life (HRQoL) among the Belgrade University students.

METHODS

Between April and June, 2009, 1624 students were enrolled in the cross-sectional study. All participants in the study completed the questionnaire that comprised demographic data, as well as information referring to education, social status, lifetime residence, and habits. HRQoL was assessed by using SF-36 questionnaire and general depressive status by Beck Depression Inventory (BDI).

RESULTS

The occurrence of getting drunk on a yearly level had a statistically significant correlation with both SF-36 composite scores (ρ = -.048, p = .049 for Physical Composite Score (PCS), ρ = -.053, p = .038 for Mental Composite Score (MCS)) and the total score (ρ= -.057, p = .025). Those who were never getting drunk had statistically significantly higher scores for Social functioning and Mental health SF-36 as well as for MCS compared to students who were getting drunk on monthly and weekly basis. After adjustment for multiple testing, Social functioning domain and MCS remained statistically significant. The final models of hierarchical regression analysis demonstrated that gender, place of residence during high schooling, type of faculty, depression, chronic conditions, and alcohol consumption accounted 15.2% of the variance in PCS and 17.7% of the variance in MCS.

CONCLUSION

Information regarding drinking patterns and its influence on HRQoL in the Belgrade University students can help public health professionals, university administration, and local health care providers in developing appropriate prevention and treatment strategies.

Student drinking patterns and blood alcohol concentration on commercially organised pub crawls in the UK

BACKGROUND

Commercial student pub crawls are associated with high levels of alcohol consumption, and are of growing concern amongst public health and student bodies. However, little is currently known about drinking behaviours whilst participating in these events.

METHODS

A questionnaire was implemented amongst 227 students attending commercial pub crawls across three UK events. Questions established alcohol consumption patterns up to the point of interview and throughout the remaining night out, and pub crawl experience. Breathalyser tests were used to measure breath alcohol concentration (converted to blood alcohol concentration [BAC]) at interview. Analyses used chi squared, Mann-Whitney U, Kruskal-Wallis and logistic regression.

RESULTS

94.3% of participants had consumed alcohol, 90.9% of whom reported preloading. Drinkers reported consuming a median of 10.0 alcohol units (80g of pure alcohol) up to the point of interview (range one-40.6), with estimated total consumption over the evening exceeding 16units (range three-70.6). Median BAC of drinkers at the time of interview was 0.10%BAC (range 0.00-0.27). High BAC (>0.08%; at interview) was associated with having not eaten food in the four hours prior (AOR 4.8, p<0.01), time spent drinking (AOR 1.4, p<0.01) and number of units drank per hour (AOR 1.2, p<0.01).

CONCLUSIONS

Measures to prevent high levels of alcohol consumption before and during commercial pub crawls should aim to alter drinking behaviours such as preloading and rapid and excessive drinking. Organisers, local authorities, universities and students should all be involved in ensuring the effective management of pub crawls, including implementation of harm prevention measures.

Socio-demographic correlates of six indicators of alcohol consumption: survey findings of students across seven universities in England, Wales and Northern Ireland

Background

This study assessed the prevalence of six alcohol consumption indicators in a sample of university students. We also examined whether students’ sociodemographic and educational characteristics were associated with any of the six alcohol consumption indicators; and whether associations between students’ sociodemographic and educational characteristics and the six alcohol consumption indicators differed by gender.

Methods

A cross-sectional study of 3706 students enrolled at 7 universities in England, Wales and Northern Ireland. A self-administered questionnaire assessed six alcohol consumption measures: length of time of last (most recent) drinking occasion; amount consumed during last drinking occasion; frequency of alcohol consumption; heavy episodic drinking (≥ 5 drinks in a row); problem drinking; and possible alcohol dependence as measured by CAGE. The questionnaire also collected information on seven relevant student sociodemographic characteristics (age, gender, academic year of study, current living circumstances - accommodation with parents, whether student was in intimate relationship, socioeconomic status of parents - parental education, income sufficiency) and two academic achievement variables (importance of achieving good grades at university, and one’s academic performance in comparison with one’s peers).

Results

The majority of students (65% of females, 76% of males) reported heavy episodic drinking at least once within the last 2 weeks, and problem drinking was prevalent in 20% of females and 29% of males. Factors consistently positively associated with all six indicators of alcohol consumption were male gender and perceived insufficient income. Other factors such as living away from home, being in 1^st or 2^nd year of studies, having no intimate partner, and lower academic achievement were associated with some, but not all indicators of alcohol consumption.

Conclusions

The high level of alcohol consumption calls for regular/periodic monitoring of student use of alcohol, and for urgent preventive actions and intervention programmes at the universities in the UK.

The effectiveness of a Web-based personalized feedback and social norms alcohol intervention on United Kingdom university students: randomized controlled trial

Background

Alcohol consumption in the student population continues to be cause for concern. Building on the established evidence base for traditional brief interventions, interventions using the Internet as a mode of delivery are being developed. Published evidence of replication of initial findings and ongoing development and modification of Web-based personalized feedback interventions for student alcohol use is relatively rare. The current paper reports on the replication of the initial Unitcheck feasibility trial.

Objective

To evaluate the effectiveness of Unitcheck, a Web-based intervention that provides instant personalized feedback on alcohol consumption. It was hypothesized that use of Unitcheck would be associated with a reduction in alcohol consumption.

Methods

A randomized control trial with two arms (control=assessment only; intervention=fully automated personalized feedback delivered using a Web-based intervention). The intervention was available week 1 through to week 15. Students at a UK university who were completing a university-wide annual student union electronic survey were invited to participate in the current study. Participants (n=1618) were stratified by sex, age group, year of study, self-reported alcohol consumption, then randomly assigned to one of the two arms, and invited to participate in the current trial. Participants were not blind to allocation. In total, n=1478 (n=723 intervention, n=755 control) participants accepted the invitation. Of these, 70% were female, the age ranged from 17-50 years old, and 88% were white/white British. Data were collected electronically via two websites: one for each treatment arm. Participants completed assessments at weeks 1, 16, and 34. Assessment included CAGE, a 7-day retrospective drinking diary, and drinks consumed per drinking occasion.

Results

The regression model predicted a monitoring effect, with participants who completed assessments reducing alcohol consumption over the final week. Further reductions were predicted for those allocated to receive the intervention, and additional reductions were predicted as the number of visits to the intervention website increased.

Conclusions

Unitcheck can reduce the amount of alcohol consumed, and the reduction can be sustained in the medium term (ie, 19 weeks after intervention was withdrawn). The findings suggest self-monitoring is an active ingredient to Web-based personalized feedback.

An exploratory cluster randomised trial of a university halls of residence based social norms marketing campaign to reduce alcohol consumption among 1st year students

AIMS

This exploratory trial examines the feasibility of implementing a social norms marketing campaign to reduce student drinking in universities in Wales, and evaluating it using cluster randomised trial methodology.

METHODS

Fifty residence halls in 4 universities in Wales were randomly assigned to intervention or control arms. Web and paper surveys were distributed to students within these halls (n = 3800), assessing exposure/contamination, recall of and evaluative responses to intervention messages, perceived drinking norms and personal drinking behaviour. Measures included the Drinking Norms Rating Form, the Daily Drinking Questionnaire and AUDIT-C.

RESULTS

A response rate of 15% (n = 554) was achieved, varying substantially between sites. Intervention posters were seen by 80% and 43% of students in intervention and control halls respectively, with most remaining materials seen by a minority in both groups. Intervention messages were rated as credible and relevant by little more than half of students, though fewer felt they would influence their behaviour, with lighter drinkers more likely to perceive messages as credible. No differences in perceived norms were observed between intervention and control groups. Students reporting having seen intervention materials reported lower descriptive and injunctive norms than those who did not.

CONCLUSIONS

Attention is needed to enhancing exposure, credibility and perceived relevance of intervention messages, particularly among heavier drinkers, before definitive evaluation can be recommended. A definitive evaluation would need to consider how it would achieve sufficient response rates, whilst hall-level cluster randomisation appears subject to a significant degree of contamination.

TRIAL REGISTRATION

ISRCTN: ISRCTN48556384.

Adjusting for unrecorded consumption in survey and per capita sales data: quantification of impact on gender- and age-specific alcohol-attributable fractions for oral and pharyngeal cancers in Great Britain

AIMS

Large discrepancies are typically found between per capita alcohol consumption estimated via survey data compared with sales, excise or production figures. This may lead to significant inaccuracies when calculating levels of alcohol-attributable harms. Using British data, we demonstrate an approach to adjusting survey data to give more accurate estimates of per capita alcohol consumption.

METHODS

First, sales and survey data are adjusted to account for potential biases (e.g. self-pouring, under-sampled populations) using evidence from external data sources. Secondly, survey and sales data are aligned using different implementations of Rehm et al.'s method [in (2010) Statistical modeling of volume of alcohol exposure for epidemiological studies of population health: the US example. Pop Health Metrics 8, 1-12]. Thirdly, the impact of our approaches is tested by using our revised survey dataset to calculate alcohol-attributable fractions (AAFs) for oral and pharyngeal cancers.

RESULTS

British sales data under-estimate per capita consumption by 8%, primarily due to illicit alcohol. Adjustments to survey data increase per capita consumption estimates by 35%, primarily due to under-sampling of dependent drinkers and under-estimation of home-poured spirits volumes. Before aligning sales and survey data, the revised survey estimate remains 22% lower than the revised sales estimate. Revised AAFs for oral and pharyngeal cancers are substantially larger with our preferred method for aligning data sources, yielding increases in an AAF from the original survey dataset of 0.47-0.60 (males) and 0.28-0.35 (females).

CONCLUSION

It is possible to use external data sources to adjust survey data to reduce the under-estimation of alcohol consumption and then account for residual under-estimation using a statistical calibration technique. These revisions lead to markedly higher estimated levels of alcohol-attributable harm.

A randomized control trial: training program of university students as health promoters

BACKGROUND

Several studies have reported the following as determining factors for the adoption of healthy lifestyles among undergraduate students: gender, socioeconomic level, prior lifestyles, environment, parental lifestyles and health status, career choice, and healthy support networks. However, these factors are influenced by students' knowledge about healthy lifestyles.

METHODS/DESIGN

We will carry out a randomized trial in a sample of 280 new undergraduate students at the National Autonomous University of Mexico's Faculty of Higher Studies-Zaragoza (FES-Zaragoza, UNAM). There will be an experimental group (n = 140), comprising 20 students from each of the seven university departments (careers); these students will receive training as university student health promoters through an e-learning course. This course will allow the topics necessary for such promoters to be reviewed. There will be a control group (n = 140), comprising 20 students from each of the seven departments (careers); these students will not undergo the training. Later, the students who comply satisfactorily with the e-learning course will replicate the course to 10 of their classmates. A healthy-lifestyle questionnaire will be given to all the participants, and the parameters established in the self-care card will be recorded before and after the training. The study variables are as follows: (i) independent variable-compliance with the e-learning course; (ii) dependent variables-lifestyles changes prior to the educative intervention (including healthy eating, physical activity, and addiction prevention) and parameters related to health status established in self-care (including weight, body mass index, waist circumference, and hip circumference). Data will be analyzed using Student's t test and logistic regression analysis odds ratios with 95% confidence intervals. The analysis of the open answers will be carried out with ATLAS. ti 5.5 software.

DISCUSSION

Health promotion among university students should incorporate options that are feasible for and attractive to students. Thus, as proposed in the present protocol, e-learning courses offer excellent possibilities because they allow students to program their learning in their available time without affecting their academic studies.

TRIAL REGISTRATION

http://ISRCTN77787889.

‘Man up!’: Discursive constructions of non-drinkers among UK undergraduates

This study adopted a discursive approach to explore how not drinking alcohol (non-drinking) is construed in relation to masculine identity among 12 undergraduate interviewees. Three prominent discourses were revealed. First, non-drinking was constructed as something strange requiring explanation. Second, contradictory discourses constructed non-drinking as, simultaneously, unsociable yet reflective of greater sociability. Third, non-drinking was constructed as something which has greater negative social consequences for men than for women. Opportunities for challenging traditional gender role expectations are considered.