Normative misperceptions have been widely documented for alcohol use among U.S. college students. There is less research on other substances or European cultural contexts. This study explores which factors are associated with alcohol, tobacco and cannabis use misperceptions among French college students, focusing on substance use.
12 classes of second-year college students (n = 731) in sociology, medicine, nursing or foreign language estimated the proportion of tobacco, cannabis, alcohol use and heavy episodic drinking among their peers and reported their own use.
Peer substance use overestimation frequency was 84% for tobacco, 55% for cannabis, 37% for alcohol and 56% for heavy episodic drinking. Cannabis users (p = 0.006), alcohol (p = 0.003) and heavy episodic drinkers (p = 0.002), are more likely to overestimate the prevalence of use of these consumptions. Tobacco users are less likely to overestimate peer prevalence of smoking (p = 0.044). Women are more likely to overestimate tobacco (p < 0.001) and heavy episodic drinking (p = 0.007) prevalence. Students having already completed another substance use questionnaire were more likely to overestimate alcohol use prevalence (p = 0.012). Students exposed to cannabis prevention campaigns were more likely to overestimate cannabis (p = 0.018) and tobacco use (p = 0.022) prevalence. Other identified factors are class-level use prevalences and academic discipline.
Local interventions that focus on creating realistic perceptions of substance use prevalence could be considered for cannabis and alcohol prevention in French campuses.
Social norms for alcohol use are important influences on individual college student drinking. The present study extends social norms research by examining alcohol-related consequences and, in particular, whether similar misperceptions exist regarding the frequency and evaluation of these consequences over time. The associations between social norms and alcohol-related consequences are examined in the context of projection and conformity models. College student drinkers (N=624) participating in a longitudinal study completed web-based surveys assessing alcohol use and related consequences, as well as their beliefs about frequency and evaluation of consequences for the typical college student. Findings suggest that students overestimated how often typical college students experience negative consequences and underestimated how negative other students evaluated those consequences. Finally, results support a bidirectional model for alcohol-related consequences, possibly indicating a reciprocal, mutually influential feed-forward loop of norms and consequences that promotes maintenance of college student drinking and consequences.
alcohol-related problems; evaluations; descriptive and injunctive norms; conformity; projection; drinking consequences
Due to the emergence of research literature examining the prepartying behavior of college students, the present study examines students’ varying drinking rates, blood alcohol levels (BALs), and alcohol-related consequences during two drinking events – one involving prepartying and one devoid of prepartying. Two-hundred and thirty-eight student drinkers completed an online drinking assessment detailing their two most recent drinking occasions involving and not involving prepartying. Participants responded to a series of questions regarding quantities consumed on the drinking day and occurrence of alcohol-related consequences. While men did not differ in drinking or estimated BALs, between the two drinking days, female participants drank significantly more drinks and reached higher BALs on the prepartying drinking day. Both males and females reported increased experience of alcohol-related consequences on the prepartying drinking day. In analyzing the prepartying drinking day specifically, we found that while men drink more alcohol during prepartying, but both men and women reached similar BALs during the event. Also, mount consumed during prepartying related to further drinking throughout the evening.. It appears that prepartying may influence women to reach comparable levels of intoxication and alcohol-related consequences as their male peers. Quick drinking during prepartying may raise BAC levels and lead to alcohol-related consequences particularly for female students.
To examine country differences in reasons for abstaining including the association of reasons with country abstaining rate and drinking pattern.
Samples of men and women from eight countries participating in GENACIS (Gender Alcohol and Culture: an International Study).
Surveys were conducted with 3338 lifetime abstainers and 3105 former drinkers. Respondents selected all applicable reasons for not drinking from a provided list. Analyses included two-level HLM regression.
Reasons for abstaining differed significantly for lifetime abstainers compared to former drinkers, by gender and age, and by country-level abstaining rate and frequency of drinking. Lifetime abstainers were more likely than former drinkers to endorse no interest, religion and upbringing and more reasons overall. Gender differences, among former drinkers especially, suggested that norms restricting drinking may influence reasons that women abstain (no interest, not liking taste) while drinking experiences may be more important considerations for men (afraid of alcohol problems, bad effect on activities). Younger age was associated with normative reasons (no interest, taste, waste of money) and possibly bad experiences (afraid of problems). Reasons such as religion, waste of money and afraid of alcohol problems were associated with higher country-level rates of abstaining. Higher endorsement of drinking is bad for health and taste were associated with a country pattern of less frequent drinking while not liking effects was associated with higher drinking frequency.
Reasons for abstaining depend on type of abstainer, gender, age and country drinking norms and patterns.
alcohol; abstention; reasons; cross-cultural; gender
Previous research has shown that students overestimate the drinking of their peers, and that perceived norms are strongly associated with drinking behavior. Explanations for these findings have been based largely on cross-sectional data, precluding the ability to evaluate the stability of normative misperceptions or to disentangle the direction of influence between perceived norms and drinking. The present research was designed to evaluate (1) the stability of normative misperceptions and (2) temporal precedence of perceived norms and drinking.
Participants were college students (N = 164; 94 women) who completed assessments of perceived norms and reported behavior for drinking frequency and weekly quantity. Most participants (68%) completed the same measures again two months later.
Results indicated large and stable overestimations of peer drinking for frequency and weekly quantity. Results also showed that for weekly quantity, perceived norms predicted later drinking, but drinking also predicted later perceived norms. Results for frequency revealed perceived norms predicted later drinking, but drinking did not predict later perceived norms.
These findings underscore the importance of longitudinal designs in evaluating normative influences on drinking. The present findings suggest that normative misperceptions are stable, at least over a relatively short time period. Findings support a mutual influence model of the relationship between perceived norms and drinking quantity but are more strongly associated with conformity explanations for the relationship between perceived norms and drinking frequency. Results are discussed in terms of implications for prevention interventions.
This research evaluated a brief mailed intervention for alcohol use as an adjunct to a brief depression treatment for college students with depression symptoms. The intervention aimed to correct normative misperceptions and reduce students’ drinking and related consequences.
One hundred seventy seven college students (70% Female) with elevated scores on the Beck Depression Inventory were randomly assigned to intervention or control group. Participants in the intervention were mailed feedback and information detailing their reported alcohol use, moderation strategies, and accurate normative information regarding student drinking.
Results indicated no main effects of the intervention on drinking or related problems but students receiving feedback showed significant reductions in their perception of drinking norms compared to the control group. Furthermore, students whose normative perceptions reduced showed significant reductions in total drinks per week and total alcohol related problems compared to those whose norms did not reduce.
Results support the importance of correcting normative perceptions and provide direction for selective prevention of alcohol use and related problems among college students with depressed mood.
Alcohol; Norms; Selective Prevention; College Students
To estimate the prevalence of hazardous drinking and its socio-economic distribution among Russian men.
Participants were an age-stratified, population-based random sample of men aged 25–54 years living in Izhevsk, a city in the Urals, Russia. Interviewers administered questionnaires to cohabiting proxy respondents about behavioural indicators of hazardous drinking derived from frequency of hangover, frequency of drinking beverage spirits, episodes in the last year of extended periods of drunkenness during which the participant withdraws from normal life (zapoi), consumption of alcoholic substances not intended to be drunk (surrogates) and socio-economic position. Logistic regression was used to examine associations between socio-economic position and indicators of hazardous drinking in the past year.
Of 1750 men, 79% drank spirits and 8% drank surrogates at least sometimes in the past year; 25% drank spirits and 4% drank surrogates at least weekly and 10% had had an episode of zapoi in the past year. After adjustment for other socio-economic factors, education was strongly associated with indicators of hazardous drinking. Men with the lowest level of education compared to the highest level of education had an odds ratio of surrogate drinking of 7.7 (95% CI 3.2–18.5), of zapoi of 5.2 (2.3–11.8) and of frequent hangover of 3.7 (1.8–7.4). These indicators of hazardous drinking were also independently strongly associated with being unemployed (versus employed) and with levels of household wealth/amenities. Associations of all these variables with daily consumption of beverage spirits were weaker.
Using a novel range of indicator variables of hazardous drinking, this paper shows that the prevalence of these behaviours is high among working-age men in this Russian city. Moreover, these hazardous behaviours show very clear socio-economic patterns, with particularly high prevalence among those who have had the least education and are not in employment. In contrast, more conventional measures of heavy drinking, based on frequency of consumption of beverage spirits, are less prevalent and show much weaker associations with socio-economic position.
Alcohol; hazardous drinking; premature mortality; Russia; socioeconomic
This study estimated the association of cultural and social mechanisms with Korean American women’s drinking behaviors. Data were drawn from telephone interviews with 591 Korean women selected from a random sample of households in California with Korean surnames during 2007. About 62% of eligible respondents completed the interview. Respondents reported any lifetime drinking (yes/no), drinking volume (typical number of drinks consumed on drinking days), level of acculturation, and described their social network by assessing who encouraged or discouraged drinking (drinking support) or drank (drinking models). Multivariable regressions were used for analyses. About 70% (95% confidence interval [95%CI], 67 to 74) of Korean American women reported any lifetime drinking and current drinkers drank 1.18 (95%CI, 1.07 to 1.28) drinks on drinking days. Acculturation was not significantly associated with any lifetime drinking or drinking volume, while models and support for drinking were statistically significantly associated with a higher probability of any lifetime drinking and drinking more on drinking days. Each additional encourager, or one fewer discourager, for drinking in women’s social networks was associated with a 2% (95%CI, 1 to 3) higher probability of any lifetime drinking and drinking 0.25 (95%CI, −0.53 to 1.18) more drinks on drinking days. Each additional drinker in women’s networks was associated with a 4% (95%CI, 1 to 8) higher probability of any lifetime drinking and drinking 0.26 (95%CI, −0.05 to 0.60) more drinks on drinking days. Korean American women’s drinking appears to be strongly related to their social networks, though how women take on traits of their new environment was not.
Korean American Women; Social Networks; Acculturation; Ecological Models of Health Behavior
Previous research has shown that social norms are among the strongest predictors of college student drinking and that normative misperceptions of more similar groups’ drinking behavior may be more influential on individual drinking than those groups perceived to be more different. However, limited research has explored the moderating role of ethnicity in this context. The current study examined the differential impact that Hispanic/Latino/a and Caucasian students’ normative perceptions of both typical and same-ethnicity college students’ drinking behavior had on their own drinking. Participants (N = 5,369 students; 60.4% female; 81.4% Caucasian; mean age 19.9 years) from two colleges completed web-based surveys assessing their alcohol consumption, and their perceptions of the drinking behaviors of both the typical college student and the typical same-ethnicity college student at their campus. Results demonstrated that perceived norms were significantly associated with likelihood of drinking regardless of race or ethnicity specificity, but that Hispanics/Latinos/as typically had weaker relationships between ethnicity-specific norms and drinking than general student norms and drinking. The opposite was true for Caucasians such that the relationship between same-ethnicity norms and drinking was stronger than the relationship between general student norms and drinking. Further, Hispanic/Latino/a students with high perceived norms were less likely to have consumed any alcohol than Caucasians with similar normative beliefs. Further, a campus site interaction suggests that the size of the minority population on campus relative to other students may influence the relationship between norms and drinking. Implications and targets for future investigation are discussed.
Social Norms; College Student Drinking; Latino; Latina
This research evaluated the importance of reference groups in the relationships among injunctive norms and alcohol consumption for college student drinkers. First year students (N = 811; 58% female) completed online assessments of their drinking behavior, as well as their perceptions of the approval (injunctive norms) and prevalence (descriptive norms) of drinking by others Injunctive norms were evaluated with respect to typical students, typical same-sex students, friends, and parents. Descriptive norms were evaluated with respect to typical students and typical same-sex students. Results suggested that for injunctive norms, only perceptions of proximal reference groups (friends and parents) are positively associated with drinking behavior. However, when considered in the context of multiple referents and norms, injunctive norms for more distal groups (typical students/same sex students) were negatively associated with personal drinking whereas descriptive norms for distal referents remained positively associated with drinking. Results suggest that injunctive norms are more complex than descriptive norms and these complexities warrant important consideration in the development of intervention strategies.
social norms; descriptive norms; injunctive norms; reference group; alcohol
Personalized normative feedback approaches focus on correcting overestimated peer drinking norms in order to reduce problematic drinking among college students. Generally, personalized normative feedback utilizes the “typical college student” as a normative referent. Prior research has found these interventions to be less effective for women and has suggested the implementation of the typical student referent as one possible explanation. The current research explored how the typical college student is perceived when estimating peer drinking norms. Participants included 182 (98 women, 84 men) students who reported consuming 5/4 or more drinks for men/ women on at least one occasion in the previous month. Participants completed a battery of questionnaires on computers located in small private rooms assessing their drinking behavior, perceptions of “typical student” drinking behavior, and demographics of the perceived “typical college student.” Overall, the majority of students perceived the typical student to be male. More specifically, the vast majority of men and about half of women perceived the typical student as male when estimating drinking norms. These findings provide empirical corroboration for previous researchers’ suggestions that both men and women tend to think of the typical college student as male when estimating peer drinking norms. Results are discussed in terms of implications for personalized normative feedback interventions.
Alcohol; Social norms; Gender
Young people tend to over-estimate peer group drinking levels. Personalised normative feedback (PNF) aims to correct this misperception by providing information about personal drinking levels and patterns compared with norms in similar aged peer groups. PNF is intended to raise motivation for behaviour change and has been highlighted for alcohol misuse prevention by the British Government Behavioural Insight Team. The objective of the trial was to assess the effectiveness of PNF with college students for the prevention of alcohol misuse.
Solomon three-group randomised controlled trial. 1751 students, from 22 British Universities, allocated to a PNF group, a normal control group, or a delayed measurement control group to allow assessment of any measurement effects. PNF was provided by email. Participants completed online questionnaires at baseline, 6- and 12-months (only 12-months for the delayed measurement controls). Drinking behaviour measures were (i) alcohol disorders; (ii) frequency; (iii) typical quantity, (iv) weekly consumption; (v) alcohol-related problems; (vi) perceived drinking norms; and (vii) positive alcohol expectancies. Analyses focused on high-risk drinkers, as well as all students, because of research evidence for the prevention paradox in student drinkers.
Follow-up rates were low, with only 50% and 40% responding at 6- and 12-months, respectively, though comparable to similar European studies. We found no evidence for any systematic attrition bias. Overall, statistical analyses with the high risk sub-sample, and for all students, showed no significant effects of the intervention, at either time-point, in a completed case analysis and a multiple imputation analysis.
We found no evidence for the effectiveness of PNF for the prevention of alcohol misuse and alcohol-related problems in a UK student population.
U.S. college drinking data and a simple population model of alcohol consumption are used to explore the impact of social and contextual parameters on the distribution of light, moderate, and heavy drinkers. Light drinkers become moderate under social influence, moderate drinkers may change environments and become heavy drinkers. We estimate the drinking reproduction number, Rd, the average number of individual transitions from light to moderate drinking that result from the introduction of a moderate drinker in a population of light drinkers.
Ways of assessing and ranking progression of drinking risks and data-driven definitions of high- and low-risk drinking environments are introduced. Uncertainty and sensitivity analyses, via a novel statistical approach, are conducted to assess Rd variability and to analyze the role of context on drinking dynamics.
Our estimates show Rd well above the critical value of 1. Rd estimates correlate positively with the proportion of time spent by moderate drinkers in high-risk drinking environments. Rd is most sensitive to variations in local social mixing contact rates within low-risk environments. The parameterized model with college data, suggests that high residence times of moderate drinkers in low-risk environments maintain heavy drinking.
With regard to alcohol consumption in US college students, drinking places, the connectivity (traffic) between drinking venues, and the strength of socialization in local environments are important determinants in transitions between light, moderate and heavy drinking as well as in long-term prediction of the drinking dynamics.
Drinking reproduction number; drinking environments; social influence; college drinking; uncertainty and sensitivity analyses
College students overestimate other students’ drinking behavior (descriptive norms) and attitudes (injunctive norms). This study explored the effects of demographics, norm type, and reference group on the magnitude of self-other differences (SODs). Participants (N = 1611; 64% women) completed surveys assessing demographics, drinking patterns, and perceived norms. A subset of 122 students provided consumption data one month later to test predictors of changes in drinking. Overall, women and non-Greeks reported larger SODs for both norm types compared to men and Greeks. Heavier drinkers reported smaller SODs. Gender-by-reference group interactions revealed that women had larger SODs for reference groups increasingly distal to them; for men, the largest SODs occur for close friends versus more distal groups. Larger SODs for descriptive norms predicted increases in drinking, consistent with Social Norms Theory.
Aims: To describe and discuss the alcohol drinking patterns of the younger generation of hospital doctors in Norway and Germany – respectively the abstainers, frequent drinkers, episodic heavy drinkers and hazardous drinkers.
Methods: Data were collected in nationwide postal surveys among doctors in Norway (2000) and Germany (2006). A representative sample of 1898 German and 602 Norwegian hospital doctors aged 27–65 years were included in the analyses (N=2500). Alcohol drinking patterns were measured using the first three items of AUDIT in Norway and the AUDIT-C in Germany, scores of ≥5 (ranking from 0 to 12) indicating hazardous drinking. Episodic heavy drinking was defined by the intake of ≥60g of ethanol, on one occasion, at least once a week. Frequent drinkers were who drank alcoholic beverages at least twice a week. Abstainers were persons who drank no alcohol. The analyses were performed separately for age groups (27–44 years versus 45–65 years) and genders.
Results: Compared to the age groups 45 to 65 years in the Norwegian and German samples, the younger age groups (27–44 years) tend to have higher rates of abstainers, higher rates of infrequent drinking of moderate amount of alcoholic drinks, lower rates of episodic heavy drinking and lower rates of hazardous drinking.
Conclusion: The younger generation of hospital doctors in Norway and Germany showed tendencies to healthier drinking habits. Changes in professional life, and in the attitude towards alcohol consumption, may go some way towards explaining these findings.
alcohol; drinking patterns; hospital; doctors; Norway; Germany
This research was designed to evaluate a personalized normative feedback birthday card intervention aimed at reducing normative perceptions, alcohol consumption, and negative consequences associated with 21st birthday celebrations among college students (N = 281; 59.15% women). Students were randomly assigned to receive or not receive a birthday card about 1 week prior to their 21st birthday. Approximately 1 week following their birthday, students were asked to complete a brief survey concerning their birthday celebration activities. Findings indicated that the birthday card intervention was not successful at reducing drinking or consequences; however, the card did reduce normative misperceptions. Additional findings indicated that many students experienced negative consequences, such as passing out or driving after consuming alcohol. Combined, these findings suggest that prevention is needed for drinking associated with turning 21. However, prevention efforts should consist of more than a birthday card.
21st birthday; alcohol; alcohol-related problems; social norms; personalized normative feedback
This study examined college freshmen who intentionally drink alcohol to get drunk (DTGD). Survey data from 307 incoming freshmen college students living in freshmen residence halls who reported drinking alcohol in the last 30 days were analyzed. The majority (76.9%) of these self-reported drinkers reported DTGD. Relative to other freshmen drinkers, those who reported DTGD were significantly more likely to have consumed alcohol before going out to a party or bar, participated in a drinking game, drank heavily on a non-school night but not on a school night, used liquor, used beer, combined alcohol and drugs, experienced a hangover, vomited, passed out, and/or blacked out. The associations support DTGD as a measure of pre-meditated, controlled, and intentional consumption of alcohol to reach a state of inebriation. Common intentional drunkenness as observed in this study population may have implications for college alcohol risk reduction programs.
college; alcohol; binge drinking; freshmen
This study evaluated the relationship between alcohol-related problems and 3 indexes of risky drinking in college student drinkers: number of drinks consumed per week, frequency of binge drinking, and estimated blood alcohol levels (BALs). Use of 2 independent samples (N1 = 204, N2 = 181) allowed a cross-validation of obtained associations. Results indicated that neither binge drinking frequency nor BAL were more highly related to alcohol-related problems than was weekly drinking. Furthermore, BAL did not provide unique explanatory power in accounting for alcohol-related problems; mixed results were obtained regarding the relationship of binge drinking estimates with problems.
In this paper we investigated the question, how do older women who drink moderate amounts of alcohol differ from those who do not drink on measurements of cognitive function, memory, affect and health?
The nonprobability sample of female participants (n = 182) averaged 75 years of age and had a Mini Mental State Examination scores of 28. The participants were asked to indicate whether they drank alcohol or abstained (yes/no) and if they indicated that they did drink, to describe how many drinks they consumed in a given period of time (day/week/month).
None of the participants acknowledged drinking more than 2 drinks a day. Caucasian women had the largest number of moderate drinkers (53% vs 47%), while the majority of African–American and Hispanic women reported not drinking. The moderate drinkers reported less depression, had higher self-reported health, performed better on instrumental everyday tasks, had stronger memory self-efficacy, and used more strategies to improve memory performance. In addition, these women had higher performance on tests of executive function: attention, concentration, psychomotor skills, verbal-associative capacities, and oral fluency.
The circumstances under which people drink are complex and were not evaluated in this study. Therefore, rather than endorsing drinking behavior, these findings suggest that future research might examine why elders make the decision to drink, the circumstances that predispose women to drink (alone/with others), and other qualities that characterize female drinkers over the age of 65.
alcohol; cognition; depression; memory performance; executive function; health benefits; older adults; health promotion; moderate consumption
To examine differences in alcohol consumption among Hispanic national groups in the United States [Puerto Ricans, Mexican, Cuban, and Dominican South Central (D/SC) Americans] and identify sociodemographic predictors of drinking and binge drinking (four drinks for women and five for men in a 2-hr period).
The study used a household probability sample of adult Hispanics in five metropolitan areas in the United States. Comprehensive data on alcohol consumption were collected. Analyses included bivariate and multivariate regression techniques.
Puerto Rican and Mexican American men reported higher drinking rates, weekly consumption, and binge drinking than D/SC and Cuban Americans. Women drank significantly less than men. Mexican American women reported the highest abstention rate (61%); Puerto Rican women drank more per week and binged more frequently compared with their counterparts in other groups. Puerto Rican origin, initiating drinking during high school years (<18), and male gender (US- or foreign-born) were significant predictors of weekly alcohol consumption. Being younger, being single, Puerto Rican or D/SC American origin, initiating drinking at <18 years, being a US- or foreign-born male and being a US-born female were significant predictors of binge drinking.
There are considerable differences in drinking behavior across Hispanic national groups as well as between men and women. Results underscore the need to recognize heterogeneity in drinking practices while designing effective prevention interventions in the community.
Hispanic subgroups; alcohol consumption; binge drinking; risk drinking
Reflective opposite sex norms are behavior that an individual believes the opposite sex prefers them to do. The current study extends research on this recently introduced construct by examining estimates and influences of reflective norms on drinking in a large high-risk heterosexual sample of male and female college students from two universities. Both gender and Greek-affiliation served as potential statistical moderators of the reflective norms and drinking relationship. All participants (N = 1790; 57% female) answered questions regarding the amount of alcohol they believe members of the opposite sex would like their opposite sex friends, dates, and sexual partners to drink. Participants also answered questions regarding their actual preferences for drinking levels in each of these three relationship categories. Overall, women overestimated how much men prefer their female friends and potential sexual partners to drink, whereas men overestimated how much women prefer their sexual partners to drink. Greek-affiliated males demonstrated higher reflective norms than non-Greek males across all relationship categories, and for dating partners, only Greek-affiliated males misperceived women’s actual preferences. Among women however, there were no differences between reflective norms estimates or the degree of misperception as a function of Greek status. Most importantly, over and above perceived same-sex social norms, higher perceived reflective norms tended to account for greater variance in alcohol consumption for Greeks (vs. non-Greeks) and males (vs. females), particularly within the friend and sexual partner contexts. The findings highlight that potential benefits might arise if existing normative feedback interventions were augmented with reflective normative feedback designed to target the discrepancy between perceived and actual drinking preferences of the opposite sex.
reflective norms; college students; alcohol; fraternity and sorority; social norms; normative feedback
OBJECTIVE: To describe alcohol disorders in the general Canadian population, using as a standard indicator the CAGE questionnaire (Have you felt you needed to cut down on your drinking? Have you felt annoyed by criticism of your drinking? Have you felt guilty about drinking? Have you felt you needed a drink first thing in the morning [eye-opener]?). DESIGN: Secondary analysis of data from Canada's Alcohol and Other Drugs Survey (CADS), a national telephone survey conducted in 1994 of a representative sample of 12,155 people aged 15 years or more. PARTICIPANTS: The CAGE questionnaire was administered to 5894 drinkers who had consumed alcohol in the 12 months before the CADS survey. MAIN OUTCOME MEASURES: Respondents with positive (2 or more affirmative responses) and negative results on the CAGE questionnaire were compared as to demographic characteristics, alcohol consumption and harmful consequences of their drinking. Independent predictors of a positive result were identified by means of logistic regression analysis. RESULTS: A total of 5.8% of CAGE-tested current drinkers had a positive result on the past-year CAGE in 1994. The proportion of respondents reporting alcohol-related problems in one or more areas of their life was 7 times greater among drinkers with a positive result on the CAGE questionnaire than among those with a negative result (66.8% v. 9.5%) (p < 0.0001). When all demographic characteristics were controlled for simultaneously, male sex, residence in the Atlantic provinces, Quebec or the Prairies, single/never married or divorced/separated marital status, and low education level were found to be independent risk factors for a positive result on the CAGE questionnaire. About 85% of the respondents with a positive result had not sought help for their drinking. Applying the estimated sensitivity and specificity of the CAGE questionnaire in detecting alcohol dependence, as per criteria of the Diagnostic and Statistical Manual, in a general US population, the authors estimated that 4.1% of Canadians had an alcohol dependence in 1994. CONCLUSION: The large proportion of current drinkers with a positive result on the CAGE questionnaire who did not seek help for their drinking underscores the need for identification and brief interventions by physicians. Further research is needed to elucidate the underlying reasons for regional differences in CAGE status.
In order to examine the degree to which heavy drinking specifically contributes to risks for problems among college drinkers this paper develops and tests a dose-response model of alcohol use that relates frequencies of drinking specific quantities of alcohol to the incidence of drinking problems.
A mathematical model was developed that enabled estimation of dose-response relationships between drinking quantities and drinking problems using self-report data from 8,698 college drinkers across 14 campuses in California, USA. The model assumes that drinking risks are a direct monotone function of the amount consumed per day and additive across drinking days. Drinking problems accumulate across drinking occasions and are the basis for cumulative reports of drinking problems reported by college drinkers.
Statistical analyses using the model showed that drinking problems were related to every drinking level, but increased 5-fold at three drinks and more gradually thereafter. Problems were most strongly associated with occasions on which three drinks were consumed, and over half of all reported problems were related to occasions on which 4 or fewer drinks were consumed. There were some important differences in dose-responsiveness between men and women and between different groups of “light,” “moderate,” and “heavier” drinkers.
Many problems among college students are associated with drinking relatively small amounts of alcohol (2 – 4 drinks). Programs to reduce college drinking problems should emphasize risks associated with low drinking levels.
College Drinking; Dose-Response; Alcohol Problems; Epidemiology; Prevention
The current study documents and examines college students’ perceptions of the drinking behavior of peers from varying class years (i.e., freshman, sophomore, junior, and senior). A sample of 522 college students estimated the drinking behavior of peers within their own specific class year, as well as across the three other class years. Participants in each class year overestimated the drinking of students in their own class year as well as the drinking of students in the three other class years. These within class year-specific perceived norms associated with drinking for freshmen, sophomores, and juniors. Poisson regression analyses revealed freshmen and juniors were more impacted by their class year-specific perceived norms than students in other class years, while students in other class years were more impacted by sophomore-specific perceived norms than sophomores. These findings suggest that perceptions of class year-specific drinking norms can be impactful on individual drinking rates within one’s own class year; however, perceived drinking norms of other class years may also associate with actual drinking for students. Future research is needed to establish the longitudinal development of class year-specific perceived norms and to explore the impact of providing students with actual drinking norms of students in their own class years and of students in other class years during interventions and prevention programs.
college students; alcohol; perceived norms; peer influence
The “prevention paradox”, a notion that most alcohol-related problems are generated by non-heavy drinkers, has significant relevance to public health policy and prevention efforts. The extent of the paradox has driven debate over the type of balance that should be struck between alcohol policies targeting a select group of high-risk drinkers versus more global approaches that target the population at-large. This paper examines the notion that most alcohol problems among four Hispanic national groups in the U.S. are attributable to moderate drinkers.
A general population survey employing a multistage cluster sample design, with face-to-face interviews in respondents' homes was conducted in five metropolitan areas of the U.S. Study participants included a total of 2,773 current drinkers 18 years and older. Alcohol consumed in the past year (bottom 90% vs. top 10%), binge drinking (binge vs. no binge), and a four-way grouping defined by volume and binge criteria were used. Alcohol-related harms included 14 social and dependence problems.
Drinkers at the bottom 90% of the distribution are responsible for 56% to 73% of all social problems, and for 55% to 73% of all dependence-related problems reported, depending on Hispanic national group. Binge drinkers are responsible for the majority of the social problems (53% to 75%) and dependence-related problems (59% to 73%), also depending on Hispanic national group. Binge drinkers at the bottom 90% of the distribution are responsible for a larger proportion of all social and dependence-related problems reported than those at the top 10% of the volume distribution. Cuban Americans are an exception.
The prevention paradox holds when using volume-based risk groupings and disappears when using a binge-drinking risk grouping. Binge drinkers who drink moderately on an average account for more harms than those who drink heavily across all groups, with exception of Cuban Americans.
U.S. Hispanics; alcohol problems; prevention paradox