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1.  Social and Behavioral Characteristics of Young Adult Drink/Drivers Adjusted for Level of Alcohol Use 
Background
Alcohol consumption and drink/driving are positively correlated and many predictors of alcohol use also predict drink/driving. Past research has not fully distinguished the contributions of personal risk factors from the level of alcohol use in the prediction of drink/driving. As a result, the extent to which predictors are specific to drink/driving, versus due to a mutual association to alcohol use, is unclear.
Methods
This study examined the unique and shared risk factors for drink/driving and alcohol use, and examined the attributable risk (AR) associated with predictors of drink/driving while adjusting for alcohol use. Study data were from a telephone survey of 3,480 Michigan-licensed young adults who were drinkers. Four groups of drink/drivers were formed based on the prior 12-month maximum severity of drink/driving: (1) never drink/driving; (2) driving at least once within an hour of 1 or 2 drinks; (3) driving within an hour of 3 or more drinks or while feeling the effects of alcohol; and (4) drinking while driving.
Results
Lower perceived risk of drink/driving, greater social support for drinking and drink/driving, greater aggression and delinquency, more cigarette smoking, and more risky driving behaviors uniquely predicted drink/driving severity in models adjusted for alcohol use. The largest ARs were associated with social support for drinking and drink/driving and perceived risk of drink/driving.
Conclusions
These results confirm that alcohol use and drink/driving share risk factors, but also indicate that part of the variation in these factors is specific to drink/driving. Implications for interventions to reduce drink/driving are discussed.
doi:10.1111/j.1530-0277.2007.00350.x
PMCID: PMC1989671  PMID: 17374045
Drink-Driving; Population-Attributable Risk; Young Adults; Risk-Factors; Driving Behaviour; Alcohol Use
2.  A survey of energy drink consumption patterns among college students 
Nutrition Journal  2007;6:35.
Background
Energy drink consumption has continued to gain in popularity since the 1997 debut of Red Bull, the current leader in the energy drink market. Although energy drinks are targeted to young adult consumers, there has been little research regarding energy drink consumption patterns among college students in the United States. The purpose of this study was to determine energy drink consumption patterns among college students, prevalence and frequency of energy drink use for six situations, namely for insufficient sleep, to increase energy (in general), while studying, driving long periods of time, drinking with alcohol while partying, and to treat a hangover, and prevalence of adverse side effects and energy drink use dose effects among college energy drink users.
Methods
Based on the responses from a 32 member college student focus group and a field test, a 19 item survey was used to assess energy drink consumption patterns of 496 randomly surveyed college students attending a state university in the Central Atlantic region of the United States.
Results
Fifty one percent of participants (n = 253) reported consuming greater than one energy drink each month in an average month for the current semester (defined as energy drink user). The majority of users consumed energy drinks for insufficient sleep (67%), to increase energy (65%), and to drink with alcohol while partying (54%). The majority of users consumed one energy drink to treat most situations although using three or more was a common practice to drink with alcohol while partying (49%). Weekly jolt and crash episodes were experienced by 29% of users, 22% reported ever having headaches, and 19% heart palpitations from consuming energy drinks. There was a significant dose effect only for jolt and crash episodes.
Conclusion
Using energy drinks is a popular practice among college students for a variety of situations. Although for the majority of situations assessed, users consumed one energy drink with a reported frequency of 1 – 4 days per month, many users consumed three or more when combining with alcohol while partying. Further, side effects from consuming energy drinks are fairly common, and a significant dose effect was found with jolt and crash episodes. Future research should identify if college students recognize the amounts of caffeine that are present in the wide variety of caffeine-containing products that they are consuming, the amounts of caffeine that they are consuming in various situations, and the physical side effects associated with caffeine consumption.
doi:10.1186/1475-2891-6-35
PMCID: PMC2206048  PMID: 17974021
3.  Social Context of Drinking and Alcohol Problems Among College Students 
Objective
To examine how social contexts of drinking are related to alcohol use disorders, other alcohol-related problems, and depression among college students.
Methods
Logistic regression models controlling for drinking frequency measured the association between social context and problems, among 728 current drinkers.
Results
Drinking for social facilitation was associated with drinking and driving and housing violations. Drinking in the context of motor vehicles was associated with alcohol abuse/dependence. Drinking in a context of emotional pain was associated with clinical depression.
Conclusions
Alcohol-free programming that fulfills needs for conviviality and addresses early signs of depression might reduce alcohol problems among college students.
doi:10.5555/ajhb.2008.32.4.420
PMCID: PMC2390773  PMID: 18092902
social context; alcohol abuse and dependence; impaired driving; college students; mental health
4.  Conjoint Developmental Trajectories of Young Adult Alcohol and Tobacco Use 
Journal of abnormal psychology  2005;114(4):612-626.
Developmental and etiological advances have set the stage for considering trajectories of problem behavior across the life course, but little work thus far addresses co-occurring problem behavior trajectories. Although recent work characterizes drinking and smoking trajectories, none has explored the course of concurrent drinking and smoking. Using panel data from the Monitoring the Future Project (N = 32,087), the authors applied growth mixture modeling to 4 waves of heavy drinking and smoking in a young-adult sample. The authors extracted a single latent group membership factor from heavy drinking and smoking. Associations between trajectory classes and risk factors were relatively unique to the substance being predicted. The association of smoking with alcohol expectancies and delinquency appeared to exist by virtue of smoking’s comorbidity with drinking.
doi:10.1037/0021-843X.114.4.612
PMCID: PMC2898725  PMID: 16351384
alcohol; tobacco; comorbidity; trajectory; developmental
5.  Identifying Two Potential Mechanisms for Changes in Alcohol Use Among College-attending and Non-attending Emerging Adults 
Developmental psychology  2008;44(6):1625-1639.
This study tests whether pro-alcohol peer influences and prosocial involvement account for increases in drinking during the transition into emerging adulthood and whether these mechanisms differ depending on college attendance and/or moving away from home. We use structural equation modeling of prospective data from 825 young men and women. For four groups defined by college and residential status, more drinking in the spring of 12th grade predicts more pro-alcohol peer influences the following fall, and more pro-alcohol peer influences in the fall predict increases in drinking the following spring. Going to college while living at home is a protective factor for increases in drinking and selection of pro-alcohol peer involvements. Prosocial involvement (measured by involvement in religious activities and volunteer work) is not significantly related to post-high school drinking except among college students living away from home. Prevention efforts should focus on reducing opportunities for heavy drinking for college and noncollege emerging adults as they leave home and increasing prosocial involvement among college students not living at home.
doi:10.1037/a0013855
PMCID: PMC2770066  PMID: 18999326
Drinking; alcohol; emerging adulthood; college students; non-college youth; transition to adulthood; peer influence
6.  Conjoint Developmental Trajectories of Young Adult Substance Use 
Background
Despite the prominence of comorbidity among substances and the recent attention focused on trajectory-based approaches to characterizing developmental change, little research in the substance use field has simultaneously considered both course and comorbidity.
Methods
Using nationally representative panel data from the Monitoring the Future Project (MTF; n = 32,087; 56% female; 82% Caucasian), we identified developmental courses of heavy drinking, smoking, and marijuana use using 4 waves of data spanning ages 18 to 26 in a multi-cohort young adult sample. Comorbidity was examined by cross-classifying group membership in substance use trajectories. Finally, the extent to which risk factors (sex, race, alcohol expectancies, delinquency, sensation seeking, depressive affect, religiosity, academic achievement, and parent education) accounted for combinations of comorbidity that occurred at a rate greater than chance was examined.
Results
For each substance, we identified 4 courses of substance use that were largely consistent with those found in the literature (chronic high use, late-onset use, developmentally limited use, and low-use), with a fifth moderate smoking group. Heavy drinking, smoking, and marijuana use were each highly associated, and distinct patterns of comorbidity were evident, with greatest agreement along the diagonal. All risk factors explained comorbidity to some degree, with delinquency, sensation seeking, alcohol expectancies, and religion in particular predicting combinations of comorbidity that were characterized by early onset and chronic high use.
Conclusions
Cross-substance trajectory concordance was high, with parallel changes in substance use over emerging adulthood. This suggests similar developmental timing of use, perhaps due to the experience of developmental transitions that have a common influence on use of different substances. Prediction of combinations of comorbidity characterized by early onset and persistently high use suggests that to some extent, individuals use multiple substances because of a common vulnerability to each, rather than directional relations among substances (e.g., cross-tolerance, cueing).
doi:10.1111/j.1530-0277.2008.00643.x
PMCID: PMC2705997  PMID: 18331376
Alcohol; Tobacco; Marijuana; Comorbidity; Trajectory; Developmental
7.  Are Social Norms the Best Predictor of Outcomes Among Heavy-Drinking College Students?* 
Objective
This research was designed to evaluate the relative contribution of social norms, demographics, drinking motives, and alcohol expectancies in predicting alcohol consumption and related problems among heavy-drinking college students.
Method
Participants included 818 (57.6% women) first-year undergraduates who reported at least one heavy-drinking episode in the previous month. In addition to providing demographic information (gender and fraternity/sorority membership) participants completed Web-based assessments of social norms (perceived descriptive norms regarding typical student drinking, injunctive norms regarding friends’ and parents’ approval), motives (social, enhancement, coping, and conformity), and expectancies and evaluations of positive and negative alcohol effects.
Results
Regression results indicated that descriptive and injunctive norms were among the best predictors of college student drinking. With respect to alcohol problems, results indicated that coping motives accounted for the largest proportion of unique variance. Finally, results revealed that alcohol consumption mediated the relationships between predictors and problems for social norms, whereas coping motives, negative expectancies, and evaluation of negative effects were directly associated with alcohol problems despite having relatively weak or null unique associations with consumption.
Conclusions
The results of this study substantiate social norms as being among the best predictors of alcohol consumption in this population and suggest that drinking to cope is a better predictor of problems. The findings are discussed in terms of practical prevention and treatment implications.
PMCID: PMC2443637  PMID: 17568961
8.  Latent deleterious effects of binge drinking over a short period of time revealed only by electrophysiological measures  
Background
Episodic excessive alcohol consumption (i.e., binge drinking) is now considered to be a major public health problem, but whereas short-and long-term harmful consequences of this behaviour are clearly established at medical, social and cognitive levels, the cerebral correlates of these impairments are still unknown. Our study explores the midterm cerebral effects of binge-drinking behaviours among young adults.
Methods
We selected 2 groups of first-year university students with no history of drinking habits, paired for psychological and behavioural measures on the basis of their expected alcohol consumption during the forthcoming academic year. The binge drinker group expected to have high personal alcohol consumption, whereas the control group expected low consumption. We used a test–retest paradigm within a 9-month period (session 1 in September 2005, session 2 in May 2006). At each testing session, we recorded auditory event-related potentials while the participants performed an emotional valence judgment task.
Results
There were no differences between the groups in behavioural or electrophysiological measures at baseline. After 9 months, the binge drinkers had significantly delayed latencies for all event-related potential components (P1, N2, P3b) of emotional auditory processing compared with the control group (p < 0.006), with no behavioural differences.
Limitations
As the present study explored the electrophysiological correlates of binge drinking with an emotional task only, the results will have to be extended to other cognitive processes using various experimental tasks.
Conclusion
We report the first direct evidence that short-term binge drinking can produce marked cerebral dysfunction undetectable by behavioural measures alone. The observed latency abnormalities, similar to those observed in long-term alcoholism, constitute an electrophysiological marker of slowed cerebral activity associated with binge drinking.
PMCID: PMC2647570  PMID: 19270761
9.  Longitudinal examination of underage drinking and subsequent drinking and risky driving 
Journal of safety research  2006;37(5):443-451.
Introduction
Alcohol use, alcohol misuse, and risky driving from adolescence into young adulthood were compared by drinking onset age.
Methods
Surveys were administered in Grades 5/6, 6/7, 7/8, 10, 12, and at approximately age 23. Participants were placed into Drinking Onset groups based on self-reported alcohol use frequency on the adolescent surveys. Driving records were examined in three age periods: under 21, 21–25, and 26+.
Results
The earliest drinking initiators reported higher alcohol use and misuse on each survey, and were more likely to have risky driving offenses before age 21 and to have alcohol driving offenses in all three age periods.
Discussion
The earliest drinking initiators engaged in risky drinking behavior and risky driving behavior that was consistently higher than those with later drinking initiation, beginning in adolescence and persisting well into young adulthood.
doi:10.1016/j.jsr.2006.06.002
PMCID: PMC1853244  PMID: 17123546
Adolescent; Young Adult; Underage Drinking; Driving
10.  Drinking Behavior from High School to Young Adulthood: Differences by College Education 
Background: Recent serious alcohol-related events have raised public awareness of the prevalence of at-risk alcohol use among college undergraduates, but heavy alcohol consumption during late adolescence and young adulthood is not limited to college students. Alcohol consumption typically peaks in young adulthood regardless of education level, and risks related to alcohol misuse are shared by young adults, regardless of their educational choices. Differences in alcohol risk between college-attending and non-college-attending young adults are generally small, and emphasize the need for research examining the drinking patterns of both of these groups.
Methods: To better understand patterns of at-risk alcohol use and its association with education, this study compared at-risk alcohol use from 12th grade to young adulthood (age 24) in a sample of never-married young adults. Three groups were formed based on completed education when the survey was administered in young adulthood: high school or less, postsecondary education without a four-year college degree, and completed college.
Results: Men who completed college experienced the greatest increase in at-risk drinking from grade 12 to young adulthood; however, their at-risk alcohol use did not differ markedly from men in the other education groups in young adulthood. Men who did not complete college had high levels of alcohol risk in 12th grade and maintained or increased those levels in young adulthood, demonstrating a pattern of prolonged risk. Women whose completed education was high school or less experienced the fewest increases in at-risk alcohol use. Education group differences were not explained by place of residence or employment status.
Conclusions: These results emphasize the need to intervene early to prevent at-risk alcohol use, and emphasize that at-risk alcohol use is neither unique, nor necessarily the highest among individuals who complete college.
PMCID: PMC1397708  PMID: 16385187
At-Risk Drinking; Education Level; High School Drinking; College Drinking; Longitudinal; Young Adulthood
11.  Underage drinking on saturday nights, sociodemographic and environmental risk factors: a cross-sectional study 
Background
Excessive alcohol consumption in underage people is a rising phenomenon. A major proportion of the disease burden and deaths of young people in developed nations is attributable to alcohol abuse. The aim of this study was to investigate social, demographic and environmental factors that may raise the risk of Saturday night drinking and binge drinking among Italian school students.
Methods
The study was conducted on a sample of 845 Italian underage school students, by means of an anonymous, self-test questionnaire. Multivariate logistic regression was applied to identify independent risk factors for alcohol drinking and binge drinking. Ordered logistic regression was used to identify independent risk factors for harmful drinking patterns.
Results
The independent variables that confer a higher risk of drinking in underage students are older age classes, male sex, returning home after midnight, belonging to a group with little respect for the rules, or to a group where young people are not seen as leaders. The higher the perception of alcohol consumption by the group, the higher the risk. Spending time in bars or discos coincides with a two-fold or four-fold increase, respectively, in the risk of alcohol consumption.
Conclusion
Our findings show that certain environmental and social risk factors are associated with underage drinking. The most important role for preventing young people's exposure to these factors lies with the family, because only parents can exert the necessary control and provide a barrier against potentially harmful situations.
doi:10.1186/1747-597X-6-15
PMCID: PMC3152933  PMID: 21729273
12.  Ups and Downs of Alcohol Use among First-year College Students: Number of Drinks, Heavy Drinking, and Stumble and Pass out Drinking Days 
Addictive behaviors  2010;36(3):197-202.
Given the dynamic fluctuating nature of alcohol use among emerging adults (Del Boca, Darkes, Greenbaum, & Goldman, 2004), patterns of alcohol use were modeled across 70 days in an intensive repeated-measures diary design. Two hundred first-year college students provided 10 weekly reports of their daily alcohol consumption via computer-assisted telephone interviews. Multi-level models demonstrated large within-person variability across days in drinks consumed, binge drinking, and days exceeding self-reported limits for stumbling around and passing out; these outcome variables were predicted by weekdays vs. weekend days (within-person) and gender, age of drinking initiation, fraternity/sorority membership, and alcohol motivations (between-persons). Repeated measurement of alternate indicators of alcohol use permits the examination of novel and important questions about alcohol use and abuse particularly in young adult and other erratically drinking populations.
doi:10.1016/j.addbeh.2010.10.005
PMCID: PMC3018543  PMID: 21106298
repeated-measures; alcohol use; emerging adults; daily diary
13.  The Role of Parental Alcohol Consumption on Driving Under the Influence of Alcohol: Results from a Longitudinal, Nationally Representative Sample 
Accident; analysis and prevention  2011;43(6):2182-2187.
Purpose
Many studies have examined the role of peer and parental alcohol use on drinking behaviors among adolescents. Few studies, however, have examined parental influences on driving under the influence (DUI) of alcohol. The current study uses data from a longitudinal study to examine the role of parental alcohol use during adolescence on the risk for DUI among young adult men and women.
Methods
Data were derived from 9,559 adolescents and young adults who participated in the National Longitudinal Study of Adolescent Health (Add Health) Waves I and III. Survey logistic regression was used to examine the relationship between multilevel risk and protective factors and self-reported DUI. Analyses were stratified by gender and frequency of parental alcohol consumption to understand the role of parental alcohol use on risk for DUI among their youth.
Results
Risk and protective factors for DUI were very similar among men and women. Parental alcohol use significantly predicted DUI among women (OR = 1.39, p<0.01) and men (OR = 1.33, p<0.05). When parents did not report alcohol use, peer alcohol use significantly increased risk for DUI for both women (OR=1.26, p<0.05) and men (OR=1.31, p<0.001). When parents reported alcohol use, however, peer alcohol use was not a significant independent predictor.
Conclusions
Findings suggest remarkable similarities in risk and protective factors for DUI across gender groups. For men and women, parental alcohol consumption was a risk factor for DUI. Peers’ alcohol use predicted DUI only when parents did not use alcohol.
doi:10.1016/j.aap.2011.06.012
PMCID: PMC3154683  PMID: 21819850
ALCOHOL; GENDER; DRUNK DRIVING; DUI; PARENT
14.  Low level of alcohol drinking among two generations of non-Western immigrants in Oslo: a multi-ethnic comparison 
BMC Public Health  2012;12:535.
Background
Alcohol drinking is a risk factor for harm and disease. A low level of drinking among non-Western immigrants may lead to less alcohol-related harm and disease. The first aim of this study was to describe frequency of drinking in two generations of immigrants in Oslo, contrasting the result to drinking frequency among ethnic Norwegians. The second aim was to study how frequency of drinking among adult immigrants was associated with social interaction with their own countrymen and ethnic Norwegians, acculturation, age, gender, socioeconomic factors and the Muslim faith.
Method
The Oslo Health Study (HUBRO) was conducted during the period 2000 to 2002 and consisted of three separate surveys: a youth study (15-16-year-olds, a total of 7343 respondents, response rate 88.3%); adult cohorts from 30 to 75 years old (18,770 respondents, response rate 46%); the five largest immigrant groups in Oslo (aged 20–60 years, a total of 3019 respondents, response rate 39.7%). Based on these three surveys, studies of frequency of drinking in the previous year (four categories) were conducted among 15-16-year-olds and their parents’ generation, 30-60-year-old Iranians, Pakistanis, Turks and ethnic Norwegians. A structural equation model with drinking frequency as outcome was established for the adult immigrants.
Results
Adults and youth of ethnic Norwegian background reported more frequent alcohol use than immigrants with backgrounds from Iran, Turkey and Pakistan. Iranians reported a higher drinking frequency than Turks and Pakistanis. In the structural equation model high drinking frequency was associated with high host culture competence and social interaction, while high own culture competence was associated with low drinking frequency. Adult first-generation immigrants with a longer stay in Norway, those of a higher age, and females drank alcohol less frequently, while those with a higher level of education and work participation drank more frequently. Muslim immigrants reported a significantly lower drinking frequency than non-Muslims, although this did not apply to Iranians.
Conclusions
The existence and growth in Western societies of immigrant groups with low-level alcohol consumption contributed to a lower level of consumption at the population level. This may imply reduced drinking and alcohol-related harm and disease even among ethnic Norwegians.
doi:10.1186/1471-2458-12-535
PMCID: PMC3438095  PMID: 22824456
Alcohol use; Social interaction; Immigration; Ethnicity; Muslim; Gender
15.  To drink or not to drink: Motives and expectancies for use and nonuse in adolescence 
Addictive behaviors  2011;36(10):972-979.
Drinking motives have a prominent role in cognitive models of adolescent and adult alcohol decision-making (Cooper, Russell, Skinner, & Windle, 1992; Cooper, 1994). The complementary construct of motivation not to drink has received less attention (Epler, Sher & Piasecki, 2009). We examined how abstinence motives interacted with drinking motives and alcohol expectancies to predict alcohol consumption in samples of US high school students (N > 2,500). Nondrinking motives predicted lower rates of lifetime and current alcohol use. Motives not to drink interacted with specific drinking motives, like social and coping motives, and alcohol expectancies to predict certain aspects of drinking behavior. For example, motives not to drink had the greatest impact on youth with weaker social motivations. Findings highlight the distinction between motives not to drink and other alcohol-related cognitions in predicting adolescent alcohol consumption. This work not only supports the utility of this construct in developing models of youth alcohol-related decision-making but also has implications for prevention programming.
doi:10.1016/j.addbeh.2011.05.009
PMCID: PMC3148801  PMID: 21665373
Drinking motives; adolescents; alcohol expectancies; alcohol
16.  Early Adult Outcomes of Adolescent Binge Drinking: Person- and Variable-Centered Analyses of Binge Drinking Trajectories 
Background
Many studies of the consequences of binge drinking take a variable-centered approach that may mask developmentally different trajectories. Recent studies have reported qualitatively different binge drinking trajectories in young adulthood. However, analyses of developmental trajectories of binge drinking have not been examined for an important period of drinking development: adolescence. The purpose of this study was to examine young adult outcomes of adolescent binge drinking using an approach that combines person-centered and variable-centered methods.
Methods
Data were from the Seattle Social Development Project, an ethnically diverse, gender balanced sample (n = 808) followed prospectively from age 10 to age 21. Semiparametric group-based modeling was used to determine groups of binge drinking trajectories in adolescence. Logistic regression was used to examine how well the trajectory groups predicted young adult outcomes after demographics, childhood measures, and adolescent drug use were considered.
Results
Four distinct trajectories of binge drinking during adolescence were identified: Early Highs, Increasers, Late Onsetters, and Nonbingers. These trajectories significantly predicted positive and negative outcomes in adulthood after controlling for demographic characteristics, early proxy measures of the outcome, and adolescent drug use.
Conclusions
This integrated person- and variable-centered approach provides more information about the effects of specific patterns of binge drinking than studies that employ variable-centered methods alone.
PMCID: PMC1847635  PMID: 10888080
Alcohol; Binge Drinking; Adolescence; Longitudinal; Adult Outcomes
17.  Alcohol Trajectories over Three Years in a Swedish Residence Hall Student Population 
Although it is known that college students have a high alcohol consumption, less is known about the long-term drinking trajectories amongst college students and, in particular, students living in residence halls, known to be high-risk drinkers. Over four consecutive years, the drinking habits of 556 Swedish residence hall students were analyzed. The main instruments for measuring outcome were AUDIT (Alcohol Use Identification Disorders Test), SIP (Short Index of Problems) and eBAC (estimated Blood Alcohol Concentration). The drinking trajectories among Swedish residence hall students showed stable and decreasing drinking patterns, with age and gender being predictors of group membership.
doi:10.3390/ijerph7041432
PMCID: PMC2872351  PMID: 20617038
alcohol; college students; residence halls; long-term follow-up; social climate
18.  Alcohol expectancy increases positive responses to cigarettes in young, escalating smokers 
Psychopharmacology  2010;210(3):355-364.
Rationale
A large proportion of smokers consolidate their smoking patterns during young adulthood, and it is possible that the high rates of drinking found in this age group may facilitate the transition from nondaily to daily cigarette use.
Objective
The primary aim of this study was to examine how alcohol alters the subjective effects of smoking in heavy-drinking young adults (age 21–25) who are still at an experimental stage of smoking but show recent increases in their smoking behavior.
Methods
Using a within-subject design, we examined whether alcohol or the expectation of receiving alcohol increased either subjective responses to smoking or the amount smoked. Subjects participated in three sessions, in which they received alcohol (0.08 g/dL targeted blood alcohol level), a taste-masked placebo presented as alcohol, or a mixer beverage not presented as alcohol. Measures included positive and negative subjective reactivity (e.g., satisfaction, nausea, craving relief, and enjoyment of airway sensations) associated with smoking a single cigarette and subsequent ad lib smoking behavior.
Results
Both conditions in which the subjects expected to receive alcohol increased positive effects of smoking (satisfaction, calm, and taste), compared to the mixer beverage. Alcohol, compared to the placebo and mixer beverages, decreased negative effects (nausea) associated with smoking a cigarette and increased subsequent smoking.
Conclusions
This initial study has implications for understanding how alcohol and the expectation of alcohol improves the experience of smoking in nondaily smokers who are still at an experimental stage of smoking.
doi:10.1007/s00213-010-1831-x
PMCID: PMC2874601  PMID: 20352411
Alcohol; Tobacco; Young adult; Subjective reactivity; Self-administration; Heavy drinker; Non-daily smoker
19.  Alcohol Effects on Cerebral Blood Flow in Subjects with Low and High Responses to Alcohol 
Background
Although there are multiple indications that alcohol can alter many physiological brain functions, including cerebral blood flow (CBF), studies of the latter have generally used small or modest sized samples. Few investigations have yet evaluated how CBF changes after alcohol relate to subsets of subjects with elevated alcoholism risks, such as those with lower levels of response (LR) to alcohol. This study used arterial spin labeling (ASL) after alcohol administration to evaluate a large sample of healthy young men and women with low and high alcohol responses, and, thus, varying risks for alcohol use disorders (AUD).
Methods
Healthy young adult social drinkers with low and high LR (N=88, 50% female) matched on demography and drinking histories were imaged with whole brain resting ASL ~1 hour after ingesting ~3 drinks of ethanol and after a placebo beverage (i.e., 178 ASL sessions). The relationships of CBF changes from placebo to alcohol for subjects with low and high LR were evaluated.
Results
CBF increased after alcohol as compared to placebo in five frontal brain regions. Despite identical BACs, these increases with alcohol were less prominent in individuals who required more drinks to experience alcohol-related effects (i.e., had a lower LR to alcohol). The LR group differences remained significant after covarying for recent drinking quantities.
Conclusions
The results confirm that alcohol intake is associated with acute increases in CBF, particularly in frontal regions. Less intense CBF changes were seen in subjects with a genetically influenced characteristic, a low LR to alcohol, that relates to the future risk of heavy drinking and alcohol problems.
doi:10.1111/j.1530-0277.2011.01435.x
PMCID: PMC3097275  PMID: 21332525
alcohol; arterial spin labeling; level of response to alcohol; alcoholism risk
20.  The Effect of Marriage on Young Adult Heavy Drinking and its Mediators: Results from Two Methods of Adjusting for Selection into Marriage 
This study tested the effect of marriage on young adult heavy drinking and tested whether this effect was mediated by involvement in social activities, religiosity, and self-control reasons for limiting drinking. The sample of 508 young adults was taken from an ongoing longitudinal study of familial alcoholism that over-sampled children of alcoholics (Chassin, Rogosch, & Barrera, 1991). In order to distinguish role socialization effects of marriage from confounding effects of role selection into marriage, analyses used both the analysis of covariance (ANCOVA) method and the change score method of adjusting for pre-marriage levels of heavy drinking and the mediators. Results showed role socialization effects of marriage on post-marriage declines in heavy drinking. This effect was mediated by involvement in social activities such that marriage predicted decreased involvement in social activities, which in turn predicted decreased heavy drinking. There were no statistically significant mediated effects of religiosity. The mediated effect of self-control reasons for limiting drinking was supported by the ANCOVA method only, and further investigation suggested that this result was detected erroneously due to violation of an assumption of the ANCOVA method that is not shared by the change score method. Findings from this study offer an explanation for the maturing out of heavy drinking that takes place for some individuals over the course of young adulthood. Methodologically, results suggest that the ANCOVA method should be employed with caution, and that the change score method is a viable approach to confirming results from the ANCOVA method.
doi:10.1037/a0020983
PMCID: PMC3058715  PMID: 21198229
marriage; heavy drinking; role socialization; role selection; the analysis of covariance method
21.  Identifying Social Mechanisms for the Prevention of Adolescent Drinking and Driving 
Accident; analysis and prevention  2007;40(2):576-585.
This study identifies social mechanisms that might help prevent youth from being involved in driving under the influence of alcohol (DUI) and riding with drinking drivers (RWDD). Data collected through telephone surveys with 1,534 adolescents and young adults aged 15–20 years (mean = 17.6, SD = 1.6) in California, USA were analyzed. Structural equation modeling analyses showed that DUI and RWDD were strongly related to drinking in unstructured situations, modeling of DUI by peers and parents, and perceived peer approval or disapproval of DUI. DUI outcome expectancies were indirectly related to DUI and RWDD through situational drinking. Parental monitoring and DUI law enforcement were also indirectly related to DUI and RWDD through DUI expectancies and other mechanisms. The findings, overall, suggest that parental influence remains important even through late adolescence. Parental monitoring, in particular, might help to reduce unstructured socializing with peers, drinking, and affiliation with peers who engage in DUI. Parental monitoring may also foster beliefs about the risks of DUI. Conversely, parents’ own DUI behavior may normalize drinking and DUI behaviors, thus countering monitoring efforts.
doi:10.1016/j.aap.2007.08.013
PMCID: PMC2432526  PMID: 18329409
drinking and driving; riding with drinking drivers; parental monitoring; late adolescence
22.  Alcohol consumption in tertiary education students 
BMC Public Health  2011;11:545.
Background
Heavy alcohol consumption among adolescents and young adults is an issue of significant public concern. With approximately 50% of young people aged 18-24 attending tertiary education, there is an opportunity within these settings to implement programs that target risky drinking. The aim of the current study was to survey students and staff within a tertiary education institution to investigate patterns of alcohol use, alcohol-related problems, knowledge of current National Health and Medical Research Council (NHMRC) guidelines for alcohol consumption and intentions to seek help for alcohol problems.
Methods
Students of an Australian metropolitan university (with staff as a comparison group) participated in a telephone interview. Questions related to knowledge of NHMRC guidelines, drinking behaviour, alcohol-related problems and help-seeking intentions for alcohol problems. Level of psychological distress was also assessed.
Results
Of the completed interviews, 774 (65%) were students and 422 (35%) were staff. While staff were more likely to drink regularly, students were more likely to drink heavily. Alcohol consumption was significantly higher in students, in males and in those with a history of earlier onset drinking. In most cases, alcohol-related problems were more likely to occur in students. The majority of students and staff had accurate knowledge of the current NHMRC guidelines, but this was not associated with lower levels of risky drinking. Psychological distress was associated with patterns of risky drinking in students.
Conclusions
Our findings are consistent with previous studies of tertiary student populations, and highlight the disconnect between knowledge of relevant guidelines and actual behaviour. There is a clear need for interventions within tertiary education institutions that promote more effective means of coping with psychological distress and improve help-seeking for alcohol problems, particularly among young men.
doi:10.1186/1471-2458-11-545
PMCID: PMC3223920  PMID: 21740593
23.  The Association Between Earlier Age of First Drink, Disinhibited Personality, and Externalizing Psychopathology in Young Adults 
Addictive behaviors  2009;35(5):414-418.
Earlier age of first drink (AFD) of alcohol is associated with higher rates of alcohol abuse and dependence as well as a range of other externalizing problems. This study tested the hypotheses that in young adults earlier AFD is associated with [1] the common variance among externalizing problems (lifetime alcohol, marijuana, other drug, childhood conduct, and adult antisocial behavior problems) rather than being uniquely associated with alcohol problems, and [2] the disinhibited personality traits of social deviance and impulsivity, and that the association between earlier AFD and externalizing problems is partly accounted for by disinhibited personality. The sample (N=502) included 299 young adults with a history of alcohol dependence (AD) and 203 subjects with no history of AD. Analyses showed that [1] earlier AFD was associated with the covariance among the different domains of externalizing problems and was not unique to any one externalizing problem, [2] earlier AFD was associated with social deviance and impulsivity, and [3] social deviance and impulsivity accounted for part of the association between earlier AFD and externalizing problems. The results suggest that earlier AFD is associated with a vulnerability to disinhibitory disorders and is not specifically associated with alcohol problems.
doi:10.1016/j.addbeh.2009.12.004
PMCID: PMC2830366  PMID: 20074861
Age of first drink; alcoholism; personality; externalizing behavior; externalizing psychopathology
24.  Development and Vulnerability Factors in Adolescent Alcohol Use 
This article provides an overview of the characteristics of adolescent alcohol use, normative and subgroup variations in drinking behavior, and important factors associated with an increased risk for developing alcohol problems in later adolescence and young adulthood. A parental/family history of alcoholism, temperament traits, conduct problems, cognitive functioning, alcohol expectancies, and peer and other social relations are identified as influencing an adolescent’s susceptibility for initiating a variety of alcohol use behaviors. The Deviance Prone Model, proposed by Sher (1991), is presented as an important tool for testing possible relationships among the various risk factors and their sequencing that leads to early adolescent alcohol and drug initiation and use. It is also possible to extend the model to allow for an examination of the complex interplay of risk factors that leads to the development of alcohol use problems in late adolescence and young adults.
doi:10.1016/j.chc.2010.03.004
PMCID: PMC2916876  PMID: 20682217
Adolescents; alcohol use; vulnerability factors; deviance proneness
25.  The role of Alcoholics Anonymous in mobilizing adaptive social network changes: A prospective lagged mediational analysis 
Drug and alcohol dependence  2010;114(2-3):119-126.
Objective
Many individuals entering treatment are involved in social networks and activities that heighten relapse risk. Consequently, treatment programs facilitate engagement in social recovery resources, such as Alcoholics Anonymous (AA), to provide a low risk network. While it is assumed that AA works partially through this social mechanism, research has been limited in rigor and scope. This study used lagged mediational methods to examine changes in pro-abstinent and pro-drinking network ties and activities.
Method
Adults (N = 1,726) participating in a randomized controlled trial of alcohol use disorder treatment were assessed at intake, and 3, 9, and 15 months. Generalized linear modeling (GLM) tested whether changes in pro-abstinent and pro-drinking network ties and drinking and abstinent activities helped explain AA's effects.
Results
Greater AA attendance facilitated substantial decreases in pro-drinking social ties and significant, but less substantial increases in pro-abstinent ties. Also, AA attendance reduced engagement in drinking-related activities and increased engagement in abstinent activities. Lagged mediational analyses revealed that it was through reductions in pro-drinking network ties and, to a lesser degree, increases in pro-abstinent ties that AA exerted its salutary effect on abstinence, and to a lesser extent, on drinking intensity.
Conclusions
AA appears to facilitate recovery by mobilizing adaptive changes in the social networks of individuals exhibiting a broad range of impairment. Specifically by reducing involvement with pro-drinking ties and increasing involvement with pro-abstinent ties. These changes may aid recovery by decreasing exposure to alcohol-related cues thereby reducing craving, while simultaneously increasing rewarding social relationships.
doi:10.1016/j.drugalcdep.2010.09.009
PMCID: PMC3062700  PMID: 21035276
Alcoholics Anonymous; social networks; self help groups; alcoholism; alcohol dependence

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