These community risk factors were more pronounced for excessive drinking patterns than for the quantity or frequency of drinking. These effects of college environmental factors were partly explained by social-involvement, experiential, and normative expectations: college students drank for the positive consequences, because they over-estimate the drinking of their friends, or because of other normative expectations. The role of living arrangements has been shown in previous American [ 31 ], European [ 10 , 32 ], and cross-comparative [ 3 , 33 ] studies in which living with parents, not living on the campus, and not living in fraternity and sorority houses protected against heavy or abusive drinking.
We found that living on the campus was a more potent predictor of frequent abusive drinking than living in a dormitory both in model 1 and model 2. On the surface, this might seem to contradict a previous European review [ 10 ]. However, this is in part because of the strong association between living on the campus and living in a dormitory. This is also consistent with the Harvard School of Public Health college alcohol study which found that living off-campus was a stronger and more significant factor than staying in a dormitory [ 31 ].
The finding that the dormitory became non-significant in model 2 suggests that social-involvement, experiential, and normative expectations contribute to explain college environmental factors of drinking behaviours. Yet, our study shows that the college environment influences drinking behaviour in a much more complex way that involves not only where students live but also the kind of living arrangements, participation in traditional student folklore, the duration of college training, and the type of faculty in which the student is studying.
In particular, living in a dormitory with a high number of room-mates and being highly involved in traditional student folklore also play a role in the frequency of abusive drinking. There is thus not one college environmental risk factor but several that relate to different aspects of student life. The role of dormitory size needs, in particular, to be emphasized and could be explained by innovation diffusion.
As adolescent social network studies have shown, teenagers who have a denser social network are more likely to drink than those with less dense social networks [ 34 ]. The finding on that pre-partying contribution to the relationship between college environmental factors and frequency of abusive drinking supports this hypothesis. As in previous studies [ 15 ], pre-partying was revealed to be a common practice contributing to both drinking behaviour and the influence of community factors on drinking behaviour.
College students pre-party to ease the discomfort or awkwardness associated with meeting new people. Our study shows that abusive drinking increased with the period attending the college, whereas it decreased with age. These two opposite effects were of similar magnitude: this may explain why previous studies have found no clear relationship between age and drinking behaviour [ 10 ]: it all depends on the time spent in the university.
Few studies have controlled for the time spent in college, so that the protective maturing effect of age was confounded by the risk attached to the time spent attending college. One important prospective American study found, moreover, that heavy drinking decreased with age [ 35 ], while there is wide evidence of an association between late adolescent drinking behaviour and subsequent drinking into adulthood [ 8 ].
Why did older students drink less while, at the same time, more years at the University were associated with more drinking? Some start a postgraduate programme later in life, while working part-time. Secondly, age and time at the University capture different risks linked to drinking alcohol: age may also capture a cohort effect and, in particular, changes in drinking habits: older students may not only adapt their consumption but may also have started drinking later than the younger age group.
A third possible explication is that a significant proportion of students had studied outside the University for their first undergraduate degree and where thus not exposed to the campus for as long as those who followed both under- and postgraduate programmes on the same campus.
Our study suggests that the maturing effect on heavy drinking is modest and depends on the time spent attending the University, leaving one particular group of college students at risk: those starting university at a younger age and studying there for longer periods. But these results should be approached with caution. Our Z Fisher correlation was 0. The college social environment increases drinking through a combination of social activities and normative and motivational expectations.
It puts students at risk of frequent and abusive drinking because students expect positive social consequences, because of social activities such as pre-parties, and because of injunctive and descriptive drinking norms. The role of such social and normative influences, evidenced in previous studies [ 36 , 37 ], may result from two different and complementary processes: social learning, in which drinking behaviour is acquired through social interaction, and social control, which emphasizes the role of social expectations such as norms and peer pressure [ 38 ].
Finally, pre-partying and participation in traditional student folklore, both of which provide strong opportunities for social learning, emerged as strong predictors of drinking behaviour. All this suggests that social learning is a key factor that contributes to the effect of the college social environment on drinking behaviour, as found elsewhere [ 39 ]. Our cross-sectional study is vulnerable to reversed causality, so the results need to be interpreted with caution.
It could be that involvement in student life and drinking behaviour are confounded by unobserved vulnerability. Extraverted individuals are sensitive to positive social rewards and, thus, more likely to engage in socially-motivated drinking, so the relationship between traditional student folklore and drinking behaviour may be biased upwards. Moreover, the dose-response relationship with involvement in traditional student folklore or with the number of room-mates may downplay this risk of confounding without totally removing it.
To assess the risk of confounding we replicated the analysis controlling for the age at which the student reported that he or she started drinking, a factor known to predict a heavy alcohol consumption trajectory [ 40 ].
Our results suggest that this kind of self-selection risk may slightly affect our conclusions. The second limitation has to do with the setting, which unlike other campuses in Belgium or abroad, is much less socially mixed, giving the college environmental factors more clout while mitigating other social control effects.
Our results, nevertheless, are in line with a cross-comparative study such as the College Alcohol study in the U. Finally, it could be that our setting provides a pessimistic picture of community factors and is, in that sense, a good model for reflecting on the community risk factors linked to college drinking behaviour.
It is foreseen that in the future most young adults will attend university where, our study shows, they will be exposed to frequent and intensive drinking behaviour. That experience will have subsequent and important consequences lasting into adulthood [ 8 ]. Colleges need thus to acknowledge their role in this issue and to commit themselves to lower exposure to excessive alcohol consumption.
In particular, they need to combine multi-level strategies: individual, group, and organization-level, from a community health promotion perspective. One danger would be a top-down approach of undertaking community actions in ways that do not consider the realities of student life. A first step would be to involve members of the community in identifying realistic objectives, e.
A second step would be to define interventions, e. Third and fourth steps would be to evaluate what has been implemented, to provide feedback in order to improve and extend interventions, which requires sustained funding, and to analyse gaps between national policies and what is locally feasible. More community-based research is needed to face the problem of hazardous alcohol use, which is persistent and pervasive. Google Scholar. Schulenberg JE, Maggs JL: A developmental perspective on alcohol use and heavy drinking during adolescence and the transition to young adulthood.
J Stud Alcohol. Dantzer C, Wardle J, Fuller R, et al: International study of heavy drinking: Attitudes and sociodemographic factors in university students. J Am Coll Health. Article PubMed Google Scholar. Stock C, Mikolajczyk R, Bloomfield K, et al: Alcohol consumption and attitudes towards banning alcohol sales on campus among European university students. Public Health. Rehm J, Mathers C, Popova S, et al: Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders.
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Institute for Health and Society, Clos- chapelle aux champs 30 - B1. You can also search for this author in PubMed Google Scholar. Correspondence to Victoria Eugenia Soto. The authors declare that they have no conflicts of interest relevant to the manuscript submitted to BMC Public Health. VL conceived the study, carried out the survey, performed the data analysis, and drafted the manuscript. PN participated in the design of the study, carried out the survey, contributed to analysis and helped draft the manuscript.
VES contributed to analysis and helped draft the manuscript. WD contributed to analysis and helped draft the manuscript. All authors read and approved the final manuscript. Reprints and Permissions. Lorant, V. Alcohol drinking among college students: college responsibility for personal troubles. BMC Public Health 13, Download citation. Received : 10 December Accepted : 25 June Published : 28 June Skip to main content. Search all BMC articles Search.
Download PDF. Abstract Background One young adult in two has entered university education in Western countries. Results On average each student had 1. Background In one young adult in two has entered university education in Western countries and this proportion is likely to increase in the future [ 1 ].
Objectives The study analyses alcohol consumption among college students from a community health perspective. Methods Design and participants This study is part of an important multi-method investigation into alcohol drinking among college students.
Data analysis The analysis was in two stages, according to our two research questions. Results On average, students were aged Table 1 Socio-demographic and drinking patterns, drinking at college study Belgium descriptive statistics Full size table. Discussion Main findings This study confirmed that excessive alcohol consumption is common among college students, with an average of 3 episodes of abusive drinking per month.
Consistency with previous studies The role of living arrangements has been shown in previous American [ 31 ], European [ 10 , 32 ], and cross-comparative [ 3 , 33 ] studies in which living with parents, not living on the campus, and not living in fraternity and sorority houses protected against heavy or abusive drinking. Limitations Our cross-sectional study is vulnerable to reversed causality, so the results need to be interpreted with caution.
Student personnel workers might well discuss the ramifications of this research for designing drug education projects on their campuses. Orientation programs, activities programs, and counseling programs should be concerned with intervening in the socialization process whereby students learn to be drinkers and smokers. Parents should be involved in all of these programs so that they learn more about the role of their norms in student use of the two drugs. If drinking alcohol represents conformity to parental norms whereas smoking marijuana represents nonconformity, student personnel workers should help parents and students understand the dynamics of this situation p.
Overall, this era saw increased focus on developing prevention approaches for college drinking. For example, Filstead et al. Many reported suggestions bear a striking resemblance to evidence-based practices recommended today, including developing and consistently enforcing clear alcohol policies, training residence hall staff and faculty to identify and refer students exhibiting alcohol problems, incorporating peers into alcohol prevention activities, and coordinating campus and community alcohol treatment services.
Subsequent research Engs, highlighted the importance of evaluating program effectiveness: An educational film and peer-led values-clarification exercises changed knowledge but did not change drinking behavior of college students. This recommendation remains relevant in the current climate. In addition to intervention development, researchers continued and expanded their efforts to document trends in drinking on college campuses.
Hanson a , b noted a shift from parental to peer influences on drinking and a reduction in drinking for sedative effects among students at 17 colleges from to There was a decrease in the amount of alcohol consumed over this period but no change in likelihood of drinking. Hanson a , b hypothesized that other substances were being used to achieve sedation, supporting increased focus on comorbid use of alcohol and other substances. Although college students did not appear until the survey Johnston et al.
The wealth of information on adolescent and young adult substance use within the Monitoring the Future database continues to inform prevention efforts and responses to emerging needs to this day Johnston et al.
Southwick et al. Development of prevention approaches also continued, mostly advocating educational or disease-model approaches Kazalunas, ; Kleinot and Rogers, ; Ramsey, , although there was a move toward matching interventions to specific etiologic models of college drinking. For example, Kleinot and Rogers tested three components of alcohol prevention based on protection motivation theory Rogers and Mewborn, as well as the health belief model Becker, They found that interventions increasing perceived noxiousness of alcohol consequences, personal vulnerability, and effectiveness of moderate drinking strategies were most associated with increased behavioral intentions to drink moderately rather than excessively.
Given prior research demonstrating how expectancies influence drinking, and the potential to modify such expectancies through intervention, Fromme et al. Skills covered in the STP were designed to help students who made the choice to drink do so in moderation and reduce alcohol-related harms.
STP sessions included discussion of blood alcohol level BAL monitoring, managing high-risk drinking situations, discussion-based alcohol-expectancy challenge, and stress-management training. In addition to seeing if STP would influence alcohol-related expectancies, the potential mediating effect of changing expectancies on mean drinks per week, hours per week, and BAL was tested. Significant group differences were not evident; however, within-group analyses showed significant reductions on all drinking outcomes from baseline to postintervention and 4-month follow-up in STP, with no reductions evident in AOC and reductions in only hours and BAL evident in AIS at 4-month follow-up but not postintervention.
By this time, the impact of peer influences on college drinking was clear. A growing movement involving peer health education became more visible. Researchers also began documenting the significant role played by misperceptions of the norms surrounding college student drinking. Perkins and Berkowitz showed that students tended to overestimate permissiveness of attitudes and drinking behaviors, and that these perceptions correlated with their own drinking.
This research laid the groundwork for later interventions targeting individual normative reeducation and social norms mass marketing. In addition to documenting drinking rates and consequences experienced by college students, national surveys also attempted to detail services and educational efforts offered on college campuses.
There was recognition of the need to address college student drinking, yet no clear guidelines on how to best do this. At the same time, the minimum legal drinking age MLDA started to universally move to 21 in the United States a transition accomplished in Although later research eventually showed that increases to the MLDA decreased both traffic crashes and alcohol consumption Wagenaar and Toomey, , initial evaluations of college students showed everything from shifts in where students did their drinking George et al.
One article written by student affairs staff Roberts and Nowak, concluded:. Another approach that may help during and after the transition to the [MLDA] of 21 would be to make funds available to institutions of higher education to develop, test, and disseminate information about model alcohol education programs.
Approaches to alcohol education are already in use. These approaches need to undergo rigorous evaluation and then be made available for application throughout college campuses, p. Although widespread dissemination of best practices was still 16 years away, it was time for the college-drinking field to identify efficacious programs.
In , Kivlahan and colleagues conducted a study following up on Fromme et al. Promising results led to a subsequent study by Baer and colleagues in which the ASTP was shortened to six sessions, altered to include in vivo expectancy challenge, and compared against self-help versus a 1-hour individualized feedback and advice session using motivational interviewing Miller and Rollnick, In late , Wechsler and his team from the Harvard School of Public Health College Alcohol Study used the term binge drinking to describe consumption of five or more drinks in a row for men and four or more drinks in a row for women in the past 2 weeks.
In time, academic journals led by the Journal of Studies on Alcohol [JSA] requested different terminology and generated policies requiring authors to make a distinction between a binge being several days of extended intoxication at the expense of other activities and heavy episodic drinking or other, similar phrases referring to massed consumption on isolated occasions a policy maintained by JSAD; Alcohol Research Documentation, Inc.
Unfortunately, although successfully advancing the recognition of a potential concern, this work did not identify a solution. One potential solution came through subsequent work by Marlatt and colleagues, which more definitively established the success of BASICS in reducing alcohol use and negative consequences among high-risk drinkers Baer et al.
The Task Force on College Drinking was charged with characterizing the phenomenon of college student drinking, along with its harms, and synthesizing the research literature to provide key stakeholders with science-based guidance on how to address drinking on their campuses, as well as set the research agenda for future college drinking prevention studies. Colleges, which described a four-tier system delineating the efficacy and effectiveness of different approaches in reducing alcohol use by college students, with Tier 1 having the greatest scientific support and Tier 4 having the lowest.
Individual-focused prevention approaches geared toward changing the drinking behaviors of individual students, including BMIs and expectancy challenge, predominantly occupied Tier 1, whereas environmental approaches designed to alter the context in which drinking occurred, such as increased enforcement of the MLDA, mostly occupied Tier 2. Purely educational approaches were assigned to Tier 4. These recommendations were largely based on two literature reviews compiled by Larimer and Cronce and Toomey and Wagenaar , which along with reports by other members of the task force were published in a special supplement of JSA made available to the public via www.
Along with dissemination of the report and supporting scientific review articles on the website, copies of the task force report were mailed to college presidents at institutions across the United States. Also part of the task force report, and published in a separate issue of JSA in , was a study by Hingson et al.
This report estimated that approximately 1, college students lost their life to alcohol-related causes each year, and another , were injured while under the influence of alcohol. This unique mechanism paired teams of experienced alcohol research scientists with campuses experiencing an urgent alcohol-related problem, allowing for the swift implementation and evaluation of evidence-based approaches to reduce alcohol use and consequences.
Ultimately, 5 teams of scientists and 15 campus intervention sites were funded through this mechanism. Results provided support for in-person individual BMIs in a campus health setting Schaus et al. Studies reported in the JSAD supplement also provided initial quasi-experimental support for two comprehensive campus-community partnerships Saltz et al. Specifically, although only 44 unique intervention conditions had been reviewed by Larimer and Cronce in , covering a year period from to , a total of 60 intervention conditions targeting college student drinking had been tested using a randomized controlled design in the intervening 7 years — A similar trend was noted by Toomey and colleagues, with few studies available at the time of the review and evaluations of environmental approaches published of which 36 specifically targeted college students at the time of the review.
Although the broad recommendations remained the same, important insights were gained and new research directions determined through these reviews, most of which were summarized in the page report released by NIAAA: What Colleges Need to Know Now: An Update on College Drinking Research Of note, additional reviews of the literature emerged around the same time, focusing on web-based stand-alone intervention approaches e. As the evidence mounted for the efficacy of specific individual-focused interventions, exploration of moderators and mediators of treatment effect gained speed.
A host of individual difference variables have been tested as potential moderators, including gender, high-risk drinking status, drinking motives, and personality differences, although no individual moderator has consistently emerged as significant. In terms of potential mediators, normative reeducation was a key component in two of the three Tier I programs listed in the NIAAA Task Force report and emerged as an efficacious stand-alone approach i. As such, changes in normative perceptions were the focus of a wealth of research, which overwhelmingly demonstrated the mediating role of correcting normative perceptions in decreasing alcohol use e.
The specificity of the normative referent group was also found to have a mediating role e. Motivational enhancement and alcohol-specific skill building were also critical components of the Tier I approaches, and there was substantial evidence suggesting the relevance of readiness to change and use of protective behavioral strategies to drinking. Some studies have shown support for the mediating role of these variables e. Overall findings were consistent with Larimer and Cronce , ; however, the again exponential expansion of research allowed for greater exploration of web-based and other technology-based programs versus in-person programs.
Overall, personalized feedback interventions, patterned after the feedback offered as part of BASICS, were effective in reducing drinking; however, the changing nature of web-based materials and programs was noted as an area for concern, especially for commercial-based programs for which frequent version updates are the norm and little is known or tested empirically about variation in efficacy between versions.
Collectively, the research on college student drinking over the past 75 years has helped reduce individual and societal harms, but much work remains. The prevalence of drinking among college students remains high, and increased co-occurring use of both legal e. The past decade has also seen unprecedented changes in terms of how college students interact with the world and receive information. Social networking mediums, including Facebook and Twitter, have virtually replaced face-to-face contact, phone calls, and email as primary means of communication.
More research is needed to see how interacting via these mediums influences drinking and how they may be used for intervention. Most importantly, the speed with which technology is changing, and ever-tighter financial resources at the college, state, and federal level, requires that we attempt to develop intervention methods whose efficacy is not bound to a particular medium and that can be rapidly adapted to accommodate the needs of colleges and college students.
The content is solely the responsibility of the authors and does not necessarily represent the official views of any of the funding agencies. National Center for Biotechnology Information , U. J Stud Alcohol Drugs Suppl. Jason R. Kilmer , Ph. Cronce , Ph. Larimer , Ph.
Jessica M. Mary E. Author information Article notes Copyright and License information Disclaimer. Kilmer at Box , Seattle, WA —, or via email at: ude. Received Jul 15; Revised Aug 1. This article has been cited by other articles in PMC. Abstract Objective: College student drinking is not a new phenomenon, yet the field of research studying college student drinking is relatively young.
Method: Articles were selected by consensus of the authors from incarnations of the journal and other academic journals based on their relevance to the genesis of current best practices regarding college student drinking prevention. Conclusions: Understanding the rich history of science related to college drinking prevention should prepare and guide our field for the next 75 years of scientific advances, leading to even greater understanding of the etiology and topology of college student drinking as well as more effective methods to reduce alcohol-related harms.
Method In recognition and celebration of the 75th anniversary of what is now the Journal of Studies on Alcohol and Drugs JSAD , a review of college drinking research across the various incarnations of the journal was conducted. Results Early efforts to describe and understand college student drinking In , Dr. Fry concluded with a plea that alcohol disorders be seen as a health concern: It is the obligation of the university, which should be concerned with the health of its students, to view alcoholism as a possible symptom of emotional disturbance, in need of psychiatric attention, rather than as a form of behavior calling for customary disciplinary action.
Emergence of harm-reduction efforts, normative interventions, and attempts to document campus strategies Given prior research demonstrating how expectancies influence drinking, and the potential to modify such expectancies through intervention, Fromme et al. One article written by student affairs staff Roberts and Nowak, concluded: Another approach that may help during and after the transition to the [MLDA] of 21 would be to make funds available to institutions of higher education to develop, test, and disseminate information about model alcohol education programs.
Efficacious prevention efforts and high-risk drinking In , Kivlahan and colleagues conducted a study following up on Fromme et al. Updates to the science, moving beyond main effects, and emerging technology Five years following publication of the NIAAA Task Force report, NIAAA commissioned a second review of the literature to provide an update of the findings on individual and environmental prevention strategies evaluated by Larimer and Cronce and Toomey and Wagenaar Discussion Collectively, the research on college student drinking over the past 75 years has helped reduce individual and societal harms, but much work remains.
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