effects of alcohol on students research paper pdf

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• v.10(4); 2023 Apr
• PMC10006657

Prevalence of alcohol consumption among high school students: A cross‐sectional study

Jelena Šarić posavec.

1 Faculty of Medicine, University of Ljubljana, Ljubljana Slovenia

2 Maruševec High School, Maruševec Croatia

Danica Rotar Pavlič

3 Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana Slovenia

Kristina Kralik

4 Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek Croatia

Associated Data

Data available on request due to privacy/ethical restrictions.

This study addresses the risk and protective factors for alcohol consumption among medical‐technology high school students. The specific objectives of the study were to analyse standard influences on excessive alcohol consumption (influence of parents and upbringing) and possible modern influences, represented by social networks and internet use.

A cross‐sectional analysis.

The sample included the entire cohort of third‐year students attending high school in Varaždin ( n  = 1,352). Data were collected using an anonymous questionnaire. The bivariate analysis used an independent t test and a Chi‐squared test. The multivariate analysis used logistic regression. The study was conducted from September 2018 to February 2019.

Alcohol consumption was most prevalent among vocational students, followed by college‐preparatory students and medical‐technology students. Style of parenting and maternal authority have a positive influence on less alcohol use among students. The results showed that smartphone ownership and internet use do not correlate with alcohol use among high school students.

1. INTRODUCTION

Alcohol is a psychoactive substance that causes dependence, producing a large public health burden among young people (Stockings et al.,  2016 ). Alcohol consumption is the main cause of death and disease all around the world. It worsens brain function and increases the risk of death, injury, physical and sexual violence and many other social deviations (El Jilali et al.,  2020 ; Kim et al.,  2022 ).

Previous research indicates that drinking is socially acceptable on certain occasions throughout Europe. For example, the prevalent drinking pattern in the wine‐producing countries of southern Europe is frequent consumption of moderate amounts of alcohol (Kuendig et al.,  2008 ). Average consumption in central and eastern Europe (CEE) is high, with a relatively large proportion of annual unrecorded consumption of pure alcohol ranging from 1.0 L in the Czech Republic and Estonia to 10.5 L in Ukraine per capita (Popova et al.,  2007 ). In CEE, alcohol use is the fourth‐leading risk factor for disease and mortality (Forouzanfar et al.,  2015 ).

Nurses must be aware of the dangers of young people drinking, recognize the signs of alcohol abuse and know how to intervene. Frequent drinking of alcohol leads to health damage, so nurses must assume an active role in health promotion and ensure that adolescents are aware of the associated dangers (Kiernan et al.,  2012 ).

2. BACKGROUND

Risky and harmful use of alcohol is still the most important cause of death among young people between the ages of 15 and 29 (WHO,  2018 ). Risk factors for alcohol consumption are divided into two categories: the first category includes legal, social and cultural factors that provide a normative assumption for behaviour, and the second category is factors of individuals and their interpersonal environment (Petronytė et al.,  2007 ). An Australian study carried out a decade ago emphasized the use of alcohol in the family, specific communication patterns (the extent to which adolescents feel free to talk to their parents about emotional topics), adopted rules and parental involvement, quality of the parent–child relationship, family conflicts and parental monitoring of adolescents' everyday activities (Ryan et al.,  2010 ).

Studies also show that many parents take responsibility for young people's attitudes towards alcohol and their drinking habits (Ryan et al.,  2011 ). Population studies find that early age of drinking onset correlates with increased lifetime risks for developing alcohol dependence, violence and injuries (Crews et al.,  2016 ). Drinking during adolescence increases the risk of hazardous or harmful alcohol use, heavy episodic drinking, alcohol dependence, injuries and psychological distress (Pillai et al.,  2014 ).

The Varaždin region has a reputation as an area with high alcohol consumption in Croatia. The most recent ESPAD (European School Survey Project on Alcohol and Other Drugs) survey showed that 64% of Croatian secondary school students had tried an alcoholic beverage before age 13. Furthermore, 11% had been intoxicated before age 13, which is higher than the European average (8%; ESPAD,  2015 ). In 2015, the study was conducted for the sixth time. Overall, 55% of Croatian students reported drinking alcohol in the previous 30 days. The results also showed that the prevalence of drunkenness reported in the previous 30 days was 16% for all students (17% for boys and 14% for girls; Kraus et al.,  2016 ).

In Croatia, graduate nurses offer adolescents education, advice and information about the harm of alcohol consumption and abuse. They encourage the development of positive life habits and attitudes to avoid addiction (Moro & Frančišković,  2011 ). They also play an important role in educating and advising young people about the safe limits of drinking (Govier & Rees,  2013 ). However, parents and young people's social environments also play an important role in addressing alcohol misuse among adolescents (Ward & Verrinder,  2008 ). Studies show that supervision and good communication between parents and adolescents can delay the start of drinking (Koning et al.,  2009 ).

A study of Japanese adolescents indicated that those that used the internet more consumed alcohol more often and in greater amounts compared to adolescents that used the internet less (Morioka et al.,  2017 ). The authors linked this to insomnia and aggressive behaviour, which is related to more frequent drinking by students.

This study provides an overview of alcohol consumption among medical‐technology (med‐tech) high school students and formulates recommendations for the work of nurses conducting health education in schools in Varaždin County. The added value of this research is that, in addition to psychosocial factors, which also include family situations, it also investigated possible connections with electronic media use. The analysis was performed based on the type of school, and for the first time, it included students from med‐tech high schools. The specific objectives of the study were to analyse standard influences on excessive alcohol consumption (influence of parents and upbringing) and possible modern influences, represented by social networks and internet use. These results will make it possible to plan the work of nurses involved in the health education of high school students in Croatia.

3.1. Design and sample

A cross‐sectional study design was created. The survey included 1,352 students from 13 high schools in Varaždin County during the 2018/19 school year. Their ages ranged from 15 to 20. There were 692 male students (51.2%) and 660 (48.8%) female students. The students were divided by type of school into college‐preparatory (college‐prep), vocational and med‐tech students (future nurses, laboratory assistants, physiotherapists, etc.).

The entire third‐year cohort was included in the study. The inclusion criteria were that the student was attending the third year and that he or she had signed an informed consent statement. Participation in the questionnaire was voluntary. The exclusion criteria were the following: the student did not sign a consent form, did not answer all the questions or gave up filling out the survey. If the questionnaire was not fully completed, it was not processed and used for analysis. Demographic variables were part of the questionnaire. Students answered questions about age, name of the school, sex and place of origin. Among psychosocial variables, students were asked to rate satisfaction with their life on a scale of 1 to 10 (1 = worst to 10 = best). Students were also asked how often they talk to their parents, and the kind of relationships they have with their mother and father was explored. When asked about their mothers and fathers, the students chose a statement about whether they are strict or lenient. A 5‐point Likert scale was at their disposal. For the drinking habits of mothers and fathers, we asked whether the mother or father never drinks alcohol, drinks alcohol only on special occasions, occasionally drinks alcohol or often drinks alcohol.

The researcher JŠP scheduled the survey timing with the school principal or the teacher. For each class, she was given an appointment, and she gave the students surveys and informed consent forms. She was present the entire time the survey was being administered (45 min). The students returned the completed questionnaires to JŠP.

3.2. Measuring instrument and data collection

The data were collected using a questionnaire. Ajduković & Kolesarić, ( 2003 ) was fully respected throughout the entire process. The questionnaire was taken from and approved by Kolšek ( 2000 ). The current questionnaire was adapted and supplemented with questions on electronic media use. The questionnaire consisted of 59 questions. The students completed the paper version of the questionnaire during class time. They had 45 minutes to complete the questionnaire. They put their completed questionnaires in prepared envelopes and gave them to the researcher. The study was conducted from September 2018 to February 2019. The data were analysed from March to May 2019.

The primary dependent variable was the students' current drinking status. Students were asked to rate their satisfaction with their lives and what kind of relationship they have with their mothers and fathers. The electronic media variables included questions about smartphone ownership and internet use.

3.3. Ethical considerations

This study was approved by the Ethics Committee of the Ministry of Science and Education on 27 September 2018 (no. 533‐05‐18‐004). No parental consent was required for the study; according to Ajduković & Kolesarić, ( 2003 ), in Croatia children, over the age of 14 may provide their own written or oral consent. The study was in accordance with the FRA's policy on child participation in research. 1 Ajduković & Kolesarić, ( 2003 ) was fully respected in the written report.

3.4. Statistical analysis

Categorical data are represented by absolute and relative frequencies. Differences between categorical variables were tested using the chi‐squared (χ 2 ) test. The normality of the distribution of numerical variables was tested with the Shapiro–Wilk test. Numerical data are described with arithmetic means and standard deviations in the case of normal distributions and, in other cases, with medians and the limits of the interquartile range. Differences between normally distributed numerical variables between two independent groups were tested using the Mann–Whitney U test. Between the three independent groups, differences in numerical variables were tested with analysis of variance and, in the event of deviation from a normal distribution, with the Kruskal–Wallis test.

Logistic regression assessed the impact of multiple factors on the likelihood that students would consume alcohol. Ten independent variables (sex, school, satisfaction with family life, parental assistance, talking with parents, alcohol consumption with relatives, father's characteristics, mother's characteristics and each parent's alcohol consumption) were used, with the dependent variables being alcohol consumption and use of electronic media (owning a smartphone and internet use). The statistical program used was MedCalc Statistical Software version 18.11.3 (MedCalc Software, Ostend, Belgium) and SPSS Statistics 23 (IBM SPSS Statistics for Windows, Armonk, NY).

The overall reliability rating of the full scale is expressed using Cronbach's alpha. Cronbach's alpha for questions related to the parental relationship was 0.883. For the questions related to alcohol consumption, Cronbach's alpha was 0.305.

Students were divided by type of school into college‐prep with 334 (24.7%) students, vocational with 803 (59.4%) and med‐tech with 215 (15.9%). The median age of the students was 18 (interquartile range 17–18) with a range of 15–20. The results indicate that 92.4% of all students had tried alcoholic beverages. The highest percentage was in vocational schools (94%), followed by college‐prep high schools (90%) and med‐tech schools (89%). The median of alcoholic drinks consumed in the previous 30 days for all types of students was 10.

The interquartile ranges varied: for college‐prep students, it ranged from 2 to 19, for vocational students 3 to 30 and for med‐tech students 3 to 25. The median of alcoholic drinks consumed in the previous 7 days was two for college‐prep students and three for both vocational and med‐tech students. The interquartile range for college‐prep students ranged from 0 to 5, for vocational students from 0 to 10 and for med‐tech students from 0 to 5 (Table  1 ).

Medical‐technology high school students drinking habits in the last 30 days

Third‐year students mostly drink beer (38.8%), followed by cocktails, white wine with sparkling water, rum and cola or alcohol in tea (18.6%), spirits (18.5%), wine or champagne (12.5%) and cider (3%); 8.7% do not drink alcohol at all (Table  2 ).

Types of drinks consumed

Most often, students drink several times a month (41.4%). The highest number of students in this group are med‐tech students (47%) and the lowest are vocational students (39%). Overall, 26.6% of students drink weekly; 30% of those attending vocational schools, 25% at med‐tech schools and 19% at college‐prep schools. A total of 18.6% drink a few times a year, 25% of whom are college‐prep students, 17% vocational students and 15% med‐tech students.

As many as 33.1% of students reported that when they drink alcohol they usually drink more than three drinks, 22.9% drink two to three drinks and 22.3% drink one to two drinks. As seen in Table  3 , vocational students are most likely to drink more than three drinks (37.4%), med‐tech students two to three drinks (27.9%) and college‐prep students one to two drinks (27%).

Drinking frequency and amount

In terms of life satisfaction, in principle, all students are satisfied. Table  4 shows that among vocational students, 9% report that their parents talk to them never or rarely. Compared to other schools, a slightly smaller percentage (91.3%) of vocational students' parents sometimes or almost always talk to the students (med‐tech schools 93.7%; college‐prep schools 95.4%).

Family life

Abbreviation: SD, standard deviation.

There is no statistically significant difference by type of school and father's alcohol consumption. A total of 42% of college‐prep students’ fathers drink alcoholic beverages only on special occasions, whereas 44% of med‐tech students’ fathers occasionally drink alcoholic beverages. There was a statistically significant difference depending on the type of school and how the mother drinks alcohol ( p  = .006, χ 2 test). Most often the mothers drink only on special occasions (51.8%). Among mothers of med‐tech high school students, 32% never drink alcohol. Mothers of college‐prep students drink only on special occasions (60%).

Logistic regression assessed the impact of multiple factors on the likelihood that students would try alcohol. The model contains eight independent variables (sex, school, satisfaction with family life, conversation with parents, father's characteristics, mother's characteristics and each parent's alcohol consumption). The significance of individual predictors in predicting alcohol consumption is shown in Table  5 .

Predicting the probability that a student will try alcohol (univariate regression analysis) and the impact of internet use on drinking habits

Predictors that are significant were viewed as a model. The model was statistically significant overall, χ 2  = 24.78, p  = .002, indicating that it can distinguish students who drink from those who do not drink. The model as a whole explains between 8.1% (Cox & Snell) and 19.6% (Nagelkerke) of the variance among students who consume alcohol, and it accurately classifies 92.5% of the cases.

Only four independent predictors made unique statistically significant contributions to the model. If the student's parents are stricter and more determined, the student will be less likely to consume alcohol. Moreover, the strongest predictor that affects students’ alcohol consumption is their father's alcohol consumption (rare vs. frequent).

The correlation between alcohol and electronic media proved to be weak or non‐existent. There was no correlation between whether students have ever tried alcohol and owning a smartphone ( p  = .06) or using the internet ( p  = .09).

5. DISCUSSION

The study results show that the share of alcohol consumption is high among med‐tech students in Varaždin County, which was surprising because they include future health workers. Tejedor‐Cabrera and Cauli found that most of the nursing students surveyed reported regular alcohol intake, with one‐third being classified as having risky alcohol use, and one‐fifth met the criterion for hazardous drinking based on the AUDIT score (Tejedor‐Cabrera & Cauli,  2019 )

Early identification of risk factors for adolescents can help prevent and/or reduce their risk (Marshall,  2014 ). Alcohol consumption by young people (particularly early initiation) is a predictor for poorer health in later life (Bowden et al.,  2017 ).

Contrary to the findings of some other researchers (Morioka et al.,  2017 ), we did not conclude in our study that smartphone ownership and internet use correlate with alcohol use among the high school students in our study. We expected to find links regarding the use of electronic media, but the results showed that there was no connection between whether students had ever tried alcohol and owning a smartphone or using the internet. Therefore, the potential effect of digitization in future research will need to be taken as a contextualization and not as an independent variable.

The most troubling finding of our study is that the share of alcohol consumption is also high among med‐tech students. The reason for this may be that at the beginning of school, these students do not differ much from those at other schools; they follow their friends and are curious. It seems that with further education and real‐life examples, they see that, in practice, they actually become more aware of the harm and negative effect of alcohol on health. More than 90% of med‐tech school students from Varaždin County have already tried alcoholic beverages. This is in line with the findings of researchers from other countries, where concerns about frequent and excessive alcohol abuse in young people are increasing. The average age at which young people start drinking alcohol in Europe is 12.5 years. Over the last decade, the amount of alcohol consumption among adolescents in the United Kingdom has increased (Moore et al.,  2010 ). A higher frequency and higher amounts of alcohol consumption were found in students in the upper years of medical school compared to the first year (Pires et al.,  2015 ). The stress level of nursing students varies during education. Stress among students can lead to depression and anxiety, but also increased consumption of alcohol and psychoactive drugs (Pulido‐Criollo et al.,  2018 ). This may be the reason for increased alcohol consumption among medical students. This study found that certain attitudes and characteristics of parents (if the mother and father are stricter and if the mother is more determined) indicate that the student is less likely to consume alcohol. The father's alcohol consumption is the most powerful factor in transferring similar habits to the child or student (rare vs. frequent), which is similar to our study. A study investigating the influence of exposure to parental drinking on children's perception of drinking shows that what children see in their parents can be transferred to them. There is evidence of intergenerational transmission of drinking behaviour at a very young age (Cook et al.,  2022 ). Paternal alcohol consumption is associated with an increased risk of alcohol dependence and alcohol use disorders among offspring (Thor et al.,  2022 ).

The data for Varaždin County are also comparable with data for the entire country. In 2015, Croatia saw a slight decrease in how accessible alcohol was too young people. The availability of alcohol is still very high, even though it is regulated by laws that prohibit the sale and service of alcohol to minors (Pejnović Franelić et al.,  2016 ). The general problem is that students in Croatia know very little about the harmfulness of alcohol, given that the vast majority distinguish signs of intoxication, but not the harmful effects of long‐term alcohol consumption (Železnik et al.,  2015 ). ESPAD results for Croatia showed comparable results (ESPAD,  2015 ).

Another important finding that is also consistent with studies abroad is that students, despite various prevention programs, education and considerable efforts, still consume a lot of alcohol. Of particular concern is the fact that med‐tech students also consume large amounts of alcohol, and they are expected to be an example to their peers. It is obvious that prevention programs in schools are not very successful.

The most relevant problem is that alcohol use in the area where this study took place is socially acceptable and is considered a fairly harmless means of relaxation. Our study shows that alcohol consumption is most dependent on the psychosocial factors in students' environments, mostly determined by their peers and the subculture they grow up in. If parents show that they are “strong” in decision‐making and are a positive example to their children, it will certainly affect their alcohol consumption, and it is similar in other places around the world (Bowden et al.,  2017 ).

6. LIMITATIONS

This study relies on students' self‐perceptions of their drinking habits, and their subjective satisfaction with family life and relationships with parents. It would be more objective to observe them all the time and live with them, which would be difficult to do with such a large sample. It is assumed that full anonymity reduced this potential bias. The study predominantly focused on psychosocial predictors and did not include some other factors that may play a role in alcohol consumption among young people, including the media and advertising. Research conducted on adolescents aged 13–18 in Canada indicates that since social distancing began due to COVID‐19, the frequency of alcohol consumption among adolescents has increased (Dumas et al.,  2020 ). Because our research was carried out before the COVID‐19 pandemic, the results may be different now.

7. CONCLUSION

Our study resulted in some interesting conclusions; namely, that the role of the family is still at the forefront regarding alcohol consumption among med‐tech students in Varaždin County. We found that alcohol consumption is most dependent on the psychosocial factors in students' environments. If parents show that they are decisive and authoritative in decision‐making and if they provide a non‐drinking example to their children, it will certainly affect their lower alcohol consumption. The correlation between alcohol and electronic media proved to be weak or non‐existent. There was no correlation between whether students have ever tried alcohol and owning a smartphone or using the internet.

In order to reduce alcohol abuse, methods that integrate several manners of health promotion should be combined. The most important thing is to build a healthy public policy in which nurses play a key role in informing adolescents, families and the wider community. Nurses can identify strategies to focus on reducing youth alcohol use between local authorities and schools, and they can play a role in alcohol action plans designed to improve adolescent health. Nurses play a key role in fostering collaboration between the health sector, the police, education, adolescents and parents (Ward & Verrinder,  2008 ). All nurses, regardless of their place of work, should play an active role in promoting the health of children and young people, and they must have the knowledge and skills necessary to counsel adolescents and parents about the physical and mental risks of underage alcohol consumption (Kiernan et al.,  2012 ).

8. IMPLICATIONS FOR FUTURE RESEARCH

Our research focused more on psychosocial predictors and excluded some other factors that may play a role in alcohol consumption among young people, including the media, advertising and the area where they live.

Nurses should already be involved in primary prevention as educators, but by using real‐world examples, they are likely to reach students much better. Educating parents is also essential because they are the starting point for student behaviour. Nurses should be more involved in health education in schools because with their knowledge, role and involvement in prevention programs, they can contribute to reducing alcohol consumption among students. It is important that students' attention be drawn to the negative effects of alcohol on their bodies and social lives. Young people should be made aware of these negative consequences, and that there are other interesting ways to have fun and relax.

AUTHOR CONTRIBUTIONS

The authors participated in the redesign of the questionnaire. JŠP and DRP completed the study writeup and data analysis. Data analysis was conducted by KK. The authors read and contributed substantially to the draft, and they approved the final manuscript.

FUNDING INFORMATION

This research is part of a doctoral dissertation, and none of the authors has any financial benefit from it.

CONFLICT OF INTEREST

The authors declare that they have no conflict of interest.

ETHICS STATEMENT

This study was approved by the ethics committee of the Ministry of Science and Education of the Republic of Croatia on 27 September 27 2018 (no. 533‐05‐18‐004). No parental consent was required for the study; according to the Code of Ethics for Research Involving Children, in Croatia, children over the age of 14 may give written or oral consent on their own behalf. The study was in accordance with the FRA's policy on child participation in research (available at https://fra.europa.eu/en/publication/2014/child‐participation‐research ). Parents were verbally informed about the study. The Code of Ethics for Research involving Children was fully respected in the written report.

ACKNOWLEDGEMENTS

The authors are very grateful to the students who took part in this study.

Šarić Posavec, J. , Rotar Pavlič, D. , & Kralik, K. (2023). Prevalence of alcohol consumption among high school students: A cross‐sectional study . Nursing Open , 10 , 2309–2318. 10.1002/nop2.1484 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

1 Available at https://fra.europa.eu/en/publication/2014/child‐participation‐research .

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(March 2002 Supplement)

Journal of studies on alcohol  supplement.

Journal of Studies on Alcohol College Drinking, What It Is, and What To Do about It: A Review of the State of the Science

National Advisory Council on Alcohol Abuse and Alcoholism Task Force on College Drinking

Special Editors:  Mark S. Goldman, Ph.D., Gayle M. Boyd, Ph.D., Vivian Faden, Ph.D.

Supplement No:  14 Printed Date:  March 2002

Commissioned Papers

Panel 1 - contexts and consequences, studying college alcohol use: widening the lens, sharpening the focus.

Read the full Journal.

ABSTRACT Objective:  The study was designed to assess current trends in studying, and emerging approaches to furthering understanding of, college drinking. Method:  A literature review was conducted of findings and methods highlighting conceptual and methodological issues that need to be addressed. Results: Most studies address clinical, developmental and psychological variables and are conducted at single points in time on single campuses. Factors affecting college alcohol use and methods of studying them are discussed. Conclusions:  Most current studies of college drinking do not address the influence of the college and its alcohol environment. Our understanding of college drinking can be improved by expanding the scope of issues studied and choosing appropriate research designs. ( J. Stud. Alcohol,  Supplement No. 14: 14-22, 2002)

George W. Dowdall, Ph.D., Professor, Department of Sociology, St. Joseph’s University, and Henry Wechsler, Ph.D., Lecturer and Director of College Alcohol Studies, Department of Health and Social Behavior, Harvard School of Public Health

Epidemiology of Alcohol and Other Drug Use among American College Students

ABSTRACT Objective:  This article provides information on the extent of alcohol use and other drug use among American college students. Method:  Five different sources of data are examined for estimating recent levels of alcohol (and other drug) use among college students: Harvard School of Public Health College Alcohol Study (CAS), the Core Institute (CORE), Monitoring the Future (MTF), National College Health Risk Behavior Survey (NCHRBS) and National Household Survey on Drug Abuse (NHSDA). Results:  Alcohol use rates are very high among college students. Approximately two of five American college students were heavy drinkers, defined as having had five or more drinks in a row in the past 2 weeks. Alcohol use is higher among male than female students. White students are highest in heavy drinking, black students are lowest and Hispanic students are intermediate. Use of alcohol—but not cigarettes, marijuana and cocaine—is higher among college students than among noncollege age-mates. Longitudinal data show that, while in high school, students who go on to attend college have lower rates of heavy drinking than do those who will not attend college. Both groups increase their heavy drinking after high school graduation, but the college students increase distinctly more and actually surpass their nonstudent age-mates. Trend data from 1980 to 1999 show some slight improvement in recent years. Conclusions:  Despite improvements in the past 20 years, colleges need to do more to reduce heavy alcohol use among students. ( J. Stud. Alcohol , Supplement No. 14: 23- 39, 2002)

Patrick M. O’Malley, Ph.D., Senior Research Scientist, Institute for Social Research, University of Michigan, and Lloyd D. Johnston, Ph.D., Distinguished Research Scientist, Institute for Social Research, University of Michigan

Student Factors: Understanding Individual Variation in College Drinking

ABSTRACT Objective:  Research on individual differences in drinking rates and associated problems among college students is reviewed. Method:  Studies are included if completed within U.S. college and university samples and found in published scientific literature as identified by several searches of national databases. Results:  The resulting review suggests first that the extant literature is large and varied in quality, as most studies use questionnaire responses from samples of convenience in cross-sectional designs. Evidence from studies of college samples does consistently suggest that alcohol is consumed for several different purposes for different psychological effects in different contexts. A pattern of impulsivity/sensation seeking is strongly related to increased drinking among students. This pattern is supported by research into personality, drinking motives, alcohol expectancies and drinking contexts. A second pattern of drinking associated with negative emotional states is also documented. Some long-term consequences of this second pattern have been described. Social processes appear especially important for drinking in many college venues and may contribute to individual differences in drinking more than enduring personality differences. Conclusions:  Future research efforts should test interactive and mediating models of multiple risk factors and address developmental processes. ( J. Stud. Alcohol,  Supplement No. 14: 40-53, 2002)

John S. Baer, Ph.D., Research Associate Professor, Department of Psychology, University of Washington, and Coordinator of Education, Center of Excellence in Substance Abuse Treatment and Education, VA Puget Sound Health Care System

A Developmental Perspective on Alcohol Use and Heavy Drinking during Adolescence and the Transition to Young Adulthood

ABSTRACT Objective:  This article offers a developmental perspective on college drinking by focusing on broad developmental themes during adolescence and the transition to young adulthood. Method:  A literature review was conducted. Results:  The transition to college involves major individual and contextual change in every domain of life; at the same time, heavy drinking and associated problems increase during this transition. A developmental contextual perspective encourages the examination of alcohol use and heavy drinking in relation to normative developmental tasks and transitions and in the context of students' changing lives, focusing on interindividual variation in the course and consequences of drinking and on a wide range of proximal and distal influences. Links between developmental transitions and alcohol use and other health risks are discussed in light of five conceptual models: Overload, Developmental Mismatch, Increased Heterogeneity, Transition Catalyst and Heightened Vulnerability to Chance Events. We review normative developmental transitions of adolescence and young adulthood, focusing on the domains of physical and cognitive development, identity, affiliation and achievement. Conclusions: As shown in a selective review of empirical studies, these transitions offer important vantage points for examining increasing (and decreasing) alcohol and other drug use during adolescence and young adulthood. We conclude with a consideration of research and intervention implications. ( J. Stud. Alcohol,  Supplement No. 14: 54-70, 2002)

John E. Schulenberg, Ph.D., Senior Research Scientist, Institute for Social Research, Professor, Department of Psychology, and Research Scientist, Center for Human Growth and Development, University of Michigan, and Jennifer L. Maggs, Ph.D., Associate Professor, Family Studies and Human Development, University of Arizona

The Adolescent Brain and the College Drinker: Biological Basis of Propensity to Use and Misuse Alcohol

ABSTRACT Objective:  This article reviews the literature on adolescent brain development and considers the impact of these neural alterations on the propensity to use and misuse alcohol. Method:  Neural, behavioral and hormonal characteristics of adolescents across a variety of species were examined, along with a review of the ontogeny of ethanol responsiveness, tolerance development and stress/alcohol interactions. Results:  The adolescent brain is a brain in transition. Prominent among the brain regions undergoing developmental change during adolescence in a variety of species are the prefrontal cortex and other forebrain dopamine projection regions, stressor-sensitive areas that form part of the neural circuitry modulating the motivational value of alcohol and other reinforcing stimuli. Along with these characteristic brain features, adolescents also exhibit increased stressor responsivity and an altered sensitivity to a variety of ethanol effects. Findings are mixed to date as to whether exposure to ethanol during this time of rapid brain development alters neurocognitive function and later propensity for problematic ethanol use. Conclusions:  Developmental transformations of the adolescent brain may have been evolutionarily advantageous in promoting behavioral adaptations to avoid inbreeding and to facilitate the transition to independence. These brain transformations may also alter sensitivity of adolescents to a number of alcohol effects, leading perhaps in some cases to higher intakes to attain reinforcing effects. These features of the adolescent brain may also increase the sensitivity of adolescents to stressors, further escalating their propensity to initiate alcohol use. Additional investigations are needed to resolve whether ethanol use during adolescence disrupts maturational processes in ethanol-sensitive brain regions. ( J. Stud. Alcohol,  Supplement No. 14: 71-81, 2002)

College Factors That Influence Drinking

ABSTRACT Objective:  The purpose of this article is to examine the aspects of collegiate environments, rather than student characteristics, that influence drinking. Unfortunately, the existing literature is scant on this topic. Method:  A literature review of articles primarily published within the last 10 years, along with some earlier "landmark" studies of collegiate drinking in the United States, was conducted to determine institutional factors that influence the consumption of alcohol. In addition, a demonstration analysis of Core Alcohol and Drug Survey research findings was conducted to further elucidate the issues. Results:  Several factors have been shown to relate to drinking: (1) organizational property variables of campuses, including affiliations (historically black institutions, women's institutions), presence of a Greek system, athletics and 2- or 4-year designation; (2) physical and behavioral property variables of campuses, including type of residence, institution size, location and quantity of heavy episodic drinking; and (3) campus community property variables, including pricing and availability and outlet density. Studies, however, tend to look at individual variables one at a time rather than in combination (multivariate analyses). Some new analyses, using Core Alcohol and Drug Survey data sets, are presented as examples of promising approaches to future research. Conclusions:  Given the complexities of campus environments, it continues to be a challenge to the field to firmly establish the most compelling institutional and environmental factors relating to high-risk collegiate drinking. ( J. Stud. Alcohol , Supplement No. 14: 82-90, 2002)

Cheryl A. Presley, Ph.D., Director, Student Health Programs and Assistant to the Vice Chancellor for Student Affairs for Research, Executive Director, Core Institute, Southern Illinois University; Philip W. Meilman, Ph.D., Director, Counseling and Psychological Services, Courtesy Professor of Human Development, Associate Professor of Psychology in Clinical Psychiatry, Cornell University; and Jami S. Leichliter, Ph.D., Behavioral Scientist, Division of STD Prevention, Centers for Disease Control and Preventiony

Surveying the Damage: A Review of Research on Consequences of Alcohol Misuse in College Populations

ABSTRACT This article provides a review and synthesis of professional research literature on the types, extent and patterns of negative consequences produced by student's misuse of alcohol in college populations based on survey research conducted during the last two decades. Considerable evidence is available documenting a wide range of damage by some student's drinking done to themselves as well as to other individuals, although some types of consequences remain speculative. Damage and costs to institutions are likely to be substantial, but this claim remains largely an inference based on current studies. Drinking by males compared with that of females produces more consequences for self and others that involve public deviance, whereas female's drinking contributes equally with males to consequences that are personal and relatively private. Research on racial/ethnic background, time trends and developmental stages reveals patterns in student data on consequences of drinking, but these data are very limited in the literature. Evidence suggests there is only a modest correlation between student's self-perception of having a drinking problem and the many negative consequences of drinking that are reported.  (J. Stud. Alcohol,  Supplement No. 14: 91-100, 2002)

H. Wesley Perkins, Ph.D., Professor of Sociology, Department of Anthropology and Sociology, Hobart and William Smith Colleges

Alcohol Use and Risky Sexual Behavior Among College Students and Youth: Evaluating the Evidence

ABSTRACT Objective:  To evaluate the empirical associations between alcohol use and risky sex at two levels of analysis. Global associations test whether individuals who engage in one behavior are more likely to engage in the other, whereas event-specific associations test whether the likelihood of engaging in one behavior on a given occasion varies as a function of engaging in the other on that same occasion. Method:  Studies examining the association between drinking and risky sex in samples of college students and youth were reviewed. Those published in the past 10 years and using event-level methodology or random sampling were emphasized. Results:  Findings were generally consistent across levels of analysis, but differed across types of risky behaviors. Drinking was strongly related to the decision to have sex and to indiscriminate forms of risky sex (e.g., having multiple or casual sex partners), but was inconsistently related to protective behaviors (e.g., condom use). Moreover, the links among alcohol use, the decision to have sex and indiscriminate behaviors were found in both between-persons and within-persons analyses, suggesting that these relationships cannot be adequately explained by stable individual differences between people who do and do not drink. Analysis of event characteristics showed that drinking was more strongly associated with decreased protective behaviors among younger individuals, on first intercourse experiences and for events that occurred on average longer ago. Conclusions: Future efforts aimed at reducing alcohol use in potentially sexual situations may decrease some forms of risky sex, but are less likely to affect protective behaviors directly. ( J. Stud. Alcohol , Supplement No. 14: 101-117, 2002)

M. Lynne Cooper, Ph.D., Professor of Psychology, Department of Psychology, University of Missouri at Columbia

Alcohol-Related Sexual Assault: A Common Problem Among College Students

ABSTRACT Objective:  This article summarizes research on the role of alcohol in college students' sexual assault experiences. Sexual assault is extremely common among college students. At least half of these sexual assaults involve alcohol consumption by the perpetrator, the victim or both. Method:  Two research literatures were reviewed: the sexual assault literature and the literature that examines alcohol's effects on aggressive and sexual behavior. Results:  Research suggests that alcohol consumption by the perpetrator and/or the victim increases the likelihood of acquaintance sexual assault occurring through multiple pathways. Alcohol's psychological, cognitive and motor effects contribute to sexual assault. Conclusions:  Although existing research addresses some important questions, there are many gaps. Methodological limitations of past research are noted, and suggestions are made for future research. In addition, recommendations are made for college prevention programs and policy initiatives. ( J. Stud. Alcohol,  Supplement No. 14: 118-128, 2002)

Antonia Abbey, Ph.D., Associate Professor, Department of Community Medicine, Wayne State University

Alcohol-Related Aggression during the College Years: Theories, Risk Factors, and Policy Implications

ABSTRACT Objective:  The purpose of this article is to present an overview of the research literature on alcohol-related aggression with a focus on college students. Method:  Data from both survey studies and experimental laboratory investigations conducted on college students are reviewed. Various methodological approaches to studying the alcoholaggression relation, and their associated limitations, are then presented and discussed. Results:  The literature indicates that alcohol consumption facilitates aggressive behavior and increases the risk of being the victim of a violent act, particularly in heavy drinkers. Results from these studies are then placed into a context by reviewing 12 influential theories of aggression and alcohol-related aggression. On the basis of these theories and empirical data, a preliminary risk profile is presented to help identify which factors are likely to be important in predicting who will and who will not become aggressive after drinking alcohol. Conclusions:  Although much research is still needed to elucidate the intricate causes of alcohol-related aggression, current prevention efforts might focus on modifying key risk factors such as poor cognitive functioning and inaccurate expectations about the effects of alcohol. Other prevention efforts directed specifically at college students might focus on helping them to identify risky situations that might facilitate the expression of intoxicated aggression. ( J. Stud. Alcohol , Supplement No. 14: 129-139, 2002)

Peter R. Giancola, Ph.D., Assistant Professor of Psychology, University of Kentucky

Today's First-Year Students and Alcohol  (Not part of Supplement) M. Lee Upcraft, Ph.D., Senior Scientist, Center for the Study of Higher Education, Professor Emeritus of Higher Education and Assistant Vice President Emeritus for Student Affairs, The Pennsylvania State University

So What Is an Administrator to Do?  (Not part of Supplement) Susan Murphy, Ph.D., Vice President, Student and Academic Services, Cornell University

Panel 2 - PREVENTION AND TREATMENT

A Typology for Campus-Based Alcohol Prevention: Moving toward Environmental Management Strategies

ABSTRACT Objective:  This article outlines a typology of programs and policies for preventing and treating campus-based alcohol-related problems, reviews recent case studies showing the promise of campusbased environmental management strategies and reports findings from a national survey of U.S. colleges and universities about available resources for pursuing environmentally focused prevention. Method:  The typology is grounded in a social ecological framework, which recognizes that health-related behaviors are affected through multiple levels of influence: intrapersonal (individual) factors, interpersonal (group) processes, institutional factors, community factors and public policy. The survey on prevention resources and activities was mailed to senior administrators responsible for their school's institutional response to substance use problems. The study sample was an equal probability sample of 365 2- and 4-year U.S. campuses. The response rate was 76.9%. Results:  Recent case studies suggest the value of environmentally focused alcohol prevention approaches on campus, but more rigorous research is needed to establish their effectiveness. The administrators' survey showed that most U.S. colleges have not yet installed the basic infrastructure required for developing, implementing and evaluating environmental management strategies. Conclusions:  The typology of campus-based prevention options can be used to categorize current efforts and to inform strategic planning of multilevel interventions. Additional colleges and universities should establish a permanent campus task force that reports directly to the president, participate actively in a campus-community coalition that seeks to change the availability of alcohol in the local community and join a state-level association that speaks out on state and federal policy issues. ( J. Stud. Alcohol,  Supplement No. 14: 140-147, 2002)

William DeJong, Ph.D., Professor, Boston University School of Public Health, and Director, U.S. Department of Education's Higher Education Center for Alcohol and Other Drug Prevention, and Linda Langford, Sc.D., Associate Director of Evaluation and Assessment, U.S. Department of Education's Higher Education Center for Alcohol and Other Drug Prevention

Identification, Prevention, and Treatment: A Review of Individual-Focused Strategies to Reduce Problematic Alcohol Consumption by College Students

ABSTRACT Objective:  The purpose of this article is to review and assess the existing body of literature on individually focused prevention and treatment approaches for college student drinking. Method:  Studies that evaluate the overall efficacy of an approach by measuring behavioral outcomes such as reductions in alcohol use and associated negative consequences were included. All studies discussed utilized at least one outcome measure focused on behavioral change and included a control or comparison condition; however, not all trials were randomized. Results:  Consistent with the results of previous reviews, little evidence exists for the utility of educational or awareness programs. Cognitive-behavioral skills-based interventions and brief motivational feedback (including mailed graphic feedback) have consistently yielded greater support for their efficacy than have informational interventions. Conclusions:  There is mixed support for values clarification and normative reeducation approaches. Much of the research suffers from serious methodological limitations. The evidence from this review suggests that campuses would best serve the student population by implementing brief, motivational or skills-based interventions, targeting high-risk students identified either through brief screening in health care centers or other campus settings or through membership in an identified risk group (e.g., freshmen, Greek organization members, athletes, mandated students). More research is needed to determine effective strategies for identifying, recruiting and retaining students in efficacious individually focused prevention services, and research on mandated student prevention services is an urgent priority. Integration between campus policies and individually oriented prevention approaches is recommended. ( J. Stud. Alcohol,  Supplement No. 14: 148-163, 2002)

Mary Larimer, Ph.D., Assistant Professor of Psychiatry and Behavioral Sciences, Adjunct Assistant Professor of Psychology, Associate Director, Addictive Behaviors Research Center, University of Washington, and Jessica M. Cronce, B.S., Research Coordinator, Addictive Behaviors Research Center, Department of Psychology, University of Washington

Social Norms and the Prevention of Alcohol Misuse in Collegiate Contexts

ABSTRACT Objective:  This article provides a review of conceptual and empirical studies on the role of social norms in college student alcohol use and in prevention strategies to counter misuse. The normative influences of various constituencies serving as reference groups for students are examined as possible factors influencing students' drinking behavior. Method:  A review of English language studies was conducted. Results:  Parental norms have only modest impact on students once they enter college beyond the residual effects of previously instilled drinking attitudes and religious traditions. Faculty could theoretically provide a positive influence on student drinking behavior, but there is little evidence in the literature that faculty norms and expectations about avoiding alcohol misuse are effectively communicated to students. Although the norms of resident advisers (RAs) should ideally provide a restraint on student alcohol misuse, the positive influence of RAs is limited by their negotiated compromises with students whom they oversee and by their misperceptions of student norms. Research reveals student peer norms to be the strongest influence on students' personal drinking behavior, with the more socially integrated students typically drinking most heavily. The widespread prevalence among students of dramatic misperceptions of peer norms regarding drinking attitudes and behaviors is also a consistent finding. Permissiveness and problem behaviors among peers are overestimated, even in environments where problem drinking rates are relatively high in actuality. These misperceived norms, in turn, have a significant negative effect promoting and exacerbating problem drinking. Conclusions:  Interventions to reduce these misperceptions have revealed a substantial positive effect in several pilot studies and campus experiments. ( J. Stud. Alcohol,  Supplement No. 14: 164- 172, 2002)

Alcohol Advertising and Youth

ABSTRACT Objective:  The question addressed in this review is whether aggregate alcohol advertising increases alcohol consumption among college students. Both the level of alcohol-related problems on college campuses and the level of alcohol advertising are high. Some researchers have concluded that the cultural myths and symbols used in alcohol advertisements have powerful meanings for college students and affect intentions to drink. There is, however, very little empirical evidence that alcohol advertising has any effect on actual alcohol consumption. Method:  The methods used in this review include a theoretical framework for evaluating the effects of advertising. This theory suggests that the marginal effect of advertising diminishes at high levels of advertising. Many prior empirical studies measured the effect of advertising at high levels of advertising and found no effect. Those studies that measure advertising at lower, more disaggregated levels have found an effect on consumption. Results:  The results of this review suggest that advertising does increase consumption. However, advertising cannot be reduced with limited bans, which are likely to result in substitution to other available media. Comprehensive bans on all forms of advertising and promotion can eliminate options for substitution and be potentially more effective in reducing consumption. In addition, there is an increasing body of literature that suggests that alcohol counteradvertising is effective in reducing the alcohol consumption of teenagers and young adults. Conclusions:  These findings indicate that increased counteradvertising, rather than new advertising bans, appears to be the better choice for public policy. It is doubtful that the comprehensive advertising bans required to reduce advertising would ever receive much public support. New limited bans on alcohol advertising might also result in less alcohol counteradvertising. An important topic for future research is to identify the counteradvertising themes that are most effective with youth. ( J. Stud. Alcohol,  Supplement No. 14: 173-181, 2002)

Henry Saffer, Ph.D., Professor of Economics, Kean University, and Research Associate, National Bureau of Economic Research

The Role of Mass Media Campaigns in Reducing High-Risk Drinking among College Students

ABSTRACT Objective:  This article categorizes and describes current media campaigns to reduce college student drinking, reviews key principles of campaign design and outlines recommendations for future campaigns. Method:  The article describes three types of media campaigns on student drinking: information, social norms marketing, and advocacy. Key principles of campaign design are derived from work in commercial marketing, advertising, and public relations and from evaluations of past public health campaigns. Results:  Information campaigns on the dangers of high-risk drinking are common, but none has been rigorously evaluated. Quasi-experimental studies suggest that social norms marketing campaigns, which correct misperceptions of campus drinking norms, may be effective, but more rigorous research is needed. As of this writing, only one major media campaign has focused on policy advocacy to reduce college student drinking, but it is still being evaluated. Lessons for campaign design are organized as a series of steps for campaign development, implementation and assessment: launch a strategic planning process, select a strategic objective, select the target audience, develop a staged approach, define the key promise, avoid fear appeals, select the right message source, select a mix of media channels, maximize media exposure, conduct formative research, and conduct process and outcome evaluations. Conclusions:  Future campaigns should integrate information, social norms marketing, and advocacy approaches to create a climate of support for institutional, community and policy changes that will alter the environment in which students make decisions about their alcohol consumption. ( J. Stud. Alcohol,  Supplement No. 14: 182-192, 2002)

William DeJong, Ph.D., Professor, Boston University School of Public Health, and Director, U.S. Department of Education's Higher Education Center for Alcohol and Other Drug Prevention

Environmental Policies to Reduce College Drinking: Options and Research Findings

ABSTRACT Objective:  The goal of this article is to provide an overview of environmental strategies that may reduce college drinking. Drinking behavior is influenced by many environmental factors, including messages in the media, community norms and attitudes, public and institutional policies and practices and economic factors. College student drinking may be influenced by environmental factors on and off campus. Method:  A comprehensive search of MEDLINE, ETOH, Current Contents and Social Science Abstracts databases was conducted to identify research studies evaluating effects of environmental strategies on college and general populations. Results:  The identified environmental strategies fall into four categories: (1) increasing compliance with minimum legal drinking age laws, (2) reducing consumption and risky alcohol use, (3) decreasing specific types of alcohol-related problems and (4) deemphasizing the role of alcohol on campus and promoting academics and citizenship. Although the extant research indicates that many environmental strategies are promising for reducing alcohol-related problems among the general population, few of these strategies have been evaluated for effects on the college population. Conclusions:  Further research is needed to evaluate effects of alcohol control policies on alcohol consumption and its related problems among college students. ( J. Stud. Alcohol,  Supplement No. 14: 193-205, 2002)

Traci L. Toomey, Ph.D., Assistant Professor, School of Public Health, Division of Epidemiology, University of Minnesota, and Alexander C. Wagenaar, Ph.D., Professor and Director, Alcohol Epidemiology Program, School of Public Health, Division of Epidemiology, University of Minnesota

Effects of Minimum Drinking Age Laws: Review and Analyses of the Literature from 1960 to 2000

ABSTRACT Objective:  The goal of this article is to review critically the extant minimum legal drinking age (MLDA) research literature and summarize the current state of knowledge regarding the effectiveness of this policy. Method:  Comprehensive searches of four databases were conducted to identify empirical studies of the MLDA published from 1960 to 1999. Three variables were coded for each study regarding methodological quality: (1) sampling design, (2) study design and (3) presence or absence of comparison group. Results:  We identified 241 empirical analyses of the MLDA. Fifty-six percent of the analyses met our criteria for high methodological quality. Of the 33 higher quality studies of MLDA and alcohol consumption, 11 (33%) found an inverse relationship; only 1 found the opposite. Similarly, of the 79 higher quality analyses of MLDA and traffic crashes, 46 (58%) found a higher MLDA related to decreased traffic crashes; none found the opposite. Eight of the 23 analyses of other problems found a higher MLDA associated with reduced problems; none found the opposite. Only 6 of the 64 college-specific studies (9%) were of high quality; none found a significant relationship between the MLDA and outcome measures. Conclusions:  The preponderance of evidence indicates there is an inverse relationship between the MLDA and two outcome measures: alcohol consumption and traffic crashes. The quality of the studies of specific populations such as college students is poor, preventing any conclusions that the effects of MLDA might differ for such special populations. ( J. Stud. Alcohol,  Supplement No. 14: 206-225, 2002)

Alexander C. Wagenaar, Ph.D., Professor and Director, Alcohol Epidemiology Program, School of Public Health, Division of Epidemiology, University of Minnesota, and Traci L. Toomey, Ph.D., Assistant Professor, School of Public Health, Division of Epidemiology, University of Minnesota

Comprehensive Community Interventions to Promote Health: Implications for College-Age Drinking Problems

ABSTRACT Objective:  This article reviews comprehensive community interventions that sought to reduce (1) cardiovascular disease risks; (2) smoking; (3) alcohol use disorders, alcohol-related injury and illicit drug use; or (4) sexual risk taking that could lead to HIV infection, sexually transmitted disease and pregnancy. Method:  Comprehensive community programs typically involve multiple city government agencies as well as private citizens and organizations and use multiple intervention strategies such as school-based and public education programs, media advocacy, community organizing, environmental policy changes and heightened enforcement of existing policies. This review focused on English-language papers published over the past several decades. Results:  Some programs in each of the four problem areas achieved their behavioral and health goals. The most consistent benefits were found in programs targeting behaviors with immediate health consequences such as alcohol misuse or sexual risk taking. Results were less consistent when consequences of targeted behaviors were more distant in time such as cardiovascular risks and smoking. Also, programs that targeted youth to prevent them from starting new health-compromising behaviors tended to be more successful than programs aimed at modifying preexisting habits among adults. Programs that combined environmental and institutional policy change with theory-based education programs were the most likely to be successful. Finally, programs tailored to local conditions by the communities themselves tended to achieve more behavior change than programs imported from the outside. Conclusions: Comprehensive community intervention approaches may have considerable potential to reduce college-age drinking problems, especially given the success of these programs in reducing alcohol-related problems and in preventing health-compromising behaviors among youth. ( J. Stud. Alcohol,  Supplement No. 14: 226-240, 2002)

Ralph Hingson, Sc.D., Professor and Chair, Social and Behavioral Sciences Department, Boston University School of Public Health, and Jonathan Howland, Ph.D., M.P.H., Professor and Chair, Social and Behavioral Sciences Department, Boston University School of Public Health

The Role of Evaluation in Prevention of College Student Drinking Problems  (Not part of Supplement) Robert F. Saltz, Ph.D., Associate Director and Senior Research Scientist, Prevention Research Center, Berkeley, CA

View from the President's Office: The Leadership of Change  (Not part of Supplement) Joy R. Mara, M.A., Mara Communications

JOINT PANEL PAPER

The Student Perspective on College Drinking  (Not part of Supplement) Peggy Eastman, Author and Journalist

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Effects of Alcohol on College Students

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Preventive Medicine

Donald Zeigler , Richard Yoast

Background. Adolescents and college students are at high risk for initiating alcohol use and high-risk (or binge) drinking. There is a growing body of literature on neurotoxic and harmful cognitive effects of drinking by young people. On average, youths take their first drink at age 12 years.Methods. MEDLINE search on neurologic and cognitive effects of underage drinking.Results. Problematic alcohol consumption is not a benign condition that resolves with age. Individuals who first use alcohol before age 14 years are at increased risk of developing alcohol use disorders. Underage drinkers are susceptible to immediate consequences of alcohol use, including blackouts, hangovers, and alcohol poisoning and are at elevated risk of neurodegeneration (particularly in regions of the brain responsible for learning and memory), impairments in functional brain activity, and the appearance of neurocognitive deficits. Heavy episodic or binge drinking impairs study habits and erodes the development of transitional skills to adulthood.Conclusions. Underage alcohol use is associated with brain damage and neurocognitive deficits, with implications for learning and intellectual development. Impaired intellectual development may continue to affect individuals into adulthood. It is imperative for policymakers and organized medicine to address the problem of underage drinking.

Susan Tapert

Steven Nonde , Kalonji Abondance Jose Maria

Drinking at tertiary institutions has become part of the average student’s lifestyle. According the World Health Organisation (2011), approximately 320 000 young people between the ages of 15 and 29 die from alcohol-related causes every year thus representing 9% of all deaths in that age group. The consequence of alcohol drinking are countless, some of its effects includes: death, liver damage, injury, sexual abuse, assault or fetal alcohol syndrome in children born of pregnant women who abused alcohol during the course of their pregnancy. Over the years, alcoholism has become a major concern to public health, as it affects several people regardless of whether they are alcohol consumer or not. This study will focus on investigating the neuro-endocrine and pharmacological effects of alcohol on the lifestyles and academic performance of University students.

Sociology of Education: An A-to-Z Guide

Keith Goldstein

Journal of Advances in Medicine and Medical Research

Luiz Del Ciampo

Adolescence is a phase of great physical, emotional and social transformations that put individuals in vulnerability and with risks of aggravations that can be definitive. Among the various characteristics of the adolescent, the experimentation of new sensations and challenges is one of the most outstanding, being responsible for several common problems in this phase of life. Among the several factors that can adversely affect adolescents, alcohol is one of the most prevalent, offering serious immediate and late risks. This article presents some characteristics of alcohol consumption among adolescents and the effects on the development of the central nervous system, highlighting the main damages that can be caused in the brain in formation (reduced white matter volume and cortices, neuronal apoptosis, demyelination). In view of the relevance of the effects of alcohol on the developing brain all efforts should be directed towards avoiding or minimizing the risks to which adolescents...

Alcohol Research Health the Journal of the National Institute on Alcohol Abuse and Alcoholism

Ralph Hingson

Henk Hendriks

Adolescents consume alcohol in moderation mainly to enjoy and enhance mood but adolescents also drink hazardously, e.g. to cope with stressful life events. Drinking hazardously may be related to the developing adolescent brain going through a number of structural and physiological changes. These structural and physiological changes affect adolescent behavior aimed at gaining experience in life. Adolescent drinking patterns vary and may include risky behaviors such as binge drinking. Motivations to drink and risk factors for binge drinking and alcohol abuse are both internal and external. Internal risk factors include amongst others genetic predisposition to have less self-control, whereas external risk factors includes early life stress. Integrative approaches underline the value of multi-domain analysis for prediction; any one feature in isolation only modestly predicts drinking behavior. Health consequences of drinking vary widely depending on dose and drinking pattern. Moderate alcohol drinking may be associated with a lower incidence of chronic disease and mental health, whereas alcohol binging and abuse appear to negatively affect social functioning mainly in the short term and mental and physical health in the long term. Resilience towards behaving non responsibly may best prevent alcohol abuse and stimulate enjoyment of moderate alcohol consumption. Limitations in current knowledge concern the interpretation of alcohol drinking being the cause for adolescent risky behavior, generalizability of findings on abusing adolescents to the general population and insufficient knowledge of relevant covariates and mediators.

Alcoholism: Clinical & Experimental Research

Aaron White

Psychology of Addictive Behaviors

Clinton Field

American Journal of Preventive Medicine

George Dowdall

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