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CORK Bibliography: Colleges

102 citations. January 2011 to present

Prepared: September 2011

Aldridge-Gerry AA; Roesch SC; Villodas F; McCabe C; Leung QK; da Costa M. Daily stress and alcohol consumption: Modeling between-person and within-person ethnic variation in coping behavior. Journal of Studies on Alcohol and Drugs 72(1): 125-134, 2011. (86 refs.)

Objective: Using a daily diary approach, the current study evaluated the relationship between coping and alcohol consumption using a large, multiethnic sample. The primary goals of this study were to (a) identify coping strategies that are either protective or risk factors for alcohol consumption and (b) model between-ethnic and within-ethnic group variation for these relations. Method: College students (N = 365, 69.0% female) were recruited via flyers, course/club presentations, and university seminars. Participants completed Internet-based daily diaries over the course of 5 days and reported specifically on a target stressful event, how they coped with the stressful event, and the amount of alcohol consumed on a daily level. Results: Use of more avoidance-oriented coping strategies (minimization of stressor, emotional rumination) and social support were significantly associated with more alcohol consumption. Ethnicity, however, did moderate some coping alcohol associations. Use of religious coping was associated with less alcohol consumption and minimization of the stressor was associated with more alcohol consumption in African Americans; use of social support was associated with more alcohol consumption in Asian Americans; and use of problem-focused coping was associated with less alcohol consumption in Whites. Conclusions: Three maladaptive or risky coping strategies with respect to alcohol consumption were identified using an ecologically valid methodology. However, ethnic-specific variation of these risky (and protective) coping factors was identified. The findings highlight the importance of considering both between-ethnic and within-ethnic group variation with respect to the stress/coping and alcohol consumption.

Amato PR; Kane JB. Life-course pathways and the psychosocial adjustment of young adult women. Journal of Marriage and the Family 73(1): 279-295, 2011. (38 refs.)

We examined 7 life-course pathways from adolescence through the early adult years and their links with general health and psychosocial adjustment among 2,290 women from the National Longitudinal Study of Adolescent Health. Young women who followed a pathway involving college attendance to full-time employment with no family-formation transitions were functioning comparatively well with respect to general health, depression, and self-esteem. In contrast, young women who followed pathways involving early motherhood were functioning less well. Fixed-effects models suggested that the differences were due to selection factors. Young women who followed the pathway of college to full-time employment exhibited an increase in heavy drinking, whereas women who became married mothers exhibited a decrease in the same. Involvement in illegal behavior declined for all groups but least so for women who attended college.

Arbour-Nicitopoulos KP; Kwan MYW; Lowe D; Taman S; Faulkner GEJ. Social norms of alcohol, smoking, and marijuana use within a Canadian university setting. Journal of American College Health 59(3): 191-196, 2011. (17 refs.)

Objective: To study actual and perceived substance use in Canadian university students and to compare these rates with US peers. Participants: Students (N = 1,203) from a large Canadian university. Methods: Participants were surveyed using items from the National College Health (NCHA) Assessment of the American College Health Association questionnaire. Results: Alcohol was the most common substance used (65.8%), followed by marijuana (13.5%) and cigarettes (13.5%). Substance use and norms were significantly less than the NCHA US data. Overall, respondents generally perceived the typical Canadian student to have used all 3 substances. Perceived norms significantly predicted use, with students more likely to use alcohol, cigarettes, or marijuana if they perceived the typical student to use these substances. Conclusions: Similar to their US peers, Canadian university students have inaccurate perceptions of peer substance use. These misperceptions may have potentially negative influences on actual substance use and could be a target for intervention. Further research examining the cross-cultural differences for substance abuse is warranted.

Arria AM; Garnier-Dykstra LM; Caldeira KM; Vincent KB; O'Grady KE; Wish ED. Persistent nonmedical use of prescription stimulants among college students: Possible association with ADHD symptoms. Journal of Attention Disorders 15(5): 347-356, 2011. (30 refs.)

Objective: To investigate the possible association between untreated ADHD symptoms (as measured by the Adult ADHD Self-Report Scale) and persistent nonmedical use of prescription stimulants. Method: Multinomial regression modeling was used to compare ADHD symptoms among three groups of college students enrolled in a longitudinal study over 4 years: (1) persistent nonmedical users of prescription stimulants, (2) persistent users of marijuana who did not use prescription stimulants nonmedically, and (3) consistent nonusers of drugs. Results: ADHD symptoms were associated with being a persistent nonmedical user of prescription stimulants after adjustment for race/ethnicity, sex, socioeconomic status, and other illicit drug use. No associations were observed between ADHD symptoms and being a persistent marijuana user or nonuser. Conclusion: ADHD symptoms, and in particular inattention symptoms, appeared to be associated with nonmedical use of prescription stimulants.

Attila S; Cakir B. Energy-drink consumption in college students and associated factors. Nutrition 27(3): 316-322, 2011. (21 refs.)

Objective: To investigate the frequency of energy-drink consumption and associated factors in a group of college students. Methods: A cross-sectional study was conducted in Hacettepe University (Ankara, Turkey) and included 439 students pursuing a career in medicine, sports, and arts. Only fourth-year students were approached. Data were collected using a self-administered standard questionnaire. Results: In bivariate analyses, frequency of energy-drink consumption was higher in students of arts and sports and in those who did not have breakfast on a regular basis, ever smoked cigarettes, drank alcoholic beverages, and regularly engaged in sports compared with their counterparts. Many students who had "ever" tried an energy drink did so the first time because they wondered about its taste. Of regular users of energy drinks, reasons for using such drinks varied across the three selected groups of students and included obtaining getting energy, staying awake, boosting performance while doing sports, or mixing with alcoholic beverages. About 40% of all current users of energy drinks reported that they mixed those with alcoholic beverages. In multivariate analyses, statistically significant predictors of energy-drink consumption were faculty type, presence of any health insurance, use of alcoholic beverages, and monthly income, controlling for gender. Most students could not correctly define the ingredients of energy drinks or their potential hazardous'. health effects, and they could not distinguish energy and sports drinks when they were requested to select them from a list of commercial names of various drinks. Conclusion: Consumption of energy drinks, despite the variation in the reason for choosing such drinks, is quite common in college students. Awareness of university students of the ingredients and potential health hazards of energy drinks, in particular in mixing with alcoholic beverages, should be increased.

Atwoli L; Mungla PA; Ndung'u MN; Kinoti KC; Ogot EM. Prevalence of substance use among college students in Eldoret, western Kenya. BMC Psychiatry 11: article 34, 2011. (24 refs.)

Background: Substance use among college and university students predicts substance related problems in later life. Few studies on this phenomenon have been carried out in low income countries, and most focus on primary and secondary school students. This study therefore aimed to establish the prevalence and factors associated with drug use among university and college students in a low income country. Methods: Design: A descriptive cross-sectional survey using the Self-Administered WHO Model Core Questionnaire to collect information on use of various drugs among students in colleges and university campuses within Eldoret Municipality in Western Kenya. Setting: Four tertiary learning institutions in Eldoret Municipality were randomly selected for inclusion in the study-three tertiary level non-university institutions and one university campus. Subjects: Five hundred students who gave consent to participate in the study, 125 from each of the four participating institutions. The mean age was 22.9 years (18-32, s. d. 2.5), and males made up 52.2% of the sample. Results: Lifetime prevalence rate of any substance use was 69.8%, and none of the socio-demographic factors was significantly associated with this. Lifetime prevalence rate of alcohol use was 51.9%, and 97.6% of alcohol users had consumed alcohol in the week prior to the study. The prevalence rate of cigarette use was 42.8%, with males having statistically significantly higher rates than females (p < 0.05). Other substances used were cannabis (2%) and cocaine (0.6%). Among those who admitted to using substances, 75.1% were introduced by a friend while 23.5% were introduced by a relative other than a member of the nuclear family. Majority of those using substances wanted to relax (62.2%) or relieve stress (60.8%). Problems associated with alcohol use included quarrelling and fights, loss and damage to property, problems with parents, medical problems and unplanned unprotected sex. Conclusion: The prevalence of substance use among college and university students in Eldoret is high and causes significant physical and psychosocial problems in this population. A large proportion of those using alcohol reported serious adverse effects, raising the necessity of targeted interventions to reduce the risk of subsequent substance dependence and other deleterious consequences.

Baillie L; Callaghan D; Smith ML. Canadian campus smoking policies: Investigating the gap between intent and outcome from a student perspective. Journal of American College Health 59(4): 260-265, 2011. (23 refs.)

Background: Young adults remain the earliest legal target for the tobacco industry. Against this, the existence of smoking policies would appear to offer some protection to students on campus. However, little research has been conducted into the outcomes of such policies from a student perspective. Methods: The authors conducted 8 focus groups at 4 selected Canadian undergraduate campuses to investigate student perceptions and behaviors resulting from campus smoking policies. Results: Results indicated that student smoking behaviors are minimally impacted by campus smoking policies due to seriously compromised implementation and enforcement. Conclusions: These findings imply that the presence of campus smoking policies and claims of "smoke-free" campuses should not be misinterpreted as achievement and without renewed focus and adequate tobacco control infrastructure, it will remain possible for young adults to initiate and maintain tobacco smoking on campus.

Banerjee SC; Greene K; Yanovitzky I. Sensation seeking and dosage effect: An exploration of the role of surprise in anti-cocaine messages. Journal of Substance Use 16(1): 1-13, 2011. (40 refs.)

This article examines emotional and cognitive responses to graphic illustrations of the effects of cocaine among a sample of low and high sensation seekers (LSS & HSS). Two-hundred-and-five (n = 205) undergraduate students at a large northern university in the United Kingdom participated in the study and were randomly assigned to one of two conditions: low-image or high-image print adverts about the consequences of cocaine use. Results indicated that although high sensation seekers report greater cocaine use as compared with low sensation seekers, report less surprise and have less dominant cognitions than LSS, they do not differ from LSS in terms of other affective responses when exposed to anti-cocaine visual messages. However, the high-image advert was more successful than the low-image adverts in eliciting surprise, which has important theoretical and empirical implications for the design of effective messages targeting HSS.

Batigun AD; Kilic N. The relationships between internet addiction, social support, psychological symptoms and some socio-demographical variables. Turk Psikoloji Dergisi 26(67): 1-13, 2011. (49 refs.)

The main aim of the present study is to find out the purpose and prevalence of the internet usage among university students, and to study some individual variables such as personality factors, psychological symptoms and social support in relation to internet addiction. In addition, the relationships between internet addiction and demographical variables have been explored. The sample consisted of 1198 university students, 672 female and 525 male, from state and private universities in Istanbul and Ankara. Internet Addiction Scale, Big Five Personality Inventory, Social Support Inventory, Brief Symptom Inventory and demographical information form had been used as measurement devices. It has been found that, the mean duration the students spent for Internet in a day is 1.53 (SD = .79) hour; 18.89 percent of the students could be defined as Internet addict and male students were found to have higher addiction scores than female students. In addition, the students from higher SES were found to have higher Internet addiction scores than the students from lower SES. The regression analyses results showed that the daily time spent for internet (duration) and using Internet for social interaction, being in higher SES, to have lower life satisfaction and lower self-control and to have higher neuroticism, anxiety and somatization predict internet addiction among university students.

Berg CJ; Lessard L; Parelkar PP; Thrasher J; Kegler MC; Escoffery C et al. College student reactions to smoking bans in public, on campus and at home. Health Education Research 26(1): 106-118, 2011. (61 refs.)

We examined college student reactions to a statewide public smoke-free policy, campus policies and private restrictions through an online survey among 2260 students at a 2-year college and a university and 12 focus groups among smokers. Among survey participants, 34.6% smoked in the past month (35.0% daily, 65.0% non-daily). Correlates of receptivity to public policies included attending the university, not living with smokers and non-smoker status (versus daily and non-daily smoking). Correlates of receptivity to outdoor campus policies included being a university student, unmarried, without children, from homes where parents banned indoor smoking and a non-smoker. Correlates of having home restrictions included not living with smokers, no children, parents banning indoor smoking and non-smoker status. Correlates of having car restrictions included attending the university, not living with smokers, having children, parents banning indoor smoking and non-smoker status. Qualitative findings indicated support for smoke-free policies in public (albeit greater support for those in restaurants versus bars) and on campus. Participants reported concern about smokers' and bar/restaurant owners' rights, while acknowledging several benefits. Overall, 2-year college students and smokers (non-daily and daily) were less supportive of smoke-free policies.

Buckman JF; Yusko DA; Farris SG; White HR; Pandina RJ. Risk of marijuana use in male and female college student athletes and nonathletes. Journal of Studies on Alcohol and Drugs 72(4): 586-591, 2011. (36 refs.)

Objective: A large minority of collegiate athletes report past-year marijuana use even though there is a significant possibility of experiencing negative athlete-specific consequences related to performance, eligibility, and scholarship. The present study examined risk factors that can drive or curb marijuana use in college athletes and nonathletes. Method: Logistic regressions, performed separately for men and for women, assessed the relationship of past-year marijuana use to sensation seeking, negative mood, perceptions of peer marijuana use, motivations for marijuana use, and stress related to body image and academics in athletes (233 men, 156 women) and nonathletes (184 men, 313 women). Risk factors also were compared for male past-year marijuana users who reported using (n = 26) or not using (n = 61) the substance during their competitive season. Results: For athletes and nonathletes of both genders, being White, being past-year cigarette smokers, having higher sensation-seeking scores, and having exaggerated perceptions of student use norms were associated with past-year marijuana use. Enhancement motivations for use were higher among athletes compared with their same-gender nonathlete peers. In women, but not in men, greater body image stress and lower academic stress were associated with past-year marijuana use. Male athletes who continued using marijuana into their competitive season demonstrated a qualitatively different risk profile compared with athlete past-year users who reported no in-season use, including greater coping motivations for marijuana use. Conclusions: This preliminary study suggests that although the overall risk profile of college athletes and nonathletes is similar, athletes appear to be particularly motivated to use marijuana because of its enhancement or pleasurable properties.

Carrell SE; Hoekstra M; West JE. Does drinking impair college performance? Evidence from a regression discontinuity approach. Journal of Public Economics 95(1-2): 54-62, 2011. (14 refs.)

This paper examines the effect of alcohol consumption on student achievement. To do so, we exploit the discontinuity in drinking at age 21 at a college in which the minimum legal drinking age is strictly enforced. We find that drinking causes significant reductions in academic performance, particularly for the highest-performing students. This suggests that the negative consequences of alcohol consumption extend beyond the narrow segment of the population at risk of more severe, low-frequency, outcomes.

Christakis DA; Moreno MM; Jelenchick L; Myaing MT; Zhou C. Problematic internet usage in US college students: A pilot study. BMC Medicine 9(e-article 77), 2011. (52 refs.)

Background: Internet addiction among US college students remains a concern, but robust estimates of its prevalence are lacking. Methods: We conducted a pilot survey of 307 college students at two US universities. Participants completed the Internet Addiction Test (IAT) as well as the Patient Health Questionnaire. Both are validated measures of problematic Internet usage and depression, respectively. We assessed the association between problematic Internet usage and moderate to severe depression using a modified Poisson regression approach. In addition, we examined the associations between individual items in the IAT and depression. Results: A total of 224 eligible respondents completed the survey (73% response rate). Overall, 4% of students scored in the occasionally problematic or addicted range on the IAT, and 12% had moderate to severe depression. Endorsement of individual problematic usage items ranged from 1% to 70%. In the regression analysis, depressive symptoms were significantly associated with several individual items. Relative risk could not be estimated for three of the twenty items because of small cell sizes. Of the remaining 17 items, depressive symptoms were significantly associated with 13 of them, and three others had P values less than 0.10. There was also a significant association between problematic Internet usage overall and moderate to severe depression (relative risk 24.07, 95% confidence interval 3.95 to 146.69; P = 0.001). Conclusion: The prevalence of problematic Internet usage among US college students is a cause for concern, and potentially requires intervention and treatment amongst the most vulnerable groups. The prevalence reported in this study is lower than that which has been reported in other studies, however the at-risk population is very high and preventative measures are also recommended.

Ciecierski CC; Chatterji P; Chaloupka FJ; Wechsler H. Do state expenditures on tobacco control programs decrease use of tobacco products among college students? Health Economics 20(3): 253-272, 2011. (40 refs.)

The objective of this paper is to investigate the effects of state tobacco control program expenditures on individual-level tobacco use behaviors among young adults. Data come from the 1997, 1999 and 2001 waves of the Harvard School of Public Health College Alcohol Study (CAS). Our findings indicate that a higher level of state spending on tobacco control programs in the prior year is associated with a statistically significant increase in the probability that current daily smokers report at least one attempt to quit smoking in the past year. We also find evidence that higher state expenditures on tobacco control programs in the prior year are associated with reductions in the prevalence of daily smoking and 30-day cigar use among college students. We do not find any statistically significant association between state tobacco control program expenditures and the number of attempts to quit smoking among those with at least one attempt, or on the prevalence of smokeless tobacco use in the past month. Copyright

Ciesla JA; Dickson KS; Anderson NL; Neal DJ. Negative repetitive thought and college drinking: Angry rumination, depressive rumination, co-rumination, and worry. Cognitive Therapy and Research 35(2): 142-150, 2011. (28 refs.)

Alcohol abuse among college students continues to be a large societal problem in need of further study. This project investigated the influence of different types of negative repetitive thought (NRT) on alcohol use and binging behavior among undergraduates. Specifically, angry rumination, depressive rumination, co-rumination, and worry were examined. An initial exploratory factor analysis supported the distinctiveness of these four forms of NRT. With respect to quantity of weekly drinking, worry was significantly associated with less alcohol use among drinkers whereas angry rumination was associated with greater weekly usage. The effect of co-rumination was moderated by sex such that higher levels of co-rumination was associated with less weekly drinking in men but more weekly drinking in women. The tendency to co-ruminate was also significantly associated with of being a binge drinker, and demonstrated similar gender moderation. Higher levels of worry were associated with less binge drinking among women, but no association between worry and binging was present among men. The implications for these findings in the study of NRT and alcohol use are discussed.

Collins SE; Witkiewitz K; Larimer ME. The theory of planned behavior as a predictor of growth in risky college drinking. Journal of Studies on Alcohol and Drugs 72(2): 322-332, 2011. (49 refs.)

Objective: This study tested the Theory of Planned Behavior (TPB) as a predictor of growth in risky college drinking over a 3-month period. As predicted by the TPB model, it was hypothesized that attitudes, subjective norms, and perceived behavioral control would predict intention to engage in risky drinking, which would in turn predict growth in future risky drinking. Method: Participants were 837 college drinkers (64.2% female) who were randomly selected from two U.S. West Coast universities to participate in a larger study on college drinking norms. This study used latent growth analyses to test the ability of the TPB to predict baseline levels of as well as linear and quadratic growth in risky college drinking (i.e., heavy episodic drinking and peak drinking quantity). Results: Chi-square tests and fit indices indicated close fit for the final structural models. Self-efficacy, attitudes, and subjective norms significantly predicted baseline intention, which in turn predicted future heavy episodic drinking. Self-efficacy and attitudes were also related to intention in the model of peak drinking; however, subjective norms were not a significant predictor of intention in the peak drinking model. Mediation analyses showed that intention to engage in risky drinking mediated the effects of self-efficacy and attitudes on growth in risky drinking. Conclusions: Findings supported the TPB in predicting risky college drinking. Although the current findings should be replicated before definitive conclusions are drawn, results suggest that feedback on self-efficacy, attitudes, and intentions to engage in risky drinking may be a helpful addition to personalized feedback interventions for this population.

DeMartini KS; Carey KB; Lao K; Luciano M. Injunctive norms for alcohol-related consequences and protective behavioral strategies: Effects of gender and year in school. Addictive Behaviors 36(4): 347-353, 2011. (40 refs.)

Perceived drinking norms have received increased attention as one determinant of high levels of college alcohol consumption and alcohol-related problems. Excessive drinking is widely visible on college campuses, and students may therefore assume that it is peer-supported (Kitts, 2003). Research into peer relations indicates that the perceived approval of important others predicts drinking behavior (Neighbors, Lee, Lewis, Fossos, & Larimer, 2007). Neither the use of alcohol-related protective behavioral strategies nor alcohol-related negative consequences have been investigated in terms of their perceived approval. The purpose of this study was to extend previous research on injunctive norms and assess self-other discrepancies in levels of approval for campus drinking patterns, negative alcohol-related consequences, and protective behavioral strategies. Undergraduate volunteers (n = 324, 61% female, 67% Caucasian) completed an online survey of drinking patterns; they rated comfort with overall campus drinking, and the acceptability of alcohol-related consequences and protective strategies for themselves and their close friends. As predicted, students expressed lower acceptance of consequences than their friends, and higher acceptance of alcohol-related protective strategies. We observed main effects of gender and year in school. Males and upperclassmen expressed higher acceptance of negative consequences for both self and others, and lower acceptance of protective strategies for both self and others. Implications for prevention programs are discussed.

Doran N; Schweizer CA; Myers MG. Do expectancies for reinforcement from smoking change after smoking initiation? Psychology of Addictive Behaviors 25(1): 101-107, 2011. (60 refs.)

Expectancies are important predictors of smoking behavior. Recent research suggests that expectancies are not stable and vary across internal and external states and levels of cigarette consumption. Expectancies may also vary between individuals as a function of temperamental characteristics such as behavioral undercontrol (BU). Although pre-initiation expectancies have been linked to subsequent smoking behaviors, no study has assessed the effect of smoking initiation on expectancies. The present study was designed to test the hypotheses that both positive (PRE) and negative (NRE) reinforcement expectancies would increase following initiation, and that these changes would be moderated by BU. College students were interviewed 12-15 months apart. Those who initiated smoking between assessments (n = 69) were included in the present study. Linear mixed models showed a significant increase in PRE but not NRE from pre- to postinitiation. The relationship between NRE and time was moderated by BU, such that higher BU was associated with significantly larger post-initiation increases in NRE. Findings suggest that PRE and NRE change significantly following experience with smoking. Furthermore, undercontrolled, impulsive individuals may be particularly vulnerable to smoking with the intention of alleviating aversive states.

Eliason MJ; Burke A; van Olphen J; Howell R. Complex interactions of sexual identity, sex/gender, and religious/spiritual identity on substance use among college students. Sexuality Research and Social Policy 8(2): 117- 125, 2011. (32 refs.)

Alcohol, tobacco, and other drug use pose serious health problems on college campuses. A significant body of research shows student religiosity to be a protective factor, but a very little research has examined influences of sexual identities on alcohol and other drug use among college students, and its associations with religious or spiritual identity. This study examined the relationships of sex/gender, sexual identity, and religious/spiritual identity on current alcohol use, drug use, and smoking via an online survey of 2,204 college students. We found a three-way interaction between sex/gender, sexual identity, and religious/spiritual identity, with religion showing protective value for nonheterosexual women, but not nonheterosexual men, related to alcohol use. Nonheterosexual students also showed different patterns of risk and protective factors. A subset of the sample that indicated that they did not use sexual identity labels showed very high rates of alcohol, tobacco, and drug use, often exceeding the lesbian, gay, and bisexual group on these measures. These findings provide new information on nonheterosexual student drug and alcohol use and indicate the need for additional research in this area of study.

Fossos N; Kaysen D; Neighbors C; Lindgren KP; Hove MC. Coping motives as a mediator of the relationship between sexual coercion and problem drinking in college students. Addictive Behaviors 36(10): 1001-1007, 2011. (63 refs.)

Sexually coercive experiences, heavy alcohol use, and alcohol-related problems occur at relatively high base rates in college populations. As suggested by the self-medication hypothesis, alcohol consumption may be a means by which one can reduce negative affect or stress related to experiences of sexual coercion. However, few studies have directly tested the hypothesis that coping motives for drinking mediate the relation between sexual assault and problem drinking behaviors, and no published studies have tested this in men. The current study tested this hypothesis using structural equation modeling in a sample of 780 male and female undergraduates. Results: revealed that coping motives partially mediated the relation between sexual coercion and drinking and alcohol-related negative consequences. In addition, direct and indirect paths between sexual coercion and drinking were found for men whereas only indirect paths were found for women. Results provide support for self-medication models of drinking and suggest the importance of exploring gender differences in mechanisms for drinking.

Gajendra S; Ossip DJ; Panzer RJ; McIntosh S. Implementing a smoke-free campus: A medical center initiative (review). Journal of Community Health 36(4): 684-692, 2011. (27 refs.)

A large 2-campus Medical Center in Western New York, along with several other large area hospitals, planned for and simultaneously implemented successful "Smoke-Free Campus" initiatives in November of 2006. This coordinated initiative required that each system plan accordingly for the development and implementation of policies, training of employees, clinicians, support staff and provision of tobacco treatment services (directly or via referral). In order to efficiently and competently inform each of these aspects of a system-wide initiative, accurate information was needed on the prevalence of tobacco use among employees, staff, faculty, and clinicians in each system. A multi-system surveillance initiative was implemented, using a brief survey for all employees of several of the partnering institutions. Summary data from the baseline measures are discussed. Also presented are Lessons Learned from the year-long planning and implementation phases, including details on topics categorized by the specific sub-committees that coordinated each area (e.g., Policy and Procedure, Communication, Faculty/Staff/Student Issues, Patient Issues (Inpatient and Outpatient), Tobacco Dependence Treatment and Provider/Staff Training). The effort was effective in instituting system-wide changes in all of the participating hospitals in the greater metropolitan area. A community-wide consortium convened each month for a year, and subcommittees within each hospital allowed planners to break up the initiative into manageable pieces. The extended timeline of 1 year was appropriate for overcoming fears, biases, and barriers which then enabled "buy-in" and support from leadership as well as employees.

Garey L; Prince MA; Carey KB. Alcohol policy support among mandated college students. Addictive Behaviors 36(10): 1015-1018, 2011. (11 refs.)

Background: Alcohol consumption on college campuses is high, and often dangerous. College administrators have created policies to control alcohol consumption, but student body support or opposition of specific policies has been relatively unexplored. Method: The current study examined the relations of alcohol policy support with gender and alcohol consumption. Mandated students (N=229; 44% women) completed self-report assessments of alcohol policy support and alcohol consumption. Results: Women supported policies to a greater extent than did men, as did lighter drinkers relative to heavier drinkers. Drinks per drinking day fully mediated the relation between gender and alcohol policy support. Conclusion: While alcohol policy support differs by gender, this covariation is explained by differences in alcohol consumption. Findings have implications for addressing alcohol policy support among mandated college students.

Goudriaan AE; Grekin ER; Sher KJ. Decision making and response inhibition as predictors of heavy alcohol use: A prospective study. Alcoholism: Clinical and Experimental Research 35(6): 1050- 1057, 2011. (41 refs.)

Background: Very few studies have investigated the "real world" prospective, predictive value of behavioral instruments used in laboratory studies to test decision-making abilities or impulse control. The current study examines the degree to which 2 commonly used decision-making/impulse control measures prospectively predict (heavy) alcohol use in a sample of college students. Methods: Two hundred healthy young adults (50% women) performed the Iowa Gambling Task (IGT) and a StopSignal inhibition task in the second college year. At testing and at the end of the fourth college year, heavy alcohol use was assessed. Results: Disadvantageous performance on the IGT was associated with higher scores on a heavy drinking measure and higher quantity/frequency of alcohol use 2 years past neurocognitive testing in male students even after controlling for prior drinking. These results were corrected for heavy drinking and alcohol use in the period before neurocognitive testing. Interactions with gender indicated that this general pattern held for male but not for female students. Level of response inhibition was not associated with either of the alcohol use measures prospectively. Conclusion: These findings indicate that a neurocognitive decision-making task is predictive of maladaptive alcohol use. Advantageous decision makers appear to show adaptive real-life decision making, changing their drinking habits to the changing challenges of early adulthood (e.g., finishing college), whereas disadvantageous decision makers do not, and continue to drink heavily. These findings extend earlier findings of neurocognitive predictors of relapse in clinical substance-dependent groups, to subclinical alcohol use and abuse.

Gray HM; LaPlante DA; Bannon BL; Ambady N; Shaffer HJ. Development and validation of the Alcohol Identity Implicit Associations Test (AI-IAT). Addictive Behaviors 36(9): 919-926, 2011. (46 refs.)

Alcohol identity is the extent to which an individual perceives drinking alcohol to be a defining characteristic of his or her self-identity. Although alcohol identity might play an important role in risky college drinking practices, there is currently no easily administered, implicit measure of this concept. Therefore we developed a computerized implicit measure of alcohol identity (the Alcohol Identity Implicit Associations Test; AI-IAT) and assessed its reliability and predictive validity in relation to risky college drinking practices. One hundred forty-one college students completed the AI-IAT. Again 3- and 6-months later, we administered the AI-IAT and indices of engagement in risky college drinking practices. A subset of participants also completed the previously-validated implicit measure of alcohol identity. Scores on the AI-IAT were stable over time, internally consistent, and positively correlated with the previously-validated measure of alcohol identity. Baseline AI-IAT scores predicted future engagement in risky college drinking practices, even after controlling for standard alcohol consumption measures. We conclude that the AI-IAT reliably measures alcohol identity, a concept that appears to play an important role in risky college drinking practices.

Grossbard JR; Neighbors C; Larimer ME. Perceived norms for thinness and muscularity among college students: What do men and women really want? Eating Behaviors 12(3): 192-199, 2011. (48 refs.)

Background: Perceived norms are related to health-related attitudes and behaviors, including body image. The current study examined body dissatisfaction and perceived norms for thinness and muscularity among male and female college students. Method: Participants included 842 undergraduate students (64.5% female) who completed an online survey assessing body image and other health-related attitudes and behaviors. A series of independent sample and paired sample t tests were conducted to document sex differences in body dissatisfaction and misperceptions of thinness and muscularity norms. Results: Based on pictorial ratings, both males and females reported discrepancies between their ideal and actual figures. Females perceived other females as significantly thinner and less muscular than the actual norms. Males perceived other males as significantly heavier than their own figures, but the difference between men's self-reported muscularity and perceived norm was not significant. Both males and females misperceived opposite-sex attractiveness norms for thinness and muscularity. Discussion: Results suggest the importance of evaluating same-sex and opposite-sex perceived norms of thinness and muscularity in the etiology of body dissatisfaction, and this research informs social norms interventions targeting misperceptions of body image norms among both males and females.

Harwell BD; Cellucci T; Iwata AL. Rumination, anxiety sensitivity, and negative reinforcement drinking. Journal of Substance Use 16(1): 79-85, 2011. (26 refs.)

Method: Seventy-three women and 40 men collegiate drinkers completed several questionnaire measures assessing anxiety sensitivity and negative reinforcement drinking (NRD), including an adapted measure of anxiety rumination. Results: Findings indicated a moderate relationship (RCopyright 2011, Informa Healthcare

Heather N. Alcohol use disorders and hazardous drinking among undergraduates at English universities: A reply to Heffernan. (editorial). Alcohol and Alcoholism 46(4): 372-372, 2011. (2 refs.)

Heffernan TM. Alcohol use disorders and hazardous drinking among undergraduates at English universities: Some limitations of the survey by Heather et al. (editorial). Alcohol and Alcoholism 46(4): 371-371, 2011. (5 refs.)

Hosier SG; Cox WM. Personality and motivational correlates of alcohol consumption and alcohol-related problems among excessive drinking university students. Addictive Behaviors 36(1-2): 87-94, 2011. (43 refs.)

Objectives: The study had three objectives (1) to assess relationships between personality characteristics and alcohol consumption and alcohol-related problems among university students who drink alcohol excessively (2) to assess relationships between motivational structure and alcohol consumption and problems among students who consume excessive amounts of alcohol and (3) to assess how personality characteristics and motivational structure are related to each other and how the two are jointly related to alcohol consumption and problems Design Personality motivational structure alcohol use and alcohol-related problems were assessed among 111 undergraduate students Findings: Mediation analyses showed that both maladaptive motivational structure and novelty seeking predicted participants alcohol related problems beyond that predicted by alcohol consumption Conclusion: Future research should aim to reduce alcohol-related negative consequences by targeting students with a maladaptive motivational structure while taking into account the role of personality characteristics. Screening and intervention programmes would benefit from addressing novelty seeking and maladaptive motivation.

Huang JH; Jacobs DF; Derevensky JL. DSM-based problem gambling: Increasing the odds of heavy drinking in a national sample of US college athletes? Journal of Psychiatric Research 45(3): 302-308, 2011. (37 refs.)

Despite previously found co-occurrence of youth gambling and alcohol use, their relationship has not been systematically explored in a national sample using DSM-based gambling measures and multivariate modeling, adjusted for potential confounders. This study aimed to empirically examine the prevalence patterns and odds of at-least-weekly alcohol use and heavy episodic drinking (HED) in relation to various levels of gambling severity in college athletes. Multivariate logistic regression analyses were performed on data from a national sample of 20,739 U.S. college athletes from the first National Collegiate Athletic Association national survey of gambling and health-risk behaviors. Prevalence of at-least-weekly alcohol use significantly increased as DSM-IV-based gambling severity increased, from non-gambling (24.5%) to non-problem gambling (43.7%) to sub-clinical gambling (58.5%) to problem gambling (67.6%). Multivariate results indicated that all levels of gambling were associated with significantly elevated risk of at-least-weekly HED, from non-problem (OR = 1.25) to sub-clinical (OR = 1.75) to problem gambling (OR = 3.22); the steep increase in the relative risk also suggested a possible quadratic relationship between gambling level and HED risk. Notably, adjusted odds ratios showed problem gambling had the strongest association with at-least-weekly HED, followed by marijuana (OR = 3.08) and cigarette use (OR = 2.64). Gender interactions and differences were also identified and assessed. In conclusion, attention should be paid to college athletes exhibiting gambling problems, especially considering their empirical multivariate associations with high-risk drinking; accordingly, screening for problem gambling is recommended. More research is warranted to elucidate the etiologic mechanisms of these associations.

Hustad JTP; Short EE; Borsari B; Barnett NP; Tevyaw TO; Kahler CW. College alcohol citations result in modest reductions in student drinking. Journal of Substance Abuse Treatment 40(3): 281-286, 2011. (22 refs.)

College students who are cited for violating campus alcohol policy are often fined or sanctioned to complete an intervention or public service. Although some interventions have been found efficacious for mandated students, it is possible that being cited for an alcohol-related incident alone may be sufficient to reduce alcohol consumption. The purpose of this study was to investigate the course of alcohol consumption patterns following a citation for an alcohol policy violation. Participants were college students (N = 445) who received a citation for a campus alcohol policy violation at a small northeastern liberal arts college. Participants completed a Timeline Follow-Back indicating their daily alcohol use 2 weeks prior to the citation through 2 weeks after the citation. Results indicated that participants decreased their alcohol use following a citation event. However, the reduction in alcohol consumption was modest, suggesting that the citation event itself has a very temporary influence on the drinking of college students. Additional research is needed to reconcile these findings with those from other studies that found a more meaningful citation effect.

Isaak MI; Perkins DR; Labatut TR. Disregulated alcohol-related behavior among college drinkers: Associations with protective behaviors, personality, and drinking motives. Journal of American College Health 59(4): 282-288, 2011. (25 refs.)

Objective: This study investigated the psychometric properties of the Disregulated Alcohol-Related Behaviors Inventory (DARBI), a measure of harmful alcohol-related behavior, and the relationship between protective behavior use and scores on the DARBI and several other measures. Participants: Participants were 281 undergraduate volunteers (60% female) enrolled in introductory psychology sections in Summer and Fall 2007. Methods: Participants completed the DARBI along with paper-and-pencil self-report measures of broad personality domains, trait resilience, protective behavior use, and drinking motivations and consequences. Results: The DARBI's internal consistency was good (alpha = .85). DARBI scores correlated negatively with conscientiousness scores but positively with neuroticism, the Michigan Alcohol Screening Test (MAST), Rutgers Alcohol Problem Index (RAPI), and positive-reinforcement motives scores. The self-reported use of protective behaviors related negatively to DARBI, MAST, RAPI, and enhancement motives scores. Protective behavior use was unrelated to broad personality domains. Conclusions: The DARBI may prove a useful tool in campus interventions. Further research should determine the dispositional and situational determinants of protective behavior use.

Kasperski SJ; Vincent KB; Caldeira KM; Garnier-Dykstra LM; O'Grady KE; Arria AM. College students' use of cocaine: Results from a longitudinal study. Addictive Behaviors 36(4): 408-411, 2011. (24 refs.)

College students have high rates of heavy drinking and other risky behaviors, but little is known about trends in their use of cocaine. In this longitudinal study of 1253 college students at one large, public university in the mid-Atlantic region, annual interviews assessed opportunity to use cocaine, cocaine use, and DSM-IV criteria for cocaine abuse and dependence. Follow-up rates exceeded 87% annually. Data from the first four years of college were analyzed to detect changes over time and possible gender differences. By their fourth year of college, 36%(wt) of students had been offered cocaine at least once in their lifetime, and 13%(wt) had used cocaine. Annual prevalence of cocaine use increased significantly over time (4%(wt) in Year 1 to 10%(wt) in Year 4) and remained similar across genders. Opportunities to use cocaine were significantly more prevalent for males than females during Years 2 through 4. Cocaine use given opportunity increased significantly over time for both males and females. Among 243 cocaine users, females (n = 113) had more serious use patterns than males, with higher average frequency of use (18.39 vs. 8.83 days during the peak year of use, p<.05) and greater likelihood of meeting criteria for cocaine dependence (9.3% vs. 2.5%, p<.05). Gender differences in typical cocaine dosage were not apparent. College administrators and health providers should be aware of the prevalence of cocaine use among student populations and design strategies to address the problem.

Kazemi DM; Sun LM; Nies MA; Dmochowski J; Walford SM. Alcohol screening and brief interventions for college freshmen a harm reduction approach. Journal of Psychosocial Nursing and Mental Health Services 49(1): 35-42, 2011. (33 refs.)

This study examined the effectiveness of the Brief Alcohol Screening and Intervention for College Students using theory-driven harm reduction brief motivational interviewing (BMI) for decreasing high-risk drinking and negative consequences. Three surveys were administered to 102 volunteer freshmen college students at baseline and 3 months postintervention. The BMI intervention was administered at baseline and 2 weeks later. Descriptive statistics and summary graphs were used to determine longitudinal changes in drinking quantity, frequency, and negative outcomes. Number of drinks, hours of drinking, and negative consequences decreased, indicating a significant decrease in alcohol consumption and negative consequences. This study contributes valuable implications for the design of theory-driven harm reduction, evidence-based interventions for high-risk drinking among freshmen college students.

Kelly-Weeder S. Binge drinking and disordered eating in college students. Journal of The American Academy of Nurse Practitioners 23(1): 33-41, 2011. (59 refs.)

Purpose: To explore the co-occurrence of binge drinking and disordered eating behaviors in college-aged students. Data sources: Data were collected from 211 college-aged students (mean age 20.7 years) at a private university in the northeastern United States using a web-based survey. Gender-specific binge drinking rates (five drinks per occasion for men and four drinks per occasion for women) were ascertained. Disordered eating behaviors included measures of binge eating as well as unhealthy weight loss behaviors (skipping meals, fasting, diet pills, laxatives, and self-induced vomiting). Conclusions: Binge drinking rates were high (63% of female, 83% of male students). Binge eating was reported by 48% of students and was correlated with healthy and unhealthy weight loss behaviors. Female students were more likely to endorse the use of skipping meals, fasting, use of diet pills, laxatives, and self-induced vomiting. Implications for practice: Binge drinking and disordered eating behaviors are practiced by both male and female students and are common occurrences on college campuses. Nurse practitioners need to be aware of these behaviors, their co-occurrence, and the need to assess and intervene with students who are at risk for the negative health outcomes associated with the use of these behaviors.

Killos LF; Hancock LC; McGann AW; Keller AE. Do "Clicker" educational sessions enhance the effectiveness of a social norms marketing campaign? Journal of American College Health 59(3): 228-230, 2011. (5 refs.)

Objective: Social norms campaigns are a cost-effective way to reduce high-risk drinking on college campuses. This study compares effectiveness of a "standard" social norms media (SNM) campaign for those with and without exposure to additional educational sessions using audience response technology ("clickers"). Methods: American College Health Association's National College Health Assessment questions are used to evaluate actual and perceived use. Additional survey questions assess individual exposure to the interventions. Results: The authors find "clicker" technology to be more effective than social norms poster media alone in reducing misperceptions of normative alcohol use for those students who attended clicker sessions. Conclusion: Poster SNM campaigns may be most effective when supported by group "clicker" heath-related sessions.

Labbe AK; Maisto SA. Alcohol expectancy challenges for college students: A narrative review. (review). Clinical Psychology Review 31(4): 673- 683, 2011. (63 refs.)

Heavy alcohol use among college students has become a substantial health concern. With national survey data indicating that 40% of college students report consuming five or more alcoholic drinks at least monthly (Johnston, O'Malley, Bachman, & Schulenberg, 2009), prevention and intervention programs are needed to address this problem. The Task Force on College Drinking, commissioned by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), designated alcohol expectancy challenges (ECs) as a recommended treatment strategy to reduce alcohol use among college students (NIAAA, 2002). This paper is a systematic critical review of the studies that have been conducted to assess for the efficacy of ECs among college students with a focus on changes in expectancies and alcohol consumption, and possible differences in efficacy for men and women. The review revealed that ECs were most efficacious when administered to male-only groups of participants; while ECs for female-only and mixed-gender groups demonstrated less consistent results. The implications of the findings of this critical review for the direction of future research are discussed.

LaBrie JW; Cail J; Pedersen ER; Migliuri S. Reducing alcohol risk in adjudicated male college students: Further validation of a group motivational enhancement intervention. Journal of Child & Adolescent Substance Abuse 20(1): 82-98, 2011. (56 refs.)

This study examined the effectiveness of a single-session group motivational enhancement alcohol intervention on adjudicated male college students. Over two sequential academic years, 230 students sanctioned by the university for alcohol-related infractions attended a 60- to 75-minute group intervention. The intervention consisted of a timeline followback, social norms education, decisional balance for behavioral change, blood alcohol content (BAC) information, expectancy challenge, and generation of behavioral goals. Participants were followed weekly for three months and showed reductions in drinking (29%) and alcohol-related consequences (32%) at three-month follow-up. The intervention was successful in reducing drinking for both first-year students and upperclassmen, with reductions appearing to be a function of the intervention and not the citation itself. Furthermore, a post hoc control condition revealed that those participants randomly assigned to the intervention group condition reduced drinking (19%) and alcohol-related consequences (44%) more than participants in the control condition over one month. These results provide continued evidence of the effectiveness of group motivational enhancement interventions with adjudicated male college students.

LaBrie JW; Hummer JF; Lac A. Comparing injunctive marijuana use norms of salient reference groups among college student marijuana users and nonusers. Addictive Behaviors 36(7): 717-720, 2011. (21 refs.)

Marijuana is the most commonly used illicit drug among college students and has the potential for various negative outcomes. Perceptions of what constitutes typical approval/acceptability of a reference group (i.e. injunctive social norms) have been shown to have strong utility as predictors of health-risk behaviors in the college context, yet this construct remains significantly understudied for marijuana use despite its potential for use in social norms-based interventions. The current research evaluated individuals' marijuana approval level and their perceptions of others' marijuana approval level (i.e. injunctive norms) for various reference groups (typical student on campus, one's close friends, and one's parents) as a function of individual user status (abstainers, experimenters, occasional users, and regular users). A diverse sample of 3553 college students from two universities completed an online survey. Among all user status groups, individual approval yielded mean scores paralleling that of perceived close friends' approval and all groups were relatively uniform in their perception of typical students' approval. Higher levels of marijuana use tended to produce higher endorsements of individual approval, perceived close friends' approval, and perceived parental approval. Among occasional and regular users, there were no differences between one's own approval level for use and the perceptions of close friends' approval, nor did they think the typical student was more approving than themselves. Abstainers and experimenters, however, perceived typical students and close friends to have more permissive attitudes than themselves. Implications and future directions for research regarding the role of injunctive marijuana use norms in the development of social norms intervention are discussed.

LaBrie JW; Hummer JF; Lac A; Ehret PJ; Kenney SR. Parents know best, but are they accurate? Parental normative misperceptions and their relationship to students' alcohol-related outcomes. Journal of Studies on Alcohol and Drugs 72(4): 521-529, 2011. (69 refs.)

Objective: Parents often look to other parents for guidance, but how accurate are their perceptions? Expanding on existing normative literature to include parents of college students, this study first sought to determine whether parents accurately estimated the attitudes of other parents concerning their college student's alcohol-related behaviors. The effect of these (mis)perceived injunctive norms on the alcohol-related attitudes and behaviors of the parents' own children was then examined. Method: Participants were 270 college student parent dyadic pairs who completed independent online surveys. The student sample was 59% female; the parent sample was 78% female. Results: A structural equation model demonstrated that parents significantly overestimated other parents' approval of alcohol use by their respective child and, further, that these misperceptions strongly influenced parental attitudes toward their own child's drinking. Parental attitudes were subsequently found to be significantly associated with their child's attitudes toward drinking but were only marginally associated with the child's actual drinking, thereby underscoring the mediational effect of the child's attitudes. Conclusions: This is the first study to document the influence of parental normative misperceptions regarding alcohol use by their college-age children, reinforcing the importance of parental attitudes on children's alcohol-related attitudes and behaviors in college. These findings support the need to complement student-based interventions with parent-based interventions aimed at increasing parental awareness and involvement. Further, the current findings indicate that normative interventions targeting parents offer a promising avenue by which to indirectly and positively influence college students' alcohol use.

LaBrie JW; Kenney SR; Migliuri S; Lac A. Sexual experience and risky alcohol consumption among incoming first-year college females. Journal of Child & Adolescent Substance Abuse 20(1): 15-33, 2011. (73 refs.)

This study examines the relationship between sexual experience and various drinking measures in 550 incoming first-year college females. During this transition period, sexually experienced participants reported stronger alcohol expectancies and endorsed higher drinking motives, and drank more frequently and in greater quantities than sexually inexperienced participants. Sexual status was also a significant predictor of alcohol-related nonsexual consequences, over and above amount consumed. Furthermore, controlling for drinking, sexual status moderated the relationship between coping motives and consequences. Among women who endorsed strong coping motives for drinking, sexual experience was linked to greater nonsexual alcohol-related consequences. Implications for prevention and intervention are discussed.

LaBrie JW; Lac A; Kenney SR; Mirza T. Protective behavioral strategies mediate the effect of drinking motives on alcohol use among heavy drinking college students: Gender and race differences. Addictive Behaviors 36(4): 354-361, 2011. (51 refs.)

Objective: This study examined the extent to which protective behavioral strategies (PBS) mediated the influence of drinking motives on alcohol consumption, and if these hypothesized relationships were corroborated across subsamples of gender and race. Method: Online surveys were completed by 1592 heavy drinking college undergraduates from two universities (49.9% male and 50.1% female; 76.9% Caucasian and 23.1% Asian). Independent samples t-tests compared males and females as well as Caucasians and Asians on measures of drinking motives. PBS use, and alcohol consumption, and structural equation models examined the mediating role of PBS. Results: Consistent with predictions, t-tests revealed that males reported greater levels of consumption than females, but females reported greater use of PBS than males. Caucasians reported greater consumption levels, endorsed higher enhancement motives, and higher PBS related to serious harm reduction, but Asians endorsed higher coping and conformity motives, and PBS focused on stopping/limiting drinking. In multiple-sample SEM analyses, PBS were shown to largely mediate the relationship between motives and consumption in all demographic subsamples. Conclusions: Findings indicate that PBS use leads to reductions in drinking despite pre-established drinking motives, hence pointing to the potential value of standalone PBS skills training interventions in lowering alcohol use among diverse groups of heavy drinking college students.

Lange JE; Devos-Comby L; Moore RS; Daniel J; Homer K. Collegiate natural drinking groups: Characteristics, structure, and processes. Addiction Research & Theory 19(4): 312-322, 2011. (27 refs.)

College students typically consume alcohol in groups. To examine group characteristics, structure, processes, and group drinking, we conducted semi-structured, in-depth interviews with 30 (50%% female; 60%% non-Latino White) college students (18-24 years old). Participants described the last event they attended where alcohol was present. The interviews were fully transcribed and coded using an inductive approach with the software ATLAS.ti 5.2. The findings revealed that group formation often involved minimal planning and was facilitated by technologies such as phone, text messaging, and social networking Internet sites. Multiple roles were identified that supported the groups and that pertained to the drinking event organization, to drinking activities, or group regulation. As the groups reached drunkenness, decision negotiations were replaced by random actions that often exemplified the loss of judgment resulting from alcohol impairment, leading to risky situations. Understanding group dynamics and social roles in drinking groups could inform prevention efforts by identifying new loci of interventions; promoting pro-social roles in the group could encourage peers to become effective agents of prevention within the group.

Larsen E; Rise J; Astrom AN. Expectancies and intentions to use snus among Norwegian first-year students. Nicotine & Tobacco Research 13(5): 313- 318, 2011. (32 refs.)

Introduction: The prevalence of use of snus (low-nitrosamine smokeless tobacco, Swedish type) has reached epidemic proportions in parts of Northern Europe, and the trend is escalating. Knowledge of variables influencing use of snus is scarce, and this study set out to explore expectancies related to the use of snus as possible determinants of intentions to use snus in the next 6 months. Methods: The data stem from a questionnaire survey among university students in 2004 and included 141 snus users (mean age = 20.9 years, SD = 2.1). Thirteen items derived from a study by Juliano & Brandon (2004) were adapted to the use of snus, and a confirmatory factor analysis was conducted. The predictive power of expectancies on snus intentions and behavioral experience on intentions were examined using structural equation modeling. Results: Five meaningful and interpretable expectancy factors were confirmed by the factor analysis: "negative affect," "weight control," "health risks," "quitting smoking facilitation," and "craving reduction." "Health risks" turned out to be the only expectancy factor that significantly predicted intentions to use snus. In addition, "current snus behavior" had a significant direct effect on intentions. Altogether, the model explained 27% of the variance in intentions. Conclusions: The findings suggest that expectancies of snus use can be applied to understand intentions to use snus. However, the range of expectancy items should preferably be broadened in future studies, and more attention should be paid to the inclusion of groups that differs in nicotine experience.

lBonar EE; Rosenberg H; Hoffmann E; Kraus SW; Kryszak E; Young KM et al. Measuring university students' self-efficacy to use drinking self-control strategies. Psychology of Addictive Behaviors 25(1): 155-161, 2011. (33 refs.)

Using a Web-based, self-administered questionnaire, we assessed 498 university-student drinkers' self-efficacy to use 31 different behavioral strategies to reduce excessive drinking in each of three different locations (bar, party, own dorm/apartment). Averaging all 31 items within each drinking situation to create a single scale score revealed high internal consistency reliabilities and moderate inter-item correlations. Testing the association of self-efficacy with drinking location, sex, and frequency of recent binge drinking, we found that respondents reported higher self-efficacy to use these strategies when drinking in their own dorm/apartment than when drinking in bars and at parties; women reported higher mean self-efficacy than men; and drinkers who engaged in 3-or-more binges in the previous 2 weeks reported lower self-efficacy than those who reported either 0 or 1-or-2 binges in the same time period. This questionnaire could be used to identify self-efficacy deficits among clients with drinking problems and as an outcome measure to assess the degree to which interventions influence reported confidence to use specific drinking-reduction strategies in high-risk drinking situations.

Lipkus IM; Eissenberg T; Schwartz-Bloom RD; Prokhorov AV; Levy J. Affecting perceptions of harm and addiction among college waterpipe tobacco smokers. Nicotine & Tobacco Research 13(7): 599-610, 2011. (37 refs.)

The spread of waterpipe tobacco use among youth may be due in part to perceptions that waterpipe tobacco use is safer than other tobacco products, such as cigarettes. In two pilot studies, we sought to modify college waterpipe smokers' perceived risks and worry about waterpipe tobacco smoking. We conducted two web-based studies that varied whether college waterpipe users received information on (a) spread of and use of flavored tobacco in waterpipe and (b) harms of waterpipe smoking. Study 1 (N = 91) tested the "incremental" effects on perceptions of risk and worry of adding information about harms of waterpipe smoking to information on the spread of waterpipe and use of flavorings in the tobacco. Study 2 (N = 112) tested the effects on perceptions of risk and worry of reviewing information about harms of waterpipe smoking compared to a no information control group. In Study 1 only, we assessed as part of a 6-month follow-up (n = 70) the percentage of participants who reported no longer using waterpipe. Pooling data from both studies, participants who received information about the harms of waterpipe smoking reported greater perceived risk and worry about harm and addiction and expressed a stronger desire to quit. In Study 1, 62% of participants in the experimental group versus 33% in the control group reported having stopped waterpipe use. These are the first studies to show that perceptions of addiction and harm from waterpipe use can be modified using minimally intensive interventions; such interventions show promise at decreasing waterpipe use.

Lord S; Brevard J; Budman S. Connecting to young adults: An online social network survey of beliefs and attitudes associated with prescription opioid misuse among college students. Substance Use & Misuse 46(1): 66-76, 2011. (19 refs.)

A survey of motives and attitudes associated with patterns of nonmedical prescription opioid medication use among college students was conducted on Facebook, a popular online social networking Web site. Response metrics for a 2-week random advertisement post, targeting students who had misused prescription medications, surpassed typical benchmarks for online marketing campaigns and yielded 527 valid surveys. Respondent characteristics, substance use patterns, and use motives were consistent with other surveys of prescription opioid use among college populations. Results support the potential of online social networks to serve as powerful vehicles to connect with college-aged populations about their drug use. Limitations of the study are noted.

MacNeela P; Bredin O. Keeping your balance freedom and regulation in female university students' drinking practices. Journal of Health Psychology 16(2): 284-293, 2011. (35 refs.)

Binge drinking is a focus for concerns about young women's alcohol consumption at university. Twenty females, all regular binge drinkers, were interviewed individually and in focus groups to explore alcohol beliefs and exposure to harm. Four themes were identified in a thematic analysis. Alcohol use was associated with freedom but regulated by group norms. Drinking to excess was stigmatized as an abuse of freedom, yet the threshold for excess was very high. The drug effects of alcohol were enjoyed, with drinking harms managed through trivialization. As part of a problem of imbalance, peer groups must be part of the solution.

Mallett KA; Marzell M; Turrisi R. Is reducing drinking always the answer to reducing consequences in first-year college students? Journal of Studies on Alcohol and Drugs 72(2): 240-246, 2011. (40 refs.)

Objective: Pre-college drinking has been shown to be a predictor of risky drinking and harmful outcomes in college. By contrast, less is known about how pre-college alcohol consequences influence subsequent consequences during the freshman year. The present study examined pre-college drinking and consequences in relationship to consequences experienced during the freshman year to better understand alcohol-related problems in this population. Method: Incoming freshmen (N = 340, 58% female) were randomly selected and completed measures of drinking quantity, alcohol-related consequences, and drinking style behaviors at pre-college baseline and at 10-month follow-up. Results: Pre-college consequences demonstrated a unique relationship with consequences at 10-month follow-up controlling for both pre-college and freshman-year alcohol consumption. Furthermore, pre-college consequences moderated the relationship between pre-college drinking and consequences at 10-month follow-up. For individuals who reported above-average pre-college consequences, no differences in 10-month follow-up consequences were observed across different levels of drinking. Finally, drinking style significantly mediated the relationship between the interaction between pre-college drinking and consequences and consequences at follow-up. Conclusions: The findings demonstrate the need to identify students who are at an increased risk of experiencing alcohol-related problems during their freshman year based on their history of consequences before college. Interventions aimed at these students may benefit from examining the usefulness of increasing protective behaviors as a method to reduce consequences in addition to reducing drinking quantity.

Mallett KA; Marzell M; Varvil-Weld L; Turrisi R; Guttman K; Abar C. One-time or repeat offenders? An examination of the patterns of alcohol-related consequences experienced by college students across the freshman year. Addictive Behaviors 36(5): 508-511, 2011. (27 refs.)

Recent studies have examined alcohol-related consequences in college students as an independent outcome variable, rather than as a result of heavy drinking. The present study examined the patterns of consequences experienced by first-year college students (n = 169). Specifically, the number of distinct consequences and the frequency of repeated consequences were evaluated as well as the combination of the two. Results revealed that 80% of participants reported experiencing multiple consequences, with over 34% of students reporting 6 or more unique consequences over the course of their freshmen year. In addition, nearly 50% of the sample reported experiencing 3 or more consequences repeatedly. Further, 23% of the sample reported experiencing 5 or more repeated consequences and 6 or more multiple consequences. These individuals experienced 38% of the multiple consequences and 54% of the repeated consequences reported by the entire sample, suggesting individuals who endorsed experiencing multiple consequences repeatedly also experienced a disproportionate number of the total consequences reported by the sample. The findings suggest there are specific high-risk patterns of alcohol-related consequences and demonstrate a need for further examination of additional variables that predict consequences.

Mallett KA; Varvil-Weld L; Turrisi R; Read A. An examination of college students' willingness to experience consequences as a unique predictor of alcohol problems. Psychology of Addictive Behaviors 25(1): 41-47, 2011. (56 refs.)

The focus of the study was to examine (1) the unique variance between willingness to experience specific consequences (e.g., vomit) and reported experience of the consequence after controlling for drinking, and (2) the relationships between consequence specific constructs (attitudes and norms) and willingness to experience specific consequences in the context of a structural equation model. Freshmen students (n = 167) from a large northeastern university were randomly selected to participate. Results indicated willingness to experience consequences accounted for significant variance across consequence outcomes controlling for drinking. Significant relationships were observed between consequence specific constructs (attitudes and norms) and students' willingness to experience consequences. Findings provide empirical support that alcohol-related consequences have multiple determinants and are not only a function of alcohol consumption. Prevention efforts may benefit from a more comprehensive approach that includes both drinking and consequence-specific constructs as targets of change.

Martens MP; Pedersen ER; Smith AE; Stewart SH; O'Brien K. Predictors of alcohol-related outcomes in college athletes: The roles of trait urgency and drinking motives. Addictive Behaviors 36(5): 456-464, 2011. (51 refs.)

Research has shown that college students participating in athletics drink more than other students, yet relatively few studies have examined variables that are associated with alcohol-related outcomes among this population. The purpose of this study was to examine the relationships among trait urgency, general drinking motives and sport-related drinking motives, and both alcohol use and alcohol-related problems. Data were collected from 198 college students participating in either intercollegiate or recreational athletics at three U.S. universities. Structural equation modeling was used to examine a series of theoretically derived explanatory models. All variables included in the model were directly associated with alcohol use and/or alcohol-related problems. The specific patterns of relationships differed across the motives and trait urgency variables. Sport-related coping motives, sport-related positive reinforcement motives, and general enhancement motives had direct relationships with alcohol use, while trait urgency, general coping motives, and sport-related positive reinforcement motives had direct relationships with alcohol-related problems. Several indirect effects on alcohol use and alcohol-related problems were also found. This study suggests that general drinking motives, sport-related drinking motives, and trait urgency all serve as important predictors of alcohol-related outcomes in college athletes.

McAlaney J; Bewick B; Hughes C. The international development of the 'social norms' approach to drug education and prevention. Drugs: Education, Prevention and Policy 18(2): 81-89, 2011. (64 refs.)

The social norms approach to health promotion has become remarkably popular in the last 20 years, particularly in the American college system. It is an alternative to traditional fear-based approaches of health education, which a growing body of research demonstrates is often ineffective in reducing alcohol and drug misuse. The social norms approach differs by recognizing that individuals, particularly young adults, tend to overestimate how heavily and frequently their peers consume alcohol, and that these perceptions lead them to drink more heavily themselves than they would otherwise do. Similar misperceptions have been found in a range of other health and non-health behaviours. The social norms approach aims to reduce these misperceptions, and thus personal consumption, through the use of media campaigns and personal feedback. Although the numbers of completed social norms projects outside the USA is small, the evidence from them is that the approach can be equally effective in both European and Australian contexts. It is also acknowledged that as an emergent field, there are limitations to the current social norms literature. There is a lack of randomized control trial studies, a lack of clarity of the role of referent groups and a need to better understand the processes through which misperceptions are transmitted. However, despite these issues, the social norms approach represents a new avenue for reducing alcohol and drug-related harm and is an area which merits further research.

McCambridge J; Hunt C; Jenkins RJ; Strang J. Cluster randomised trial of the effectiveness of motivational interviewing for universal prevention. Drug and Alcohol Dependence 114(2-3): 177- 184, 2011. (27 refs.)

Background: The prevention of initiation of tobacco, alcohol and drug use is a major societal challenge, for which the existing research literature is generally disappointing. This study aimed to test the effectiveness of adaptation of Motivational Interviewing (MI) for universal prevention purposes, i.e. to prevent initiation of new substance use among non-users, and to reduce risks among existing users. Methods: Cluster randomised trial with 416 students aged 16-19 years old recruited in 12 London Further Education colleges without regard to substance use status. Individualised MI was compared with standard practice classroom-delivered Drug Awareness intervention, both delivered over the course of one lesson. Prevalence, initiation and cessation rates for the 3 target behaviours of cigarette smoking, alcohol consumption and cannabis use, along with reductions in use and harm indicators after both 3 and 12 months were assessed. Results: This adaptation of MI was not demonstrated to be effective in either intention-to-treat or subgroup analyses for any outcome. Unexpected lower levels of cannabis initiation and prevalence were found in the Drug Awareness control condition. Conclusions: This particular adaptation of MI is ineffective as a universal drug prevention intervention and does not merit further study.

McCauley JL; Amstadter AB; Macdonald A; Danielson CK; Ruggiero KJ; Resnick HS et al. Non-medical use of prescription drugs in a national sample of college women. Addictive Behaviors 36(7): 690-695, 2011. (38 refs.)

Non-medical use of prescription drugs (NMUPD) is one of the fastest growing forms of illicit drug use, with research indicating that college students represent a particularly high risk population. The current study examined demographic characteristics, health/mental health, substance misuse, and rape experiences as potential risk correlates of NMUPD among a national sample of college women (N = 2000). Interviews were conducted via telephone using Computer-Assisted Telephone Interviewing technology. NMUPD was assessed by asking if, participants had used a prescription drug non-medically in the past year. NMUPD was endorsed by 7.8% of the sample (n = 155). Although incapacitated and drug-alcohol facilitated rape were associated with NMUPD in the initial model, the final multivariable model showed that only lifetime major depression and other forms of substance use/abuse were significantly uniquely associated with an increased likelihood of NMUPD. Implications for primary and secondary prevention and subsequent research are addressed.

McCrystal P; Percy A. Patterns of substance use among young people attending colleges of further education in Northern Ireland. Drugs: Education, Prevention and Policy 18(1): 69-76, 2011. (18 refs.)

Aims: Substance use and misuse amongst young people attending colleges of further education (FE) has received little attention in the drug use literature in the UK. This article aims to explore the patterns of drug use amongst young people attending colleges of further education in Northern Ireland. Methods: A cross-sectional questionnaire survey of drug use was undertaken in two FE colleges in Northern Ireland. A sample of young people of the same age who were attending school also completed the questionnaire. This provided a school-based comparison group for the FE sample. Findings: The levels of educational achievement measured by performance at General Certificate of Secondary Educationation (GCSE) examinations prior to entry to FE college was the strongest predictor of substance misuse amongst the FE sample young people who performed better in these examinations were less likely to misuse drugs. Conclusions: School-based educational achievement prior to attending college is a key predictor of drug misuse amongst young people attending FE colleges.

McNiel AD; Muzzin KB; DeWald JP; McCann AL; Schneiderman ED; Scofield J et al. The nonmedical use of prescription stimulants among dental and dental hygiene students. Journal of Dental Education 75(3): 365-376, 2011. (48 refs.)

The purpose of this study was to determine the nonmedical use of prescription attention deficit disorder (ADD) stimulant medication among dental and dental hygiene students. A questionnaire was used to examine demographic information, student experiences, and perceptions of prescription stimulant medication and to determine if students used a prescription stimulant nonmedically. In 2008, 401 surveys were mailed to dental education institutions in the south-central region of the United States, and 243 surveys (61 percent) were returned. The survey found that 12.4 percent of these students used a prescription stimulant nonmedically and, of those, 70 percent took it to improve attention and/or concentration. The most commonly reported stimulant medication used nonmedically was Adderall (77 percent). The majority (87 percent) of the students obtained the medication through friends, and 90 percent began using the drug in college. Even though 74 percent of the students reported being stressed, chi-square analysis found no significant association between nonmedical use of ADD stimulant medication and stress level (p=0.585). Sixteen percent of the students surveyed felt it was easy to obtain stimulant medication for nonmedical use at their school, and 17 percent thought it was a problem within their institution. These results may help administrators and faculty members become aware of potential problems with the misuse of ADD stimulant medication.

Merlo LJ; Ahmedani BK; Barondess DA; Bohnert KM; Gold MS. Alcohol consumption associated with collegiate American football pre-game festivities. Drug and Alcohol Dependence 116(1-3): 242-245, 2011. (17 refs.)

Internationally, sporting events represent a specific context in which heavy episodic drinking is common. The current study assessed determinants of heavy episodic drinking among tailgaters (i.e., individuals engaging in pre-game social festivities) prior to American football games at two large universities. A total of 466 individuals at two universities completed a short interview and provided a breathalyzer sample to estimate breath alcohol content (BrAC) during the tailgating window (150 min prior to and 10 min after the start of the game). The plurality of participants, 48.5% at the southeastern university (School1) and 58.8% at the midwestern university (School2), engaged in heavy episodic drinking. Only 54 individuals (11.6%) from the combined sample at both universities abstained from alcohol (confirmed via BrAC). In total, 40.2% of participants at School1 and 31.9% at School2 produced breath samples over the legal limit for driving (i.e., BrAC = 0.08 or higher). In site-specific regression analyses, younger ages, males, and non-students at SchooL1, and younger ages and non-game attendance at School2 were associated with self-reported heavy episodic drinking and higher levels of estimated BrAC (p <0.05). Given the widespread participation in heavy episodic drinking among both students and non-students in this sample, public health interventions should be implemented both on- and off-campus to promote safety and to discourage heavy episodic drinking at American football games and other high-profile sporting events.

Misch DA. Changing the culture of alcohol abuse on campus: Lessons learned from secondhand smoke. Journal of American College Health 59(3): 232-234, 2011. (13 refs.)

Alcohol abuse is the single greatest public health hazard on American college and university campuses, but the culture of abusive alcohol consumption continues to be highly resistant to change. The author argues that secondhand smoke campaigns can be used as models to change the culture of alcohol abuse on campus. He proposes the implementation of "secondhand alcohol" campaigns and describes their essential components and advantages.

Mubayi A; Greenwood P; Wang XH; Castillo-Chavez C; Gorman DM; Gruenewald P et al. Types of drinkers and drinking settings: An application of a mathematical model. Addiction 106(4): 749-758, 2011. (37 refs.)

Aims: US college drinking data and a simple population model of alcohol consumption are used to explore the impact of social and contextual parameters on the distribution of light, moderate and heavy drinkers. Light drinkers become moderate drinkers under social influence, moderate drinkers may change environments and become heavy drinkers. We estimate the drinking reproduction number, R-d, the average number of individual transitions from light to moderate drinking that result from the introduction of a moderate drinker in a population of light drinkers. Design and Settings: Ways of assessing and ranking progression of drinking risks and data-driven definitions of high- and low-risk drinking environments are introduced. Uncertainty and sensitivity analyses, via a novel statistical approach, are conducted to assess R-d variability and to analyze the role of context on drinking dynamics. Findings: Our estimates show R-d well above the critical value of 1. R-d estimates correlate positively with the proportion of time spent by moderate drinkers in high-risk drinking environments. R-d is most sensitive to variations in local social mixing contact rates within low-risk environments. The parameterized model with college data suggests that high residence times of moderate drinkers in low-risk environments maintain heavy drinking. Conclusions: With regard to alcohol consumption in US college students, drinking places, the connectivity (traffic) between drinking venues and the strength of socialization in local environments are important determinants in transitions between light, moderate and heavy drinking as well as in long-term prediction of the drinking dynamics.

Mumford E; Gitchell JG; Kelley-Baker T; Romano E. Crossing a border for a low-cost, high-risk environment: Smoking status and excessive drinking among young adults in Tijuana. Substance Use & Misuse 46(4): 466-475, 2011. (34 refs.)

This study examines the drinking and smoking behavior of 2,311 college-age adults traveling from San Diego, California, to Tijuana, Mexico (December 2006 to December 2008). We describe this Border sample's drinking history and smoking status and estimate multivariate models of evening drinking participation and, conditional on drinking, blood alcohol concentration. Noting limitations, we present implications for identifying young adults at high risk for alcohol and tobacco use, particularly females, and lay the foundation for further research examining young adults" alcohol and tobacco use in reduced price scenarios.

Murphy P; Garavan H. Cognitive predictors of problem drinking and AUDIT scores among college students. Drug and Alcohol Dependence 115(1-2): 94- 100, 2011. (44 refs.)

Evidence from a number of substance abuse populations suggests that substance abuse is associated with a cluster of differences in cognitive processes. However, investigations of this kind in non-clinical samples are relatively few. The present study examined the ability of alcohol-attentional bias (an alcohol Stroop task), impulsive decision-making (a delay discounting task), and impaired inhibitory control (a GO-NOGO task) to: (a) discriminate problem from non-problem drinkers among a sample of college students; (b) predict scores on the Alcohol Use Disorders Identification Test (AUDIT; a measure of alcohol consumption, drinking behaviour, and alcohol-related problems) across all of the student drinkers; (c) predict AUDIT scores within the subgroups of problem and non-problem student drinkers. In logistic regression controlling for gender and age, student drinkers with elevated alcohol-attentional bias and impulsive decision-making were over twice as likely to be a problem than a non-problem drinker. Multiple regression analysis of the entire sample revealed that all three cognitive measures were significant predictors of AUDIT scores after gender and age had been controlled; the cognitive variables together accounted for 48% of the variance. Moreover, subsequent multiple regressions revealed that impaired inhibitory control was the only significant predictor of AUDIT scores for the group of non-problem drinkers, and alcohol-attentional bias and impulsive decision-making were the only significant predictors of AUDIT scores for the group of problem drinkers. Finally, both impulsive decision-making and impaired inhibitory control were significantly correlated with alcohol-attentional bias across the whole sample. Implications are discussed relating to the development of problematic drinking.

Nakhaee N; Divsalar K; Bahreinifar S. Prevalence of and factors associated with cigarette smoking among university students: A study from Iran. Asia-Pacific Journal of Public Health 23(2): 151-156, 2011. (20 refs.)

To determine the prevalence of cigarette use among college students and to identify correlates of cigarette smoking, a cross-sectional study was conducted on 1750 college students in the city of Kerman, located in southern Iran. The average age of college students was 21.2 +/- 2.1 years. A total of 52% participants were female, 92% were single, and 11% (184) were smokers (22% of men and 2.4% of women). The average age of smoking initiation was 15.9 +/- 4.5 years. A high association was shown with the use of cigarettes among close friends (odds ratio [OR] = 4.3), alcohol use (OR = 2.95), and being a male (OR = 2.81). Less cigarette use was shown among participants who prayed (OR = 0.52) and those with better academic standing (OR = 0.68). Based up the high prevalence of cigarette use among college students and also taking into account the correlates of cigarette use, gender-specific programs need to be tailored for cigarette use prevention among college students.

Nguyen N; Walters ST; Wyatt TM; DeJong W. Use and correlates of protective drinking behaviors during the transition to college: Analysis of a national sample. Addictive Behaviors 36(10): 1008-1014, 2011. (31 refs.)

Objective: This study examined patterns and correlates of protective drinking behaviors among incoming first-year college students. Method: Incoming first-year students (n = 76,882) from 258 colleges across the U.S. provided baseline data on demographics, drinking practices, and protective behaviors as part of a web-based alcohol education program. Across the several colleges, responses to protective behavior questions were collected from seven weeks before the start of the school year to five weeks after. Results: Factor analysis identified three protective behavior sub-factors: Limit Drinking, Avoid Drinking and Driving, and Intent to Get Drunk. Both Limit Drinking and Avoid Drinking and Driving generally declined over the course of the data collection period while Intent to Get Drunk and peak blood alcohol concentration increased immediately after the start of school. In multiple regression analyses, the number of heavy drinking episodes in the past two weeks had a strong negative association with a Total Protective Behavior Score and the Limit Drinking Score, and a positive association with the Intent to Get Drunk Score. With the exception of the Intent to Get Drunk Score, women were more likely to use protective behaviors than men. Underage drinkers used protective behaviors less often than their of-age peers, though the effect was small. Race/ethnicity, time to matriculation, and intent to join/membership in a fraternity/sorority had negligible effects on protective behavior scores. Conclusions: College students increase risky drinking after the start of school while progressively using fewer behaviors that might mitigate the consequences of drinking.

Norman P. The theory of planned behavior and binge drinking among undergraduate students: Assessing the impact of habit strength. Addictive Behaviors 36(5): 502-507, 2011. (55 refs.)

The present study sought to apply the theory of planned behavior (TPB) to the prediction of binge drinking intentions and behavior among undergraduate students and to test whether habit strength explains additional variance in binge drinking behavior. Undergraduate students (N = 137) completed measures of the TPB (i.e., attitude, subjective norm, self-efficacy, perceived control, and intention) and habit strength (Self-Report Habit Index) in relation to binge drinking. Frequency of binge drinking was assessed one month later (n = 109). The TPB explained 75% of the variance in binge drinking intentions, with attitude and self-efficacy making significant contributions, and 35% of the variance in binge drinking behavior at one-month follow-up, with only intention making a significant contribution. Habit strength explained additional variance in binge drinking behavior (Delta R-2 = .06), although intention remained as a significant predictor. The results suggest that binge drinking among undergraduate students is under the control of both intentional and habitual processes. Interventions to reduce binge drinking should therefore focus on the motivational determinants (e.g., perceived positive and negative consequences) of binge drinking as well as the environmental factors (i.e., contextual cues) that promote binge drinking.

Novik MG; Howard DE; Boekeloo BO. Drinking motivations and experiences of unwanted sexual advances among undergraduate students. Journal of Interpersonal Violence 26(1): 34-49, 2011. (25 refs.)

This study examined the relationship between drinking motivations and college students' experiences with unwanted sexual advances. Undergraduates, from a public university in the mid-Atlantic region, who reported recent (30 day) alcohol use (n = 289) completed an online survey midway through the spring 2007 academic semester. Experiencing an unwanted sexual advance was the outcome of interest for the present study. The independent variables included sociodemographics and a three-factor (social ease, social image or reputation, emotional distress) drinking motivation measure. Prevalence estimates as well as unadjusted and adjusted odds ratios (OR) were produced. A strong relationship was found between having an unwanted sexual advance and recent binge drinking as well as drinking to remove emotional distress (OR = 3.40 and 2.73, respectively, for the total sample; OR = 7.27 and 2.82 for females). Findings suggest that experiencing an unwanted sexual advance is associated with specific drinking motivations and more likely to occur among females. Further research is needed to fully understand pathways and implications.

O'Grady MA; Cullum J; Tennen H; Armeli S. Daily relationship between event-specific drinking norms and alcohol use: A four-year longitudinal study. Journal of Studies on Alcohol and Drugs 72(4): 633-641, 2011. (42 refs.)

Objective: This study examined how social-influence processes operate during specific drinking contexts as well as the stability and change in these processes throughout the college years. Method: Using a measurement-burst design, a hybrid of longitudinal and daily diary methods, we assessed the relationship between event-specific descriptive drinking norms and personal drinking. College students (N = 523) completed a baseline survey followed by a 30-day daily diary each year for up to the 4 study years. The baseline survey assessed participant gender and social anxiety, and the daily survey assessed personal drinking and perceived peer drinking (i.e., event-specific descriptive norms) during social drinking events. Results: Multilevel modeling revealed that men's social drinking slightly increased over the 4 years, whereas women's drinking remained steady. Further, on social drinking days when event-specific descriptive norms were high, students drank more, but this relationship was stronger for men than women and did not change over time. However, men's drinking norm perceptions increased across years, whereas women's decreased. Social anxiety did not moderate the relationship between norms and drinking. Conclusions: We demonstrate that although gender differences exist in the stability and change of personal drinking, norms, and normative influence on drinking across the years of college, the acute social influence of the norm on personal drinking remains a stable and important predictor of drinking throughout college. Our findings can assist with the identification of how, when, and for whom to target social influence based interventions aimed at reducing drinking.

O'Grady MA; Cullum J; Armeli S; Tennen H. Putting the relationship between social anxiety and alcohol use into context: A daily diary investigation of drinking in response to embarrassing events. Journal of Social and Clinical Psychology 30(6): 599-615, 2011. (44 refs.)

The goal of this study was to clarify mixed findings regarding the association between dispositional social anxiety and drinking among college students by using a daily diary method to examine whether a within-person social-contextual event moderated the relationship between social anxiety and alcohol use. College students (n = 476) completed a measure of dispositional social anxiety and then for 30 days reported whether they experienced an embarrassing event in public and the amount of alcohol they drank each day. We examined whether experiencing an embarrassing event moderated the relationship between dispositional social anxiety and alcohol use for same-day, same-evening, next-day, and next-evening drinking. While there was a positive relationship between dispositional social anxiety and alcohol use on evenings when an embarrassing event occurred earlier that day, this appeared to be driven by a reduction in drinking among those low in social anxiety. Individuals with high social anxiety drank in the evening regardless of embarrassing event occurrence. Results suggest that people with low social anxiety show an adaptive response to embarrassing events by lowering drinking on such evenings, while those with high social anxiety may drink to reduce their already high levels of anxiety independent of daily social events.

Olthuis JV; Zamboanga BL; Ham LS; Van Tyne K. The utility of a gender-specific definition of binge drinking on the AUDIT. Journal of American College Health 59(4): 239-245, 2011. (26 refs.)

Objective: Although binge drinking is commonly defined as the consumption of at least 5 drinks in 1 sitting for men and 4 for women, the Alcohol Use Disorders Identification Test (AUDIT) defines binge drinking as the consumption of 6 or more drinks in 1 sitting for both men and women. This study examined the effect of using gender-specific binge drinking definitions on overall AUDIT scores. Participants: Participants were 331 college men and 1224 college women. Methods: Participants completed a self-report questionnaire, which included the AUDIT. Results: Findings showed that defining binge drinking as 4 or more drinks for women, rather than 6 or more, does impact their AUDIT scores and could affect the percentage of women classified as hazardous users. Among men, AUDIT scores were unaffected by the use of a gender-specific definition of binge drinking. Conclusions: Results suggest that the AUDIT might be underidentifying hazardous users among college women.

Osberg TM; Insana M; Eggert M; Billingsley K. Incremental validity of college alcohol beliefs in the prediction of freshman drinking and its consequences: A prospective study. Addictive Behaviors 36(4): 333-340, 2011. (46 refs.)

Osberg et al. (2010) recently developed the College Life Alcohol Salience Scale (CLASS), which assesses the extent to which students identify with the college drinking culture. Using a prospective design, we explored the incremental and predictive validity of the new measure in a sample of 479 college freshmen. Scores obtained on the new measure at Time 1 demonstrated strong positive associations with concurrently assessed drinking patterns and alcohol consequences, as well as those collected at Time 2 1 month later. The college alcohol beliefs measured by the CLASS also explained significant additional variance in drinking and its consequences at Time 2 beyond that accounted for by gender, perceived descriptive and injunctive norms, and positive and negative alcohol expectancies. Moreover, CLASS scores predicted typical drinking levels and alcohol consequences at Time 2, even when baseline levels of these drinking indices were controlled. Potential future lines of research with the CLASS are discussed.

Palfai TP; Ralston TE; Wright LL. Understanding university student drinking in the context of life goal pursuits: The mediational role of enhancement motives. Personality and Individual Differences 50(2): 169-174, 2011. (35 refs.)

Previous research has shown that university students who experience lower levels of meaning in the pursuit of typical life goals use more alcohol and experience more alcohol-related problems. The main objective of the present study was to extend this work by identifying motivational mechanisms that underlie the association between goal meaning and alcohol involvement. Ninety-three introductory psychology students participated in a university health behaviors study for course credit. Students completed a goal assessment in which they generated and rated goals that characterized their lives on dimensions of meaning and efficacy and then completed a series of assessments about alcohol use. Controlling for gender, partial correlations showed that higher meaning ratings for life goals were associated with less alcohol use and fewer alcohol-related consequences. Multiple mediational analyses among drinkers showed that the association between goal meaning ratings and alcohol involvement was mediated by enhancement but not coping motives. Findings support motivational models that have suggested that those who experience less engagement in their daily life tasks may experience greater positive incentive value from drinking. Results: point to the potential value of alcohol intervention approaches that include efforts to help students engage in sources of non-substance related reinforcement in their daily lives.

Palfai TP; Zisserson R; Saitz R. Using personalized feedback to reduce alcohol use among hazardous drinking college students: The moderating effect of alcohol-related negative consequences. Addictive Behaviors 36(5): 539-542, 2011. (21 refs.)

Web-based screening and brief interventions that include personalized feedback about their alcohol use have proven to be particularly promising for reducing hazardous drinking among university students. Despite the increasing use of these approaches, there is still relatively little known about how the content of these interventions may influence outcomes and who may benefit most from these approaches. The current study sought to address these issues by examining how individual differences in alcohol consequences influence outcomes of a laboratory-based computerized intervention. Methods: One-hundred and nineteen introductory psychology students who either had two episodes of heavy episodic drinking in the past month or scored 8 on the AUDIT participated in this randomized controlled trial for course credit. Participants were assigned to 1 of 4 conditions in this 2 Intervention (Alcohol Feedback vs. Control) x 2 Assessment (Motivational Assessment vs. No Motivational Assessment) between-subjects design. Quantity of alcohol consumed per week and heavy episodic drinking one month later were the primary dependent variables. Results: Controlling for corresponding baseline alcohol measures, hierarchical linear regression analyses showed a significant interaction between intervention condition and baseline alcohol-related consequences. For those who reported more alcohol consequences at baseline, the alcohol intervention resulted in significantly less alcohol use and fewer heavy drinking episodes at follow-up, while no difference was observed between intervention conditions for those with few baseline consequences. Assessment did not moderate intervention effects. Discussion: These findings suggest that a feedback-based computerized intervention that includes normative information about alcohol use and consequences may be more effective for hazardous drinking students who are experiencing higher levels of alcohol-related consequences.

Pascual-Leone A; Gomes K; Orr ES; Kaploun KA; Abeare CA. Affective and cognitive correlates of gambling behavior in university students. Journal of Gambling Studies 27(3): 401-408, 2011. (17 refs.)

The purpose of the following study was to explore certain affective and cognitive components and their relationships to gambling behavior in an undergraduate population. Specifically, the aim was to predict gambling severity using depression scores on the BDI-II, the dependency and self-criticism subscales on the DEQ, emotional awareness scores on the LEAS, cognitive flexibility scores from the STROOP, and a creativity subtests from the TTCT. Participants were 200 undergraduate students and 3.5-7.5% of individuals reported some level of problematic gambling behavior. Multiple regression analysis indicated that self-criticism and creative originality were significant predictors of gambling behavior, explaining 7.6% of the variance. Further analyses reveal a non-linear trend in the creative originality of those who gamble; only the at-risk gamblers were high in creativity whereas abstainers and problematic gamblers display similarly lower levels of creativity. Results: are discussed in regards to Blaszczynski and Nower's Addiction 97:487-499 (2002) subtypes of gambling vulnerability.

Patrick ME; Morgan N; Maggs JL; Lefkowitz ES. "I got your back": Friends' understandings regarding college student spring break behavior. Journal of Youth and Adolescence 40(1): 108-120, 2011. (50 refs.)

Behaviors that pose threats to safety and health, including binge drinking and unprotected sex, increase during a week-long break from university. Understandings with peers regarding these behaviors may be important for predicting behavior and related harms. College students (N = 651; 48% men) reported having understandings with their friends regarding alcohol use (59%) and sexual behavior (45%) during Spring Break. These understandings were to engage in behaviors characterized by risk (e. g., get drunk [23.5%], have sex with someone new [5.2%]) and protection (e. g., drink without getting drunk [17.8%], use condoms [15.8%]). After controlling for previous semester behavior and going on a Spring Break trip, Get Drunk Understandings predicted a greater likelihood of binge drinking and alcohol-related consequences; No/Safe Sex Understandings predicted condom use; and Sex Understandings predicted not using condoms. Understandings with friends regarding Spring Break behavior may be important proximal predictors of risk behaviors and represent potential targets for event-specific prevention.

Pedrelli P; Bitran S; Shyu I; Baer L; Guidi J; Tucker DD et al. Compulsive alcohol use and other high-risk behaviors among college students. American Journal on Addictions 20(1): 14-20, 2011. (34 refs.)

The association between heavy alcohol consumption and risky behaviors has been amply investigated among college students. However, less is known with regard to types of drinking behaviors associated with high-risk activities. The present study extends this area of research by examining the relationship between compulsive drinking and hazardous behaviors in this population. Nine hundred and four college students completed measures on compulsive drinking and other risky behaviors in the context of mental health screenings at three campuses. Results showed that in males, compulsive drinking increased the risk for compulsive street drugs use, compulsive prescription drugs use, compulsive sexual activities, and gambling. Among females, compulsive drinking increased the risk for compulsive street drugs use, and compulsive sexual activities. These findings suggest that inquiring about compulsive drinking among college students may have great utility in identifying those at greater risk for other risky behaviors. The high co-occurrence of compulsive drinking, illicit substances, compulsive sexual activities, and gambling in college students suggests the need for comprehensive programs addressing high-risk behaviors together.

Pedrelli P; Farabaugh AH; Zisook S; Tucker D; Rooney K; Katz J et al. Gender, depressive symptoms and patterns of alcohol use among college students. Psychopathology 44(1): 27-33, 2011. (41 refs.)

Background: Serious alcohol-related negative consequences are associated with a number of drinking behaviors among college students. Thus, it is critical to identify students who are at greater risk for hazardous drinking. Although some studies have shown that depressive symptoms may be associated with alcohol use in this population, findings are not consistent. The current study extends previous research by investigating the relationship between depressive symptoms, daily alcohol use and compulsive drinking among college students and whether gender moderates these relationships. Sampling and Methods: The participants were 904 college students (495 females; mean age = 20.07 +/- 1.85 years) who filled out questionnaires that focused on drinking behaviors and severity of depressive symptoms. Results: Gender moderated the relationship between depressive symptoms and daily alcohol consumption. In male college students, worse depressive symptoms were associated with increased daily alcohol use and with greater risk for compulsive drinking. In female college students, worse depressive symptoms increased the risk for compulsive drinking, but not for greater daily alcohol use. Conclusions: Results suggest that prevention programs aimed at decreasing harmful alcohol use among college students must take into consideration the role of both gender and depressive symptoms in the development of problematic drinking behaviors.

Piasecki TM; Piper ME; Baker TB; Hunt-Carter EE. WISDM primary and secondary dependence motives: Associations with self-monitored motives for smoking in two college samples. Drug and Alcohol Dependence 114(2-3): 207- 216, 2011. (29 refs.)

The Wisconsin Inventory of Smoking Dependence Motives (WISDM) assesses 13 domains of smoking motivation emphasized by diverse theoretical perspectives. Emerging findings support a distinction between four primary dependence motives (PDM) indexing core features of tobacco dependence and nine secondary dependence motives (SDM) indexing accessory features. The current study explored the validity of this distinction using data from two samples (Ns = 50 and 88) of college smokers who self-monitored their reasons for smoking with electronic diaries. PDM scores were associated with diary endorsement of habitual or automatic motives for smoking individual cigarettes, which are conceptually consistent with the content of the PDM subscales. SDM did not clearly predict conceptually related self-monitored motives when tested alone. However, when these two correlated scale composites were co-entered, PDM predicted being a daily vs. nondaily smoker, being higher in nicotine dependence, and smoking individual cigarettes because of habit or automaticity. Conversely, after PDM-SDM co-entry, the unique variance in the SDM composite predicted the tendency to report smoking individual cigarettes for situational or instrumental motives (e.g., to control negative affect). The results suggest that the PDM composite may reflect core motivational features of nicotine dependence in these young smokers. The relative prominence of primary motives in advanced or dependent use may be even clearer when motives for smoking are assessed in real time rather than reported via questionnaire.

Quinn PD; Fromme K. Predictors and outcomes of variability in subjective alcohol intoxication among college students: An event-level analysis across 4 years. Alcoholism: Clinical and Experimental Research 35(3): 484-495, 2011. (45 refs.)

Background: Individual differences in subjective alcohol intoxication, as measured by laboratory-based alcohol challenge, have been identified as a phenotypic risk factor for alcohol use disorders. Further, recent evidence indicates that subjective alcohol response is also associated with event-level physiological consequences among college students, including blackouts and hangovers. Methods: The current investigation tested predictors of and outcomes associated with subjective intoxication in the natural drinking environment. In a preliminary laboratory alcohol-challenge study (n = 53), we developed a brief measure of subjective alcohol intoxication for use in event-level research. Participating students in the principal study (n = 1,867; 63% women; 54% Caucasian) completed 30 days of Web-based self-monitoring in each of the 4 college years. Results: In the principal study, generalized estimating equation analyses revealed that both lighter drinking and a family history of alcohol problems predicted greater subjective intoxication after accounting for estimated blood alcohol concentration (eBAC). Moreover, greater subjective intoxication during a given drinking episode was associated with negative alcohol-related consequences, illicit drug use, and unsafe sex, and at higher eBACs, was associated with aggression, sex, and property crime. Students who on average experienced greater subjective intoxication were also more likely to experience negative consequences and engage in illicit drug use, sex, unsafe sex, and aggression. Conclusions: These findings suggest that both within-person variability and between-person individual differences in subjective intoxication may be risk factors for adverse drinking outcomes at the event level. Intervention efforts aimed at reducing problems associated with collegiate drinking may benefit from consideration both of who experiences greater subjective intoxication and of the situations in which they are more likely to do so.

Quinn PD; Fromme K. The role of person-environment interactions in increased alcohol use in the transition to college. Addiction 106(6): 1104- 1113, 2011. (62 refs.)

Aims: Even among those at risk for problematic alcohol use, there is variability in developmental trajectories of drinking and related problems. This prospective study examined the role of person-environment interactions in increased drinking during the transition to college. Design: The authors followed a sample of recent high school graduates to test whether protective environmental factors could delay increases in drinking among those high in trait-level risk factors. Setting: Participants completed web-based surveys. Participants: A sample of 1784 students in the incoming class of 2004 at a large public United States university completed high school and first-semester-of-college assessments. Measurements: Participants completed self-report measures of alcohol use, alcohol-related problems, perceived awareness and caring from parents and other adults, sensation seeking and impulsivity. Findings: In the transition to college, high sensation seekers from more protective high school parental environments increased their alcohol use and problems more than did other students. Increases in alcohol problems were also high among more impulsive students from less protective environments. Whereas high sensation seekers drank equivalently in college regardless of high school-perceived awareness and caring, those who had greater high school-perceived awareness and caring did not experience as many alcohol-related problems in college. Conclusions: Differences in drinking trajectories may be a function of person-environment interactions. Risk associated with high sensation seeking may be masked among adolescents in protective environments, but its emergence in the college transition predicts increases in alcohol use and related problems.

Rasul JW; Rommel RG; Jacquez GM; Fitzpatrick BG; Ackleh AS; Simonsen N et al. Heavy episodic drinking on college campuses: Does changing the legal drinking age make a difference? Journal of Studies on Alcohol and Drugs 72(1): 15-23, 2011. (20 refs.)

Objective: This article extends the compartmental model previously developed by Scribner et al. in the context of college drinking to a mathematical model of the consequences of lowering the legal drinking age. Method: Using data available from 32 U.S. campuses, the analyses separate underage and legal age drinking groups into an eight-compartment model with different alcohol availability (wetness) for the underage and legal age groups. The model evaluates the likelihood that underage students will incorrectly perceive normative drinking levels to be higher than they actually are (i.e., misperception) and adjust their drinking accordingly by varying the interaction between underage students in social and heavy episodic drinking compartments. Results: The results evaluate the total heavy episodic drinker population and its dependence on the difference in misperception, as well as its dependence on underage wetness, legal age wetness, and drinking age. Conclusions: Results suggest that an unrealistically extreme combination of high wetness and low enforcement would be needed for the policies related to lowering the drinking age to be effective.

Ridner SL; Myers JA; Hahn EJ; Ciszewski TN. College students' exposure to tobacco marketing in nightclubs and bars. Journal of American College Health 59(3): 159-164, 2011. (33 refs.)

Objective: To examine whether a college student's exposure to tobacco marketing in nightclubs and bars was affected by the presence of a smoke-free law. Participants: A random sample (N = 478) of students participated in the survey (no smoke-free law, n = 240; smoke-free law, n = 238). The analysis was limited to students who reported being in nightclubs and bars (n = 171). Methods: A nonexperimental, cross-sectional, 2-group design was used. Results: Students in the smoke-free law city were more likely to be approached by tobacco marketers (34.7% versus 20.2%, p = .02), offered free gifts (41.7% versus 24.2%, p = .02), and take free gifts for themselves (34.7% versus 19.2%, p = .02). They were more likely to be exposed to direct marketing strategies (1.83 versus 1.12, p = .02). There was no difference on indirect tobacco marketing by site. Conclusions: Tobacco marketing is pervasive in nightclubs and bars. Smoke-free laws may protect against exposure to secondhand smoke but not the "pro" smoking messages students encounter.

Roohafza H; Sadeghi M; Shahnam M; Bahonar A; Sarafzadegan N. Perceived factors related to cigarette and waterpipe (ghelyan) initiation and maintenance in university students of Iran. International Journal of Public Health 56(2): 175-180, 2011. (20 refs.)

To investigate the perceived factors leading to cigarette and waterpipe (ghelyan) smoking initiation and maintenance in Iranian university students. A cross-sectional study was conducted on 233 students aged 20-25 enrolled in Isfahan University and Kashan University in 2007. Demographic factors as well as cigarette and ghelyan status, and perceived factors related to cigarette or ghelyan smoking initiation and maintenance were recorded. Principal component analysis was carried out to cluster perceived smoking initiation and maintenance factors. In a multiple logistic regression model, perceived psychological factors were more significant to cigarette smoking initiation and maintenance than ghelyan smoking among girls (odds ratio, OR = 1.90; P < 0.04) although perceived psychological factors (OR = 2.20; P < 0.001) and social factors (OR = 2.42; P < 0.001) were more significant in cigarette smoking initiation than ghelyan smoking initiation among boys (OR = 2.42; P < 0.001). Moreover, study appears that in boys, perceived entertainment factors could play more significant role in ghelyan smoking initiation compared with cigarette smoking initiation (OR = 0.42; P < 0.001). Whereas the factors related to smoking initiation and maintenance are different in both genders and in both tobacco products, identification of cigarette and ghelyan smoking may guide policy makers to develop comprehensive interventions.

Ruthig JC; Marrone S; Hladkyj S; Robinson-Epp N. Changes in college student health: Implications for academic performance. Journal of College Student Development 52(3): 307- 320, 2011. (52 refs.)

This study investigated the longitudinal associations of health perceptions and behaviors with subsequent academic performance among college students. Multiple health perceptions and behaviors were assessed for 203 college students both at the beginning and end of an academic year. Students' academic performance was also measured at the end of the year. Separate regression analyses were conducted for men and women to examine changes in health perceptions and behaviors as predictors of year-end performance. Significant gender differences were found for initial health symptoms, perceived stress, exercise, and nutrition. After controlling for prior achievement, increased binge drinking negatively predicted female students' academic performance and feelings of success; increased tobacco use negatively predicted male students' performance. Male and female college students appear to differ in the ways that their health changes over an academic year as well as how such changes impact their later academic performance. Implications for devising health promotion programs that specifically target male and female college students' health risks are discussed.

Saylor DK. Heavy drinking on college campuses: No reason to change minimum legal drinking age of 21. (editorial). Journal of American College Health 59(4): 330-333, 2011. (38 refs.)

The recent Amethyst Initiative argues that a minimum legal drinking age (MLDA) of 21 has created a culture of heavy alcohol use on college campuses by making drinking clandestine and extreme. This group and others argue that lowering the MLDA will reduce the problem of obinge drinkingo on college campuses. However, such a policy change would remove one of the most researched and supported policies in the nation's alcohol control arsenal. There is little evidence that other interventions or policies are capable of working on the same broad level as MLDA 21, and there could also be a deleterious ripple effect in related legislation because MLDA 21 works in conjunction with other drinking laws. In addition, historic and international experiences with a lowered MLDA indicate there are serious social and public health consequences. Instead of removing efficacious interventions, we must remain committed to implementing and enforcing evidence-based practices and legislation.

Scribner RA; Theall KP; Mason K; Simonsen N; Schneider SK; Towvim LG et al. Alcohol prevention on college campuses: The moderating effect of the alcohol environment on the effectiveness of social norms marketing campaigns. Journal of Studies on Alcohol and Drugs 72(2): 232-239, 2011. (14 refs.)

Objective: Evaluations of social norms marketing campaigns to reduce college student drinking have produced conflicting results. This study examines whether the effectiveness of such campaigns may be moderated by on-premise alcohol outlet density in the surrounding community. Method: Multilevel analyses were conducted of student survey responses (N = 19,838) from 32 U.S. colleges that took part in one of two 4-year randomized, controlled trials completed for the Social Norms Marketing Research Project (SNMRP). In the models, students by year were nested within treatment (n = 16) and control group (n = 16) campuses, which were characterized by the on-premise outlet density in their surrounding community. The moderating effect of outlet density was introduced into the models as an interaction between the treatment effect (i.e., the effect of the social norms marketing campaigns over time) and outlet density. The models were also stratified by campus alcohol outlet density (high vs. low) to examine the effect of the intervention in each type of setting. Results: There was a significant interaction between the treatment effect and on-premise alcohol outlet density for one of the drinking outcomes targeted by the SNMRP intervention, the number of drinks when partying, and marginal evidence of interaction effects for two other outcomes, maximum recent consumption and a composite drinking scale. In stratified analyses, an intervention effect was observed for three of the four outcomes among students from campuses with lower on-premise alcohol outlet density, whereas no intervention effect was observed among students from campuses with higher on-premise alcohol outlet density. Conclusions: The findings suggest that the campus alcohol environment moderates the effect of social norms marketing interventions. Social norms marketing intervention may be less effective on campuses with higher densities of on-sale alcohol outlets.

Seigers DKL; Carey KB. Screening and brief interventions for alcohol use in college health centers: A review. (review). Journal of American College Health 59(3): 151-158, 2011. (59 refs.)

Objectives: To provide a critical review of the efficacy of brief interventions for alcohol use in college health centers. Methods: Studies were included if (a) they examined brief intervention trials that were conducted in college- or university-based student health centers or emergency departments, and (b) they provided pre-post data to estimate change. Results: Twelve studies suggested that screening and brief interventions in these settings are acceptable, feasible, and promote risk reduction. Conclusions: Findings support continued use of time-limited, single-session interventions with motivational interviewing and feedback components.

Sher KJ; Jackson KM; Steinley D. Alcohol use trajectories and the ubiquitous cat's cradle: Cause for concern? Journal of Abnormal Psychology 120(2): 322- 335, 2011. (76 refs.)

In recent years, trajectory approaches to characterizing individual differences in the onset and course of substance involvement have gained popularity. Previous studies have sometimes reported 4 prototypic courses: (a) a consistently "low" group, (b) an "increase" group, (c) a "decrease" group, and (d) a consistently "high" group. Although not always recovered, these trajectories are often found, despite these studies varying in the ages of the samples studied and the duration of the observation periods employed. Here, the authors examined the consistency with which these longitudinal patterns of heavy drinking were recovered in a series of latent class growth analyses that systematically varied the age of the sample at baseline, the duration of observation, and the number and frequency of measurement occasions. Data were drawn from a 4-year, 8-wave panel study of college student drinking (N = 3,720). Despite some variability across analyses, there was a strong tendency for these prototypes to emerge regardless of the participants' age at baseline and the duration of observation. These findings highlight potential problems with commonly employed trajectory-based approaches and the need to not over-reify these constructs.

Skidmore JR; Murphy JG. The effect of drink price and next-day responsibilities on college student drinking: A behavioral economic analysis. Psychology of Addictive Behaviors 25(1): 57-68, 2011. (52 refs.)

More than [3/4] of U.S. college students report a heavy drinking, episode (FIDE; 5 (for men) and 4 (for women) drinks during an occasion) in the previous 90 days. This pattern of drinking is associated with various risks and social problems for both the heavy drinkers and the larger college community. According to behavioral economics, college student drinking is a contextually bound phenomenon that is impacted by contingencies such as price and competing alternative reinforcers, including next-day responsibilities such as college classes. This study systematically examines the role of these variables by using hypothetical alcohol purchase tasks to analyze alcohol consumption and expenditures among college students who reported recent heavy drinking (N = 207, 53.1% women). The impact of gender and the personality risk factor sensation seeking (SS) were also assessed. Students were asked how many drinks they would purchase and consume across 17 drink prices and 3 next-day responsibility scenarios. Mean levels of hypothetical consumption were highly sensitive to both drink price and next-day responsibility, with the lowest drinking levels associated with high drink prices and a next-day test. Men and participants with greater levels of SS reported more demand overall (greater consumption and expenditures) than women and students with low SS personality. Contrary to our hypotheses women appeared to be less sensitive to increases in price than men. The results suggest that increasing drink prices and morning academic requirements may be useful in preventing heavy drinking among college students.

Smith SW; LaPlante C; Wibert WN; Mayer A; Atkin CK; Klein K et al. Student-generated protective behaviors to avert severe harm due to high-risk alcohol consumption. Journal of College Student Development 52(1): 101-114, 2011. (36 refs.)

High-risk alcohol consumption is a significant problem on college campuses that many students see as a rite of passage in their development into adulthood. Developing effective prevention campaigns designed to lessen or avert the risks associated with alcohol consumption entails understanding how students perceive harmful consequences as well as the ways they protect themselves while drinking. This study used survey research to determine what undergraduate students perceived to be the most severe alcohol-related harms and the protective behaviors that they thought would be effective at averting those harms. Results showed that students saw forced sex as the most severe alcohol-related harm, and the most commonly described protective behavior was personal responsibility. Implications of these findings for campus-focused health communication strategists and directions for future research are discussed.

Stone AM; Merlo LJ. Attitudes of college students toward mental illness stigma and the misuse of psychiatric medications. Journal of Clinical Psychiatry 72(2): 134-139, 2011. (23 refs.)

Objective: Mental illness stigma remains a significant barrier to treatment. However, the recent increase in the medical and nonmedical use of prescription psychiatric medications among college students seems to contradict this phenomenon. This study explored students' attitudes and experiences related to psychiatric medications, as well as correlates of psychiatric medication misuse (ie, attitudes toward mental illness and beliefs about the efficacy of psychiatric medications). Method: Data were collected anonymously via self-report questionnaires from April 2008 to February 2009. Measures included the Michigan Alcoholism Screening Test, the Drug Abuse Screening Test, Day's Mental Illness Stigma Scale, the Attitudes Toward Psychiatric Medication scale, and the Psychiatric Medication Attitudes Scale. Participants: included 383 university students (59.2% female), recruited on the campus of a large state university or through online classes offered through the same university. Results: High rates of psychiatric medication misuse were shown (13.8%) when compared to rates of medical use (6.8%), and students with prescriptions for psychiatric drugs were also more likely to be misusers (chi(2)=20.60, P < .001). Psychiatric medication misusers reported less stigmatized beliefs toward mental illness, including lower anxiety around the mentally ill (t = 3.26, P < .001) as well as more favorable attitudes toward psychiatric medications (t = 2.78, P < .01) and stronger beliefs in the potential for recovery from mental illness (t = -2.11, P < .05). Students with more stigmatized beliefs had greater concerns about psychiatric medications and less favorable beliefs regarding their effectiveness. Reasons for misuse varied by medication class, with 57.1% of stimulant misusers noting help with studying as their primary reason for use and 33.3% of benzodiazepine misusers noting attempts to get high or "party" as their primary reason for misuse. Conclusions: Results suggest the need for improved education regarding the nature of mental illness, the appropriate use of psychiatric medications, and the potential consequences associated with abuse of these potent drugs.

Strahan EY; Panayiotou G; Clements R; Scott J. Beer, wine, and social anxiety: Testing the "self-medication hypothesis" in the US and Cyprus. Addiction Research & Theory 19(4): 302-311, 2011. (37 refs.)

The social anxiety literature often cites the self-medication hypothesis (SMH) to explain why socially phobic clients often present with alcohol problems. Based on some earlier hints that social anxiety and drinking might be related in a curvilinear way, we sought to examine the SMH to assess for possible non-linear relationships, and to examine whether cultural differences affect these relationships. We surveyed self-reported social anxiety, alcohol expectancies, and alcohol use in college students from Cyprus (N = 127) and the United States (US) (N =697). Participants were college students with a mean age of 19.8. Results revealed that positive and negative expectations about alcohol use were predictive of drinking for students from both cultures. Cypriot students endorsed fewer positive and more negative expectancies regarding alcohol use than their US counterparts, and engaged in less binge drinking. Social anxiety in men was related to drinking via a curvilinear relationship, in which drinking peaks at moderate levels of social anxiety. Among men, those with highest levels of social anxiety in both cultures drink the least. For women, there was no relationship between social anxiety level and drinking behavior. These findings demonstrate the complexity of the relationship between social anxiety and alcohol use. Far from being a linear relationship, these two variables are related in a curvilinear fashion, for men. This should inform future research on the SMH.

Sutfin EL; Mccoy TP; Reboussin BA; Wagoner KG; Spangler J; Wolfson M. Prevalence and correlates of waterpipe tobacco smoking by college students in North Carolina. Drug and Alcohol Dependence 115(1-2): 131- 136, 2011. (38 refs.)

Background: Known most commonly in the U.S. as "hookah," waterpipe tobacco smoking appears to be growing among college students. Despite beliefs that waterpipe use is safer than Cigarette smoking, research to date (albeit limited) has found health risks of waterpipe smoking are similar to those associated with cigarette smoking, including lung cancer, respiratory illness, and periodontal disease. The goals of this study were to estimate the prevalence of use among a large, multi-institution sample of college students and identify correlates of waterpipe use, including other health-risk behaviors (i.e., cigarette smoking, alcohol, marijuana, and other illicit drug use) and availability of commercial waterpipe tobacco smoking venues. Methods: A cross-sectional sample of 3770 college students from eight universities in North Carolina completed a web-based survey in fall 2008. Results: Forty percent of the sample reported ever having smoked tobacco from a waterpipe, and 17% reported current (past 30-day) waterpipe tobacco smoking. Correlates associated with current waterpipe use included demographic factors (male gender, freshman class); other health-risk behaviors (daily and nondaily cigarette smoking, alcohol use, marijuana use, other illicit drug use); perceiving waterpipe tobacco smoking as less harmful than regular cigarettes; and having a commercial waterpipe venue near campus. Conclusions: The results highlight the popularity of waterpipe tobacco smoking among college students and underscore the need for more research to assess the public health implications of this growing trend.

Thrasher RG; Andrew DPS; Mahony DF. The efficacy of a modified theory of reasoned action to explain gambling behavior in college students. Journal of Gambling Studies 27(3): 499-516, 2011. (57 refs.)

Recently, Thrasher et al. (College Student Affairs Journal 27(1): 57-75, 2007) explored the efficacy of the Theory of Reasoned Action (TRA; Ajzen and Fishbein, Attitudes, personality, and behavior, 1980) in explaining gambling behavior of college students. However, their study found the TRA only predicted small amounts of variance in gambling intentions. Heeding their call to enhance the efficacy of the TRA through the addition of explanatory variables to the model, the present study incorporated gambling motivations and locus of control as moderating variables within the TRA to test the potential of a modified TRA in explaining gambling behavior of college students. A total of 345 students at a major metropolitan research university in the Midwest volunteered to participate in the study. A series of hierarchical linear regressions indicated intrinsic motivation to accomplish (p = .002) significantly moderated the relationship between gambling attitudes and gambling intentions. Further, internal locus of control (p < .001), chance locus of control (p < .001), and powerful others locus of control (p < .001) also significantly moderated the relationship between gambling attitudes and gambling intentions. The significant impact of the moderating variables on the relationship between gambling attitudes and intentions suggests intrinsic motivation and locus of control can alter the impact of the relationship between gambling attitudes and gambling intentions.

Toprak S; Cetin I; Guven T; Can G; Demircan C. Self-harm, suicidal ideation and suicide attempts among college students. Psychiatry Research 187(1-2): 140- 144, 2011. (45 refs.)

Self-harm, suicidal ideation, and suicide attempts are well represented behaviours in the general population of both developed and developing countries. These behaviours are indicative of underlying risk factors that show a strong interdependent correlation. In this study we attempted to define correlates for and prevalence of self-harm, suicidal ideation, and suicide attempts among Turkish college students. This 2006 study included 636 students from two Turkish state universities. Our results showed that the lifetime prevalence of self-harm was 15.4%, the prevalence of suicidal ideation was 11.4%, and the prevalence of suicide attempts was 7.1%. We uncovered correlates for self-harm, including low income, unsatisfying familial relationships, smoking, and alcohol, inhalant, and tranquilizer abuse. Tranquilizer abuse shared a dual role as a correlate for suicide ideation and as a means to attempt suicide. Additionally, we found that drug abusers and adolescents who practise self-harm presented the highest suicide risk.

Turner J; Bauerle J; Keller A. Alcohol-related vehicular death rates for college students in the Commonwealth of Virginia. Journal of American College Health 59(4): 323-326, 2011. (17 refs.)

Objective: Determine rate of college student alcohol-related vehicular traffic fatalities in Virginia during 2007. Participants: Undergraduates at colleges and universities in Virginia. Methods: Institutions with membership in the American College Health Association were invited to participate in a survey. Data collected from institutional reports of student deaths due to vehicular accidents. Results: Twenty-four institutions were invited to participate. Sixteen responded (response rate = 67%), comprising total enrollment of 117,100 for 17- to 24-year-olds (56% of total college population in state). Five traffic deaths were reported, representing 4.3 deaths per 100,000 students. Based on statewide statistics that estimate alcohol contributes to 38.9% of traffic deaths, rate of alcohol-related motor vehicle deaths is 1.7 deaths per 100,000 college students in Virginia, which is 89% lower than leading national estimates. Conclusions: These findings suggest that past estimates of alcohol-related vehicular deaths among college students are overstated.

Wang Y; Storr C; Browne DC; Wagner FA. Early sexual experience and later onset of illegal drug use among African American students on HBCU Campuses. Substance Use & Misuse 46(4): 543-551, 2011. (36 refs.)

Few studies examine whether early sexual experience is associated with subsequent illegal drug use among adolescents. A sample of 7,372 African American students who had not used illegal drugs before the age of 14 were identified in the dataset of the 2001 Historically Black Colleges and Universities (HBCU) Substance Use Survey. Using self-reported ages of onset, discrete-time survival models estimated the hazard of illegal drug use onset after age 13 subsequent to first sexual intercourse. Early sex was modestly associated with subsequent illegal drug initiation, particularly among females. Drug use prevention services should be provided to youth engaged in early sexual activity.

Welcome MO; Razvodovsky YE; Pereverzev VA. Prevalence of alcohol-related problems among the Slavs and Arabs in Belarus: A university survey. American Journal of Drug and Alcohol Abuse 37(3): 189-195, 2011. (21 refs.)

Background: Alcohol abuse is a major problem among students in Belarus. Alcohol-related problems might vary among students of different cultural backgrounds. Objectives: To examine the different patterns in alcohol use and related problems among students of different cultural groups - the Slavs and Arabs, in major Belarusian universities. Methods: 1465 university students (1345 Slavs and 120 Arabs) from three major universities in Minsk, Belarus, were administered the Alcohol Use Disorders Identification Test, the Cut, Annoyed, Guilty and Eye questionnaire, and the Michigan Alcohol Screening Test, including other alcohol-related questions. Results: Overall, 91.08% (n = 1225) Slavs and 60.83% (n = 73) Arabs were alcohol users. A total of 16.28% (n = 219) Slavs and 32.50% (n = 39) Arabs were identified as problem drinkers. Different patterns of alcohol use and related problems were characterized for the Slavs and Arabs. The level of alcohol-related problems was higher among the Arabs, compared to the Slavs. Conclusion: Significant differences in the pattern of alcohol use and related problems exist among the students of various cultural groups - the Slavs and Arabs in Minsk, Belarus. Scientific significance: This is the first empirical study to investigate the prevalence of alcohol use and related problems among the Arab and Slav students in Belarus.

Wells S; Neighbors C; Tremblay PF; Graham K. Defending girlfriends, buddies and oneself: Injunctive norms and male barroom aggression. Addictive Behaviors 36(4): 416-420, 2011. (28 refs.)

Objective: Research has demonstrated that young adults tend to overestimate their peers' approval of risky behaviors (i.e.. injunctive norms) and that perceived peer approval is associated with actual behavior; however, no empirical studies have assessed injunctive norms in relation to male barroom aggression. The objectives of the present study were to compare young men's own approval of male barroom aggression with their perceptions of approval by male and female peers and to determine the extent that perceived peer approval of male barroom aggression was associated with self-reported physical aggression at a bar, controlling for own approval and heavy episodic drinking. Method: 525 young adult male university and community college students who reported drinking and going to a bar, club or pub rated their own approval and perceptions of peers' approval of bar aggression on items reflecting four domains of approval: (1) general approval, (2) defend self, (3) defend friend and (4) protect girlfriend. Results: For all four domains, participants attributed greater approval to male peers than to themselves. Aggression was positively associated with own approval for all domains and with perceived male peer approval for general approval, defend self and defend friend, controlling for heavy episodic drinking and own approval of aggression. Perceived approval by female peers was not associated with increased likelihood of aggression. Conclusion: The findings suggest that both perceived male peer approval and personal approval are factors associated with male barroom aggression and that addressing approval of barroom aggression is a critical direction for prevention programming.

Wray TB; Simons JS; Dvorak RD. Alcohol-related infractions among college students: Associations with subsequent drinking as a function of sensitivity to punishment. Psychology of Addictive Behaviors 25(2): 352-357, 2011. (44 refs.)

Problematic alcohol use on college campuses is a significant concern. Violations of campus alcohol policies can lead to disciplinary action from the university. These and other alcohol-related legal infractions may be a sign of significant alcohol-related problems. However, few studies have focused on determining predictors of alcohol-related infractions among college students. Likewise, the role of infractions in reducing future use is unclear. In the present study, we tested whether alcohol-related infractions were associated with decreased alcohol use, and whether the effect of the infraction varied as a function of initial drinking levels, sensitivity to punishment (SP), and sensitivity to reward (SR) in a 6-month prospective design. Alcohol use, grade point average, and SR were significantly associated with receiving an alcohol-related infraction. For heavier drinkers, receiving an infraction was associated with decreased drinking at follow-up, and this decrease was most pronounced among those with higher sensitivity to punishment. SP appeared to increase responsiveness to the infraction, resulting in greater attenuation of drinking at follow-up.

Yang TZ; Abdullah AS; Rockett IRH; Li M; Zhou YH; Ma J et al. Assessment of tobacco control advocacy: Behavioural capacity among students at schools of public health in China. Tobacco Control 20(1): 20-25, 2011. (32 refs.)

Objectives To evaluate student tobacco control advocacy behavioural capacity using longitudinal trace data. Methods A tobacco control advocacy curriculum was developed and implemented at schools of public health (SPH) or departments of public health in seven universities in China. Participants comprised undergraduate students studying the public health curriculum in these 13 Universities. A standardised assessment tool was used to evaluate their tobacco control advocacy behavioural capacity. Repeated measures analysis of variance, paired t tests and paired c 2 tests were used to determine differences between dependent variables across time. Multivariate analysis of variance (MANOVA) and multivariate logistic regression were used to assess treatment effects between intervention and control sites. Results Respective totals of 426 students in the intervention group and 338 in the control group were available for the evaluation. Approximately 90% of respondents were aged 21 years or older and 56% were women. Findings show that the capacity building program significantly improved public health student advocacy behavioural capacity, including advocacy attitude, interest, motivation and anti-secondhand smoke behaviours. The curriculum did not impact student smoking behaviour. Conclusions This study provides sufficient evidence to support the implementation of tobacco control advocacy training at Chinese schools of public health.

Zakletskaia L; Wilson E; Fleming MF. Alcohol use in students seeking primary care treatment at university health services. Journal of American College Health 59(3): 217-223, 2011. (18 refs.)

Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students seeking general medical treatment. Results: Alcohol use was similar to other studies with 57% (n = 5,840) meeting the National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking. Twenty-six percent of the students reported smoking at least once in the last 3 months. Risk factors for at-risk drinking included young age, white males, drinking at a fraternity/sorority house, and use of tobacco. Conclusions: These findings support the widespread implementation of alcohol screening and intervention in university health services.

Zimmermann F; Sieverding M; Muller SM. Gender-related traits as predictors of alcohol use in male German and Spanish university students. Sex Roles 64(5-6): 394-404, 2011. (70 refs.)

This study examined instrumental (masculine stereotyped) and expressive (feminine stereotyped) personality traits and alcohol use among men from Germany and Spain. Participants were 161 male university students (76 German, M (age) = 23 years; 77 Spanish, M (age) = 22 years), who completed either a daytime or a nighttime drinking questionnaire, each including a Short Form of the Bem Sex Role Inventory. Poisson regression analyses with latent predictors were conducted. The trait factors and their interactions with nationality predicted daytime and nighttime alcohol use. The results add support to the assumption that alcohol use is associated with the construction of masculinity and that internalization of traditionally female attributes protects against health-risk behaviors such as alcohol consumption.