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CORK Bibliography: Colleges

119 citations. January 2012 to present

Prepared: September 2012

Abar CC. Examining the relationship between parenting types and patterns of student alcohol-related behavior during the transition to college. Psychology of Addictive Behaviors 26(1): 20-29, 2012. (67 refs.)

The present study sought to examine parenting influences on student alcohol use through the use of a holistic, person-centered approach in order to accomplish three distinct research aims: (a) identify groups of college students with unique profiles of perceived parenting characteristics, (b) identify groups of college students with unique profiles of alcohol-related correlates, and (c) examine the extent to which profiles of perceived parenting characteristics are associated with profiles of college alcohol-related risk. A sample of 1,153 first-year university students (17-20 years-of-age) was assessed on a host of perceived parenting and self-reported alcohol-related items. Four profiles of perceived parenting (High Quality, High Monitoring, Anti-Alcohol, Pro-Alcohol) were found using latent profile analysis (LPA). Five profiles of student alcohol-related characteristics (Abstainers, Past Drinkers, Light Drinkers, High Risk Drinkers, Extreme Risk Drinkers) were also found using LPA. Latent transition analysis illustrated that students who perceived their parents as belonging to the Pro-Alcohol profile had much higher probabilities of belonging in the High Risk Drinker or Extreme Risk Drinker profiles than students in all other perceived parenting profiles. In addition to alcohol-specific parenting characteristics, aspects of parent-teen relationship quality may also be integral in the prevention of college alcohol misuse. Finally, this study observed complex patterns of parenting and alcohol behaviors, such that the profiles could be interpreted as qualitatively distinct types of individuals. These unique profiles suggest that a targeted approach reflecting the profiles found in the current study might greatly enhance prevention program efficacy.

Abar CC; Morgan NR; Small ML; Maggs JL. Investigating associations between perceived parental alcohol-related messages and college student drinking. Journal of Studies on Alcohol and Drugs 73(1): 71-79, 2012. (59 refs.)

Objective: A debate remains regarding whether parents should teach their children harm-reduction tips for using alcohol while in college or whether they should maintain a zero-tolerance policy. Which type of alcohol-related communication parents should endorse is not empirically clear. The current study made use of a longitudinal measurement-burst design to examine this issue. Method: The sample consisted of 585 second-year students from a large university in the northeastern United States. Participants completed a baseline survey and 14 daily web-based surveys. Students were assessed for perceptions of parental alcohol-related messages and their own alcohol use. Multilevel models were estimated using HLM 6.04. Results: The data indicate that zero-tolerance messages appeared most protective against alcohol use and consequences. Harm-reduction messages were most risky, even when compared with mixed messages or the absence of a message. Conclusions: Findings indicate that a zero-tolerance approach was associated with safer outcomes than other messages, even if students were already using alcohol.

Adams ZW; Kaiser AJ; Lynam DR; Charnigo RJ; Milich R. Drinking motives as mediators of the impulsivity-substance use relation: Pathways for negative urgency, lack of premeditation, and sensation seeking. Addictive Behaviors 37(7): 848-855, 2012. (40 refs.)

Trait impulsivity is a reliable, robust predictor of risky, problematic alcohol use. Mounting evidence supports a multidimensional model of impulsivity, whereby several distinct traits serve as personality pathways to rash action. Different impulsivity-related traits may predispose individuals to drink for different reasons (e.g., to enhance pleasure, to cope with distress) and these different motives may, in turn, influence drinking behavior. Previous findings support such a mediational model for two well-studied traits: sensation seeking and lack of premeditation. This study addresses other impulsivity-related traits, including negative urgency. College students (N = 432) completed questionnaires assessing personality, drinking motives, and multiple indicators of problematic drinking. Negative urgency, sensation seeking, and lack of premeditation were all significantly related to problematic drinking. When drinking motives were included in the model, direct effects for sensation seeking and lack of premeditation remained significant, and indirect effects of sensation seeking and lack of premeditation on problematic drinking were observed through enhancement motives. A distinct pathway was observed for negative urgency. Negative urgency bore a significant total effect on problematic drinking through both coping and enhancement motives. This study highlights unique motivational pathways through which different impulsive traits may operate, suggesting that interventions aimed at preventing or reducing problematic drinking should be tailored to individuals' personalities. For instance, individuals high in negative urgency may benefit from learning healthier strategies for coping with distress.

Al-Ajlan AR. Tobacco smoking vs. lipid profile and anthropometric measures: A cross-sectional study among students in the Riyadh College of Health Sciences. African Journal of Pharmacy and Pharmacology 6(10): 717-723, 2012. (44 refs.)

Smoking represents the most readily preventable risk factor for morbidity and mortality. The present work aimed at studying the frequency of smoking among Saudi college students and its relation to dyslipidemia and malnutrition. The study was carried out on the students of the Riyadh College of Health Sciences, from September 2006 to December 2008. 474 male students participated in the present study. All subjects answered a self-administered questionnaire which consisted of socio-demographic data. Anthropometric measurements and laboratory analysis of lipid profile were measured. The frequency of smoking among male college students was 38.19%. Triglyceride level was higher while anthropometric measures were lower, among smokers. There was positive correlation between total cholesterol (TC), low-density lipoprotein (LDL), and triglycerides from one side and anthropometric measures on the other side. There is a high frequency of smoking among college students. The smokers have high lipid profile and low anthropometric measurements. Three fourth of the smokers have a strong desire to quit smoking.

Baker L; Prevatt F; Proctor B. Drug and alcohol use in college students with and without ADHD. Journal of Attention Disorders 16(3): 255-263, 2012. (31 refs.)

Objective: This study examines differences in reported levels of drug and alcohol use between college students with and without ADHD. Method: The Michigan Alcohol Screening Test (MAST) and several self-report and interview questions, developed by Barkley, were used to examine the drug and alcohol use of college students with and without ADHD. Results: Between-group differences were found on the MAST and in the endorsement of marijuana use. Subtype differences were also found on the MAST. Several factors, including medication treatment status, ethnicity, class standing, and gender were found to be differentially related to problematic drinking behaviors. Conclusions: Difficulties in self-regulation may put college students with ADHD at a higher risk of problematic drinking and the subsequent risk for alcohol-use disorders than their peers. Possible explanations for results are discussed in terms of theory, prevention efforts, and future research.

Barry AE; Piazza-Gardner AK. Drunkorexia: Understanding the co-occurrence of alcohol consumption and eating/exercise weight management behaviors. Journal of American College Health 60(3): 236-243, 2012. (52 refs.)

Objective: Examine the co-occurrence of alcohol consumption, physical activity, and disordered eating behaviors via a drunkorexia perspective. Participants: Nationally representative sample (n = 22,488) of college students completing the Fall 2008 National College Health Assessment. Methods: Hierarchical logistic regression was employed to determine if physical activity and disordered eating behaviors uniquely predicted binge drinking, while controlling for age, race, gender, year in college, Greek membership, and place of residence. Results: Physical activity and disordered eating made unique, statistically significant contributions. Moreover, including physical activity and disordered eating behaviors allowed for the correct classification of an additional 431 cases (ie, binge drinkers) over and above the predictive ability of the covariate-only model. Conclusions: Findings corroborate prior research indicating highly active college students are more likely to binge drink than their nonactive peers, and highlight the potential of a drunkorexia perspective in explaining the counterintuitive alcohol-activity association among college students.

Bates CE; Monahan JL; Rhodes N. How neuroticism affects responses to anti-smoking messages. Health Communication 27(5): 486-497, 2012. (37 refs.)

The effect of trait neuroticism on college students' (n = 200) responses to anti-smoking public service announcements (PSAs) was examined using a 2 (neuroticism: high vs. low) x 3 (message type: personal testimony, secondhand smoke, and informative) x 3 (message: nested within message type) design. We hypothesized that those high in neuroticism would be avoidant toward anti-smoking messages, have quicker and stronger negative reactions and perceive the messages as more biased and less involving. As hypothesized, those high in neuroticism were more likely to want to avoid thinking about smoking as a function of viewing the messages and more likely to see messages as biased; however, neuroticism did not affect judgments of message involvement. Tobacco use and gender also affected message bias and avoidance. Those scoring high in neuroticism also responded quicker to negative emotion assessments to messages. Implications for the importance of neuroticism in message design and message processing research are discussed.

Berg CJ; Ling PM; Hayes RB; Berg E; Nollen N; Nehl E et al. Smoking frequency among current college student smokers: Distinguishing characteristics and factors related to readiness to quit smoking. Health Education Research 27(1): 141-150, 2012. (61 refs.)

Given the increased prevalence of non-daily smoking and changes in smoking patterns, particularly among young adults, we examined correlates of smoking level, specifically motives for smoking, and readiness to quit smoking among 2682 college undergraduates who completed an online survey. Overall, 64.7% (n = 1736) were non-smokers, 11.6% (n = 312) smoked 1-5 days, 10.5% (n = 281) smoked 6-29 days and 13.2% (n = 353) were daily smokers. Ordinal regression analyses modeling smoking level indicated that correlates of higher smoking level included having more friends who smoke (beta = 0.63, 95% CI 0.57-0.69) and more frequent other tobacco use (beta = 0.04, 95% CI 0.02-0.05), drinking (beta = 0.04, 95% CI 0.02-0.07) and binge drinking (beta = 0.09, 95% CI 0.06-0.13). Bivariate analyses indicated that daily smokers (versus the subgroups of non-daily smokers) were less likely to smoke for social reasons but more likely to smoke for self-confidence, boredom, and affect regulation. Controlling for sociodemographics, correlates of readiness to quit among current smokers included fewer friends who smoke (P = 0.002), less frequent binge drinking (P = 0.03), being a social smoker (P < 0.001), smoking less for self-confidence (P = 0.04), smoking more for boredom (P = 0.03) and less frequent smoking (P = 0.001). Specific motives for smoking and potential barriers to cessation particularly may be relevant to different groups of college student smokers.

Berg CJ; Sutfin EL; Mendel J; Ahluwalia js. Use of and interest in smoking cessation strategies among daily and nondaily college student smokers. Journal of American College Health 60(3): 194-202, 2012. (51 refs.)

Objective: To examine use of and interest in cessation strategies among nondaily and daily college student smokers. Participants: 800 undergraduate student smokers aged 18 to 25. Methods: The authors examined nondaily versus daily smoking in relation to use of and interest in cessation strategies using an online survey. Results: Nondaily (65.8%) versus daily smokers (34.3%) were more likely to have made a quit attempt (p=.01) but less likely to have used any assistance (p<.001). Nondaily smokers were less interested in pharmacotherapy and traditional behavioral interventions; however, there was no difference in interest in technology-based interventions among nondaily versus daily smokers. Controlling for covariates, there were no significant differences in interest in traditional or technology-based behavioral interventions. Higher motivation, lower confidence, and depressive symptomatology were related to interest in each intervention. Smoking for social reasons was related to interest in technology-based interventions. Conclusions: Different intervention strategies may be appropriate for nondaily and daily smokers.

Beseler CL; Taylor LA; Kraemer DT; Leeman RF. A latent class analysis of DSM-IV alcohol use disorder criteria and binge drinking in undergraduates. Alcoholism: Clinical and Experimental Research 36(1): 153-161, 2012. (53 refs.)

Background: Adolescent and adult samples have shown that the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) abuse and dependence criteria lie on a continuum of alcohol problem severity, but information on criteria functioning in college students is lacking. Prior factor analyses in a college sample (Beseler et al., 2010) indicated that a 2-factor solution fit the data better than a single-factor solution after a binge drinking criterion was included. The second dimension may indicate a clustering of criteria related to excessive alcohol use in this college sample. Methods: The present study was an analysis of data from an anonymous, online survey of undergraduates (N = 361) that included items pertaining to the DSM-IV alcohol use disorder (AUD) diagnostic criteria and binge drinking. Latent class analysis (LCA) was used to determine whether the criteria best fit a categorical model, with and without a binge drinking criterion. Results: In an LCA including the AUD criteria only, a 3-class solution was the best fit. Binge drinking worsened the fit of the models. The largest class (class 1, n = 217) primarily endorsed tolerance (18.4%); none were alcohol dependent. The middle class (class 2, n = 114) endorsed primarily tolerance (81.6%) and drinking more than intended (74.6%); 34.2% met criteria for dependence. The smallest class (class 3, n = 30) endorsed all criteria with high probabilities (30 to 100%); all met criteria for dependence. Alcohol consumption patterns did not differ significantly between classes 2 and 3. Class 3 was characterized by higher levels on several variables thought to predict risk of alcohol-related problems (e. g., enhancement motives for drinking, impulsivity, and aggression). Conclusions: Two classes of heavy-drinking college students were identified, one of which appeared to be at higher risk than the other. The highest risk group may be less likely to "mature out'' of high-risk drinking after college.

Black JJ; Tran GQ; Goldsmith AA; Thompson RD; Smith JP; Welge JA. Alcohol expectancies and social self-efficacy as mediators of differential intervention outcomes for college hazardous drinkers with social anxiety. Addictive Behaviors 37(3): 248-255, 2012. (57 refs.)

The current pilot study examined the roles of two cognitive factors - positive alcohol expectancies of social anxiety reduction and drink refusal self-efficacy relevant to social situations - in mediating greater reduction in alcohol behaviors by the Brief Intervention for Socially Anxious Drinkers (BISAD; n = 21) compared to an alcohol psychoeducation (n = 20) in a sample of college hazardous drinkers with social anxiety. Mediation analysis results indicated that decreased positive alcohol expectancies and increased drink refusal self-efficacy relevant to social situations accounted for an average of 67% of the variance in treatment outcomes as measured by total quantity of alcohol consumption, heavy drinking days and problems related to alcohol use in the past month. Study results may enhance the understanding of cognitive factors' role in alcohol treatment outcomes, which could in turn improve the efficacy of interventions aimed to reduce hazardous drinking and comorbid social anxiety.

Bonar EE; Young KM; Hoffmann E; Gumber S; Cummings JP; Pavlick M et al. Quantitative and qualitative assessment of university students' definitions of binge drinking. Psychology of Addictive Behaviors 26(2): 187-193, 2012. (26 refs.)

This study was designed to assess undergraduates' (N = 424) definitions of binge drinking and to evaluate whether the number of drinks they said comprise a binge varied as a function of beverage type, respondent gender, and respondent binge drinking status. When asked to designate the specific number of drinks that comprise a binge for each of four beverage types, students reported that the number of beers constituting a binge was significantly larger than the number of glasses of wine, shots of hard liquor, and servings of any combination of alcoholic beverage types; men reported that a larger number of drinks constitute a binge than did women; and those who had engaged in 3 or more binges in the past 2 weeks reported that more drinks comprise a binge than those who had binged less often. Responses to an open-ended question asking their definition of a binge revealed that students sometimes characterize a binge in terms of motivations for and unhealthy consequences of drinking, in addition to defining a binge as comprising consumption of a large amount of alcohol in a limited (though often unspecified) time period. Furthermore, students attributed their open-ended definitions of binge drinking to informal sources of information and observation of others' drinking almost as often as they did to school-based or media-based sources. This suggests that educators might look for innovative ways to use both formal and informal social networking, and video illustrations of restrained drinking, as ways to influence young people's views of binge drinking.

Buckner JD; Crosby RD; Silgado J; Wonderlich SA; Schmidt NB. Immediate antecedents of marijuana use: An analysis from ecological momentary assessment. Journal of Behavior Therapy and Experimental Psychiatry 43(1): 647-655, 2012. (54 refs.)

Background and objectives: Marijuana remains the most commonly used illicit substance. Marijuana craving, anxiety, and peer marijuana use are thought to play important roles in the etiology and maintenance of marijuana use. The present study aimed to identify patterns between marijuana use and these affective and situational risk factors in the natural environment. Methods: The sample consisted of 49 current marijuana users (38.8% female), 63.2% of whom evinced a current cannabis use disorder. Ecological momentary assessment was used to collect multiple daily ratings of marijuana craving, state anxiety, and peer marijuana use over two weeks. Mixed effects linear models were used to examine within- and between-day antecedents, correlates, and consequences of marijuana use. Results: Between-day analyses indicated that marijuana use days were associated with higher marijuana craving but lower state anxiety. Within-day analyses confirmed that marijuana craving was higher prior to marijuana use and lower following use. Anxiety was related to marijuana craving. Although anxiety was somewhat higher prior to marijuana use, it did not decrease significantly following use. The vast majority of marijuana use occurred when others were also using marijuana. Limitations: The sample was comprised of college students, a group at particular risk for marijuana use and use-related problems. Future work is necessary to determine whether results generalize to other populations. Conclusions: These data support the contention that marijuana craving, anxiety, and peer use play important roles in the maintenance of marijuana use.

Buettner CK; Debies-Carl JS. The ties that bind: Bonding versus bridging social capital and college student party attendance. Journal of Studies on Alcohol and Drugs 73(4): 604-612, 2012. (45 refs.)

Objective: This study explored the relationship between bonding and bridging social capital and college student attendance at alcohol-present parties, a common method for building informal social networks. Method: A random sample of students (n = 6,291; 52% female) from a large public midwestern university completed a survey regarding their alcohol use and party-related behaviors on targeted weekends. The survey also included questions regarding students' living arrangements, romantic relationships, and membership in student and community organizations. Results: Based on a dichotomous logistic regression analysis, we concluded that the act of attending parties largely serves as a complement to, rather than a substitute for, more conventional and formal social capital. Membership in bonding groups is associated with increased odds of party attendance, and bridging exerts no direct effect on party attendance. However, bridging capital does mitigate the effect of bonding capital, reducing its apparent tendency to promote or contribute to partying. Conclusions: Off-campus parties may offer an informal supplement to more conventional social capital as students establish themselves in their new context. These findings may have implications for structural decisions, (e.g., number of roommates) as well as the design of context-based prevention programs that address students' need to quickly build social capital without exposing both themselves and the students around them to the harms associated with high-risk drinking.

Butler KM; Fallin A; Ridner SL. Evidence-based smoking cessation for college students. Nursing Clinics of North America 47(1): 21-30, 2012. (57 refs.)

Despite a strong stance by the American College Health Association and years of prevention and control efforts on US college campuses, smoking and exposure to secondhand smoke remain a problem among college students. This article provides an overview of what is known about cigarette smoking in this population as well as existing interventions for smoking prevention, cessation, and exposure to secondhand smoke on college campuses. Strategies to reduce tobacco use are presented, many of which have been demonstrated to be effective in the short-term.

Butler KM; Rayens MK; Hahn EJ; Adkins SM; Staten RR. Smoke-free policy and alcohol use among undergraduate college students. Public Health Nursing 29(3): 256-265, 2012. (37 refs.)

Objectives: The purpose of this study was to assess attitudes and behaviors related to smoke-free policy among undergraduate student alcohol drinkers on a campus in a community with smoke-free bars. Design and Sample: This was a secondary data analysis of a study in which participants completed mailed surveys assessing demographic characteristics, attitudes and behaviors related to alcohol and tobacco use and smoke-free policy (n = 337). Opinion and behavior items were summarized descriptively; associations were examined using Kruskal Wallis tests and chi-square tests of association. Logistic regression tested for predictors of importance of smoke-free policy. Results: Respondents were predominantly female and Caucasian; mean age 20.3 years. One fourth were current smokers. Seventy-nine percent said the community smoke-free law had no effect on frequency of visiting bars. Eighty-seven percent said smoke-free policy in campus buildings was somewhat or very important. Predictors of perceived importance of smoke-free policy included gender and smoking status. Conclusions: Most smokers in this sample did not experience a change in their motivation to quit smoking or in number of cigarettes smoked daily. Implementation of a community smoke-free law did not reduce the likelihood of visiting bars. Women and nonsmokers were more likely to rate smoke-free campus policy as very important.

Caldeira KM; O'Grady KE; Garnier-Dykstra LM; Vincent KB; Pickworth WB; Arria AM. Cigarette smoking among college students: Longitudinal trajectories and health outcomes. Nicotine & Tobacco Research 14(7): 777-785, 2012. (43 refs.)

Light and intermittent patterns of cigarette smoking are prevalent among U.S. college-aged individuals. It is unclear whether intermittent smokers maintain their use over time or are transitioning to daily use or nonuse, and whether they experience more adverse health outcomes than nonsmokers. This study examined the trajectories of tobacco cigarette smoking, their predictors, and health outcomes among students (N = 1,253) assessed during their first year of college (Y-1) and annually thereafter (Y-2, Y-3, and Y-4). In Y-1, 3.4% smoked daily and 4.1% exhibited signs of dependence (first cigarette within 30 min of waking). Growth curve modeling identified five distinct smoking trajectories. After stable nonsmokers (71.5%(wt)), the low-stable smoking trajectory was the most common (13.3%(wt)), outnumbering both low-increasing (6.5%(wt)) and high-stable smokers (5.5%(wt)) by 2:1 and high-decreasing smokers (3.2%(wt)) by 4:1. The likelihood of maintaining a low level of smoking over time was inversely related to Y-1 smoking frequency. Few demographic, smoking, and alcohol use characteristics measured in Y-1 distinguished low-increasers from low-stable smokers or high-decreasers from high-stable smokers. By Y-4, high-stable smokers rated their health significantly worse than all others except low-increasers. High-stable smokers had the most Y-4 health problems (i.e., provider visits for health problems and days of illness-related impairment), but only among nonWhites. Many college students smoke, but few smoke daily or are nicotine dependent. Intermittent smoking patterns are often stable throughout college and are associated with adverse health outcomes. Prevention strategies should be designed to mitigate the possible long-term health consequences of light and intermittent smoking.

Campos-Melady M; Smith JE. Memory associations between negative emotions and alcohol on the lexical decision task predict alcohol use in women. Addictive Behaviors 37(1): 60-66, 2012. (69 refs.)

Implicit alcohol expectancies, or beliefs about alcohol which exist in the form of automatic memory associations, are thought to uniquely affect drinking behavior. Research also has indicated that there may be a distinctive relationship between negative reinforcement and alcohol use in women. However, the most common measures used to examine implicit alcohol cognitions may be insufficient to examine associations involving negative reinforcement. The current study utilized the Lexical Decision Task (LDT) to examine the relationship between implicit alcohol cognitions and reported drinking in a sample of college women. Seventy-eight female participants completed a LDT including alcohol- and emotion-words, questionnaire measures of explicit alcohol expectancies, and a measure of drinking behavior at baseline and after two months. Strong associations between negative emotion-words and alcohol-words (as measured by the LDT) were found to predict drinking at follow up, and to account for unique variance in drinking beyond the contribution of explicit measures. In addition, women who reported heavier drinking in response to social conflict on an explicit measure showed stronger priming of alcohol words by negative emotion words, thus implying that the LDT may tap into implicit cognitions related to alcohol use as a method of coping. These findings suggest that the LDT is sensitive to negative-reinforcement associations in a way that other measures are not.

Capron DW; Schmidt NB. Positive drinking consequences among hazardous drinking college students. Addictive Behaviors 37(5): 663-667, 2012. (35 refs.)

Negative drinking consequences in college students have been well studied, but emerging evidence points to a role for positive drinking consequences in predicting alcohol related problems. Positive drinking consequences appear to be distinct from other drinking constructs such as drinking expectancies and drinking motives. However, no work has evaluated the role of positive drinking consequences in hazardous drinking college students, a population at high risk for alcohol related problems. The goal of the current study was to examine the effect of positive drinking consequences on problem drinking and alcohol problem recognition in a hazardous drinking college sample. Participants (N = 222) were hazardous drinking undergraduate students completing a battery of self-report measures about alcohol use. Findings indicated that positive drinking consequences predicted-problem drinking above and beyond other related constructs including positive drinking motives (i.e. enhancement and social). However, positive drinking consequences did not appear to play a significant role in alcohol problem recognition. Future research directions and implications for interventions with hazardous drinking college students are discussed.

Carlson SR; Johnson SC. Impulsivity is not always associated with student drinking: A moderation study of impulsivity and drinking by positive alcohol expectancies. Addictive Behaviors 37(4): 556-560, 2012. (30 refs.)

Student drinking is a major problem on North American campuses and impulsivity is a significant risk factor for heavy drinking. The present study investigates the moderation of the impulsivity-drinking relationship by the expectation that having a drink will lead to positive experiences. Undergraduate drinkers (n = 292) completed measures of impulsivity (Barratt Impulsiveness Scale 11; BIS-11), positive drinking expectancies, and alcohol use. Expectancies moderated the relationship between BIS-11 scores and alcohol use. BIS-11 scores were significantly related to typical alcohol quantity, frequency, quantity x frequency, and binge drinking frequency for individuals with average and high levels of positive expectancies, but not for those with few Positive expectancies. Implications for interventions targeted at highly impulsive students, using expectancy modification are discussed.

Castaldi S; Gelatti U; Orizio G; Hartung U; Moreno-Londono AM; Nobile M. Use of cognitive enhancement medication among northern Italian university students. Journal of Addiction Medicine 6(2): 112-117, 2012. (17 refs.)

This study assesses the use of cognitive enhancement medication among university students in Northern Italy. It was conducted as a cross-sectional analysis on the basis of a paper-and-pencil survey of 77 undergraduate students attending courses in the Faculty of Medicine of the University of Milan, Milano, Italy. Although the share of students who have taken cognitive enhancement medication themselves in the past is still small (16%), the use of these drugs is rather common and freely communicated in some social circles. Enhancing the ability to study outside of the class was students' primary motive for use. Students who think that there is no or an acceptable risk involved in cognitive enhancement medication are more likely to take drugs and dietary supplements than those who perceive the risk as high.

Chuang SH; Huang SL. Changes in smoking behavior among college students following implementation of a strict campus smoking policy in Taiwan. International Journal of Public Health 57(1): 199-205, 2012. (28 refs.)

To understand the perception and responses among college students to a strict campus smoking policy which was in accordance with a national law requiring complete prohibition indoors and permission to smoke in designated outdoor smoking areas only. This study was conducted in the third to sixth month after the implementation of the revised Tobacco Hazard Prevention Act in Taiwan. In-depth interviews were conducted with 22 smokers who were second and third year students of a college in Taiwan. Thematic analysis was used to categorize ideas into concept themes. In interviews, most smokers revealed some modification in their smoking behavior and attitude: they sensed that smoking was unwelcome, reduced smoking in campus, thought about quitting, and tried to avoid exposing roommates in the dormitory. The reasons cited by the students for behavior change were grouped into four major themes: a changed smoking experience, change in social norm, the respect for law, and concern for others' health. Implementation of a strict smoking policy in college prompted smokers to markedly reduce smoking in campus.

Cullum J; O'Grady M; Armeli S; Tennen H. Change and stability in active and passive social influence dynamics during natural drinking events: A longitudinal measurement-burst study. Journal of Social and Clinical Psychology 31(1): 51-80, 2012. (60 refs.)

We examined the link between social norms and active social influences occurring during natural social drinking contexts. Across 4 yearly measurement-bursts, college students (N = 523) reported daily for 30-day periods on drinking norms, drinking offers, how many drinks they accepted, and personal drinking levels during social drinking events. In contexts where drinking norms were higher, students were more likely to both receive and comply with drinking offers. These acute social influences were highly stable throughout college, but affected men and women differently across time: Women received more drinking offers than men, especially at the beginning of college and when norms were higher, but men complied with more drinking offers per occasion. These effects were not attributable to between-person differences in social drinking motives, drinking levels, or to within-person patterns of situation-selection. The present work suggests that context-specific drinking norms catalyze active social influence attempts, and further promote compliance drinking.

Dawson DA; Goldstein RB; Grant BF. Factors associated with first utilization of different types of care for alcohol problems. Journal of Studies on Alcohol and Drugs 73(4): 647-656, 2012. (52 refs.)

Objective: The purpose of this research was to investigate whether factors associated with first obtaining care for alcohol problems vary by source of care. Method: This study used data from the National Epidemiologic Survey on Alcohol and Related Conditions to examine initiation of different types of care over a 3-year follow-up interval among individuals with baseline alcohol use disorders who had not previously obtained any care (n = 2,170). Three hierarchical, mutually exclusive types of care were compared: substance use disorder (SUD) specialty sources, general medical but no SUD specialty sources, and nonmedical sources only. Results: Having injured oneself or someone else because of drinking was associated with initiating all three types of care. Additional factors associated with initiating care from SUD specialty treatment sources (vs. no care) comprised male sex, alcohol use disorder severity, major financial problems, and nondependent tobacco/drug use. Factors associated with initiating care from general medical but not SUD specialty sources (vs. no care) comprised marriage/cohabitation, college student status, number of medical conditions, and other substance dependence. Factors associated with obtaining care only from nonmedical sources (vs. no care) comprised low income and anxiety disorder. When direct comparisons were made among types of care, factors drawing individuals into general medical care for reasons not necessarily related to alcohol problems were those that primarily distinguished utilization of general medical sources from the other two types of care. Conclusions: Results support the importance of screening in general medical practice and student health services as an important means of identifying individuals in need of brief intervention or more intensive SUD treatment and reiterate the importance of nonmedical sources for individuals whose alcohol problems might never be addressed in routine medical visits.

Dermody SS; Cheong J; Walther CA. A study of alcohol use by designated drivers among college students. Journal of American College Health 60(4): 310-315, 2012. (24 refs.)

Objective: College students tend to drink while serving as a designated driver (DD). The predictors of alcohol use by DDs among college students were examined. Participants: Participants were 119 undergraduate students in introductory psychology courses who had experience with DD use. Methods: Survey data were analyzed to examine the predictors of planning components of DD use, such as choosing a DD before drinking and choosing an abstinent DD, and the relations of these components to alcohol use by DDs. Results: History of DD use, friends' willingness to be the DD, frequency of riding with a driver who drank and drove, and age of drinking onset were associated with planning components of DD use. Among the planning components of DD use, choosing a DD before drinking was significantly related to less alcohol use by DDs. Conclusions: Increasing awareness of the planning components of DD use could deter alcohol use by DDs among college students.

DiFulvio GT; Linowski SA; Mazziotti JS; Puleo E. Effectiveness of the Brief Alcohol and Screening Intervention for College Students (BASICS) program with a mandated population. Journal of American College Health 60(4): 269-280, 2012. (38 refs.)

Objective: This study evaluated the effectiveness of a large-scale intervention designed to reduce alcohol abuse among adjudicated college students. Participants: Participants were college students mandated to attend a Brief Alcohol Screening and Intervention for College Students (BASICS) program and a randomly selected comparison group of high-risk drinkers. Methods: Data were collected from January 2006 through December 2008. A total of 1,390 (67%) students in the intervention group and 508 (61%) students in the comparison group completed baseline and 6-month follow-up surveys. Results: Male students in the intervention group significantly decreased their drinking at follow-up, whereas those in the comparison group increased their drinking. Women in both the intervention and comparison groups decreased their drinking at 6 months. Conclusions: When implemented with fidelity, BASICS is a generally effective intervention, especially for male adjudicated college students. The intervention was most effective for moderate- and high-risk drinkers.

Donovan E; Wood M; Frayjo K; Black RA; Surette DA. A randomized, controlled trial to test the efficacy of an online, parent-based intervention for reducing the risks associated with college-student alcohol use. Addictive Behaviors 37(1): 25-35, 2012. (37 refs.)

Alcohol consumption among college students remains a major public health concern. Universal, Web-based interventions to reduce risks associated with student alcohol consumption have been found to be effective in changing their alcohol-related behavior. Recent studies also indicate that parent-based interventions, delivered in booklet form, are effective. A parent-based intervention that is also Web-based may be well suited to a dispersed parent population; however, no such tool is currently available. The purpose of this study was to test the efficacy of an online parent-based intervention designed to (1) increase communication between parents and students about alcohol and (2) reduce risks associated with alcohol use to students. A total of 558 participants, comprising 279 parent-teen dyads, were enrolled in the study. The findings suggested that parents who participated in the online intervention were more likely to discuss protective behavioral strategies, particularly those related to manner of drinking and stopping/limiting drinking, with their teens, as compared with parents in an e-newsletter control group. Moreover, students whose parents received the intervention were more likely to use a range of protective behavioral strategies, particularly those related to manner of drinking and stopping/limiting drinking, as compared with students whose parents did not receive the intervention. A universal, online, parent-based intervention to reduce risks associated with student alcohol consumption may be an efficient and effective component of a college's overall prevention strategy.

El Ansari W; Stock C. Factors associated with smoking, quit attempts and attitudes towards total smoking bans at university: A survey of seven universities in England, Wales and Northern Ireland. Asian Pacific Journal of Cancer Prevention 13(2): 705-714, 2012. (80 refs.)

Objectives: This study assessed the associations between socio-demographic, health and wellbeing variables (independent variables) and daily smoking, attempts to quit smoking, and agreement with smoking ban (dependent variables). Methods: Data from 3,706 undergraduate students were collected from seven universities in England, Wales, and Northern Ireland using a standardised questionnaire. Results: About 15.8% of the whole sample reported daily smoking, while 12% were occasional smokers. Smoking was significantly more prevalent among males, but the difference was due to a higher rate of occasional smokers. About every second smoker (55%) had attempted to quit smoking. Almost 45% of the whole sample agreed or strongly agreed with implementing a total smoking ban on campus. Daily smoking was more likely among students with not sufficient income, students whose fathers had at least a bachelor degree; and, students who reported binge drinking. Conversely, daily smoking was less likely among students who rated their health as very good/excellent, those who ate >= 5 portions of fruit or vegetables, and those who had never taken illicit drugs. Previous attempt/s to quit smoking were more likely among students who have never taken illicit drugs and those who agreed with a total smoking ban; and less likely among those with not sufficient income. Daily smokers were less likely to report quit attempts as compared to occasional smokers. An agreement with smoking ban was more likely among students who rated their health as very good/excellent, those who ate >= 5 portions of fruit or vegetables daily, and those who had never taken illicit drugs, but less likely among daily smokers. Conclusion: Favourable health practices and positive attitudes towards smoking ban were associated with each other. Interventions would need to comprise multi-component programmes that do not solely focus on smoking prevention/cessation, but also on other health promoting practices as well.

Elliott MA; Ainsworth K. Predicting university undergraduates' binge-drinking behavior: A comparative test of the one- and two-component theories of planned behavior. Addictive Behaviors 37(1): 92-101, 2012. (87 refs.)

This study provides a comparative test of the one- and two-component theories of planned behavior (TPB) in the context of university undergraduates' binge-drinking. Participants (N=120) self-completed questionnaire measures of all TPB constructs at time 1 and subsequent binge-drinking at time 2 (two-weeks later). The data were analyzed using a combination of path analyses and bootstrapping procedures. Both models accounted for a substantial proportion of the variation in behavior. However, the two-component TPB provided a significantly better fit to the data, with the total direct and indirect effects accounting for 90% of the variance. Intention was the only direct predictor of behavior. Instrumental attitude, affective attitude and self-efficacy had indirect effects. Although health interventions could usefully target these cognitive antecedents, simulation analyses, modeling the effects of cognition change on behavior, showed that only large-sized (0.8 SD) changes to affective attitude, or moderate-sized changes to all of these cognitions in combination were sufficient to reduce binge-drinking.

Espejo B; Cortes MT; del Rio BM; Gimenez JA; Gomez C. Traits that define the different alcohol intensive consume type during the practice of "botellon". Spanish Journal of Psychology 15(1): 256-264, 2012. (38 refs.)

There is a phenomenon contributing to the current pattern of alcohol consumption among youngsters in Spain known as "botellon". From research financed by the National Plan on Drugs (2004-2007), data of 6009 youngsters (14-25 years old) were collected from three Spanish cities. Only individuals who engage in intensive consumption of alcohol (n = 2807) have been included. The purpose of this work has been to identify the different types of consumers at risk through a cluster analysis and to establish a profile for each particular group. Four groups were differentiated by age, gender, alcohol consumption and years of consumption. It was observed that adolescent students and university students of the same sex consume similar quantities of alcohol, and justify their consumption alluding to personal factors, whereas university students refer to issues related to control of leisure. The consumption by males is the highest, and they are the most likely to seek drunkenness. They associate to a lesser degree their consumption with the possibility of developing an addictive process. In general, all youngsters consider that their consumption will have no negative consequences. These results indicate the need to come up with different alternatives, addressing the particularities of each group.

Fairlie AM; Wood MD; Laird RD. Prospective protective effect of parents on peer influences and college alcohol involvement. Psychology of Addictive Behaviors 26(1): 30-41, 2012. (69 refs.)

This prospective study used a conceptually based risk and protective framework to investigate whether parental influences exert a protective effect on the robust association between peer influences and college alcohol involvement. Participants were incoming freshmen in the control condition of a randomized clinical trial, N = 256, 57.0% female, baseline age: M = 18.36 years (SD = 0.41). Participants completed telephone surveys in the summer before matriculation (baseline) and in the spring of the freshman (10-month) and sophomore years (22-month) with 85.6% retention at 22-months. Latent growth models were estimated for heavy episodic drinking and alcohol-related consequences. Descriptive norms and social modeling among peers were positively associated with initial heavy drinking and consequences; parental drinking permissiveness was positively associated with initial heavy drinlcing. Greater social modeling among peers was associated with less growth in consequences. Parental monitoring was not significantly associated with alcohol involvement. Prematriculation social modeling exhibited a weaker positive association with initial heavy drinking and consequences at low prematriculation parental drinking permissiveness compared to high. Similarly, prematriculation descriptive norms exhibited a weaker positive association with initial heavy drinking at low prematriculation parental drinking permissiveness compared to high. Prematriculation descriptive norms were not significantly associated with growth in heavy drinking at low parental drinking permissiveness; in contrast, higher prematriculation descriptive norms were associated with less growth in heavy drinking at high parental drinking permissiveness. Findings provide support for a protective parental influence on peer-alcohol relations extending into college. Parental drinking permissiveness may be an important target for parent-based interventions.

Fielder RL; Carey KB; Carey MP. Prevalence, frequency, and initiation of hookah tobacco smoking among first-year female college students: A one-year longitudinal study. Addictive Behaviors 37(2): 221-224, 2012. (16 refs.)

Hookah tobacco smoking has become increasingly prevalent among college students, but little is known about frequency of use or patterns of use over time, including during the transition to college. The goals of this longitudinal cohort study were to assess the: (a) lifetime prevalence, (b) current prevalence, (c) frequency of use, and (d) pattern of initiation of hookah tobacco smoking among female students during the first year of college. First-year female college students (N=483) at a large private university in upstate New York completed 13 monthly online surveys about their hookah tobacco use from August 2009 to August 2010. Lifetime prevalence of hookah use increased from 29% at college entry to 45% at one-year follow-up. The highest rates of hookah initiation occurred in the first two months of students' first semester of college. Current (past 30 days) hookah use ranged from 5% to 13% during the year after college entry. On average, hookah users reported smoking hookah two days per month. Hookah tobacco use is common among female college students. The transition to college is a vulnerable time for hookah initiation. Preventive efforts should begin in high school and continue through college, with a focus on students' first few months on campus.

Finlay AK; Ram N; Maggs JL; Caldwell LL. Leisure activities, the social weekend, and alcohol use: Evidence from a daily study of first-year college students. Journal of Studies on Alcohol and Drugs 73(2): 250-259, 2012. (50 refs.)

Objective: The aim of this study was to document within-person and between-persons associations between the duration of day-to-day activities (volunteering, spiritual activities, media use, socializing, entertainment/campus events and clubs, athletics, classes, working for pay) and alcohol use (quantity and heavy drinking) and to examine whether these associations differed by gender and the time of week. Method: First-semester college students (N = 717 persons; 51.6% female) provided up to 14 consecutive days of data (N = 9, 431 days) via daily web-based surveys. Multilevel analyses tested whether alcohol use was associated with activity duration, gender, and time of week. Results: Between-persons associations indicated that alcohol use was higher among individuals who spent more time involved in athletics and socializing and lower among students who spent more time in spiritual and volunteer activities. Within-person associations indicated that students consumed more alcohol and were more likely to drink heavily on weekends, on days they spent more time than usual socializing, and on days they spent less time than usual in spiritual activities and using media. Conclusions: Select activities and days were linked with less alcohol use at both the between- and within-person levels, suggesting that attention should be paid to both selection effects and social context to understand the mechanisms linking activity duration and student drinking.

Fischer B; Dawe M; Mcguire F; Shuper PA; Jones W; Rudzinski K et al. Characteristics and predictors of health problems from use among high-frequency cannabis users in a Canadian university student population. Drugs: Education, Prevention and Policy 19(1): 49-58, 2012. (68 refs.)

Aims: Assess key cannabis use, risk and outcome characteristics among high-frequency cannabis users within a university student sample in Toronto, Canada. Methods: N = 134 active universities students (ages of 18-28) using cannabis at least three times per week were recruited by mass advertisement, telephone-screened and anonymously assessed by an interviewer-administered questionnaire. Relevant descriptive statistics are presented; subsequent univariate and multivariate logistic regression analyses (MLRA) identified independent predictors of experiencing physical or mental health problems. Findings: The majority of respondents used cannabis >5 years, almost daily and >1 times/day, socially and medically on occasion. In past 30 days, 79% used cannabis by deep inhalation, 38% drove a car after use, 45% had difficulty controlling or limiting use and 52% experienced negative mental/physical health effects, with few respondents reporting any past treatment. The MLRA identified 'difficulty controlling or limiting use' (OR = 3.40, 95% CI = 1.58-7.30), 'non-white ethnicity' (OR = 2.78, 95% CI = 1.13-6.83), and 'living with others' (OR = 2.37, 95% CI = 1.02-5.55) as independent predictors (p < 0.01) of negative health problems. Conclusions: Our sample was characterized by several use-related risks and problems, which may result in long-term burden of disease. University environment may offer suitable settings for targeted interventions. Determinants of future cannabis use and problems should be assessed in this population.

Fraeyman J; Van Royen P; Vriesacker B; De Mey L; Van Hal G. How is an electronic screening and brief intervention tool on alcohol use received in a student population? A qualitative and quantitative evaluation. Journal of Medical Internet Research 14(2): e-journal 56, 2012. (48 refs.)

Background: A previous study among Antwerp college and university students showed that more male (10.2%-11.1%) than female (1.8%-6.2%) students are at risk for problematic alcohol use. The current literature shows promising results in terms of feasibility and effectiveness for the use of brief electronic interventions to address this health problem in college and university students. We evaluated this type of intervention and cite existing literature on the topic. Objective: To develop a website, www.eentjeteveel.be, to motivate college and university students with problematic alcohol use to reduce alcohol consumption and increase their willingness to seek help. Method: The website contained a questionnaire (Alcohol Use Disorders Identification Test [ AUDIT]) for students to test their alcohol use. According to their answers, the students immediately received personalized feedback (personal AUDIT score and additional information on risks associated with alcohol use) and a suggestion for further action. Afterward, students could send an email to a student counselor for questions, guidance, or advice. To obtain in-depth qualitative information on the opinions and experiences of students, we held 5 focus group discussions. The topics were publicity, experiences, impressions, and effects of the website. We analyzed the quantitative results of the online test in SPSS 15.0. Results: More than 3500 students visited www.eentjeteveel.be; over half were men (55.0%). A total of 34 students participated in the focus group discussions. The mixture of quantitative and qualitative methods to evaluate the intervention allowed a thorough analysis and provided complementary results. The intervention was well received by the student population. However, some minor aspects should be reconsidered, such as website publicity and providing students with options that were added after intermediate evaluation. The intervention increased the motivation of students to think about their alcohol use but could not stimulate them to change their behavior. The website attracted relatively more male than female students and more students in the high-risk group than in the low-risk group. The high-risk group was more inclined to seek advice or guidance (23/400, 6%;chi(2)(2=32.4), P < .001) than the low-risk group (34/1714, 2%; chi(2)(2=32.4), P < .001). Conclusions: We gained unique insight into students' experiences, opinions, and perceptions with regard to the intervention. The results show that the intervention was positively received in the population, and the willingness to seek help was increased. However, real behavior change needs further research. The results of this study can assist health providers and researchers in better understanding college and university students' perceptions of eHealth initiatives.

Garnier-Dykstra LM; Caldeira KM; Vincent KB; O'Grady KE; Arria AM. Nonmedical use of prescription stimulants during college: Four-year trends in exposure opportunity, use, motives, and sources. Journal of American College Health 60(3): 226-234, 2012. (32 refs.)

Objective: Examine trends in nonmedical use of prescription stimulants (NPS), including motives, routes of administration, sources, cost, and risk factors. Participants: 1,253 college students. Methods: Data were collected annually during academic years 2004-2005 through 2008-2009. Generalized estimating equations analyses evaluated longitudinal trends. Logistic regression models evaluated stability of associations between risk factors and NPS over time. Results: Almost two-thirds (61.8%(wt)) were offered prescription stimulants for nonmedical use by Year 4, and 31.0%(wt) used. Studying was the predominant motive (73.8% to 91.5% annually), intranasal administration was modest (<17% annually), and the most common source was a friend with a prescription (>= 73.9% annually). Significant changes over time included decreasing curiosity motives, increasing overuse of one's own prescription, and increasing proportion paying $5+ per pill. Lower grade point average and alcohol/cannabis use disorders were consistently associated with NPS, holding constant other factors. Conclusions: Prevention opportunities exist for parents, physicians, and college administrators to reduce NPS.

Ghandour LA; El Sayed DS; Martins SS. Prevalence and patterns of commonly abused psychoactive prescription drugs in a sample of university students from Lebanon: An opportunity for cross-cultural comparisons. Drug and Alcohol Dependence 121(1-2): 110-117, 2012. (40 refs.)

Background: Concerns about psychoactive prescription drug abuse among youth are growing worldwide, but the majority of published studies remain from the US and Canada impeding cross-cultural comparisons. This study examines the prevalence, sources, motivations and substance-use correlates of commonly abused medications among youth from Lebanon. Methods: An IRB-approved cross-sectional study was conducted (May 2010) at the American University of Beirut. Proportionate cluster sampling was used to generate a representative sample of AUB students (n = 570). A self-filled anonymous questionnaire was administered. Results: Lifetime medical and nonmedical prevalence of medications were (respectively): pain (36.9%, 15.1%), anxiety (8.3%, 4.6%), sleeping (6.5%, 5.8%) and stimulants (2.6%, 3.5%). Gender differences were not observed. Lebanese were least likely to report non-medical use. Nonmedical users mostly used the drugs for their intended purpose (e.g., sleeping to help in sleep, stimulants to increase alertness). Parents and pharmacists (without a doctor's prescription) were the top two sources of all medications, except for stimulants (friends predominated). Diversion was observed in about 20% of the medical users. Lifetime marijuana users and past year alcohol abusers were three times as likely to use any prescription drug nonmedically. Conclusions: In Lebanon, as in Western cultures, a considerable proportion of youth may be self-medicating. The absence of medical supervision coupled with motivations such as "to get high" renders this issue a high priority on the national youth agenda. Besides larger more comprehensive surveys, the findings signal the immediate need to reinforce relevant policies, and raise awareness among youth, parents, health professionals and other stakeholders.

Glass K; Flory K. Are symptoms of ADHD related to substance use among college students? Psychology of Addictive Behaviors 26(1): 124-132, 2012. (67 refs.)

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood disorder that often persists into adolescence and adulthood and has been associated with an increased risk for substance use. Due to improved treatment and educational policies, more students with high levels of ADHD symptoms are attending college despite continued ADHD symptoms. Little research has examined whether college students with higher levels of ADHD symptoms are at increased risk for heavy substance use compared to college students with few ADHD symptoms. The current study examined the relation of ADHD symptoms to substance use (e.g., cigarette smoking, alcohol use, marijuana use, and cocaine use). We hypothesized that greater ADHD symptomatology (inattentive, hyperactive/impulsive, and total ADHD) would be related to higher rates of cigarette smolcing, alcohol use, alcohol-problems, and illicit drug use. Participants were 889 college undergraduates who completed an online survey. Results suggest that ADHD symptoms, particularly inattentive symptoms, were positively associated with cigarette smoking and problems associated with alcohol after controlling for conduct disorder (CD) symptoms. ADHD symptoms were not significantly associated with alcohol use or illicit drug use after the effects of CD symptoms were accounted for. Results have important implications for prevention and treatment of college student substance use. Limitations and future directions are discussed.

Grant S; LaBrie JW; Hummer JF; Lac A. How drunk am I? Misperceiving one's level of intoxication in the college drinking environment. Psychology of Addictive Behaviors 26(1): 51-58, 2012. (45 refs.)

One effective event-level index that can assist in identifying risky intoxication levels among college students is blood alcohol concentration (BAC). Despite widespread exposure to BAC information, doubt exists as to whether American college students can accurately estimate their own BAC level or drinking behaviors while intoxicated. This study assessed whether students can accurately guesstimate their BAC level and drinking behaviors used to estimate BAC (eBAC) while drinking in social college settings. Participants (N = 225; 56.4% male) consisted of emerging adults attending either a 2- or 4-year college who had at least one alcoholic drink within the 2 hr before assessment. Participants were approached at night when returning from parties and/or alcohol-serving establishments. They completed an initial questionnaire, gave a breath sample to assess breath alcohol content, and then completed an online follow-up questionnaire within 48 hr of baseline assessment. Participants at lower levels of intoxication tended to slightly overestimate their BAC level, while those at higher levels tended to markedly underestimate their BAC level. In addition, discrepancies among breath alcohol content, guesstimated BAC, and eBAC were found as a function of gender. Lastly, differences in eBAC scores did not differ when drinking behaviors were obtained via in vivo versus retrospective methodology. Findings suggest that college students generally have difficulty assessing their BAC level and drinking behaviors while drinking in the college social setting. This study offers particular insight for research relying on estimates of BAC as well as interventions utilizing BAC education.

Hagger MS; Lonsdale A; Chatzisarantis NLD. A theory-based intervention to reduce alcohol drinking in excess of guideline limits among undergraduate students. British Journal of Health Psychology 17, Part 1(18-43), 2012. (98 refs.)

Objectives. Undergraduate students frequently exceed guideline limits for alcohol intake in a single session and are highly susceptible to associated health, social, and economic problems. Psychological theory suggests that interventions aimed at reducing alcohol consumption should target both motivational and volitional phases of action to be effective. This study reports an integrated theory-based intervention aimed at reducing undergraduates alcohol consumption in excess of guideline limits. Design. The study adopted a 2 (motivation: mental simulation vs. no mental simulation) x 2 (volitional: implementation intention vs. no implementation intention) randomized controlled design presented in an online format. Methods. Undergraduate students (N = 238; females, n = 133, M age = 20.11, SD = 2.09; males, n = 105, M age = 20.38, SD = 1.35) completed baseline psychological measures and self-reported alcohol consumption as units consumed and heavy episodic drinking occasions followed by the intervention manipulation (if any). One month later participants completed follow-up measures of the psychological variables and alcohol consumption. Results. Significant reductions in alcohol consumption were observed at follow-up. Participants receiving a mental simulation intervention reported significantly fewer units of alcohol consumed and heavy episodic drinking occasions. Among participants with high baseline alcohol consumption, participants in the combined mental simulation and implementation intention intervention group consumed significantly fewer units than other groups. Conclusion. Results support the use of these theory-based strategies to reduce alcohol drinking in excess of guideline limits among undergraduates. There was preliminary support for the interaction between the two strategies among heavier drinkers. Targeting both motivational and implemental phases of action poses a high probability for success in changing alcohol-related behaviour in this population.

Hagman BT; Cohn AM. Drinking correlates of DSM-IV alcohol use disorder diagnostic orphans in college students. American Journal on Addictions 21(3): 233-242, 2012. (31 refs.)

One major limitation of the DSM-IV criteria for alcohol abuse and dependence is that a cluster of individuals who endorse a subthreshold number of dependence criteria and no abuse criteria do not receive a formal diagnosis; despite elevated risk for alcohol-related problems relative to those with an abuse diagnosis. These individuals have been referred to as diagnostic orphans. The primary aim of this study was to examine alcohol use correlates of a group of diagnostic orphans in a sample of 396 nontreatment seeking college students who reported drinking on at least one occasion in the last 90 days. DSM-IV criteria were assessed using a modified version of the Composite International Diagnostic Interview-Substance Abuse Module (CIDI-SAM). Diagnostic orphans represented 34.1% (n = 135) of the original sample who did not receive a formal diagnosis; with the most frequently endorsed dependence criteria being tolerance and drinking larger/longer amounts than intended. Diagnostic orphans reported a range of alcohol-related negative consequences and reported greater frequencies of social and enhancement drinking motives in comparison to coping motives. They were similar to alcohol abusers and dissimilar to those with dependence or those without a diagnosis on alcohol consumption, alcohol problem severity, drinking motives and restraint variables. The present findings indicate that diagnostic orphans in college students represent a distinct group of drinkers who may be at risk for the development of alcohol use disorders and may be in need of intervention, given their similarity to those with an abuse diagnosis. Prevention and intervention efforts across college campuses should target this group to prevent escalation of alcohol problem severity.

Hahn EJ; Fallin A; Darville A; Kercsmar SE; McCann M; Record RA. The Three Ts of adopting tobacco-free policies on college campuses. Nursing Clinics of North America 47(1): 109-118, 2012. (18 refs.)

This article describes a 3-pronged compliance strategy to implement a tobacco-free campus policy at 1 large, land grant public university in the South, and evaluates its impact on outcomes and costs. Although there has been a recent wave of tobacco-free colleges, policy restrictiveness and implementation vary, and compliance remains a challenge. The 3 Ts strategy (Tell-Treat-Train) involves regular, consistent communications, access to tobacco treatment medications and counseling, and ongoing training of supervisors and student leaders. Administrative support, access to tobacco treatment, campus buy-in, sustained communications, and careful implementation planning are critical to instituting a tobacco-free university policy.

Hamdan-Mansour AM; Dardas LA; Nawafleh H; Abu-Asba MH. Psychosocial predictors of anger among university students. Children and Youth Services Review 34(2): 474, 2012. (34 refs.)

Anger is regarded as one of the basic human emotions and has been linked to adverse health outcomes. The purpose of this study was to investigate mental health predictors of anger among university students in Jordan. Methods: A sample of 241 university students from private and governmental universities in Jordan answered self-report questionnaires that include state-trait anger, perceived social support, personal mastery, and life satisfaction scale. The results showed that university students have moderate level of state and trait anger, and that student's perception of life satisfaction is a strong predictor of state and trait anger (p<.001) while social support and personal mastery were not. Number of smoked cigarette has significant correlation with trait anger (r=.18, p=.009), and no differences were found between male and female university students in their level of anger. The study's implications for educational and counseling programs, and research interventions were discussed.

Han MY; Chen WQ; Wen XZ; Liang CH; Ling WH. Differences of smoking knowledge, attitudes, and behaviors between medical and non-medical students. International Journal of Behavioral Medicine 19(1): 104, 2012. (29 refs.)

Previous studies in the world reported inconsistent results about the relationship of medical professional education with medical students' smoking behaviors, and no similar research had been published in China. This paper aims to explore whether the differences of smoking-related knowledge, attitudes, and behaviors existed between medical and non-medical undergraduate students. Eight thousand one hundred thirty-eight undergraduate students sampled from a university in Guangzhou were investigated with a self-administered structured questionnaire about their smoking-related knowledge, attitude and behaviors, and other relevant factors. General linear model and multinomial logistic regression were conducted to test the differences in smoking-related knowledge, attitude, and behaviors between medical and non-medical students while controlling for potential confounding variables. There was no difference in smoking-related knowledge scores between medical and non-medical freshmen, but medical sophomores and juniors had higher scores of smoking-related knowledge than their non-medical counterparts. The medical sophomores had higher mean score of attitudes towards smoking than non-medical ones. Before entering university, the difference in the prevalence of experimental and regular smoking between medical and non-medical college students was not significant. After entering university, in contrast, the overall prevalence of regular smoking was significantly higher among male non-medical college students than among male medical students. Stratified by current academic year, this difference was significant only among male sophomores. Medical students have higher smoking-related knowledge, stronger anti-smoking attitude, and lower prevalence of regular smoking than non-medical college students of similar age, which may be associated with medical professional education.

Herschl LC; McChargue DE; MacKillop J; Stoltenberg SF; Highland KB. Implicit and explicit alcohol-related motivations among college binge drinkers. Psychopharmacology 221(4): 685-692, 2012. (51 refs.)

Positive alcohol outcome expectancies and behavioral economic indices of alcohol consumption are related to binge drinking among college students and may reflect explicit and implicit motivations that are differentially associated with this behavior. The present study hypothesized that implicit (alcohol purchase task) and explicit (positive expectancy for alcohol's effects) motivations for drinking would not be correlated. It was also hypothesized that greater implicit and explicit motivations would predict alcohol-related risk. Participants were 297 college student binge drinkers (54% female; 88% European-American; Alcohol Use Disorders Identification Test: M = 9.53, SD = 5.04). Three indices from the alcohol purchase task (APT) were modeled as a latent implicit alcohol-related motivations variable. Explicit alcohol-related motivations were measured using a global positive expectancy subscale from the Comprehensive Effects of Alcohol Questionnaire. Alcohol Use Disorders Identification Test total, Rutgers Alcohol Problem Index total, and age of drinking onset were modeled as a latent alcohol-related risk variable. Structural equation modeling was used to examine associations amongst implicit motivations, explicit motivations, and alcohol-related risk. Implicit and explicit motivations were not correlated. Partially consistent with the second hypothesis, greater implicit motivations were associated with greater alcohol-related risk. Relations between explicit motivations and alcohol-related risk were marginally significant. Implicit and explicit drinking motivations are differentially associated with problem drinking behaviors. Future research should examine the underlying neurobiological mechanisms associated with these factors.

Hester RK; Delaney HD; Campbell W. The College Drinker's Check-Up: Outcomes of two randomized clinical trials of a computer-delivered intervention. Psychology of Addictive Behaviors 26(1): 1-12, 2012. (48 refs.)

The objective of the study was to evaluate the effectiveness of a computer-delivered intervention (CDI) to reduce heavy drinking and alcohol-related problems in college students in two randomized clinical trials. In Experiment 1, we randomized 144 students to either the CDI or an assessment-only control group with follow-ups at 1 and 12 months. In Experiment 2, we randomized 82 students to either the CDI or a delayed-assessment control group with follow-up at I month. In Experiment I, participants in both groups significantly reduced their drinking at both follow-ups. Compared to the control group, the CDI group reduced their drinking significantly more at 1 and 12 months on three drinking measures at a alpha < .05. Using a more conservative, Bonferroni-adjusted criterion yielded one significant difference in a measure of heavier drinking at the 1 month follow-up. The mean between-groups effect sizes were d =.34 and .36 at 1 and 12 months, respectively. Experiment 2. Compared to the delayed assessment control group, the CDI group significantly reduced (by the Bonferroni-adjusted criterion) their drinking on all consumption measures. These results support the effectiveness of the CDI with heavy drinking college students when used in a clinical setting. In addition, the significant reductions in typical drinking in the control group in Experiment 1 and not in Experiment 2 combined with comparable baseline characteristics suggests that the control group in Experiment I demonstrated assessment reactivity.

Hoeppner BB; Barnett NP; Jackson KM; Colby SM; Kahler CW; Monti PM et al. Daily college student drinking patterns across the first year of college. Journal of Studies on Alcohol and Drugs 73(4): 613-624, 2012. (59 refs.)

Objective: Despite the long recognized importance and well-documented impact of drinking patterns on health and safety, college student drinking patterns are understudied. This study used a daily-level, academic-year-long, multisite sample to identify subpopulations of college student drinking patterns and to describe how these groups differ from one another before, during, and after their first year of college. Method: Two cohorts of first-year college students (n = 588; 59% female) reported daily drinking on a biweekly basis using web-based surveys and completed surveys before and after their first year of college. Results: Cluster analyses based on time series analysis estimates of within-person drinking differences (per weekday, semester, first 6 weeks) and other descriptors of day-to-day drinking identified five drinking patterns: two low (47% and 6%), two medium (24% and 15%), and one high (8%) drinking cluster. Multinomial logistic regression analyses examined cluster differences in pre-college characteristics (i.e., demographics, alcohol outcome expectancies, alcohol problems, depression, other substance use) and first-year college experiences (i.e., academic engagement, alcohol consequences, risky drinking practices, alcohol problems, drinking during academic breaks). Low-drinking students appeared to form a relatively homogeneous group, whereas two distinct patterns were found for medium-drinking students with different weekend and Thursday drinking rates. The Thursday drinking cluster showed lower academic engagement and greater participation in risky drinking practices. Conclusions: These findings highlight quantitative and qualitative differences in day-to-day drinking patterns and suggest a link between motivational differences and drinking patterns, which may be addressed in developing tailored interventional strategies.

Holloway K; Bennett T. Prescription drug misuse among university staff and students: A survey of motives, nature and extent. Drugs: Education, Prevention and Policy 19(2): 137-144, 2012. (17 refs.)

Aims: To determine the prevalence and nature of prescription drug misuse among university staff and students in the UK. Methods: In 2009, an online questionnaire regarding non-medical use of prescription drugs was completed by 1614 students and 489 staff registered at a large university in Wales. The sample data were weighted to match the population of students and staff and were analysed using SPSS. Findings: The lifetime prevalence of prescription drug misuse (using prescription drugs not prescribed to the person) was 33% among students and 24% among staff. The main medications misused were pain relievers, followed by sedatives and sleeping aids. The main motives for misusing prescription drugs were to gain therapeutic benefit and 'to get high'. Conclusions: The study shows that a notable proportion of staff and students at the university used prescription drugs in a way that was not intended. The discussion draws attention to a debate about whether all forms of non-medical drug use should be regarded as misuse. The implications of non-medical use include health risks to the user as well as hidden social and economic costs. More research should be done to generate a more in-depth understanding of prescription drug misuse.

Hummer JF; LaBrie JW; Pedersen ER. First impressions on the scene: The influence of the immediate reference group on incoming first-year students' alcohol behavior and attitudes. Journal of College Student Development 53(1): 149-162, 2012. (43 refs.)

This study examined incoming first-year students' normative perceptions of alcohol use and alcohol-related attitudes of other students of the same gender living on their residence hall floor. Male and female residents overestimated the alcohol use behavior and related attitudes among their floormates. Results also showed that perceived norms were strongly related to individual drinking behaviors and permissive attitudes toward drinking. Moreover, feelings of connectedness to one's residence hall were found to moderate this relationship. These findings identify a salient reference group to target in initiatives aimed at utilizing normative feedback to reduce alcohol-related risk in the first year of college.

Hutton F. Harm reduction, students and pleasure: An examination of student responses to a binge drinking campaign. International Journal of Drug Policy 23(3): 229-235, 2012. (34 refs.)

Background: Recent debates about 'binge drinking' in New Zealand have positioned alcohol consumption amongst young drinkers as of concern. Research notes that students drink more heavily than their peers and that they have a higher incidence of alcohol related harms. In response, a harm reduction campaign aimed at first year university students was developed at a New Zealand university. Methods: This mixed methods study used questionnaires (225) and a small number of semi-structured interviews (4) to elicit student responses to the harm reduction campaign. Results: The majority of students in this study can be characterised as binge drinkers, although their drinking does not appear to cause them concern. The term 'binge drinking' is explored in three developed categories; 'light', 'moderate' and 'heavy' bingeing. Results are considered within a discussion of pleasure as a hindrance to harm reduction campaigns. Conclusions: The concept of 'determined drunkenness' and the notion of pleasure are important in students' motivations for drinking and may contribute to the resistance they have in viewing their alcohol consumption as concerning. It is argued that students already felt that they exercised control over their drinking for pleasure and this produced contradictions in responses towards the campaign compared to actual behaviour.

Iwamoto D; Takamatsu S; Castellanos J. Binge drinking and alcohol-related problems among U.S.-born Asian Americans. Cultural Diversity & Ethnic Minority Psychology 18(3): 219-227, 2012. (73 refs.)

Binge drinking (five drinks or more in a 2-h sitting for men or four or more drinks in a 2-h sitting for women) and alcohol-related problems are a growing problem among Asian American young adults. The current study examines the sociocultural (i.e., generational status and ethnic identity) determinants of binge drinking and alcohol-related problems across U.S.-born, young-adult, Asian American ethnic groups. Data were collected from 1,575 Asian American undergraduates from a public university in Southern California. Chinese Americans consisted of the largest Asian ethnicity in the study, followed by Vietnamese, Filipino, Korean, South Asian, Japanese, Multi-Asian, and "other Asian American." Participants completed a web-based assessment of binge drinking, alcohol-related problems, ethnic identity, descriptive norms (i.e., perceived peer drinking norms), and demographic information. An analysis of variance was used to determine potential gender and ethnic differences in binge drinking and alcohol-related problems. Negative binomial regression was selected to examine the relationship between the predictors and outcomes in our model. There were no gender differences between Asian American men and women in regards to binge drinking; however, men reported more alcohol-related problems. Japanese Americans reported the highest number of binge-drinking episodes and alcohol-related problems, followed by Filipino and Multi-Asian Americans (e.g., Chinese and Korean). Living off-campus; higher scores in descriptive norms; Greek status; and belonging to the ethnic groups Japanese, Filipino, Multi-Asian, Korean, and South Asian increased the risk of engaging in binge drinking. Quantity of alcohol consumed, Greek status, gender, Filipino, South Asian, other Asian, and lower ethnic identity scores were related to alcohol-related problems. Using one of the largest samples collected to date on sociocultural determinants and drinking among U.S.-born Asian American young adults, the findings highlight the significant variability in drinking patterns among Asian American ethnic groups.

Kazemi DM; Sun LM; Nies MA; Dmochowski J; Walford S. Baseline characteristics of college freshmen enrolled in an alcohol intervention program. Journal of Addictions Nursing 23(2): 116-122, 2012. (58 refs.)

This study is a baseline analysis of the demographic and behavioral characteristics of freshmen students recruited to enter a longitudinal multi-component intervention program based on the Brief Alcohol Screening, and Intervention for College Students (BASICS) program. The aim of the study was to determine the associations among the participants' gender, ethnicity, age, drinking, psychological problems, sexual contacts, and illegal substance use. Freshmen participants (n = 186) were between the ages of 18 and 20 with a mean age of 18.51 = 0.62, and 37.6% of the participants were males. Three surveys were administered at baseline: the Daily Drinking Questionnaire (DDQ; Collins, Parks, & Marlatt, 1985); Rutgers Alcohol Problem Index (RAPI; White & Labouvie, 1989), Government Performance and Results Act (GPRA; Office of Management and Budget [OMB], 1993), Client Outcome Measures for Discretionary Programs and Best Practices grantees. Descriptive statistics were used to determine the behavioral characteristics. During past 30 days participants on average consumed alcohol on 7.3 = 5.2 days, used illegal substances 3.0 = 7.2 days and had 5.3 = 7.0 sexual contacts and less 2.1 = 4.6 unprotected sexual contacts (USC). Results of this baseline analysis demonstrate the diversity of the program participant demographic characteristics and behavioral patterns. This study contributes valuable implications for the design of interventions programs to address high-risk behaviors among freshmen college students.

Kenney SR; LaBrie JW; Hummer JF; Pham AT. Global sleep quality as a moderator of alcohol consumption and consequences in college students. Addictive Behaviors 37(4): 507-512, 2012. (49 refs.)

The authors examined the relationship between global sleep quality and alcohol risk, including the extent to which global sleep quality moderated the relationship between alcohol use and drinking-related consequences. Global sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and alcohol-related consequences were assessed using the Rutgers Alcohol Problem Index (RAM). The sample consisted of 261 college students (61.3% female, 58.2% Caucasian) who completed online surveys. Using a four-step hierarchical multiple regression model, global sleep quality was found to predict alcohol consequences, over and above assessed covariates (demographics and weekly drinking). Further, global sleep quality emerged as a strong moderator in the drinking-consequences relationship such that among heavier drinkers, those with poorer global sleep quality experienced significantly greater alcohol-related harm. Campus health education and alcohol interventions may be adapted to address the importance of maintaining a healthy lifestyle, both in terms of healthful sleeping and drinking behaviors, which appear to play a strong synergistic role in alcohol-related risk.

Kim EK; Choo J. Secondhand tobacco smoke exposure and associated factors among college students on campus and in the home: A preliminary study. International Journal of Environmental Research and Public Health 9(1): 212-222, 2012. (25 refs.)

To explore the prevalence of secondhand tobacco smoke (SHS) exposure of college students at two locations, i.e., on campus and in the home, and to identify factors associated with SHS exposure at each location, a preliminary cross-sectional study was conducted on 1754 nonsmoking students from two universities in Korea. In total, 83.1% were exposed to SHS at least once a week on campus or at home; the average SHS exposure was 3.4 times per week. Specifically, 79.7% and 23.5% were exposed to SHS on campus and in the home, respectively. On campus, SHS exposure was significantly more prevalent in freshmen and sophomore students. In the home, SHS exposure was significantly more prevalent among females, those with smokers in their families, and those who rated their health as poor. SHS exposure was common among nonsmoking college students, with more than two-thirds exposed on campus. The prevalence of SHS exposure was greater on campus than in the home; the factors associated with SHS exposure were location-specific.

Kim YS; Choi Y. College students' perception of Philip Morris's tobacco-related smoking prevention and tobacco-unrelated social responsibility. Journal of Public Relations Research 24(2): 184-199, 2012. (57 refs.)

This study examined the effects of 2 Philip Morris corporate social responsibility (CSR) programs -- a tobacco-related smoking prevention versus a tobacco-unrelated program -- on college students' perceived CSR motive, attitudes toward Philip Morris, and behavioral intentions to support the company. Using 2 college student samples in the United States and South Korea, this study found that the tobacco-unrelated program and a positively perceived CSR motive elicited more positive responses about CSR values, attitudes toward CSR activities and the company, and behavioral intentions to support Philip Morris. Korean college students were more likely to perceive Philip Morris's CSR activities as mutually beneficial and to support Philip Morris than were American college students.

Kittinger R; Correia CJ; Irons JG. Relationship between Facebook use and problematic internet use among college students. Cyberpsychology, Behavior and Social Networking 15(6): 324-327, 2012. (19 refs.)

The popularity of Facebook and other online social-networking sites has led to research on the potential risks of use, including Internet addiction. Previous studies have reported that between 8 percent and 50 percent of college students report problems consistent with Internet addiction. The current study assessed a range of variables related to Facebook use, and sought to determine how the use of Facebook relates to problematic Internet use. Undergraduate participants (N=281, 72 percent women) completed a battery of self-report measures, including the Internet Addiction Test, via an online interface. The results of the current study suggest that a sizable minority of students experience problems related to Internet use and that the use of Facebook may contribute to the severity of symptoms associated with Internet addiction.

LaBrie JW; Atkins DC; Neighbors C; Mirza T; Larimer ME. Ethnicity specific norms and alcohol consumption among Hispanic/Latino/and Caucasian students. Addictive Behaviors 37(4): 573-576, 2012. (35 refs.)

Previous research has shown that social norms are among the strongest predictors of college student drinking and that normative misperceptions of more similar groups' drinking behavior may be more influential on individual drinking than those groups perceived to be more different. However, limited research has explored the moderating role of ethnicity in this context. The current study examined the differential impact that Hispanic/Latino/a and Caucasian students' normative perceptions of both typical and same-ethnicity college students' drinking behavior had on their own drinking. Participants (N = 5,369 students; 60.4% female; 81.4% Caucasian; mean age 19.9 years) from two colleges completed web-based surveys assessing their alcohol consumption, and their perceptions of the drinking behaviors of both the typical college student and the typical same race/ethnicity college student at their campus. Results demonstrated that perceived norms were significantly associated with likelihood of drinking regardless of race or ethnicity specificity, but that Hispanics/Latinos/as typically had weaker relationships between ethnicity-specific norms and drinking than general student norms and drinking. The opposite was true for Caucasians such that the relationship between same-race norms and drinking was stronger than the relationship between general student norms and drinking. Further, Hispanic/Latino/a students with high perceived norms were less likely to have consumed any alcohol than Caucasians with similar normative beliefs. Further, a campus site interaction suggests that the size of the minority population on campus relative to other students may influence the relationship between norms and drinking. Implications and targets for future investigation are discussed.

LaBrie JW; Ehret PJ; Hummer JF; Prenovost K. Poor adjustment to college life mediates the relationship between drinking motives and alcohol consequences: A look at college adjustment, drinking motives, and drinking outcomes. Addictive Behaviors 37(4): 379-386, 2012. (68 refs.)

The current study examined whether the relationship between drinking motives and alcohol-related outcomes was mediated by college adjustment. Participants (N=253) completed an online survey that assessed drinking motives, degree of both positive and negative college adjustment, typical weekly drinking, and past month negative alcohol-related consequences. Structural equation modeling examined negative alcohol consequences as a function of college adjustment, drinking motives, and weekly drinking behavior in college students. Negative college adjustment mediated the relationship between coping drinking motives and drinking consequences. Positive college adjustment was not related to alcohol consumption or consequences. Positive reinforcement drinking motives (i.e. social and enhancement) not only directly predicted consequences, but were partially mediated by weekly drinking and degree of negative college adjustment. Gender specific models revealed that males exhibited more variability in drinking and their positive reinforcement drinking motives were more strongly associated with weekly drinking. Uniquely for females, coping motives were directly and indirectly (via negative adjustment) related to consequences. These findings suggest that interventions which seek to decrease alcohol-related risk may wish to incorporate discussions about strategies for decreasing stress and increasing other factors associated with better college adjustment.

Larimer ME; Neighbors C; Lostutter TW; Whiteside U; Cronce JM; Kaysen D. Brief motivational feedback and cognitive behavioral interventions for prevention of disordered gambling: A randomized clinical trial. Addiction 107(6): 1148-1158, 2012. (69 refs.)

Aims The purpose of the current study was to evaluate feasibility and efficacy of two promising approaches to indicated prevention of disordered gambling in a college population. Design Randomized clinical trial with assignment to a personalized feedback intervention (PFI), cognitivebehavioral intervention (CBI) or assessment-only control (AOC). PFI was delivered individually in a single session and included feedback regarding gambling behavior, norms, consequences and risk-reduction tips, delivered in a motivational interviewing style. CBI was delivered in small groups over four to six sessions and included functional analysis and brief cognitive correction, as well as identification of and alternatives for responding to gambling triggers. Setting College campus. Participants At-risk or probable pathological gamblers (n = 147; 65.3% male; group assignment: PFI, n = 52; CBI, n = 44; AOC, n = 51). Measurements Self-reported gambling quantity, frequency, consequences, psychopathology, normative perceptions and beliefs. Findings Relative to control, results at 6-month follow-up indicated reductions in both interventions for gambling consequences (PFI d = 0.48; CBI d = 0.39) and DSM-IV criteria (PFI d = 0.60; CBI d = 0.48), reductions in frequency for PFI (d = 0.48). CBI was associated with reduced illusions of control, whereas PFI was associated with reduced perceptions of gambling frequency norms. Reductions in perceived gambling frequency norms mediated effects of PFI on gambling frequency. Conclusions: A single-session personalized feedback intervention and a multi-session cognitive behavioral intervention may be helpful in reducing disordered gambling in US college students.

Larsen H; Engels RCME; Wiers RW; Granic I; Spijkerman R. Implicit and explicit alcohol cognitions and observed alcohol consumption: three studies in (semi)naturalistic drinking settings. Addiction 107(8): 1420-1428, 2012. (52 refs.)

Aims: Dual-process models imply that alcohol use is related to implicit as well as explicit cognitive processes. Few studies have tested whether both types of processes are related to ad libitum drinking. In a series of three studies, we tested whether both implicit and explicit alcohol-related cognitions predicted the amount of alcohol consumed in an ad libitum (semi)naturalistic drinking situation. Design: Two experimental studies used trained confederates (same-sex peers) who consumed either alcoholic or non-alcoholic beverages, while observing participants' drinking behaviour in a 30-minute session. The third study involved observations of participants' alcohol use during a 45-minute session in which participants spent time with five to seven friends. Setting A (semi)naturalistic drinking setting, a laboratory bar. Participants: Participants were undergraduates recruited at Radboud University (study 1: n = 115; study 2: n = 121; study 3: n = 200). Measurements: We used coding of drinking behaviour from observations, questionnaire data on positive alcohol expectancies and alcohol use patterns and implicit association tests to assess alcohol associations. Findings: Implicit associations were not related to observed alcohol use, whereas explicit positive expectancies were related positively to observed alcohol use in study 1 and study 2. Conclusions: Among undergraduate students in (semi)naturalistic drinking settings with peers, implicit alcohol-related cognitions do not predict the amount of alcohol consumed.

Lawrence SA; Hall T; Lancey P. The relationship among alcohol consumption, tailgating, and negative consequences. Journal of Child & Adolescent Substance Abuse 21(3): 222-237, 2012. (40 refs.)

Tailgating has been associated with both problem drinking and high-risk behaviors. The purpose of this study was to determine if student participation in game day on-campus tailgating activities is associated with increased alcohol consumption. Employing a convenience sample of 567 university students, the authors compared the alcohol use patterns of students who participated in tailgating activities with students who did not. Survey results indicate that tailgating is positively associated (p < .05) with increased drinking and greater high-risk behaviors for college students. Implications for practice and future research are highlighted.

Lazev AB; Norton TR; Collins B; Ma G; Miller S. The use of university debit cards for purchasing cigarettes: An opportunity for tobacco use prevention on university campuses. Drugs: Education, Prevention and Policy 19(1): 59-63, 2012. (27 refs.)

Aims: Young adults have the highest smoking rate of any age group in the United States. However, little is known about how young adults, including college students, access and pay for cigarettes - important information for guiding policies and prevention and intervention efforts. This study examined students' use of university debit cards, which provide money intended for school-related purchases and living expenses, to purchase cigarettes. Methods: Undergraduate students (N = 1302) at a large urban university completed an online survey during the spring 2009 semester. Students received a $10 gift card for completing at least 90% of the survey. Findings: Among past 30-day smokers (n = 367), 42% purchased cigarettes with university debit cards and were more likely to be daily smokers, smoked more cigarettes per day and tended to be younger than those who used other purchasing methods only. Conclusion: These data suggest that a significant number of students use their university debit cards to buy cigarettes, possibly increasing their access to cigarettes and contributing to their smoking behaviour. This trend may be more commonplace than parents or university administrators realize and should be considered when designing smoking prevention/intervention efforts as well as university policies.

Lee HS; Catley D; Harris KJ. A comparison of autonomous regulation and negative self-evaluative emotions as predictors of smoking behavior change among college students. Journal of Health Psychology 17(4): 600-609, 2012. (34 refs.)

This study compared autonomous self-regulation and negative self-evaluative emotions as predictors of smoking behavior change in college student smokers (N = 303) in a smoking cessation intervention study. Although the two constructs were moderately correlated, latent growth curve modeling revealed that only autonomous regulation, but not negative self-evaluative emotions, was negatively related to the number of days smoked. Results suggest that the two variables tap different aspects of motivation to change smoking behaviors, and that autonomous regulation predicts smoking behavior change better than negative self-evaluative emotions.

Leeman RF; Kulesza M; Stewart DW; Copeland AL. Cluster analysis of undergraduate drinkers based on alcohol expectancy scores. Journal of Studies on Alcohol and Drugs 73(2): 238-249, 2012. (63 refs.)

Objective: Expectancies of alcohol's effects have been associated with problem drinking in undergraduates. If subgroups can be classified based on expectancies, this may facilitate identifying those at highest risk for problem drinking. Method: Undergraduates (N=612) from two state universities completed a web-based survey. Responses to the Comprehensive Effects of Alcohol scale were analyzed using k-means cluster analysis separately within each university sample. Results: Hartigan's heuristic was used to determine that five was the optimal number of clusters in each sample. Clusters were distinguishable based on their overall magnitude of expectancy endorsement and by a tendency to endorse stronger positive than negative expectancies. Subsequent analyses were conducted to compare clusters on alcohol involvement and trait disinhibition. A cluster characterized by endorsement of positive and negative expectancies ("strong expectancy") was associated with a particularly problematic risk profile, specifically concerning difficulties with self-control (i.e., trait disinhibition and impaired control over alcohol use). A cluster with higher positive and lower negative expectancies reported frequent heavy drinking but appeared to be at lower risk than the strong expectancy cluster in a number of respects. Negative expectancy endorsement appeared to represent added risk above and beyond positive expectancies. Conclusions: Results suggest that both the magnitude and combination of expectancies endorsed by subgroups of undergraduate drinkers may relate to their risk level in terms of alcohol involvement and personality traits. These findings may have implications for interventions with young adult drinkers.

Lefkowitz ES; Patrick ME; Morgan NR; Bezemer DH; Vasilenko SA. State Patty's Day: College student drinking and local crime increased on a student-constructed holiday. Journal of Adolescent Research 27(3): 323-350, 2012. (63 refs.)

College student alcohol consumption is a major concern, and is known to increase during the celebration of special events. This study examined a student-constructed holiday, State Patty's Day, at a university with a dominant drinking culture using three sources of data-coded data from Facebook groups, daily web surveys from first-year students (N = 227, 51% male, age 18 to 20; 27.3% Hispanic/Latino; of non-Hispanic/Latino, 26.9% of sample European American/White, 19.4% Asian American/Hawaiian/Pacific Islander, 15.9% African American/Black, 10.6% more than one race), and criminal offense data from police records. Results indicated that messages about State Patty's Day on Facebook focused on drinking and social aspects of the holiday, such as the social context of drinking, a sense of belonging to a larger community, and the social norms of drinking. These messages were rarely about consequences and rarely negative. On State Patty's Day, 51% of students consumed alcohol, compared to 29% across other sampled weekend days. Students consumed more drinks (M = 8.2 [SD = 5.3] drinks per State Patty's Day drinker) and were more likely to engage in heavy drinking on State Patty's Day, after controlling for gender, drinking motives, and weekend, demonstrating the event-specific spike in heavy drinking associated with this holiday. The impact of this student-constructed holiday went beyond individual drinking behavior; alcohol-specific and other crime also peaked on State Patty's Day and the day after. Event-specific prevention strategies may be particularly important in addressing these spontaneous, quickly-constructed, and dynamic events.

Lenk K; Rode P; Fabian L; Bernat D; Klein E; Forster J. Cigarette use among young adults: Comparisons between 2-year college students, 4-year college students, and those not in college. Journal of American College Health 60(4): 303-308, 2012. (20 refs.)

Objective: To examine cigarette smoking among young adults based on education status. Participants: Community-based sample of 2,694 young adults in the United States. Methods: The authors compared 3 groups -- those not in college with no college degree, 2-year college students/graduates, 4-year college students/graduates -- on various smoking measures: ever smoked, smoked in past month, smoked in past week, consider self a smoker, began smoking before age 15, smoked over 100 cigarettes in lifetime, ever tried to quit, and plan to quit in next year. Results: The authors found that for nearly all the smoking measures, the 4-year college group was at lowest risk, the noncollege group was at highest risk, and the 2-year college group represented a midpoint. Differences between groups remain after adjusting for parents' education and other potential confounding factors. Conclusions: Smoking behaviors clearly differ between the 2-year, 4-year, and no college groups. Interventions should be tailored for each group.

Lenk KM; Erickson DJ; Nelson TF; Winters KC; Toomey TL. Alcohol policies and practices among four-year colleges in the United States: Prevalence and patterns. Journal of Studies on Alcohol and Drugs 73(3): 361-367, 2012. (18 refs.)

Objective: The purpose of this study was to assess the prevalence of college alcohol policies and practices and to identify patterns of policies/practices across colleges. Method: An online survey of administrators at a random sample of 351 4-year U.S. colleges was conducted in 2008. The prevalence of 31 alcohol policies and practices was assessed as well as differences across size and type of colleges. Latent class analyses identified classes of colleges based on their alcohol policies/practices. Results: The majority of colleges prohibit alcohol use at sporting events, whereas less than half prohibit alcohol use at fraternity and sorority events. Less than half of the colleges also prohibit alcohol advertising inion campus newspapers and radio stations. Small colleges are more likely than large colleges to prohibit alcohol use at tailgating events and to prohibit newspaper alcohol advertising. Public colleges are more likely than private colleges to prohibit alcohol use in dorms but less likely to prohibit alcohol advertising. We identified four classes of colleges-the largest class (38%) was characterized by having many alcohol policies/practices, the smallest class (13%) had none or few alcohol policies/practices, and the remainder fit into two middle classes that had certain policies/practices in place but lacked others. Conclusions: Most colleges report implementing some alcohol policies/practices but are lacking others. Only two of every five colleges fit into a class that has many alcohol policies. More studies are needed to validate our findings and assess whether certain policies/practices and patterns of policies are associated with reducing student alcohol consumption and related problems.

Linowski SA; DiFulvio GT. Mobilizing for change: A case study of a campus and community coalition to reduce high-risk drinking. Journal of Community Health 37(3): 685-693, 2012. (25 refs.)

Campus and community coalitions include a partnership between campus leaders and community stakeholders and can effectively address the environment that may promote high-risk drinking. Despite evidence suggesting that coalitions may be effective vehicles for producing sustainable changes in college drinking, few campuses work within such a structure. The purpose of this study was to examine the effectiveness of a campus and community coalition to implement environmental changes and thereby reduce high-risk drinking and associated consequences. This study utilized a case study method to tell the story of a campus and community coalition (CCC) implemented on a large university campus in the Northeast. The study employed multiple methods including archival document review, review of campus and community level data (i.e. alcohol-related arrests and sanctions) and analysis of student level data. The case study discusses the strategies employed, the environmental changes that occurred and the impact these changes have had on student drinking and consequences. Since implementing the campus and community coalition, the campus has seen an increase in enforcement by campus and local police, changes in community by-laws, and significant reductions in student drinking and consequences. The data provide evidence that a comprehensive approach to reducing high-risk drinking can have an impact on the campus and community environment, which in turn impacts student drinking and associated consequences. The CCC utilized a strategic and comprehensive approach to substance abuse prevention, allowing all participants to have a shared understanding of the challenges and best practices. Implications for research and practice are also discussed.

Lookatch SJ; Dunne EM; Katz EC. Predictors of nonmedical use of prescription stimulants. Journal of Psychoactive Drugs 44(1): 86-91, 2012. (30 refs.)

College students across the U.S. engage in nonmedical use of prescription stimulants (NMUPS) at increasing rates. While it has been found that use is frequently motivated by a belief that stimulants will act as a study aid, little is known about predictors of NMUPS. The present study addressed impulsivity, outcome expectancies, and evaluations of expected outcomes as predictors of NMUPS in a sample of 206 college students at a mid-Atlantic university. Approximately 26.1% of students endorsed past year NMUPS. Results indicated an increased likelihood of self-reported NMUPS was associated with increases in lack of premeditation, sensation seeking, positive expectancies and positive evaluations. Moreover, the extent to which participants believed that potential negative consequences were more severe was associated with a decreased likelihood of NMUPS. The current study suggests that impulsive personality, outcome expectancies, and evaluations of expected outcomes are important predictors of NMUPS among college students. Future research should consider other potential predictors of NMUPS in order to inform the development of prevention strategies.

Mamudu HM; Veeranki SP; He Y; Dadkar S; Boone E. University personnel's attitudes and behaviors toward the first tobacco-free campus policy in Tennessee. Journal of Community Health 37(4): 855-864, 2012. (25 refs.)

In 1994, Tennessee, the third largest tobacco-producing state in the U.S., preempted tobacco regulation. However, in 2005, higher educational institutions were exempted from this preemption and the 2007 Non-Smoker Protection Act required educational facilities to create smoke-free environment. To this date, while all higher educational institutions have some sort of smoke-free policy, East Tennessee State University is the only public institution with a tobacco-free policy. We investigated attitudes and behaviors of the university personnel, the most stable segment of the population, toward the policy and compliance with it using an internet-based survey. All employees (2, 318) were invited to participate in a survey; 58% responded. Bivariate analyses found 79% of the respondents favored the policy. Multiple variable logistic regression analyses found support for the policy was higher among females [OR = 3.14; 95% CI (1.68, 5.86)], administrators/professionals [OR = 3.47; 95% CI (1.78, 6.74)], faculty [OR = 2.69; 95% CI (1.31, 5.53)] and those affiliated with the College of Medicine [OR = 4.14; 95% CI (1.45, 7.85)]. While only 67 employees (5.6% of sample) reported they have not complied with the policy, around 80.8% reported observing someone engaged in non-compliance. The high level of support for the policy suggests it should be promoted throughout the higher education system and nationwide. At the same time, in preemptive states, higher educational institutions should be targeted as venues for strong tobacco-free policies. The gap in compliance, however, implies in tobacco-friendly environments, a tobacco-free campus policy with no reporting and enforcement mechanisms could lead to high levels of non-compliance.

Martin RJ; Cremeens JL; Umstattd MR; Usdan SL; Talbott-Forbes L; Garner MM. Drinking behaviour, protective behavioural strategies and school performance of college students. Drugs: Education, Prevention and Policy 19(1): 64-71, 2012. (43 refs.)

Aims: Concepts that may be effective in alleviating negative alcohol-related consequences among college students are protective behavioural strategies (PBSs), such as alternating alcoholic and non-alcoholic drinks. Our study used an innovative hypothesis-testing statistical technique (structural equation modelling, SEM) to examine the relationship of PBSs, drinking behaviour and school performance among college student drinkers. Methods: We used confirmatory factor analysis and SEM to explore the relationship between drinking behaviour, PBSs and school performance among a sample of college students (N = 371) who reported drinking alcohol in the past 30 days. Findings: Results indicated that PBSs were positively associated with school performance and drinking behaviour mediated the relationship. Based on the combinatory rules for standardized root mean square residual (SRMR) and comparative fit index (CFI), this model represented a good fit to the data (chi(2) = 34.4, df = 17, SRMR = 0.03 and CFI = 0.98). Conclusions: Our study extends the line of research examining the relationship between drinking behaviour, including PBSs, and academic performance of college students by showing the usefulness of an innovative hypothesis-testing statistical technique - SEM. Researchers might want to consider utilizing SEM when examining such relationships in the future. In addition, based on the results of our analyses, colleges and universities with an interest in the academic performance of their students may want to consider implementing and promoting programmes that concern increasing the awareness of PBSs.

Mazhari S. Association between problematic internet use and impulse control disorders among Iranian university students. Cyberpsychology, Behavior and Social Networking 15(5): 270-273, 2012. (27 refs.)

Previous studies have examined the relationship between problematic Internet use (PIU) with pathological gambling and impulsivity. However, few studies have investigated the association between PIU and other impulse control disorders. This study aimed to assess whether PIU is related to compulsive buying, kleptomania, trichotillomania, intermittent explosive disorder, and pyromania, among a sample of Iranian university students. A cross-sectional study design was used among a random sample of (n = 950) university students. Self-reported questionnaires, including demographic, Problematic Internet Use Questionnaire (PIUQ) and Minnesota Impulse Disorders Interview were utilized. The prevalence of PIU was 21.2 percent. Students with diagnosis of either compulsive buying, or intermittent explosive disorder, or pyromania had significantly higher scores on PIUQ compared to the students without the diagnosis. Multivariate regression analyses indicated that in the male gender, the diagnosis of either compulsive buying or intermittent explosive disorder were significant predictors of the risk of the PIU. The results support the proposal that PIU should be considered as a spectrum of impulse control disorder.

McCambridge J; Bendtsen P; Bendtsen M; Nilsen P. Alcohol e-mail assessment and feedback study dismantling effectiveness for university students (AMADEUS-1): Study protocol for a randomized controlled trial. Trials 13: article 49, 2012. (59 refs.)

Background: Alcohol causes huge problems for population health and for society, which require interventions with individuals as well as populations to prevent and reduce harms. Brief interventions can be effective and increasingly take advantage of the internet to reach high-risk groups such as students. The research literature on the effectiveness of online interventions is developing rapidly and is confronted by methodological challenges common to other areas of e-health including attrition and assessment reactivity and in the design of control conditions. Methods/design: The study aim is to evaluate the effectiveness of a brief online intervention, employing a randomized controlled trial (RCT) design that takes account of baseline assessment reactivity, and other possible effects of the research process. Outcomes will be evaluated after 3 months both among student populations as a whole including for a randomized no contact control group and among those who are risky drinkers randomized to brief assessment and feedback (routine practice) or to brief assessment only. A three-arm parallel groups trial will also allow exploration of the magnitude of the feedback and assessment component effects. The trial will be undertaken simultaneously in 2 universities randomizing approximately 15,300 students who will all be blinded to trial participation. All participants will be offered routine practice intervention at the end of the study. Discussion: This trial informs the development of routine service delivery in Swedish universities and more broadly contributes a new approach to the study of the effectiveness of online interventions in student populations, with relevance to behaviors other than alcohol consumption. The use of blinding and deception in this study raise ethical issues that warrant further attention.

Monahan CJ; Bracken-Minor KL; McCausland CM; McDevitt-Murphy ME; Murphy JG. Health-related quality of life among heavy-drinking college students. American Journal of Health Behavior 36(3): 289-299, 2012. (54 refs.)

Objective: To examine unique contributions of depression, alcohol consumption, and alcohol-related consequences on functional health outcomes in college students. Methods: Participants were heavy-drinking undergraduate students (N = 207) who completed self-report questionnaires. Results: For men and women, depression predicted overall general health and mental health ratings. For women, depression predicted number of days of role limitations due to poor physical or mental health and number of days of not getting enough sleep or rest. Conclusions: Findings suggest that depression may have a more pervasive association with HRQOL than alcohol misuse or alcohol-related consequences in college students.

Moreno MA; Christakis DA; Egan KG; Brockman LN; Becker T. Associations between displayed alcohol references on Facebook and problem drinking among college students. Archives of Pediatrics & Adolescent Medicine 166(2): 157-163, 2012. (34 refs.)

Objective: To examine the associations between displayed alcohol use and intoxication/problem drinking (I/PD) references on Facebook and self-reported problem drinking using a clinical scale. Design: Content analysis and cross-sectional survey. Setting: Facebook Web site (http: www.facebook.com/). Participants: The study included undergraduate students (age range, 18-20 years) at 2 state universities with public Facebook profiles. Main Exposures: The profiles were categorized into 1 of 3 distinct categories: Nondisplayers, Alcohol Displayers, and I/PD Displayers. Outcome Measures: An online survey measured problem drinking using the Alcohol Use Disorders Identification Test (AUDIT) scale. Analyses examined associations between alcohol display category and (1) AUDIT problem drinking category using logistic regression, (2) AUDIT score using negative binomial regression, and (3) alcohol-related injury using the Fisher exact test. Results: Among 307 profiles identified, 224 participants completed the survey (73% response rate). The average age was 18.8 years; 122 (54%) were female; 152 (68%) were white; and approximately 50% were from each university. Profile owners who displayed I/PD were more likely (odds ratio, 4.4; 95% Cl, 2.0-9.4) to score in the problem drinking category of the AUDIT scale, had 64.0% (incidence rate ratio, 1.64; 95% CI, 1.27-11.0) higher AUDIT scores overall, and were more likely to report an alcohol-related injury in the past year (P=.002). Conclusions: Displayed references to I/PD were positively associated with AUDIT scores suggesting problem drinking as well as alcohol-related injury. Results suggest that clinical criteria for problem drinking can be applied to Facebook alcohol references.

Mundt MP; Zakletskaia LI; Brown DD; Fleming MF. Alcohol-induced memory blackouts as an indicator of injury risk among college drinkers. Injury Prevention 18(1): 44-49, 2012. (36 refs.)

Background: An alcohol-induced memory blackout represents an amnesia to recall events but does not involve a loss of consciousness. Memory blackouts are a common occurrence among college drinkers, but it is not clear if a history of memory blackouts is predictive of future alcohol-related injury above and beyond the risk associated with heavy drinking episodes. Objective To determine whether baseline memory blackouts can prospectively identify college students with alcohol-related injury in the next 24 months after controlling for heavy drinking days. Methods: Data were analysed from the College Health Intervention Project Study (CHIPS), a randomised controlled trial of screening and brief physician intervention for problem alcohol use among 796 undergraduate and 158 graduate students at four university sites in the and one in Canada, conducted from 2004 to 2009. Multivariate analyses used generalised estimating equations with the logit link. Results: The overall 24-month alcohol-related injury rate was 25.6%, with no significant difference between men and women (p=0.51). Alcohol-induced memory blackouts at baseline exhibited a significant dose-response on odds of alcohol-related injury during follow-up, increasing from 1.57 (95% CI 1.13 to 2.19) for subjects reporting 1-2 memory blackouts at baseline to 2.64 (95% CI 1.65 to 4.21) for students acknowledging 6 + memory blackouts at baseline. The link between memory blackouts and injury was mediated by younger age, prior alcohol-related injury, heavy drinking, and sensation-seeking disposition. Conclusions: Memory blackouts are a significant predictor of future alcohol-related injury among college drinkers after adjusting for heavy drinking episodes.

Mundt MP; Zakletskaia LI. Prevention for college students who suffer alcohol-induced blackouts could deter high-cost emergency department visits. Health Affairs 31(4): 863-870, 2012. (34 refs.)

Fifty percent of college students who drink report alcohol-induced blackouts, and alcohol abusers in general put a heavy burden on the medical care system. Using data drawn from a randomized, controlled alcohol intervention trial at five university sites, our study quantified the costs of visits to emergency departments by college students who experienced blackouts from drinking alcohol. Of 954 students in the study, 52 percent of males and 50 percent of females at the outset of the study had experienced an alcohol-induced blackout in the past year. Of 404 emergency department visits among the study participants over a two-year observation period, about one in eight were associated with blackout drinking. Injuries ranged from broken bones to head and brain injuries requiring computed tomography. We calculate that on a large university campus having more than 40,000 students, blackout-associated emergency department visit costs would range from $469,000 to $546,000 per year. We conclude that blackouts are a strong predictor of emergency department visits for college drinkers and that prevention efforts aimed at students with a history of blackouts might reduce injuries and emergency department costs.

Murphy S; Moore G; Williams A; Moore L. An exploratory cluster randomised trial of a university halls of residence based social norms intervention in Wales, UK. BMC Public Health 12: e-article 186, 2012. (18 refs.)

Background: Excessive alcohol consumption amongst university students has received increasing attention. A social norms approach to reducing drinking behaviours has met with some success in the USA. Such an approach is based on the assumption that student's perceptions of the norms of their peers are highly influential, but that these perceptions are often incorrect. Social norms interventions therefore aim to correct these inaccurate perceptions, and in turn, to change behaviours. However, UK studies are scarce and it is increasingly recognised that social norm interventions need to be supported by socio ecological approaches that address the wider determinants of behaviour. Objectives: To describe the research design for an exploratory trial examining the acceptability, hypothesised process of change and implementation of a social norm marketing campaign designed to correct misperceptions of normative alcohol use and reduce levels of misuse, implemented alongside a university wide alcohol harm reduction toolkit. It also assesses the feasibility of a potential large scale effectiveness trial by providing key trial design parameters including randomisation, recruitment and retention, contamination, data collection methods, outcome measures and intracluster correlations. Methods/design: The study adopts an exploratory cluster randomised controlled trial design with halls of residence as the unit of allocation, and a nested mixed methods process evaluation. Four Welsh (UK) universities participated in the study, with residence hall managers consenting to implementation of the trial in 50 university owned campus based halls of residence. Consenting halls were randomised to either a phased multi channel social norm marketing campaign addressing normative discrepancies (n = 25 intervention) or normal practice (n = 25 control). The primary outcome is alcohol consumption (units per week) measured using the Daily Drinking Questionnaire. Secondary outcomes assess frequency of alcohol consumption, higher risk drinking, alcohol related problems and change in perceptions of alcohol-related descriptive and injunctive norms. Data will be collected for all 50 halls at 4 months follow up through a cross-sectional on line and postal survey of approximately 4000 first year students. The process evaluation will explore the acceptability and implementation of the social norms intervention and toolkit and hypothesised process of change including awareness, receptivity and normative changes. Discussion: Exploratory trials such as this are essential to inform future definitive trials by providing crucial methodological parameters and guidance on designing and implementing optimum interventions.

Nies MA; Sun LM; Kazemi D; Carriker A; Dmochowski J. Relationship of body mass index to alcohol consumption in college freshmen. Scientific World Journal : article 849018, 2012. (12 refs.)

Objective. Assess the relationship between body mass index (BMI) and drinking in college freshman. Method. College freshman (N = 199) at a university completed the drinking questionnaires. Drinking amount and the alcohol problem index (RAPI) served as outcomes, and BMI was the independent variable. Results. RAPI scores were associated with gender, amount of drinking, and BMI (P < 0.001, F = 13.44). Increase of RAPI with drinking amount was larger for females (slope = 0.06) than for males (slope = 0.03). Conclusion. This information can be helpful when providing health promotion strategies to college students regarding nutrition modifications that would be most beneficial for their health.

Noonan D; Kulbok PA. Beliefs and norms associated with smoking tobacco using a waterpipe among college students. Journal of Addictions Nursing 23(2): 123-128, 2012. (25 refs.)

This web-based, cross-sectional survey guided by the Theory of Reasoned Action (TRA), examined behavioral beliefs and normative beliefs associated with smoking tobacco using a waterpipe in a sample of 223 undergraduate college students. Beliefs and norms associated with waterpipe smoking intention were captured using the investigator-developed TRA Waterpipe Questionnaire. Significant behavioral beliefs that contributed to the prediction of smoking intentions included smoking tobacco with a waterpipe "will taste pleasant" and "will allow me to have a good time with my friends. "Significant norms that emerged were perceived approval of waterpipe smoking from friends and significant others. Current smoking status, both waterpipe and cigarette, also contributed to the prediction of smoking intention. The variables of the TRA represent prime targets for intervention and provide useful information that can be used to tailor waterpipe prevention messages.

Nova P; Hernandez B; Ptolemy AS; Zeitzer JM. Modeling caffeine concentrations with the Stanford Caffeine Questionnaire: Preliminary evidence for an interaction of chronotype with the effects of caffeine on sleep. Sleep Medicine 13(4): 362-367, 2012. (43 refs.)

Objective: To examine the validity of a novel caffeine intake questionnaire and to examine the effects of caffeine on sleep in college students. Methods: One-week, ad libitum behavior of 50 university students (28 female, 22 male; aged 20.9 +/- 1.78 years) was examined with sleep logs, wrist actigraphy, and a novel daily questionnaire assessing caffeine intake at different times of day. Saliva samples were collected for caffeine assessment (questionnaire validation) and DNA extraction, and for analysis of a single nucleotide polymorphism in the adenosine receptor 2A (ADORA2A) gene. Results: The caffeine questionnaire was able to accurately predict salivary concentrations of caffeine (R-2 = 0.41, P < 0.001). Estimations of integrated salivary caffeine concentration during sleep were correlated with wake after sleep onset (WASO) most strongly in morning-type individuals (R-2 = 0.49; P < 0.001, ANOVA), less so in intermediate chronotypes (R-2 = 0.16; P < 0.001, ANOVA), and not significantly in evening-types (R-2 = 0.00098; P = 0.13, ANOVA). Using multivariate modeling methods we found that the ADORA2A genotype did not moderate the effects of caffeine on WASO, but did independently alter WASO such that those with the CC genotype had nearly three-times as much WASO as those with CT or TT. Conclusions: Our questionnaire was able to accurately predict salivary caffeine concentrations and helped to describe a novel relationship between the effects of caffeine on sleep and genotype and chronotype.

O'Brien KS; Lynott D. Commentary on Larsen et al. (2012): Throwing the baby out with the bathwater - teething problems with implicit attitude-behaviour links. Addiction 107(8): 1429-1430, 2012. (14 refs.)

Orchowski LM; Barnett NP. Alcohol-related sexual consequences during the transition from high school to college. Addictive Behaviors 37(3): 256-263, 2012. (67 refs.)

Alcohol use and risky sexual behavior are significant problems on college campuses. Using a prospective design, the present study sought to explore the relationship between alcohol use and experience of alcohol-related sexual consequences (ARSC) during the transition from high school to the first year of college. During the senior year of high school, and following the first year of college, participants completed assessments of alcohol use, problem drinking behavior, ARSC, and potential influences on drinking behaviors, including parental knowledge of alcohol use, peer influences, motivation for alcohol use, and mood state. Data indicated that 29% of men and 35% of women indicated some form of ARSC during the last year of high school, rates that increased by 6-7% for the first year of college (36% of men and 41% of women). The onset or recurrence of ARSC in college was not explained by differential increases in alcohol use between high school and college. Low levels of positive affect, low motivation to consume alcohol to cope, and high levels of peer alcohol use were associated with repeated ARSC in high school and college; whereas drinking to enhance positive affect and low parental knowledge of alcohol use were associated with the onset of such consequences in college. Implications for intervention are discussed.

Orchowski LM; Creech SK; Reddy MK; Capezza NM; Ratcliff T. College women's perceived risk to experience sexual victimization: A prospective analysis. Violence and Victims 27(2): 194-214, 2012. (74 refs.)

This study implemented a prospective design to explore college women's perceived risk to experience sexual victimization over a 2-month interim (N = 143). Compared to women without such histories, women with a history of unwanted sexual contact via arguments/pressure, or a history of unwanted sexual intercourse via administration of alcohol/drugs reported higher perceived risk to subsequently experience these forms of victimization. Compared to women who were not victimized, women who subsequently experienced unwanted sexual intercourse via administration of alcohol/drugs or arguments/pressure reported higher levels of risk to experience these forms of victimization. Controlling for victimization history, higher levels of risk to experience sexual intercourse over the interim via arguments predicted this form of victimization over the follow-up. Implications are discussed.

Palmer RS; McMahon TJ; Moreggi DI; Rounsaville BJ; Ball SA. College student drug use: Patterns, concerns, consequences, and interest in intervention. Journal of College Student Development 53(1): 124-132, 2012. (14 refs.)

Although previous surveys have indicated high rates of illicit and prescription drug misuse among college students, few have assessed negative consequences, personal concerns, or interest in interventions for drug use. In a survey of 262 college students who self-reported lifetime use of an illicit drug, 69% reported at least one negative consequence over the course of their lifetime and 63% in the past year. Many also reported being moderately concerned (28%) about their drug or medication misuse and moderately interested in some form of intervention (76%). The frequency of marijuana use and medication misuse in the past month was related to increased negative consequences and personal concerns even when controlling for the frequency of past month alcohol use. There were relatively few differences as a function of gender or year in college.

Parada M; Corral M; Mota N; Crego A; Holguin SR; Cadaveira F. Executive functioning and alcohol binge drinking in university students. Addictive Behaviors 37(2): 167-172, 2012. (72 refs.)

Background: Binge drinking (BD) is prevalent among college students. Studies on alcoholism have shown that the prefrontal cortex is vulnerable to the neurotoxic effects of alcohol. The prefrontal cortex undergoes both structural and functional changes during adolescence and young adulthood. Sex differences have been observed in brain maturation and in alcohol-induced damage. The objective of the present study was to analyze the relationship between BD and cognitive functions subserved by the prefrontal cortex in male and female university students. Methods: The sample comprised 122 undergraduates (aged 18 to 20 years): 62 BD (30 females) and 60 non-BD (29 females). Executive functions were assessed by WMS-III (Backward Digit Span and Backward Spatial Span), SOFT (abstract designs), Letter Fluency (PMR), BADS (Zoo Map and Key Search) and WCST-3. Results: BD students scored lower in the Backward Digit Span Subtest and generated more perseverative responses in the SOPT In relation to interaction BD by sex, BD males scored lower in the Backward Digit Span test than BD females and non-BD males. Conclusions: BD is associated with poorer performance of executive functions subserved by the dorsolateral prefrontal cortex. The results do not support enhanced vulnerability of women to alcohol neurotoxic effects. These difficulties may reflect developmental delay or frontal lobe dysfunction.

Pearson MR; D'Lima GM; Kelley ML. Maternal and paternal alcohol misuse and alcohol-related outcomes among college students. Substance Use & Misuse 47(6): 708-717, 2012. (48 refs.)

Using a large college student sample (N = 1,095), the present study examined whether the relationship between parental alcohol abuse and offspring alcohol use varied as a function of parent and offspring gender, and whether the relationship to the non-substance-abusing mother or father buffered against the risk associated with being an adult child of an alcoholic (ACOA). Among women, maternal ACOAs (i.e., the mother only was suspected of alcohol misuse) had the greatest risk of problematic alcohol consumption, whereas among men, both parent ACOAs (i.e., both parents were suspected of alcohol misuse) had the greatest risk of problematic alcohol consumption. No support was found for the buffering hypothesis. We discuss implications of our findings and future directions.

Pinchevsky GM; Arria AM; Caldeira KM; Garnier-Dykstra LM; Vincent KB; O'Grady KE. Marijuana exposure opportunity and initiation during college: Parent and peer influences. Prevention Science 13(1): 43-54, 2012. (48 refs.)

Marijuana is the most prevalent illicit drug used by adolescents and young adults, yet marijuana initiation is rarely studied past adolescence. The present study sought to advance our understanding of parent and peer influences on marijuana exposure opportunity and incident use during college. A sample of 1,253 students was assessed annually for 4 years starting with the summer prior to college entry. More than one-third (38%(wt)) of students had already used marijuana at least once prior to college entry; another 25%(wt) initiated use after starting college. Of the 360 students who did not use marijuana prior to college, 74% were offered marijuana during college; of these individuals, 54% initiated marijuana use. Both low levels of parental monitoring during the last year of high school and a high percentage of marijuana-using peers independently predicted marijuana exposure opportunity during college, holding constant demographics and other factors (AOR = 0.92, 95% CI = 0.88-0.96, p < .001 and AOR = 1.11, 95% CI = 1.08-1.14, p < .001, respectively). Among individuals with exposure opportunity, peer marijuana use (AOR = 1.04, 95% CI = 1.03-1.05, p < .001), but not parental monitoring, was associated with marijuana initiation. Results underscore that peer influences operate well into late adolescence and young adulthood and thus suggest the need for innovative peer-focused prevention strategies. Parental monitoring during high school appears to influence exposure opportunity in college; thus, parents should be encouraged to sustain rule-setting and communication about adolescent activities and friend selection throughout high school.

Plaspohl SS; Parrillo AV; Vogel R; Tedders S; Epstein A. An assessment of America's tobacco-free colleges and universities. Journal of American College Health 60(2): 162-167, 2012. (20 refs.)

Objective: This study examined the extent to which US campuses identified as "100% tobacco-free" by the American Lung Association of Oregon adhered to the American College Health Association's the most recent guidelines and recommendations promoting tobacco-free environments in colleges and universities. Participants: A key informant from 162 of175 institutions (92.6% response rate) completed an online survey between January 2010 and February 2010. Methods: The variables under study were assessed via a cross-sectional research design. Participants completed a 35-item survey regarding their school's tobacco policies, procedures, and enforcement practices. Results: Although the vast majority of schools had written policies and procedures in place, schools with current policies were the most compliant. Numerous opportunities for improved adherence were identified in the results. Conclusions: Findings from this study may help institutions in the development and implementation of a new tobacco policy, as well as strengthen policies among existing tobacco-free schools.

Primack BA; Kim KH; Shensa A; Sidani JE; Barnett TE; Switzer GE. Tobacco, marijuana, and alcohol use in university students: A cluster analysis. Journal of American College Health 60(5): 374-386, 2012. (58 refs.)

Objective: Segmentation of populations may facilitate development of targeted substance abuse prevention programs. The authors aimed to partition a national sample of university students according to profiles based on substance use. Participants: The authors used 2008-2009 data from the National College Health Assessment from the American College Health Association. The sample consisted of 111,245 individuals from 158 institutions. Methods: The sample was partitioned using cluster analysis according to current substance use behaviors. The association of cluster membership with individual and institutional characteristics was examined. Results: Cluster analysis yielded 6 distinct clusters. Three individual factors-gender, year in school, and fraternity/sorority membership-were the most strongly associated with cluster membership. Conclusions: In a large sample of university students, the authors were able to identify 6 distinct patterns of substance abuse. It may be valuable to target specific populations of college-aged substance users based on individual factors. However, comprehensive intervention will require a multifaceted approach.

Ragsdale K; Porter JR; Zamboanga BL; St Lawrence JS; Read-Wahidi R; White A. High-risk drinking among female college drinkers at two reporting intervals: Comparing spring break to the 30 days prior. Sexuality Research and Social Policy 9(1): 31, 2012. (44 refs.)

Alcohol use has increased among college women in the past decade, and although event-specific high-risk drinking is common among college students, few studies have focused on Spring Break-specific high-risk drinking and other risk behaviors among female college drinkers. As such, we compared substance use (e.g., alcohol and marijuana use) and engagement in other risk behaviors (e.g., riding with an impaired driver) in the 30 days prior (T-1) and during Spring Break (T-2) in a sample of 86 female college drinkers (mean age = 19.9, SD = 1.3, 18-23 years). Participants were recruited on a public beach during their Spring Break vacation and were administered a survey that included the TWEAK, a brief screener to identify alcohol use disorder (AUD) risk. Initial results indicated that heavy alcohol use, riding with an alcohol-impaired driver, and marijuana use were high during T-1 and increased significantly during T-2. The TWEAK results indicated that 78% of respondents were at high AUD risk, yet only 25% felt the need to reduce their alcohol consumption. OLS regression results indicated significant relationships between changes in engagement in risk behaviors at T-2 as compared to T-1 across a number of sample characteristics and TWEAK indicators (e.g., age at first drink; age at first sex). Implications for prevention programming targeting female college drinkers are discussed.

Ragsdale K; Porter JR; Mathews R; White A; Gore-Felton C; McGarvey EL. "Liquor before beer, you're in the clear": Binge drinking and other risk behaviors among fraternity/sorority members and their non-Greek peers. Journal of Substance Use 17(4): 323-339, 2012. (39 refs.)

Objective: To examine "college drinking culture" and explore alcohol use and other variables among a sample of US college students. Methods: Bivariate cross tabulation and logistic regression analyses were used to examine associations between alcohol use, gender, Greek membership and risk behaviours among a random sample of 823 undergraduates who completed a health behaviour survey. Results: Respondents who binged were significantly more likely to be male and belong to a fraternity/sorority. Fraternity bingers were significantly more likely to engage in physical fights (p < 0.05) than non-Greek male bingers. Sorority bingers were significantly more likely to be injured (p < 0.01), drive under the influence of alcohol (DUI) (p < 0.001), be sexually victimised (p < 0.01) and engage in unwanted sex (p < 0.05) than non-Greek female bingers. Fraternity members who binged frequently (>= 3 times in 2 weeks) were significantly more likely to DUI (p < 0.01) and engage in unprotected sex (p < 0.05) than were those who binged intermittently. Sorority members who binged frequently were significantly more likely to DUI (p < 0.05) than were those who binged intermittently. Conclusion: Prevention efforts likely to be effective in changing binge drinking among college students should be gender specific, consider peer drinking norms, target "windows of risk" and be tailored to the campus' culture of drinking.

Ralston TE; Palfai TP. Depressive symptoms and the implicit evaluation of alcohol: The moderating role of coping motives. Drug and Alcohol Dependence 122(1-2): 149-151, 2012. (28 refs.)

Background: Depressive symptoms in college students have been associated with a number of indices of hazardous drinking. Investigators have utilized a variety of experimental paradigms to better understand the cognitive-motivational mechanisms that may underlie this association. Implicit cognition studies have provided increasing support for the view that coping motives may moderate the association between negative affect and the incentive value of alcohol. However, less is known about how symptoms of depression may be linked with implicit evaluative responses to alcohol. The current research sought to investigate the association between depressive symptoms and implicit evaluations of alcohol stimuli as measured by an evaluative priming task. Methods: Eighty-two current drinkers completed assessments of depressive symptoms, alcohol use, and drinking motives before engaging in a computerized alcohol evaluative priming task. Results: Analyses showed that the association between depressive symptoms and the positive implicit evaluation of alcohol was moderated by drinking motives, such that the positive association between depression and alcohol evaluation was stronger for students who had higher coping motives. Conclusions: These findings add to our understanding of how depressive symptoms may influence responses to alcohol and provide further support for the view that individual differences in coping motives may be a critical moderator of the association between depressive symptoms and alcohol-related cognitive motivational processes.

Ray AE; Stapleton JL; Turrisi R; Philion E. Patterns of drinking-related protective and risk behaviors in college student drinkers. Addictive Behaviors 37(4): 449-455, 2012. (47 refs.)

Drinking-related protective (e.g., pacing consumption) and risk (e.g., participating in drinking games) behaviors influence both the amount of alcohol consumed and the consequences experienced by college students. Previous studies of these behaviors have typically examined use and predictors of these constructs separately. In the current study, latent profile analysis (LPA) was used to identify latent subgroups of drinkers with distinct patterns of use of both drinking-related protective and risk behaviors in a sample of college students. A random sample of first year student drinkers (N=229, 59.4% female) at a large, public university in the Northeastern United States completed a web-based assessment of drinking-related protective and risk behaviors, alcohol use, and related consequences. Three patterns of use were identified, including: 1) students who used protective behaviors frequently and seldom engaged in risk behaviors (10%), 2) students who used risk behaviors more frequently and used protective behaviors less often (30%), and 3) students who used both risk and protective behaviors at similar frequencies (60%). Significant differences in the distribution of profiles were observed when considering gender, age of onset of alcohol use, and recent drinking outcomes including weekend alcohol use, heavy-episodic drinking, and alcohol-related problems. Prevention and intervention programs may benefit from a focus on not only increasing protective actions, but on also reducing risk behaviors beyond that of quantity and frequency of alcohol use alone.

Read JP; Colder CR; Merrill JE; Ouimette P; White J; Swartout A. Trauma and posttraumatic stress symptoms predict alcohol and other drug consequence trajectories in the first year of college. Journal of Consulting and Clinical Psychology 80(3): 426-439, 2012. (108 refs.)

Objective: College matriculation begins a period of transition into adulthood, one that is marked by new freedoms and responsibilities. This transition also is marked by an escalation in heavy drinking and other drug use as well as a variety of use-related negative consequences. Trauma and symptoms of posttraumatic stress disorder (FTSD) may affect alcohol and drug problems and, thus, may be a point of intervention. Yet, no studies have examined trauma, PTSD, and alcohol and drug problem associations during this developmental period. The present study provides such an examination. Method: Matriculating college students (N = 997) completed surveys in September (Time 1) and at 5 subsequent time points (Time 2 Time 6) over their 1st year of college. With latent growth analysis, trajectories of alcohol- and drug-related consequences were modeled to examine how trauma (No Criterion A Trauma, Criterion A Only, No PTSD Symptoms) and PTSD (partial or full) symptom status predicted these trajectories. Results: Results showed substantial risk for alcohol- and other drug-related negative consequences that is conferred by the presence of PTSD at matriculation. Those with both partial and full PTSD started the year with more alcohol and drug consequences. These individuals showed a steeper decrease in consequences in the 1st semester, which leveled off as the year progressed. Both alcohol and drug consequences remained higher for those in the PTSD group throughout the academic year. Hyperarousal symptoms showed unique effects on substance consequence trajectories. Risk patterns were consistent for both partial and full PTSD symptom presentations. Trajectories did not vary by gender. Conclusions: Interventions that offer support and resources to students entering college with PTSD may help to ameliorate problem substance use and may ultimately facilitate a stronger transition into college and beyond.

Ridout B; Campbell A; Ellis L. 'Off your Face(book)': Alcohol in online social identity construction and its relation to problem drinking in university students. Drug and Alcohol Review 31(1): 20-26, 2012. (40 refs.)

Introduction and Aims. Alcohol is a key component of identity exploration for many young people, yet few studies have investigated identity construction in relation to problematic drinking. Increases in youth alcohol consumption have coincided with expanding use of communications technologies, particularly social networking sites (SNS), which have altered traditional conditions of identity construction. It has been found young people often engage with alcohol in the SNS environment by portraying themselves as binge drinkers. The current study applied an innovative approach to identity construction (the photographic essay) to provide insight into the portrayal of alcohol-identity on Facebook. Design and Methods. One hundred and fifty-eight university students completed a range of alcohol measures before providing access for researchers to view their Facebook profiles to operationalise their alcohol-identity according to autophotographic methodology. Results. Participants utilised a variety of photographic and textual material to present alcohol as a component of their identity on Facebook, with over half having selected an alcohol-related profile image. Alcohol-identity predicted alcohol consumption and problematic alcohol-related behaviours as measured by questionnaires used to reliably identify alcohol-related problems in university students. Almost 60% reported potentially problematic alcohol use according to the Alcohol Use Disorders Identification Test. Discussion and Conclusions. Findings suggest that portraying oneself as a drinker is considered by many young people to be a socially desirable component of identity in the SNS environment, perpetuating an online culture that normalises binge drinking. Ready-made Facebook photo essays provide an alternate method of accessing problematic alcohol use, supplementing self-report measures.

Rodgers KC. A review of multicomponent interventions to prevent and control tobacco use among college students. (review). Journal of American College Health 60(3): 257-261, 2012. (18 refs.)

Objective: Multicomponent tobacco control programs have been implemented at the state and community levels and have led to a reduction in tobacco use. The purpose was to review the public health research literature on tobacco prevention and control programs on college campuses and derive evidence-based implications for comprehensive program implementation. Methods: MEDLINE, PsycINFO, ERIC, and PubMed databases were used to search the research literature concerning tobacco prevention and control programs conducted on college campuses published between 2000 and 2009. Results: No studies were found that implemented all 5 recommended components of a comprehensive program. Tobacco control programs containing policy and prevention education were used the most and promotion of tobacco-free environments and banning sales of tobacco products were used the least. Conclusion: The review suggests that despite the recommendation of comprehensive tobacco control programs to reduce tobacco use on college campuses, few institutions have implemented and evaluated programs consisting of multiple components.

Rohrer JE; Cole LJ; Schulze FW. Cigarettes and self-rated health among online university students. Journal of Immigrant and Minority Health 14(3): 502-505, 2012. (10 refs.)

An increasing number of university students are earning their degrees online. Thus far, the determinants of health among online university students have not been studied. The purpose of this cross-sectional internet survey was to test the association between behavioral risk factors and self-rated health in a diverse sample of online university students. Cigarette smoking was associated with lower odds of good self-rated health (OR = 0.27, P < 0.01). Compared to having zero days of mental distress, 14 or more days of mental distress was associated with lower odds of good self-rated health (OR = 0.08, P < 0.05). White students had lower odds of reporting good self-rated health compared to African-American students (OR = 0.35, P < 0.05). Health education, screening and health promotion programs should be developed for online students.

Rooney M; Chronis-Tuscano A; Yoon Y. Substance use in college students with ADHD. Journal of Attention Disorders 16(3): 221-234, 2012. (84 refs.)

Objective: The college years represent a developmental transition during which the initiation and escalation of heavy drinking set the stage for lifelong difficulties with alcohol and other drugs. Evidence from studies of adolescents and young adults with ADHD suggests that college students with the disorder may be uniquely vulnerable to alcohol- and drug-related problems. However, no studies have examined substance use in college students with ADHD. Method: Tobacco, alcohol, illicit drug use, and associated impairment were examined in 91 college students with (n = 53) and without (n = 38) ADHD. Results: ADHD was associated with increased frequency of tobacco use, higher rates of dangerous or hazardous patterns of alcohol use, and higher levels of impairment related to marijuana and nonmarijuana illicit drug use, independent of conduct disorder history. Conclusion: These findings suggest that college students with ADHD may be at elevated risk for problematic patterns of substance use.

Schleicher HE; Harris KJ; Campbell DG; Harrar SW. Mood management intervention for college smokers with elevated depressive symptoms: A pilot study. Journal of American College Health 60(1): 37-45, 2012. (43 refs.)

Objective: This pilot study examined smoking reduction and cessation among college smokers with elevated depressive symptomatology participating in a group-based behavioral counseling, mood management, and motivational enhancement combined intervention (CBT). Participants and Methods: Fifty-eight smokers (smoked 6 days in the past 30) were randomized to 6 sessions of CBT (n = 29) or a nutrition-focused attention-matched control group (CG; n = 29). Results: Relative to CG participants, significantly more CBT participants reduced smoking intensity by 50% (chi(2)[1, N = 58] = 4.86, p = .028) at end of treatment. Although CBT participants maintained smoking reductions at 3- and 6-month follow-up, group differences were no longer significant. No group differences in cessation emerged. Finally, participants in both groups evidenced increased motivation to reduce smoking at end of treatment (F[1, 44] = 11.717, p =.001, eta p(2) = .207). Conclusions: Findings demonstrate the utility of this intervention for smoking reduction and maintenance of reductions over time among a population of college students with elevated depressive symptomatology.

Schuckit MA; Kalmijn JA; Smith TL; Saunders G; Fromme K. Structuring a college alcohol prevention program on the low level of response to alcohol model: A pilot study. Alcoholism: Clinical and Experimental Research 36(7): 1244-1252, 2012. (62 refs.)

Background: New approaches are needed to bolster the modest effects of campus drinking prevention programs. However, more definitive research on new paradigms is very expensive, and in the current economic climate, progress can be made by evaluating smaller pilot studies. This study describes one such approach. Methods A sample of 18-year-old or older, healthy, drinking freshmen at our university was assigned to 2 groups stratified to be similar on demography, drinking histories, and their level of response (LR) to alcohol. In the spring quarter of the school year, the 32 subjects in each of 2 groups viewed four 45-minute Internet-based videotapes as part of 4 prevention sessions. All 8 modules were based on the same techniques and general content, but the 4 videos for the first group were structured around the validated model of how a low LR affects heavy drinking (the low level of response-based [LRB] Group), with partial mediation by heavier drinking peers, positive alcohol expectancies, and drinking to cope with stress. Videos for the state-of-the-art (SOTA) comparison group did not place the similar prevention messages into the low LR framework. Changes in drinking were evaluated at 3 times: before Module 1, before Module 4, and 1 month after Module 4. Results: Usual and maximum drinks per occasion decreased over time for both high and low LR subjects in both LRB and SOTA groups. As predicted, the low LR students showed greater decreases in the LRB Group, while high LR students showed greater decreases in the more generic SOTA Group. Conclusions: The results support the hypothesis that tailoring prevention efforts to address specific predisposing factors, such as a low LR, may be associated with beneficial effects on drinking quantity. We hope that these data will encourage additional efforts to validate the low LR-based prevention paradigm and test other interventions that are targeted toward predisposing phenotypes such as impulsivity and negative affect.

Scott DM. Magnitude of the problem of drinking alcohol on college campuses. Commentary on "structuring a college alcohol prevention program on the low level of response to alcohol model: A pilot model". Alcoholism: Clinical and Experimental Research 36(7): 1126-1130, 2012. (30 refs.)

Background: The objective of this commentary is to discuss the significance of the study entitled, Structuring a College Alcohol Prevention Program on the Low Level of Response to Alcohol Model: A Pilot Model by Schuckit and colleagues (2012) published in this issue of the Alcoholism: Clinical and Experimental Research. The work by Schuckit and colleagues emphasizes the importance of personalizing an alcohol prevention program for college students. Methods: This pilot model is the result of over 30 years of clinical translational research on an individual's level of response to alcohol. The prevention program is efficient, simple, safe, cost-effective and self-directed. Results: The results indicate the computerized intervention was associated with decreases in drinking overall and students with a low level of response to alcohol showed greater decreases when the prevention program is personalized to focus on how level of response is affected by peer influence, alcohol expectancies, and stress management. It concludes that college students with a low level of response to alcohol will benefit from a prevention program that is personalized to this well documented endophenotype. Conclusions: The findings provide the foundation for developing future longitudinal studies of the proposed prevention program with a larger sample size on diverse campuses. In addition, as mentioned in the Discussion section, future studies could also evaluate the effectiveness of other easily measured clinical endophenotypes known to be associated with alcohol use such as impulsivity, negative effect, and maximum number of drinks per occasion.

Sebena R; El Ansari W; Stock C; Orosova O; Mikolajczyk RT. Are perceived stress, depressive symptoms and religiosity associated with alcohol consumption? A survey of freshmen university students across five European countries. Substance Abuse Treatment, Prevention and Policy 7: article 21, 2012. (68 refs.)

Background: The aim of this study was to investigate the association of perceived stress, depressive symptoms and religiosity with frequent alcohol consumption and problem drinking among freshmen university students from five European countries. Methods: 2529 university freshmen (mean age 20.37, 64.9% females) from Germany (n = 654), Poland (n = 561), Bulgaria (n = 688), the UK (n = 311) and Slovakia (n = 315) completed a questionnaire containing the modified Beck Depression Inventory for measuring depressive symptoms, the Cohen's perceived stress scale for measuring perceived stress, the CAGE-questionnaire for measuring problem drinking and questions concerning frequency of alcohol use and the personal importance of religious faith. Results: Neither perceived stress nor depressive symptoms were associated with a high frequency of drinking (several times per week), but were associated with problem drinking. Religiosity (personal importance of faith) was associated with a lower risk for both alcohol-related variables among females. There were also country differences in the relationship between perceived stress and problem drinking. Conclusion: The association between perceived stress and depressive symptoms on the one side and problem drinking on the other demonstrates the importance of intervention programs to improve the coping with stress.

Seitz CM; Strack RW; Orsini MM; Rosario C; Haugh C; Rice R. Quantifying littered cigarette butts to measure effectiveness of smoking bans to building perimeters. Journal of American College Health 60(4): 331-334, 2012. (10 refs.)

Objective: The authors estimated the number of violations of a university policy that prohibited smoking within 25 ft of all campus buildings. Participants: The project was conducted by 13 student researchers from the university and a member of the local public health department. Methods: Students quantified cigarette butts that were littered in a 30-day period inside the prohibited smoking area of 7 campus buildings (large residential hall, small residential hall, administrative building, 2 academic buildings, campus cafeteria, and student union). Results: Investigators found a total of 7,861 cigarette butts (large residential hall: 1,198; small residential hall: 344; administrative building: 107; 2 academic buildings: 1,123 and 806; campus cafeteria: 2,651; and student union: 1,632). Conclusions: Findings suggest that there is low compliance with the university's smoking policy. The described project may be repeated by students at other universities as a method to advocate for policy change.

Shead NW; Derevensky JL; Fong TW; Gupta R. Characteristics of internet gamblers among a sample of students at a large, public university in southwestern United States. Journal of College Student Development 53(1): 133-148, 2012. (38 refs.)

There is a current lack of descriptive information on college students who gamble on the Internet. With the increasing popularity of Internet gambling, this study aimed to better understand the profile of Internet gamblers among a sample of college students. of 909 students at the University of California Los Angeles who completed an online survey, 8.1% reported gambling for money on the Internet at least once in their lifetime and 5.7% reported Internet gambling within the past year Approximately one third of Internet gamblers were identified as either at-risk or probable pathological gamblers. Males were much more likely to gamble on the Internet compared to females. Those who gambled on the Internet gambled more frequently and were more likely to report indicators of potentially harmful lifestyles (e.g., drinking alcohol, smoking, using marijuana, using illicit drugs, and unhealthy body mass indices) compared to non-Internet gamblers and nongamblers. Poker, the predominant gambling activity, is discussed in terms of its role as the driving force behind Internet wagering among college students.

Silva DAS; Petroski EL. The simultaneous presence of health risk behaviors in freshman college students in Brazil. Journal of Community Health 37(3): 591-598, 2012. (21 refs.)

The objective of this study was to assess the prevalence and factors associated with simultaneous health risk behaviors in freshmen college students enrolled in a Brazilian university. We interviewed 738 students (59.2% men) with average age of 20.1 years (CI 95%: 19.8-20.5). The risk behaviors assessed were smoking habit, alcohol use, unhealthy diet and physical inactivity. Independent variables were sex, age, employment, marital status, maternal education, study shift and socioeconomic level. It was found that 8.7% were smokers, 45.9% showed alcohol abuse, 59.4% had inadequate diet and 18.5% were physically inactive. Of the students, 20.2% showed no risk behavior, 39.1% one behavior, 29.0% two risk behaviors and 11.7% three and/or four risk behaviors. Males (OR: 2.04, CI 95%: 1.13-3.67) and night shift students (OR: 1.83, CI 95%: 1.01-3.33) were more likely to have three and/or four risk behaviors. Health promotion interventions focusing simultaneous behavior changes should be employed at the university.

Stone AM; Merlo LJ. Psychiatric medication-seeking beliefs and behaviors among college students. American Journal of Drug and Alcohol Abuse 38(4): 314-321, 2012. (34 refs.)

Background: Misuse of prescription psychiatric medications is increasing on college campuses. Sources of medications include friends or family, obtaining prescriptions fraudulently or from multiple physicians, and buying drugs online. Objective: This study assessed psychosocial correlates of medication-seeking behaviors in college students to identify characteristics of potential prescription drug misusers. Methods: The sample included 383 participants (59.2% female) recruited from various campus locations and online classes of a Division I university in the southeastern region of the United States, with an enrollment of approximately 50,000 students. Participants anonymously completed self-report questionnaires. Results: Misusers of prescription psychiatric medication were more likely to have health insurance and to know someone else who had misused that medication. They were more likely to endorse positive attitudes regarding medication-seeking. There was a significant correlation between positive medication-seeking beliefs and reported medication-seeking behaviors. The most common and most accepted form of medication-seeking was asking for the medication from a peer. Conclusions: Results suggest the need for further education regarding the dangers of psychiatric medication-seeking, particularly related to seeking medication from peers. Scientific Significance: This study is the first to assess psychosocial characteristics of college students who seek prescription psychiatric medications for misuse. The information obtained may be used for risk assessment and preventive efforts.

Sutfin EL; McNamara RS; Blocker JN; Ip EH; O'Brien MC; Wolfson M. Screening and brief intervention for tobacco use by student health providers on college campuses. Journal of American College Health 60(1): 66-73, 2012. (36 refs.)

Objective: This study assessed college students' reports of tobacco screening and brief intervention by student health center providers. Participants: Participants were 3,800 students from 8 universities in North Carolina. Methods: Web-based survey of a stratified random sample of undergraduates. Results: Fifty-three percent reported ever visiting their student health center. Of those, 62% reported being screened for tobacco use. Logistic regression revealed screening was higher among females and smokers, compared to nonsmokers. Among students who were screened and who reported tobacco use, 50% reported being advised to quit or reduce use. Brief intervention was more likely among current daily smokers compared to current nondaily smokers, as well as at schools with higher smoking rates. Screening and brief intervention were more likely at schools with lower clinic caseloads. Conclusions: Results highlight the need to encourage college health providers to screen every patient at every visit and to provide brief intervention for tobacco users.

Talbott LL; Moore CG; Usdan SL. Social modeling influences and alcohol consumption during the first semester of college: A natural history study. Substance Abuse 33(2): 146-155, 2012. (45 refs.)

The authors examine both the alcohol consumption pattern of freshmen students during their first semester and the degree to which social modeling of peer behavior impacts consumption. A total of 534 students, residing on campus, were prospectively examined at four 30-day intervals. Data were evaluated on the basis of age, gender, and the effects of time using generalized estimating equations (GEEs). Results reflected nonsignificant increases in the amount of alcohol consumed; however, affiliations with alcohol-consuming peer groups was significantly associated with increased alcohol consumption. The mean number of drinks consumed in the past 30 days remained the same for whites (chi(2) = 3.35, 3 df, P = .3411) but increased slightly for blacks (chi(2) = 7.99, 3 df, P = .0462). Prevention programs should include screening for growth in alcohol consumption among first-year university students, and such screenings should include the extent and nature of affiliation with peers who consume alcohol.

Utpala-Kumar R; Deane FP. Heavy episodic drinking among university students: Drinking status and perceived normative comparisons. Substance Use & Misuse 47(3): 278-285, 2012. (34 refs.)

The present study tests the perceived norms hypothesis in relation to different levels of heavy episodic drinking (HED) among university students. In 2007, 303 students from residence halls and the School of Psychology at the University of Wollongong, Australia, completed a questionnaire about their alcohol consumption and associated attitudes and behaviors. Between-groups analyses of variance (ANOVAs) revealed significantly higher AUDIT (Alcohol Use Disorders Identification Test) scores among students in higher-frequency HED groups. Students who engaged in HED tended to underestimate their own drinking when comparing themselves with others. Improving the accuracy of perceptions about one's own drinking in relation to others (normative information) may help reduce levels of HED among students.

VanKim NA; Laska MN. Socioeconomic disparities in emerging adult weight and weight behaviors. American Journal of Health Behavior 36(4): 433-445, 2012. (38 refs.)

Objectives: To explore weight, weight behaviors, and tobacco and alcohol use among emerging adults by parental education and financial strain. Methods: Cross-sectional analyses of 2010 survey data from an urban Minnesota public 4-year university and 2-year community college (n=1201). Results: Low parental education was associated with lower fruit/vegetable consumption and physical activity and more fast food and unhealthy weight control. Financial strain was associated with less physical activity and more unhealthy weight control, binge drinking, and tobacco use. Conclusions: Unique relationships exist between socioeconomic indicators and emerging adult health behaviors. Additional research is needed to understand financial context among emerging adults.

Varvil-Weld L; Mallett KA; Turrisi R; Abar CC. Using parental profiles to predict membership in a subset of college students experiencing excessive alcohol consequences: Findings from a longitudinal study. Journal of Studies on Alcohol and Drugs 73(3): 434-443, 2012. (59 refs.)

Objective: Previous research identified a high-risk subset of college students experiencing a disproportionate number of alcohol-related consequences at the end of their first year. With the goal of identifying pre-college predictors of membership in this high-risk subset, the present study used a prospective design to identify latent profiles of student-reported maternal and paternal parenting styles and alcohol-specific behaviors and to determine whether these profiles were associated with membership in the high-risk consequences subset. Method: A sample of randomly selected 370 incoming first-year students at a large public university reported on their mothers' and fathers' communication quality, monitoring, approval of alcohol use, and modeling of drinking behaviors and on consequences experienced across the first year of college. Results: Students in the high-risk subset comprised 15.5% of the sample but accounted for almost half (46.6%) of the total consequences reported by the entire sample. Latent profile analyses identified four parental profiles: positive pro-alcohol, positive anti-alcohol, negative mother, and negative father. Logistic regression analyses revealed that students in the negative-father profile were at greatest odds of being in the high-risk consequences subset at a follow-up assessment 1 year later, even after drinking at baseline was controlled for. Students in the positive pro-alcohol profile also were at increased odds of being in the high-risk subset, although this association was attenuated after baseline drinking was controlled for. Conclusions: These findings have important implications for the improvement of existing parent- and individual-based college student drinking interventions designed to reduce alcohol-related consequences.

Venegas J; Cooper TV; Naylor N; Hanson BS; Blow JA. Potential cultural predictors of heavy episodic drinking in Hispanic college students. American Journal on Addictions 21(2): 145-149, 2012. (35 refs.)

Heavy alcohol use in college students is a serious health risk. It is unclear how cultural variables impact alcohol use in Hispanic college populations. Here, the relationships between gender, bicultural identity, familism, and adherence to traditional gender roles with heavy episodic drinking (HED) in a Hispanic college sample are assessed. Participants, 80 males and 80 females, were asked to complete a questionnaire packet, which assessed demographic information, as well as measures designed to rate drinking amount and frequency, bicultural integration, familism, and traditional gender role adherence. Average age of the sample was 19.9 years (SD = 3.05), in which the majority of participants were classified as either Freshmen or Sophomores (88.8%). Overall, 47.5% of participants reported engaging in HED, with 51% of men and 44% of women reporting HED. Univariate analyses along with logistic regression were utilized to assess possible differences and correlates of HED. Neither individual predictors nor the overall model were statistically significant. These findings suggest the need for continued assessment of HED in Hispanic college students using other culturally based constructs, as well as psychosocial factors that are found to predict heavy drinking in other ethnocultural college-aged students.

Wagoner KG; Blocker J; Mccoy TP; Sutfin EL; Champion H; Wolfson M. Free alcohol use and consequences: Gender differences among undergraduates. American Journal of Health Behavior 36(4): 446-458, 2012. (48 refs.)

Objective: To examine gender differences in obtaining free alcohol, high-risk drinking, and consequences. Methods: Web-based surveys were administered annually (2003-2005) to random samples of undergraduates (N=10, 729). Results: Gender, race, age under 21, sorority/fraternity membership, lower disposable income, and relationship status were significant predictors of obtaining free alcohol. Frequent obtainers had greater odds of heavy episodic drinking and consequences compared to infrequent obtainers. Females were less likely to report heavy episodic drinking; however, frequently obtaining females were more likely to report heavy episodic drinking. Conclusions: Approximately 25% of undergraduates frequently obtained free alcohol. Females obtained more often, had higher odds of high-risk drinking, and experienced fewer consequences compared to males.

Weaver CC; Martens MP; Smith AE. Do protective behavioral strategies moderate the relationship between negative urgency and alcohol-related outcomes among intercollegiate athletes? Journal of Studies on Alcohol and Drugs 73(3): 498-503, 2012. (32 refs.)

Objective: The purpose of this study was to examine the moderating effect of protective behavioral strategies on the relationship between negative urgency and alcohol outcomes. Method: Participants were college students who endorsed participating in club/intramural or varsity athletics. The students (N = 234; 73.9% female) completed measures of negative urgency, protective behavioral strategies, alcohol use, and alcohol-related problems. Separate hierarchical multiple regression analyses were conducted for each subscale of the Protective Behavioral Strategies Scale to test for moderation. Results: Results indicated that protective behavioral strategies aimed at serious harm reduction moderated the relationship between negative urgency and alcohol use, whereas strategies aimed at avoiding excessive or rapid drinking moderated the relationship between negative urgency and alcohol-related problems. Strategies that involved planning drinking activities in advance did not moderate the relationship between negative urgency and alcohol outcomes. Conclusions: The current investigation provides further evidence for the role of protective behavioral strategies against known risk factors for alcohol use and related problems. Further, the paper suggests that type of strategy used matters when attempting to mitigate the relationship between negative urgency and alcohol outcomes. Limitations and future directions are discussed.

White C; Oliffe JL; Bottorff JL. Smokeless tobacco: A gender analysis and nursing focus. Nursing Clinics of North America 47(1): 149-158, 2012. (37 refs.)

In recent times, rates of consumption of smokeless tobacco have increased significantly amongst specific subgroups of men, particularly young college men. Recent increases in smokeless tobacco consumption have been characterized by a shift from chewing tobacco to moist snuff. In addition to laying out the health risks of moist snuff, this article describes the social and gendered meanings of smokeless tobacco that reinforce its use. Men-centered approaches to raising awareness about the connections between moist snuff and oral cancer and the availability of oral cancer screening are highlighted as 2 key nursing practice considerations.

Wodarski JS; MacMaster S; Miller NK. The use of computer technology to reduce and prevent college drinking. Social Work in Public Health 27(3): 270-282, 2012. (20 refs.)

Underage drinking, or binge drinking, has become a major concern in U.S. society. At The University of Tennessee (UT) a computer-based intervention was put into place for the past 3 years with funding from the Substance Abuse and Mental Health Services Administration (SAMHSA). The intervention was provided to all college students via UT's computer network system and was completed mostly online. Students were given a computerized, standardized assessment of alcohol use, and then a brief intervention was given based on the students' information. The intervention targeted students who were at highest risk for developing unsafe alcohol behaviors and/or increasing prior alcohol consumption habits in their first year of college. More than 54,000 graduate and undergraduate students completed the program. Since the launch of the program binge drinking has dropped 27% on campus, frequent binge drinking dropped 44%, and the number of liquor law violations to 18- to 20-year-olds decreased from 542 in 2004 to approximately 158 in 2007. The use of a computer-based intervention was comprehensive, low cost, and required low maintenance.

Wright LL; Palfai TP. Life goal appraisal and marijuana use among college students. Addictive Behaviors 37(7): 797-802, 2012. (45 refs.)

The current study was designed to examine the motivational context of marijuana use among college students using idiographic and nomothetic goal assessment approaches. One hundred and ninety-eight introductory psychology students completed a questionnaire that included measures of life goals and marijuana use behavior. Forty-three percent of students surveyed reported the use of marijuana in the past 90 days. Students rated a set of five personally salient, self-generated and five normative life goals on a series of dimensions using the personal projects methodology (Little, 1983). Goal meaning and goal efficacy ratings for each type of assessment were studied in relation to the likelihood of marijuana use and the frequency of use among current users. Logistic regression analyses showed that levels of meaning for self-generated life goals and normative academic life goals were independent predictors of whether students used marijuana in the past 90 days. Students who reported high levels of meaning were less likely to have used marijuana in the past 90 days. For students who used marijuana, higher meaning ratings related to involvement in groups/organizations and fitness were correlated with decreased frequency of use. Moreover, ratings of efficacy related to self-generated goals were associated with less frequent use among smokers. These results suggest that meaning related to life goal pursuit may be associated with students' decisions to use marijuana. Potential implications for interventions are discussed.

Zullig KJ; Divin AL. The association between non-medical prescription drug use, depressive symptoms, and suicidality among college students. Addictive Behaviors 37(8): 890-899, 2012. (157 refs.)

Purpose: Studies have substantiated a relationship between drug use, depression, and suicidality. However, little research has examined this relationship with prescription drugs. Given the prevalence of non-medical prescription drug use (NMPDU) among college students, this study explored the association between general and specific NMPDU, depressive symptoms, and suicidality. Methods: Data from the Fall 2008 National College Health Assessment (NCHA) was utilized (N = 22,783). Five separate logistic regression models were employed, with the first combining any NMPDU (antidepressants, painkillers, sedatives, and stimulants) followed by four additional regressions for each drug, and then separated by gender. Models were estimated before and after control for key covariates. Results: Approximately 13% of participants reported NMPDU. After covariate adjustment, those who reported feeling hopeless, sad, depressed. or considered suicide were 1.22-1.31 times more likely to report NMPDU (p<.05). Those who reported feeling hopeless, sad, or depressed were 1.18-1.43 times more likely to report opioid painkiller use; those who reported feeling sad, depressed, or considered suicide were 1.22-1.38 times more likely to report stimulant use; those who reported being depressed were 1.36 times more likely to report sedative use; and those who reported feeling hopeless or depressed were 1.44 and 1.91 times more likely to report antidepressant use (p<.05). When the adjusted models were repeated separately by gender, results were more pronounced for females, especially for females who reported painkiller use. Conclusions: Depressive symptoms and suicidality were significantly associated with greater odds of any NMPDU, with painkiller use (especially for females) representing the greatest correlate among college students. Results suggest that students may be inappropriately self-medicating psychological distress with prescription medications.