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      Self-reported campus alcohol policy and college alcohol consumption: a multilevel analysis of 4592 Korean students from 82 colleges

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          Abstract

          Background

          Campus alcohol policy has been associated with student alcohol consumption in numerous studies. However, more information is required to assess the extent to which school policy affects student drinking behavior; especially when both individual-level sociodemographic characteristics of students and area-level characteristics of college campuses are controlled for. Thus, this paper explores the association between campus alcohol policy and student alcohol consumption among a nationally representative sample of college students in South Korea, while controlling for both individual and area-level characteristics.

          Methods

          We surveyed and analyzed the data of 4592 students from 82 colleges. Multilevel (hierarchical) linear modeling was used to identify the association between campus alcohol policy and alcohol consumption levels, measured via the AUDIT-C (Alcohol Use Disorders Identification Test – Consumption). Controlled individual-level characteristics included sex, year level, major, GPA (grade point average), pocket money, smoking status, stress level, depressive thoughts, suicidal thoughts, and number of clubs/organizations. Controlled area-level characteristics included college type, number of students, number of faculty members, number of workers/administrators, and region.

          Results

          Compared to students unaware of their school’s campus alcohol policy, students who self-reported that their campuses allow drinking in outdoor spaces (β = 0.755 p = 0.010) or in all areas (β = 0.820, p = 0.044) had higher AUDIT-C scores. Students attending schools with a large number of students, males, freshmen, students with low GPA, students with high amounts of pocket money, and smokers also had higher alcohol consumption scores relative to their peers. Alcohol education experience in the form of lectures, mail, and/or campaigns were not associated with student alcohol consumption levels.

          Conclusion

          Our results suggest an association between self-reported campus alcohol policy and student alcohol consumption. College educators and administrators must be aware that relative to students unaware of their school’s campus alcohol policy, students at colleges that allow drinking in outdoor spaces or all areas consume higher amounts of alcohol than their peers; even when area-level factors are controlled for.

          Trial registration

          Yonsei IRB (IRB number: Y-2017-0084). https://irb.yonsei.ac.kr Date of registration: 01/2017. Date of enrolment of first participant to trial: 03/01/2017. Y-2017-0084.

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          Most cited references27

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          Mental health of college students and their non-college-attending peers: results from the National Epidemiologic Study on Alcohol and Related Conditions.

          Although young adulthood is often characterized by rapid intellectual and social development, college-aged individuals are also commonly exposed to circumstances that place them at risk for psychiatric disorders. To assess the 12-month prevalence of psychiatric disorders, sociodemographic correlates, and rates of treatment among individuals attending college and their non-college-attending peers in the United States. Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093). Analyses were done for the subsample of college-aged individuals, defined as those aged 19 to 25 years who were both attending (n = 2188) and not attending (n = 2904) college in the previous year. Sociodemographic correlates and prevalence of 12-month DSM-IV psychiatric disorders, substance use, and treatment seeking among college-attending individuals and their non-college-attending peers. Almost half of college-aged individuals had a psychiatric disorder in the past year. The overall rate of psychiatric disorders was not different between college-attending individuals and their non-college-attending peers. The unadjusted risk of alcohol use disorders was significantly greater for college students than for their non-college-attending peers (odds ratio = 1.25; 95% confidence interval, 1.04-1.50), although not after adjusting for background sociodemographic characteristics (adjusted odds ratio = 1.19; 95% confidence interval, 0.98-1.44). College students were significantly less likely (unadjusted and adjusted) to have a diagnosis of drug use disorder or nicotine dependence or to have used tobacco than their non-college-attending peers. Bipolar disorder was less common in individuals attending college. College students were significantly less likely to receive past-year treatment for alcohol or drug use disorders than their non-college-attending peers. Psychiatric disorders, particularly alcohol use disorders, are common in the college-aged population. Although treatment rates varied across disorders, overall fewer than 25% of individuals with a mental disorder sought treatment in the year prior to the survey. These findings underscore the importance of treatment and prevention interventions among college-aged individuals.
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            The Epidemiology of Binge Drinking Among College-Age Individuals in the United States

            Rates of alcohol consumption continue to be a concern, particularly for individuals who are college age. Drinking patterns have changed over time, with the frequency of binge drinking (consuming four/five or more drinks for women/men) remaining high (30% to 40%). Young adults in the college age range are developmentally and socially at higher risk for drinking at binge levels. Changes in autonomy, parental control, norms, and attitudes affect binge drinking behaviors. This article reviews those changes, as well as the individual and environmental factors that increase or decrease the risk of participating in binge drinking behaviors. Risk factors include risky drinking events (e.g., 21st birthdays), other substance use, and drinking to cope, while protective factors include religious beliefs, low normative perceptions of drinking, and use of protective behavioral strategies. Additionally, this article discusses the physical, social, emotional, and cognitive consequences of consuming alcohol at binge levels. Alcohol policies and prevention and intervention techniques need to incorporate these factors to reduce experiences of alcohol-related problems. Targeting policy changes and prevention and intervention efforts toward young adults may increase effectiveness and prevent both short- and long-term consequences of binge drinking.
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              What we have learned from the Harvard School Of Public Health College Alcohol Study: focusing attention on college student alcohol consumption and the environmental conditions that promote it.

              The Harvard School of Public Health College Alcohol Study surveyed students at a nationally representative sample of 4-year colleges in the United States four times between 1993 and 2001. More than 50,000 students at 120 colleges took part in the study. This article reviews what we have learned about college drinking and the implications for prevention: the need to focus on lower drink thresholds, the harms produced at this level of drinking for the drinkers, the secondhand effects experienced by other students and neighborhood residents, the continuing extent of the problem, and the role of the college alcohol environment in promoting heavy drinking by students. In particular, the roles of campus culture, alcohol control policies, enforcement of policies, access, availability, pricing, marketing, and special promotions of alcohol are highlighted.
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                Author and article information

                Contributors
                ecpark@yuhs.ac
                Journal
                Subst Abuse Treat Prev Policy
                Subst Abuse Treat Prev Policy
                Substance Abuse Treatment, Prevention, and Policy
                BioMed Central (London )
                1747-597X
                1 February 2020
                1 February 2020
                2020
                : 15
                : 9
                Affiliations
                [1 ]ISNI 0000 0004 0470 5454, GRID grid.15444.30, Institute of Health Services Research, , Yonsei University, ; Seoul, Republic of Korea
                [2 ]ISNI 0000 0004 0470 5454, GRID grid.15444.30, Department of Public Health, Graduate School, , Yonsei University, ; Seoul, Republic of Korea
                [3 ]ISNI 0000 0004 0532 3933, GRID grid.251916.8, Department of Preventive Medicine, , Ajou University College of Medicine, ; Gyeonggi Suwon, Republic of Korea
                [4 ]ISNI 0000 0004 0470 5454, GRID grid.15444.30, Department of Preventive Medicine, , Yonsei University College of Medicine, ; 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752 South Korea
                Author information
                http://orcid.org/0000-0001-5709-2311
                Article
                255
                10.1186/s13011-020-0255-9
                6995649
                32007097
                a25c6d00-0d0b-4cd4-a5cf-e3c98499b6db
                © The Author(s). 2020

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 8 July 2019
                : 20 January 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100003669, Korea Centers for Disease Control and Prevention;
                Award ID: 11180165
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2020

                Health & Social care
                college drinking,college alcohol policy,audit-c,campus policy,alcohol education

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