College Student Binge Drinking

College Student Binge Drinking - J. DRUG EDUCATION, Vol....

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J. DRUG EDUCATION, Vol. 34(3) 247-266, 2004 COLLEGE STUDENT BINGE DRINKING AND THE “PREVENTION PARADOX”: IMPLICATIONS FOR PREVENTION AND HARM REDUCTION* ELISSA R. WEITZMAN, SC.D., M.SC. TOBEN F. NELSON, M.S. Harvard School of Public Health ABSTRACT Considerable attention has been paid to heavy episodic or “binge” drinking among college youth in the United States. Despite widespread use, the binge measure is perceived by some as a low intervention threshold. We use data from the Harvard School of Public Health College Alcohol Study ( n = 49,163) to describe patterns of consumption and harms along a continuum including the binge measure to demonstrate the validity of the binge threshold and prevention paradox in college. While the heaviest drinkers are at greatest risk for harm, they are relatively few and generate proportionately small amounts of all drinking-harms. The risk of harms is not zero among lower level drinkers in college. Because they are numerous, they account for the majority of harms. This paradoxical pattern suggests we moderate consumption among the majority using environmental approaches, the efficacy of which are described using case study data from a national prevention demonstration. Implications for prevention policy, programming, and media advocacy are discussed. *Data used in this article were collected with the generous support from the Robert Wood Johnson Foundation. 247 Ó 2004, Baywood Publishing Co., Inc.
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INTRODUCTION The problem of heavy episodic or “binge” drinking among young adults in college in the United States has received considerable attention from researchers, college administrators, substance abuse educators, students, parents, politicians, and the media [1]. Defined as 5/4 consecutive drinks among men/women at least once in the two weeks prior to be surveyed, binge drinking occurs among two out of every five U.S. college students, half of whom did so multiple times [2]. Binge drinking may typify consumption among other populations of drinkers in the United States as well [3]. Despite its common use and its stability in repeated national surveys [1, 4], the binge measure is controversial. Some think that the 5/4 drinking measure is too low a threshold on which to base preventive interventions [5, 6]. This perspective may reflect a belief that heavy drinking among youth is a normal expression of experimentation and development and that chronic effects of long-term alcohol use and diagnosable alcoholism are more salient consequences, which college students are likely to avoid when they reduce their consumption after leaving college [7]. This perspective is not supported by recent longitudinal study [8]. Attempts to address problems associated with the heavy drinking of college students have employed a variety of methods, including increased punitive sanctions, expedited judicial process, and counseling and treatment for problem drinkers [9]. Social marketing strategies that promote a latent healthy drinking
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College Student Binge Drinking - J. DRUG EDUCATION, Vol....

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