Why Underage College Students Drink in Excess: Qualitative Research Findings

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ABSTRACT

Background: Excessive alcohol consumption by underage students is a serious and persistent problem facing most U.S. colleges and universities. Purpose: This qualitative study explores why underage students engage in high-risk drinking and examines motivational cues that may serve as behavioral deterrents. Methods: Focus groups were conducted with college students under the age of 21 years (N=59) attending a large university in the southeast. All participants reported consuming five or more drinks in one sitting within the last two weeks (four or more for a female). Results: Participants attach positive expectancies to alcohol use, including peer influence/support and reduction of social anxiety. Negative social consequences such as embarrassment and relationship issues, including perceived sexual opportunities, were cited as disincentives for excessive drinking. Gender distinctions were present among the referenced costs and benefits of excessive alcohol consumption. Discussion: Overall, the negative consequences associated with excess drinking by underage college students are outweighed by positive expectancies such as social approval and acceptance by their peers. Translation to Health Education Practice: Understanding the language, motives and expectancies young people attach to alcohol use can enhance the efficacy of health education and prevention efforts.

BACKGROUND

The practice of high-risk drinking may be regarded as the most serious health problem faced by U.S. colleges and universities. (1,2) Recent findings by Hingson and colleagues indicate a lack of overall progress in attempts to reduce alcohol-related mortality and morbidity rates among 18-to-24-year-old college students)National College Health Assessment data collected in the fall of 2006 indicate that approximately 32% of female and 47% of male college students engage in high-risk drinking, (3) defined as the consumption of at least five or more drinks for men or four or more drinks for women on at least one occasion in the past two weeks. (4) Previous studies also reveal that high-risk drinking rates among college students are greater than rates among their same-age peers not attending college. (1,5,6) This pattern of high-risk drinking results in serious negative consequences for college students including unintentional injuries, risky sexual behavior, violence, academic difficulties and trouble with the law. (1,8) Further, based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, nearly one-third of college students meet the criteria for a formal diagnosis of alcohol abuse, and one in 17 can be classified as alcohol dependent. (4) In order to address this problem, the U.S. Surgeon General established a national health goal aimed at reducing high-risk drinking among college students by 50% by the year 2010; (6,7) a goal that is unlikely to be achieved.

A specific problem for senior administrators at colleges and universities involves the high percentage of underage students who engage in drinking. Wechsler and colleagues estimate that underage alcohol consumption by college students represents about half of the overall alcohol consumption among college students. (9) However, of particular concern are estimates indicating that 90% of underage alcohol consumption occurs under conditions meeting the criteria for "binge" or high-risk drinking. (10) As a result, institutions of higher education are an important setting for reaching young people and improving their health status.

The increased national attention focusing on high-risk college drinking has prompted universities to initiate or increase their prevention efforts? Yet, several national studies indicate little or no change in the high-risk drinking rate among college students. (1,4,10-12) Given the continued pervasiveness of high-risk drinking among college students, recent efforts have focused on understanding the nature of problem drinking. (13) However, current research on college drinking is dominated by large-scale survey-based (quantitative) studies such as the Monitoring the Future Survey and the CORE Alcohol and Drug Surveys. (5,6,14) These studies have played an important role in directing alcohol education, prevention and promotion efforts through identification of the many social and cultural factors influencing excess alcohol consumption among college students. However, the unremitting rate of excess drinking among college students suggests that other forms of data, such as qualitative data, may be useful in augmenting present health education and prevention efforts. (6) A major challenge facing health education efforts in this arena is understanding what motivates underage students to engage in excess drinking and identifying factors that might serve as deterrents to the behavior. Previous research using a qualitative approach revealed complex perspectives regarding alcohol use among Hispanic college students and provided evidence that individual perspectives vary according to context and outcomes. (6)

PURPOSE

The purpose of this study was to gain greater insight into issues associated with excess drinking among underage college students. More specifically, our goal was to identify benefits and barriers relating to excessive drinking as perceived by underage college students. The overarching goal of this study was to gain a personally relevant perspective of excess drinking among underage college students for the purpose of designing highly targeted health messages to discourage the behavior and reduce associated negative consequences.

METHODS

Based on their ability to add depth to research findings, focus groups were conducted to better understand college students' attitudes and expectations regarding excessive drinking (consuming five or more drinks in one sitting for a male and four or more drinks in one sitting for a female). Prior to implementation, the protocol for this study was approved by the University's Institutional Review Board (IRB). Focus group questions were designed to: (1) determine student motives for drinking in excess, (2) identify deterrents to mitigate alcohol consumption, (3) explore the psycho-social differences between male and female drinking patterns, and (4) determine how and where students acquire alcohol-related information.

Focus groups (4 male and 3 female) were conducted during the 2006 fall semester. Participants were recruited for the study through a classified ad in the school newspaper and flyers distributed on-campus. Inclusion data required participants to be currently enrolled in university classes, between the age of 18 and 20 years, and to have consumed five or more drinks in one sitting within the last two weeks (four or more drinks for a female).Volunteers were prescreened prior to being appointed to a …