Elsevier

Addictive Behaviors

Volume 35, Issue 11, November 2010, Pages 913-924
Addictive Behaviors

Drinking at European universities? A review of students' alcohol use

https://doi.org/10.1016/j.addbeh.2010.06.015Get rights and content

Abstract

Background

High volumes of alcohol consumption and risky single occasion drinking (RSOD) among university students have been shown to be associated with considerable harm to both those who consume alcohol and their fellow students. The vast majority of these studies are based on US and Canadian samples.

Aim

The present article provides an overview of the characteristics of alcohol-consuming university students in Europe.

Method

65 relevant articles published within the last 20 years using European student populations could be identified.

Results

Sociodemographic, individual, social, and university-related characteristics associated with alcohol consumption patterns could be identified. Male students, in particular, tended to consume alcohol more often and in higher quantities, including RSOD. Students consumed alcohol chiefly during social gatherings and for social and enhancement motives. Those without family obligations and those living alone, with roommates or in areas with a high density of students were more likely to consume alcohol in higher quantities, and to engage in RSOD. Students tend to overestimate the extent of their fellow students' alcohol consumption.

Conclusions

Health promotion and prevention efforts which focus on these characteristics (i.e., gender, drinking motives, living conditions and social norms), and which have been successful and evaluated among university students in the US and Canada, may also be very promising for their European counterparts.

Research Highlights

► reviews research on student’s alcohol use in Europe in the past 20 years. ► international collaborations and cross-national comparable surveys are only emerging. ► subgroups of students with a risky alcohol consumption are described. ► recommendation for effective health promotion and preventive actions are given.

Introduction

High-volume alcohol consumption and risky single occasion drinking (RSOD) drinking are the leading causes of injury and death among university students and young adults. They are associated with personal adverse consequences, such as academic failure, unintended pregnancy, sexually transmitted diseases, property damage, and criminal consequences that jeopardize future job prospects (Berkowitz and Perkins, 1986, Cook and Moore, 1993, Hingson et al., 2002, Perkins, 1992, Wechsler et al., 1995). In addition, there are second-hand consequences for fellow students, ranging from disrupted study and sleep to physical and sexual assault (Brener and Collins, 1998, Donovan et al., 1993, Hingson et al., 2002, Jessor and Jessor, 1977, Osgood et al., 1988, Perkins, 2002). Analyzing patterns of heavy drinking among university students is crucial because they tend to engage in riskier alcohol consumption than their non-university peers (Johnston et al., 2001, O'Malley and Johnston, 2002, Wechsler et al., 1994, Wechsler et al., 1995). However, these findings are almost exclusively based on research among university students in the US and Canada.

Beginning with the pioneering work by Straus and Bacon (1953), research on alcohol use among university students has a long tradition in the US and Canada. An unrefined literature search with “Pubmed” using the keywords “college students” (the North American pendant to the European term “university student” which is used here), “alcohol”, “USA” and “Canada” indicates over 1000 published articles during the past 20 years; about 50 of these are literature reviews. By comparison, few empirical studies have been conducted among university students in Europe (Karam et al., 2007, Stock et al., 2009). Serious doubts on whether insights into alcohol use from the US and Canada can be easily transferred to other drinking cultures have been raised by several authors who were involved in surveys of the general population (Kuntsche et al., 2004, Room and Mäkelä, 2000) and of university students in particular (Delk and Meilman, 1996, Engs et al., 1991). Besides differences in drinking cultures (Heath, 1995), three main factors may limit the possibility of transferring findings on the US and Canadian university student population to Europe.

First, the legal drinking age in most European countries ranges from 16 to 18 (19 in Nordic countries), while in the US it is 21, and in Canada it is 18 or 19 (World Health Organization (WHO), 2004).

Second, large cross-cultural studies among adolescents, such as ESPAD (European School Survey Project on Alcohol and Other Drugs) or HBSC (Health Behaviour in School-aged Children), consistently indicate a lower prevalence of regular alcohol consumption and RSOD in the US compared to European countries (Hibell et al., 2004, Langness et al., 2005, Schmid and Nic Gabhainn, 2004). This means that the prevalence of alcohol consumption may be higher among European freshmen than among their North American peers.

Third, European university systems differ considerably from those in the US and Canada. While US students at greatest risk of problematic patterns of alcohol consumption tend to be members of sororities, fraternities or special athletic clubs (Ham and Hope, 2003, Sher et al., 2001, Turrisi et al., 2006), this type of campus system with the accompanying drinking culture is far less common in Europe. Only one empirical study reviewed here reports the frequency of fraternity and sorority membership (Keller, Maddock, Laforge, Velicer, & Basler, 2007), but membership rates were too low (only 2%) to explore its association with alcohol consumption. Similarly, the university sport culture is completely different in Europe. While sports activities in North America are almost exclusively organized in schools, high schools or universities, in Europe these tend to take place in clubs outside of the education system.

In spite of differences in drinking cultures and alcohol policies, prevention strategies that have been successful among US and Canadian university students (Hunter Fager and Mazurek Melnyk, 2004, Larimer and Cronce, 2007, Moreira et al., 2009, Toomey et al., 2007) may be instructive for the planning of health promotion and prevention programs at European universities. To enable such a transfer of knowledge, however, it is important first to identify which groups of university students in Europe are at greatest risk of heavy alcohol use and RSOD. The present article provides an overview of individual (e.g., sociodemographics, drinking motives), social (e.g., living situation) and university-related (e.g., academic field) characteristics of alcohol-consuming university students in Europe.

Section snippets

Definitions of alcohol consumption

To investigate alcohol consumption a variety of definitions and measurements are currently in use in Europe. For example, no international and only few national standards have been established to define RSOD (for review see Gmel, Rehm, & Kuntsche, 2003). Reported prevalence and consumption indicators would therefore not be directly comparable between studies since culture-related variations and methodological differences are confounded. As associations between alcohol consumption and university

Gender

In about half of the studies which reported students' alcohol consumption separately by gender, male students were more likely to use alcohol (CRO: Trkulja, Živcec, Cuk, & Lackovic, 2003; ITA: DiGrande, Perrier, Lauro, & Contu, 2000; GRE: Mammas et al., 2003; IRL: Boland et al., 2006; ROU: Dumitrescu, 2007; SWE: Andersson, Johnsson, Berglund, & Ojehagen, 2007; various: Dantzer, Wardle, Fuller, Pampalone, & Steptoe, 2006). In nearly all studies, among drinkers male students consumed alcohol at a

General conclusions and comments

Alcohol consumption among university students has been explored extensively during the past decades in the US and Canada. For Europe, this is a relatively new, but growing field of research: almost half of the studies reviewed here have been published in the past five years. While the UK can look back on a longer tradition of research among university students (for a review see Gill, 2002), in most other countries considerably less research using student samples which were representative for

Role of Funding Sources

Funding for this review has been provided by the Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA). The SIPA had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or in the decision where to submit the paper for publication. The authors' views expressed in this review do not necessarily reflect the official positions by the SIPA.

Contributors

The outline of this review was planned by all three authors. The first author conducted the literature research and wrote the first draft of the manuscript. All three authors contributed to and approved the final manuscript.

Conflict of Interests

All authors declare that they have no conflicts of interest.

Acknowledgement

We thank the two anonymous reviewers for their comments.

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