Background
Underage alcohol consumption has received a significant amount of attention as a major public health concern [
1]. High risk drinking in adolescence is associated with a variety of adverse consequences, including motor vehicle injury and death, suicide, sexual assault, high-risk sexual activity, and neurodevelopmental impairment [
2‐
7]. Drinking in early adolescence is also known to increase the risk for alcohol dependence [
8,
9].
While drinking alcohol in college is often seen as an expected rite of passage, heavy drinking among college students adversely affects students' health, safety, and academic performance [
10,
11]. The 2005
Monitoring the Future survey indicated that while 8.6% of male and 2.3% of female full-time college students drink every day, a much larger proportion have had five or more drinks in a row in the past two weeks (50.1% of males and 34.4% of females) [
12]. Unfortunately, the trend line for this indicator of heavy episodic drinking has remained fairly flat and hovered in the region of 40% on average over the last twenty-six years, with a peak of 45.4% in 1984 [
13]. As Schulenberg et al. [
14] describes, the developmental transition from high school to college and the achievement of milestones beyond college can be compromised by heavy alcohol consumption during the first few years of college. Moreover, recent studies have estimated that one-quarter to one-third of college students meet standard criteria for an alcohol use disorder and few seek treatment while attending college [
15‐
17].
Taken together, the mass of scientific literature regarding college student drinking makes the problem appear almost intractable unless new prevention and intervention strategies are developed and embraced by college administrators, parents, and health care professionals. To this end, researchers have attempted to identify risk factors which then could become targets of interventions. Several cross-sectional studies have identified sociodemographic and other individual-level characteristics that are associated with increased risk for excessive alcohol consumption among college students. For instance, males are heavier drinkers than females [
18], White students have higher rates of drinking than minority groups, and members of sororities and fraternities drink significantly more than non-members [
19,
20]. Consistent with other findings showing a protective effect of religiosity on alcohol consumption among high school students [
21], Patock-Peckham et al. [
22] found that intrinsic religiosity was associated with a lower risk for college students' drinking.
In addition to sociodemographic characteristics, several studies have shown that high school drinking patterns are highly predictive of college drinking patterns; however, surprisingly few longitudinal studies have been conducted on the risk factors for escalation of drinking during the transition from high school to the first year of college. The
Monitoring the Future survey, while very useful for describing trends in drinking and identifying differences between college and non-college attending peers [
12,
19], is limited in scope with respect to possible predictors of college drinking patterns. Baer et al. [
23] observed that being male, having Greek system affiliations, and having conduct problems were risk factors for increased drinking in college among a selected sample of 366 high school students who were heavy drinkers. Sher and Rutledge [
24] conducted a much larger study of over 3,000 college students using a systematic sampling design, and found a high degree of continuity in the level of alcohol consumption between high school and the first semester of college. Moreover, 54% of the variance in heavy college drinking could be predicted by sex, race, pre-college cigarette use, religiosity, peer drinking norms and ease of obtaining alcohol in high school.
None of the aforementioned longitudinal studies explored whether pre-college parenting practices influence the risk for drinking in college students, despite the substantial body of literature demonstrating the important influences of family characteristics, especially parental drinking behaviors, parent-child relationships, communication, and parental monitoring, on the risk for underage alcohol use [
25‐
29]. Using both cross-sectional and prospective designs, studies have consistently demonstrated that effective parenting practices have a strong impact on reducing the risk of early adolescent alcohol consumption. Different facets of effective parenting have all been shown to be important, including parental monitoring and supervision, expression of unambiguous disapproval of underage drinking, and low levels of parent-child hostility. For example, Nash et al. [
30] studied a cohort of high school students (all in 9
th grade at the start of the study) and found that higher levels of parental disapproval of alcohol use were associated with lower levels of alcohol use in 12
th grade, as compared to students whose parents had low levels of disapproval. The results of that study also suggested that the effects of parental disapproval were mediated by lower levels of peer influence over drinking behaviors [
30]. Additionally, Chilcoat and Anthony [
31] evaluated 8 to 10 year old children during a three-year period and found that increased levels of parental monitoring and supervision were associated with a 1.6-fold reduction in drug use initiation even holding constant baseline monitoring. In that study, adolescents in the highest parental monitoring quartile experienced a 2-year delay in the onset of drug use compared to adolescents in the lowest quartile of parental monitoring. Similarly, Guo et al. [
32] studied a youth cohort from age 10 through 21 and observed that clear rules and close parental monitoring during early adolescence were associated with lower risk for alcohol abuse and dependence during later adolescence. As a final example, Beck et al. [
33] found that teens aged 12 to 17 who were monitored more closely were less likely to drink than their less-monitored counterparts, even when controlling for age, gender, drinking at baseline, and being in various high-risk situations, such as seeing teens drink, hanging out with friends who drink, and riding with a driver who had been drinking.
Although the bulk of evidence on parental monitoring and decreased risk for alcohol consumption stems from research on young adolescents, a few studies involving college students warrant mention. First, Turrisi et al. [
28] found evidence that teens whose parents who were educated about binge drinking and communication strategies with their teenager experienced fewer alcohol-related problems than a control group. Second, Weitzman et al. [
34] analyzed changes in drinking behavior and found that parental attitudes and use were related to a college student's likelihood of engaging in binge drinking. This study, however, did not look at specific parental supervision or parental monitoring behaviors and measures. Third, Sessa [
35] conducted a small study of 106 male college students and found that higher perceived parental monitoring during college was related to less alcohol and marijuana use among commuter students, but not residential students. Lastly, in a small convenience sample of college students, Jung [
36] observed a correlation between closeness of the parent-student relationship and similarity between parent and student alcohol consumption.
The present study aimed to determine the extent to which the level of parental monitoring and supervision during the last year of high school might account for variation in alcohol consumption during the first year of college. Consistent with prior literature, we expected that students who experienced higher levels of parental monitoring and supervision during their last year in high school would consume less alcohol during high school. Moreover, we hypothesized that pre-college alcohol consumption levels would significantly predict the level of alcohol consumption in college. Lastly, we tested the hypothesis that parental monitoring would exert a significant protective, albeit indirect, effect on college drinking that would be mediated by reductions in high school drinking level.
Discussion
Consistent with prior studies with younger adolescents [
32], this study observed that higher levels of parental monitoring and supervision were associated with lower levels of high school alcohol consumption, independent of sex, race and religiosity. Moreover, it appears that parental monitoring may exert an indirect protective effect on college drinking through its effect on high school drinking.
The findings of this study must be tempered by several limitations. First, because students were sampled from one university, findings may not be generalizable to other college student populations, for example at smaller colleges or where different demographic characteristics or geographic regions are represented. Second, this study only measured one facet of college drinking, future studies should attempt to see if other measures of drinking provide varying results. The distribution of responses for our drinking measure was skewed positively for both high school drinking (.35) and college drinking (.78), because the proportion of non-drinkers was higher than expected in a normal distribution (15.8% and 7.7%, respectively). However, we obtained similar results from replicating the multivariate models in a restricted sample that excluded non-drinkers. Nevertheless, results should be interpreted cautiously whenever the criterion variable in a regression model is not normally distributed. Third, although a standard measure of parental monitoring was used in this study, the construct being measured might be highly correlated with positive child characteristics and not simply parent behaviors. For example, the item pertaining to leaving a note is both a reflection of the child's willingness to conform to prosocial behavior and perhaps the expectation set by parents about the need to leave a note. Future studies should attempt to disentangle the relative effects that are more child-driven from behaviors that are under the parents' control, such as taking away privileges if a student comes home past curfew. Fourth, it is important to recognize that the measure of parental monitoring used in the present study is limited to only one facet of effective parenting, namely the student's perception of parental monitoring, and may not necessarily reflect actual parent behavior. Moreover, our measure may be a proxy for the presence of other parenting behaviors, such as parental disapproval of underage drinking [
42], and effective parent-child bonding and communication [
43,
44], which also have been found to be associated with risk of adolescent tobacco and alcohol use.
Fifth, the observed protective effect of parental monitoring during the last year of high school could be interpreted to be a marker of effective parenting throughout adolescence. Unfortunately, the current study did not measure parent monitoring and supervision during earlier developmental periods.
This study is also limited in its ability to explain the mechanism by which parental monitoring exerts its protective effects. Several studies have suggested that parental monitoring might limit affiliation with deviant peers [
45‐
47], or might be a sign of lower family conflict, higher quality and/or quantity of communication, greater parental warmth, or greater parent-child attachment [
27,
36,
48,
49]. Also, higher levels of willingness to cooperate with parents might indicate a desire to model healthy drinking behaviors of parents, which may be subsequently translated into a reduced risk for heavy drinking in college [
36]. Prior evidence indicates that children develop positive attitudes about alcohol use when their parents drink more and hold positive alcohol-related expectancies [
1]. Conversely, adolescents whose parents have negative attitudes toward alcohol and disapprove of underage drinking, show lower levels of alcohol use, are more likely to engage with peers who also do not drink, and have a higher level of self-efficacy for alcohol refusal [
30]. This study did not measure the possible direct influence of peer alcohol use, or individual expectancies related to alcohol use, which have been shown to be important predictors of college alcohol consumption [
50]. Future research should aim to understand the interplay between these sorts of family characteristics and college alcohol drinking patterns, and examine how a child's temperament characteristics may influence this already complex chain of variables. In addition, other environmental characteristics, such as price [
51] or campus policies, should be examined.
Conclusion
Despite the above limitations, the present findings have implications for both prevention and future research. Based on our findings, we speculate that with regard to prevention, the results extend support for parental monitoring and supervision during the high school years as a strategy to reduce adolescent drinking. An interesting policy debate exists around the degree to which parents should be involved in monitoring their college student's behavior related to alcohol consumption, since, legally their children are adults. There is more, but not unanimous, agreement pertaining to involving parents when there is a life-threatening situation involving their child. For example, not all universities have mandatory parental notification policies in cases of alcohol poisoning. The issue raised by the results of this study is whether it might be useful to engage parents at an earlier stage – namely, in prevention strategies to reduce underage drinking during college. While the results of this study showed that parental monitoring during the last year of high school was associated with reduced levels of high school drinking, and high school drinking levels in turn predicted college drinking levels, it would be important to know whether continued parental involvement in college had additional benefits on reductions in college student drinking over and above the effects of high school drinking levels. Evaluations of programs that focus on modifying parenting practices have shown promising results in reducing risk among younger adolescents. Providing consistent discipline, setting rules, monitoring adolescents' activities, providing positive reinforcement, and communicating with adolescents are all parenting tools that have proven efficacious in reducing and delaying adolescent drinking and risk-taking behaviors [
25,
26,
31‐
33,
52‐
54]. Two programs that have been particularly effective in this regard are Preparing for the Drug-Free Years and the Iowa Strengthening Families Program, both of which focus on competency training sessions for parents and include adolescents in part of the trainings [
55].
To our knowledge, few interventions have focused specifically on parental engagement strategies to reduce college drinking [
28]. In their recent report "Wasting the Best and the Brightest: Substance Abuse at America's Colleges and Universities", the National Center for Addiction and Substance Abuse at Columbia University (CASA) strongly advocates for parental involvement as part of a comprehensive strategy to reduce underage drinking on campus.
There are a variety of possible ways to involve parents in prevention. First, at the very least, parents can communicate with their college-age child about campus policies related to underage drinking and illicit drug use. For this to happen, campus officials must inform parents of these policies, at orientation and on an ongoing basis during the time their child is in college. CASA notes that close to 90% of colleges report that their policies are available for inspection by parents, either through direct communication, or through the college website [
56].
Second, parents could be encouraged by colleges to express disapproval of underage drinking while their child attends college. Research shows that college students who report that their parents have permissive attitudes about underage drinking and substance use are more likely to engage in these behaviors [
57]. This is contrary to the belief that college binge drinkers are the ones who were prohibited drink in high school. In a blog on the Wall Street Journal website that was focused on an article about college parental notification guidelines of alcohol and drug use, comments such as this were posted,
"The only reason for college binge drinking is prohibition. Kids that binge drink in college are the same ones that were raised by 'responsible' parents who did not let their kids try a drop of alchohol (sic) at home.
Once kids get to college and away from parents' relatively frequent control they go on a rampage. Binge drinking can easily be resolved in late teenagehood by educating kids how to drink, what it means to drink a lot, and what hangover is [
58]."
However, our study has shown that binge drinking in high school predicts college binge drinking. In addition, the CASA survey found that 70% of college students reported that their parents' concerns or expectations either somewhat or very much influenced whether or how much they drank, smoked, or used other drugs, and that parental attitudes were significantly related to the likelihood to binge drink, use marijuana, and smoke tobacco.
Third, colleges could encourage parents to play an important role in recognizing early warning signs of alcohol abuse and intervening by facilitating access to services. If parental notification policies were in place when a student receives a citation from residence life for underage drinking, then parents could encourage their student to undergo a comprehensive assessment, which includes exploration of underlying mental health issues. The 1998 amendments to Part E, Section 952 of the Higher Education Act of 1965 (PL 105–244) allow institutions of higher education to notify parents of students who are under the age of 21 when the student has committed a school disciplinary violation involving alcohol or a controlled substance. The United States Department of Education clarified the ruling in 2000 by stating that "school officials may notify parents whenever they determine that a disciplinary violation has occurred, and that those determinations can be made without conducting a formal disciplinary preceding or hearing [
59]." The point to be made is that the parental notification does not necessarily imply a punitive action; rather the policy can serve a critical purpose to guide the student toward services that may be necessary to avert further problems downstream [
60].
Although many students may be physically separated from their parents once they begin college, future studies are needed to investigate whether or not certain parental practices with college-age children (e.g., frequent appropriate communication, parental support and encouragement, and monitoring of peer group activities) might be helpful in reducing the risk of problematic alcohol consumption. In the 2002 landmark report "A Call to Action: Changing the culture of drinking at US colleges," several potential strategies for reducing excessive drinking, such as social marketing campaigns and environmental strategies were described. Evaluation research should continue to understand the extent to which these types of prevention strategies are effective. This report offered scant information about the protective role of parents except to say that parents should be aware of campus policies on alcohol and illicit drugs [
61]. Arguably, traditional forms of parent-child interaction such as parent monitoring and supervision will naturally decrease as adolescents get older and leave home for college. An important aim for future research should be to define the characteristics of an appropriate parent-child relationship that is associated with low risk for the development of alcohol and other drug problems. Defining this balance between parental guidance and youth autonomy is challenging since too much monitoring in the college years might cause strain in the parent-student relationship and increase the risk for negative outcomes. Research in this area will depend on the development of instruments that can measure changes in the parent-child relationship during the transition from older adolescence through young adulthood.
In summary, the transition to college marks a high-risk period for escalation of alcohol consumption. Parents and prevention practitioners can benefit from evidence that points to specific parenting practices that might help reduce the risk for heavy drinking, while at the same time allow for appropriate levels of autonomy that are critical for young adult development. Colleges should invest in initiatives that involve parents as partners in communicating the message to students about the risks of heavy drinking and promote appropriate levels of parental monitoring through the college years.
Competing interests
The author(s) declare that they have no competing interests.
Authors' contributions
AA, KO'G, and EW contributed to the overall scientific direction of the project. KC and KV managed the day-to-day operational aspects of data collection. KV supervised staff involved in data collection. VK, KC and KO'G performed the statistical analyses. AA, VK, KO'G, KC, KV, and EW assisted with writing. All authors read and approved the final manuscript.