Alcohol on College Campuses: What Research Shows About Culture, Risk, and Prevention

Alcohol use on college campuses is a well-documented and persistent public health challenge. Research consistently finds that college students drink at higher rates than their non-college age peers, and that hazardous drinking, defined as patterns associated with harm, is common among a significant proportion of the student population. The consequences include academic difficulties, sexual assault, injuries, overdoses, and deaths. Research on why college drinking is so prevalent, what risk factors identify students most vulnerable to harm, and what prevention approaches are most effective provides a basis for institutional policy and practice. The prevalence of alcohol use among college students is documented across multiple large-scale surveys. Annual surveys including the Monitoring the Future study and the American College Health Association National College Health Assessment consistently find that approximately 60 to 65 percent of college students report drinking in the past month, with 30 to 40 percent reporting binge drinking defined as five or more drinks for men or four or more for women in a single occasion. These rates are higher than those for same-age non-students, suggesting that the college environment specifically contributes to elevated drinking. Environmental factors that shape college drinking culture have been studied extensively. Research finds that perceptions of peer drinking norms, specifically how much and how often students believe their peers drink, are among the strongest predictors of individual drinking behavior. Students who overestimate how much their peers drink, which research finds is the norm on most campuses, are more likely to drink heavily in an attempt to conform to what they perceive as normal. This finding underlies social norms marketing as a prevention approach, which corrects misperceptions of peer norms. Social norms marketing campaigns, which publicize accurate data about actual student drinking norms to correct the common overestimation, have been evaluated in randomized and quasi-experimental studies with generally positive findings for reducing drinking. Research finds that correcting misperceptions of peer drinking norms reduces individual drinking among students who learn that their peers actually drink less than they thought. The approach has shown effectiveness in reducing heavy drinking, though the effects are modest and may diminish over time or with poor campaign quality. Brief motivational interventions, which involve one or two sessions with a counselor exploring a student's alcohol use and its consequences in a non-judgmental way, have strong evidence of effectiveness for students who already drink at risky levels. The Brief Alcohol Screening and Intervention for College Students program and similar brief intervention protocols have been evaluated in multiple randomized trials and found to reduce drinking and alcohol-related consequences compared to control conditions. These interventions are most effective when targeted at students who are already drinking heavily rather than applied universally, and they work well as a secondary prevention strategy for students identified through screening, medical encounters, or mandated referral after an alcohol-related incident. Environmental prevention strategies, which address the availability, price, and marketing of alcohol in the campus and surrounding community environment, have theoretical support but are more difficult to implement and evaluate than individual-level approaches. Research on alcohol outlet density near campuses finds associations with student drinking rates, and on communities that have enacted restrictions on alcohol marketing and outlet density near colleges. These environmental approaches address upstream factors that individual interventions cannot change and are recommended as components of comprehensive campus alcohol prevention. Alcohol-related sexual assault is a particularly serious consequence that drives much of the prevention investment on campuses. Research finds that alcohol use by perpetrators and victims is involved in a substantial proportion of campus sexual assaults, with alcohol lowering perpetrator inhibition and impairing victim resistance. Prevention programs that target both alcohol use and sexual violence risk in combination have been developed and show promise in research, addressing the intersection of these risk factors simultaneously rather than treating them as separate issues. Greek life, specifically fraternities and sororities, is associated with higher rates of heavy drinking and alcohol-related consequences in research, controlling for individual risk factors. This association reflects a combination of party culture norms within some Greek organizations, high housing density, and patterns of alcohol access. Research on Greek-affiliated students finds that membership predicts alcohol use above and beyond the characteristics that predict Greek membership, suggesting an independent effect of the organizational environment. Prevention efforts that engage Greek leadership and address organizational norms as well as individual behavior have shown some effectiveness.