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Alcohol-induced amnesia ("blackout") is a reliable predictor of alcohol-related harm. Given its association with other negative consequences, experience of alcohol-induced amnesia may serve as a teachable moment, after which individuals are more likely to respond to intervention. To test this hypothesis, alcohol-induced amnesia was evaluated as a moderator of brief intervention effect on (a) alcohol-related consequences and (b) the proposed intervention mediators, protective behavioral strategies and peak blood alcohol concentration (BAC). Baseline alcohol risk measured using the Alcohol Use Disorders Identification Test (AUDIT) was also evaluated as a moderator to rule out the possibility that amnesia is simply an indicator of more general alcohol risk. College students (N = 198) reporting alcohol use in a typical week completed assessments at baseline and 1-month follow-up as part of a larger intervention trial. Participants were randomized to assessment only (AO; n = 58) or personalized feedback intervention (PFI; n = 140). Hierarchical regression was used to examine direct and indirect intervention effects. A significant group-by-amnesia interaction revealed that only PFI participants who had experienced alcohol-induced amnesia in the past month reported decreases in alcohol consequences at 1-month follow-up. The PFI reduced alcohol-related consequences indirectly through changes in peak BAC, but only among those who had experienced amnesia at baseline. In contrast, baseline alcohol risk (AUDIT) did not moderate intervention effects, and use of protective behavioral strategies did not statistically mediate intervention effects. Findings suggest that loss of memory for drinking events is a unique determinant of young adult response to brief alcohol intervention. Normative feedback interventions may be particularly effective for individuals who have experienced alcohol-induced amnesia in the past 30 days., (Copyright © 2018. Published by Elsevier Ltd.)

Background and Aims: Concurrent alcohol use and waterpipe (WP) smoking is common among young adults. WP smokers are more than twice as likely to use alcohol as non-users and frequently consume alcohol immediately before and during a WP smoking session. It is unclear what impact alcohol has on WP smoking patterns and resultant exposure to tobacco-related toxicants. The current research aimed to understand the association between alcohol consumption and WP smoke exposure among WP lounge patrons., Methods: Seventy-one lounge patrons (66.2% male; M age =27.03, SD=5.32) completed pre- and post-WP session self-report measures and biomarkers of smoking (expired carbon monoxide; eCO) and alcohol consumption (breath alcohol concentration; BrAC) upon entering and exiting the WP lounge., Results: After controlling for number of bowls and charcoals smoked, greater consumption of alcohol was associated with greater smoke exposure among WP lounge patrons (p<0.05), such that a 0.1 unit increase in BrAC was associated with an eCO increase of 19.44ppm. This relationship was mediated by time spent in the WP lounge., Conclusions: Concurrent alcohol use resulted in greater eCO, likley due to participants spending a greater amount of time in the WP lounge and experiencing longer sustained exposure to secondhand smoke. These findings illustrate a need for further research on the impact of alcohol consumption on WP smoking to assess the potential need for regulation of these products in WP lounges., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)