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Objective: To test if precollege drinking data gathered during an online brief intervention are associated with problems and could inform screening for campus alcohol prevention efforts. Participants: Two cohorts of incoming students ( N  = 5300). Method: Precollege alcohol drinking was gathered through an online preenrollment alcohol brief intervention. Drop out was obtained from university records. On-campus alcohol violations were obtained from university judicial affairs, and off-campus alcohol citations were obtained from the city police. The 2011 cohort was tracked for 4 years, the 2012 cohort for 3 years. Results: Precollege abstaining and heavy drinking were significantly associated with retention and alcohol violations, even with ethnicity, residency, and gender controlled. Association of precollege drinking with later college problems extended beyond the first year and affected retention up to four years of enrollment. Conclusions: The findings support using data from preenrollment alcohol brief interventions as screening tools to customize further campus alcohol interventions.

Objective: To determine whether completing a pre-enrollment Web-based alcohol brief motivational intervention (BMI) increased student retention and reduced student alcohol-related violations., Participants: Fall 2011 (3,364) and Fall 2012 (3,111) entering cohorts of all first-year students at a midwestern state university., Method: Students completing the brief intervention (BI) were compared to students not completing the BI. Retention was tracked for four years for the 2011 cohort and three years for the 2012 cohort. Campus and community alcohol violations were tracked for two academic years following enrollment. Kaplan-Meier survival analysis and Cox regression were used to test retention survival. Logistic regression was used to test campus and community violations., Results: Students in both cohorts who completed the BI had significantly higher retention and significantly fewer alcohol-related violations than noncompleters., Conclusions: Population-level Web-based BIs help prevent student dropout and decrease alcohol-related violations, with impacts extending multiple years. Web-based BI is an efficacious population-level prevention tool.

Objectives: This pilot study tested the effectiveness of a brief alcohol-related intervention delivered by the social media app WeChat to teach about ethanol-induced facial flushing and increase the willingness of students who see another student flushing to suggest that he or she should reduce or stop drinking. In the context of Chinese drinking culture, it is sometimes socially difficult to refuse a drink, even when experiencing physical discomfort, such as flushing., Methods: Classrooms of students in a medical university in China were randomly assigned to the intervention or control group. Students in the intervention group were invited to view 3 alcohol education lessons on WeChat during a 2-week period. A pretest and posttest before and after the 2-week period assessed changes in students' willingness to intervene if they saw someone flush while drinking. Data were collected about students' alcohol use and their ratings of the lessons., Results: Mixed-design analysis of variance yielded a significant time-by-treatment interaction effect on the variable of willingness to suggest that a flushing person stop or slow down their drinking, and the change was significant between the intervention and control groups. One-way analysis of covariance yielded a significant treatment effect at the posttest, after controlling for the pretest score. Students rated the lessons above the midpoint of the scale for being informative, interesting, and useful., Conclusions: The pilot study showed that a brief alcohol-related intervention delivered by WeChat could produce a measurable positive change in the willingness of university students to suggest that a student who flushes should stop drinking. This pilot study also suggested improvements for future lessons and evaluation design.

This paper presents a descriptive analysis of data gathered by personal interviews from a multistage random sample of 1640 residents aged 18⁻34 years in Wuhan, China. First, alcohol drinkers and abstainers were compared based on demographic, attitude, and belief variables. Next, the drinkers from the sample were classified into four groups based on frequency-quantity of alcohol use, and the frequency-quantity groups were compared on the same variables. For Abstainers versus Drinkers, we found no difference by age or gender in this sample. Married people and people with children were more likely to be abstainers. University-educated, currently-employed individuals in mid-level jobs were more likely to abstain from alcohol. Vocational/Technical graduates, people who were currently attending college, currently unemployed and never-employed individuals were more likely to be drinkers. Abstainers also responded with less-positive attitudes and beliefs about drinking and attached more importance to reasons for not drinking compared to drinkers. When the drinking frequency-quantity groups were compared, gender differences became significant: more high-quantity drinkers were women; however the guideline for quantity for women was >1 drink at a time compared to >2 drinks at a time for men. Quantity and frequency of drinking was significantly associated with having children, educational level, employment status, and type of occupation. Age, marital status, and being in college did not relate significantly with quantity and frequency of drinking alcohol. Attitudes and beliefs about drinking tended to be more positive among high-frequency and high-quantity drinkers. Drinkers in all frequency-quantity groups attached greater importance to social reasons for drinking compared to personal/psychological reasons for drinking. Drinkers in the lowest frequency-quantity group attached the most importance to reasons for not drinking. These findings confirmed that in China drinking plays an important role in socializing and celebrating, and that there are important differences between alcohol drinkers and abstainers and between frequency/quantity groups of drinkers. Western models of individualized motivation of behaviors may not accurately explain alcohol use in China. We believe the findings from this study suggest the need for more detailed studies of alcohol drinking and abstaining.

This study explored bystanders’ willingness to help a friend who flushes when drinking to reduce his/her drinking. Alcohol-related facial flushing is an indicator of an inherited variant enzyme, aldehyde dehydrogenase (ALDH), that impairs alcohol metabolism and increases drinkers’ lifetime risk of certain aerodigestive cancers. Individuals who flush should reduce their alcohol exposure, but they may continue to drink if social pressures and rules of etiquette make not drinking socially risky. The analysis used data from 2912 undergraduate students from 13 universities in southwestern, central and northeastern China from a survey asking how they respond to someone’s flushing in various scenarios. Latent class analysis grouped students by similar responses to flushing. A multinomial logistic regression explored how class membership was associated with knowledge, drinking status, and reactions to one’s own flushing. Five classes were derived from the latent class analysis, ranging from always intervene to mostly hesitate to help; in between were classes of students who were willing to help in some scenarios and hesitant in other scenarios. Only 11.6% students knew the connection between facial flushing and impaired alcohol metabolism, and knowledgeable students were somewhat more likely to assist when they saw someone flushing. In the absence of knowledge, other factors—such as drinking status, the gender of the bystander, the gender of the person who flushed, and degree of friendship with the person who flushed—determined how willing a person was to help someone reduce or stop drinking. Class membership was predicted by knowledge, gender, drinking status, and reactions to one’s own flushing. Of these 4 factors, knowledge and reactions to one’s own flushing could be influenced through alcohol education programs. It will take some time for alcohol education to catch up to and change social and cultural patterns of drinking. Meanwhile, motivational strategies should be developed to increase the willingness of bystanders to assist friends and to create a social expectation that flushers should stop or reduce their drinking.

About 70% of the beverage alcohol consumed in China annually is spirits. Recorded spirits make up most spirit consumption, but about 25% of total alcohol consumption (1.7 L pure alcohol per capita annually) is unrecorded spirits (bai jiu), either homemade or made in unregulated distilleries. In some parts of China, the consumption of unrecorded spirits is higher than average. This paper compares the patterns of use of unrecorded distilled spirits and recorded distilled spirits among rural residents in Central China. Interviews were conducted with 3298 individuals in 21 towns/villages in 10 counties in the Hubei, Anhui, and Hebei provinces in the People's Republic of China. Unrecorded bai jiu drinkers chose it because of its taste and its low price. It was consumed mostly by older men, mostly at home with family, more regularly and at higher alcohol by volume (ABV) compared to recorded alcohol. Recorded bai jiu drinkers were more likely to drink away from their homes, consumed more bai jiu at memorable drinking occasions, and reported feeling sick after drinking more often than unrecorded bai jiu drinkers. This comparison of patterns of use of unrecorded bai jiu and recorded bai jiu does not suggest that unrecorded bai jiu is more problematic for drinkers., Competing Interests: Shiqing Wei, Duane F. Shell, and Lok-wa Yuen each declare that she/he has no competing interests. Prior to 2014 Ian M. Newman was a member of the Research Advisory Committee of the International Center for Alcohol Policies, Washington, D.C. Prior to 2014 he received fees and travel support to attend meetings sponsored or co-sponsored by the International Center for Alcohol Policies. Prior to 2013, Ian M. Newman consulted for the National Health Education Institute, Chinese CDC, Chinese Center for Health Education. In the past 5 years, he has received University of Nebraska employment-related funding from the U.S. Department of Education, the Nebraska Department of Health and Human Services, the Nebraska Department of Roads/Nebraska Office of Highway Safety. As American deputy director of the American Exchange Center at Xi’an Jiaotong University, Newman received funds from the US State Department and the University of Nebraska. Ian M. Newman owns an equity interest in The Buffalo Beach Company (Lincoln, Nebraska) and has received consulting fees from The Buffalo Beach Company for independent research on indigenous alcohol use and traffic safety. Ling Qian is a member of an International Center for Alcohol Policies advisory committee, has received fees and travel support to attend and to speak at meetings sponsored or co-sponsored by the International Center for Alcohol Policies. Through a private consulting company, Ling Qian has received fees for assisting in the organization of and data collection for projects funded by the International Center for Alcohol Policies. Ping Yin has received fees from International Center for Alcohol Policies for epidemiological and data collection consultation. The sponsor, ICAP (now IARD), is funded by a consortium of the world’s largest alcohol beverage producers. The authors received no financial support for the preparation of the article. The sponsor had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Alcohol-related facial flushing is a sign of compromised alcohol metabolism and increased risk of certain cancers. This project examined how facial flushing might be used to reduce alcohol use to lower cancer risks. Interviews with Chinese university students identified gender, friendship, and drinking purpose as important variables related to whether someone would encourage a person who flushes when drinking alcohol to stop or reduce their drinking. A questionnaire was developed that incorporated these variables into 24 drinking scenarios in which someone flushed while drinking. Students responded whether they would (a) encourage the flusher to stop or drink less; (b) do nothing while wishing they could; or (c) do nothing because there was no need. Analysis of survey responses from 2912 university students showed a three-way interaction of the variables and implied that the probability students will intervene when a drinker flushes was highest when the flusher was a female, a close friend, and the drinking purpose was for fun and lowest if the flusher was a male, the friendship was general, and the drinking purpose was risky. The results provide important details about the social factors affecting how other people respond to a person who flushes when drinking alcohol. This information is useful for those considering ways to reduce and prevent aerodigestive cancers through education and information programs., Competing Interests: Lida Lin and Lanyan Ding declare no conflicts of interest. Duane F. Shell has consulted for the National Institute for Health Education, Chinese CDC, and received an honorarium and travel support. In the past five years, Duane F. Shell has received university employment-related funding through grants from the U.S. Department of Education, the National Science Foundation, U.S. Department of Energy, University of Nebraska-Lincoln Office of Research, the Association of American Colleges and Universities, the Nebraska Department of Health and Human Services, the Nebraska Department of Roads/Office of Highway Safety, and the Association of Performing Arts Presenters. He has received private consulting funds from the Buffalo Beach Company, Lincoln, NE, and the St. Elizabeth Foundation, Lincoln, NE. Prior to 2014, Ian Newman was a member of the Research Advisory Committee of the International Center for Alcohol Policies, Washington, D.C. Prior to 2014, he received fees and travel support to attend meetings sponsored or co-sponsored by the International Center for Alcohol Policies. Prior to 2013, Ian Newman consulted for the National Health Education Institute, Chinese CDC, and the Chinese Center for Health Education (CCHE). In the past five years, he has received University of Nebraska employment-related funding from the U.S. Department of Education, the Nebraska Department of Health and Human Services, the Nebraska Department of Roads/Nebraska Office of Highway Safety. As the American deputy director of the American Exchange Center at Xi’an Jiaotong University, Newman received funds from the U.S. State Department and the University of Nebraska. Ian Newman owns an equity interest in The Buffalo Beach Company (Lincoln, Nebraska) and has received consulting fees from The Buffalo Beach Company for independent research on indigenous alcohol use and traffic safety.

Objectives: This study examines the association between cultural orientation and drinking behaviors among university students. Cultural orientation is the measure of how the cultural values of individuals living in their own society are influenced by cultural values introduced from the outside., Methods: In 2011, a cross-sectional survey collected data from 1279 university students from six universities in central China. Participants used a likert scale to rank a series of statements reflecting cultural values from the previously validated Chinese Cultural Orientation Scale and answered questions about their drinking behaviors and socio-demographic characteristics., Results: Statistically significant differences in cultural orientation were observed for gender, hometown and type of university attendance. Traditional-oriented students were more likely to be occasional drinkers or nondrinkers, while marginal-oriented students, bicultural-oriented students and western-oriented students were more likely to be regular drinkers. Bicultural orientation (OR = 1.80, P<0.05) and marginal orientation (OR = 1.64, P<0.05) increased the likelihood of the student being regular drinking, compared to students with traditional orientations. Males (OR = 4.40, P<0.05) had a higher likelihood of regular drinking than females, graduate students (OR = 2.59, P<0.05) had a higher likelihood of regular drinking than undergraduates, students from urban areas (OR = 1.79, P<0.05) had a higher likelihood of regular drinking than those from towns/rural areas, and students attending key universities (OR = 0.48, P<0.05) had a lower likelihood of regular drinking than those attending general universities., Conclusions: Cultural orientation influences drinking behaviors. Traditional cultural orientation was associated with less drinking while western cultural orientation, marginal cultural orientation and bicultural orientation were associated with more drinking. The role of gender, hometown and university attendance is partially moderated through the influence of cultural orientation. The relationship between a traditional cultural orientation and alcohol drinking suggests that traditional Chinese cultural values should be examined for their role in possibly reducing alcohol-related risks through education and policy initiatives.

Objective: We hypothesized that the drinking behavior of adolescents in China is influenced by expectancies and self-efficacy and that adolescents' cultural orientation towards western versus traditional Chinese values influences expectancies, self-efficacy and drinking behavior, with western values leading to more dysfunctional patterns of beliefs and drinking, and that these beliefs are influenced by students' gender and school environment., Methods: A total of 1020 high school students from Beijing completed the Chinese Adolescent Alcohol Expectancy, the Chinese Cultural Orientation and the Chinese Self-regulation Self-efficacy questionnaires., Results: Results generally confirmed our hypotheses. Higher negative expectancies and higher self-efficacy reduced the likelihood of drinking significantly. Higher positive expectancies increased the likelihood of regular drinking but not occasional drinking. Having western cultural orientation increased the likelihood of drinking. Higher levels of western cultural orientation also increased positive expectancies, lowered negative expectancies and lowered self-efficacy. Having more western (less traditional) views towards traditional Chinese values decreased positive and negative expectancies. Gender influenced beliefs, with males having higher positive and lower negative expectancies, lower self-efficacy and more traditional cultural orientation. Students in key and general schools had less traditional cultural orientation and key school students had higher self-efficacy., Conclusions: Results indicate that cultural orientation influences adolescent drinking and this influence is mediated partially through cultural orientation influences on adolescent drinking expectancies and self-efficacy. Having more western and less traditional Chinese cultural orientation leads to more drinking, lower self-efficacy for regulating drinking and more risk-promoting alcohol expectancies.

Objective: This study examines differences in Chinese high school students' alcohol expectancies by drinking status (nondrinker, occasional drinker, regular drinker) and gender (male, female)., Method: The authors administered the Chinese Adolescent Alcohol Expectancy Questionnaire (CAEQ) to a convenience sample of 1244 high school students (M = 627; F = 617) from schools in Huhhot City and Tongliao City in Inner Mongolia, China., Results: Differences were found in the 8 CAEQ factors (3 negative and 5 positive factors). Regular drinkers had lower negative consequences and higher positive perception expectancies than nondrinkers or occasional drinkers. Nondrinkers had higher harm to person/reputation expectancies than occasional or regular drinkers. Occasional drinkers had higher beneficial/moderation and lower harm to person/ reputation expectancies than nondrinkers. Boys had higher positive perception expectancies than girls., Conclusions: Expectancies are associated with Chinese adolescents' drinking. Identifying the characteristics of alcohol consuming youth can inform the development of prevention interventions and alcohol policies.

A sample of 2019 Thai secondary school students in grades equivalent to U.S. 10 through 12 completed a 43-item alcohol expectancy questionnaire in June 2000. Factor analysis revealed four factors: (a) positive expectancies, (b) negative expectancies, (c) sex and power expectancies, and (d) religious expectancies. Practicing Buddhists were less likely to drink than nonpracticing Buddhists and had fewer positive and more negative expectancies about alcohol. Among students who did drink, Buddhist beliefs did not appear to influence whether or not they were binge drinkers. Buddhist beliefs may influence decisions to drink but not decisions related to drinking patterns.

Aim: This paper describes Chinese university students' understanding of the meaning of the alcohol-related flushing response and how they reacted to their own and someone else's flushing in a group drinking situation. Method: The researcher surveyed 530 Chinese university students about their understanding of flushing and their perception of how people respond to a person who visibly flushes while drinking alcohol. Findings: Most students did not know about the physiological cause of flushing. There were significant gender differences in both reactions to and perception of responses to a person who flushes. There was no direct relationship between flushing and drinking behaviour. Conclusions: This description of flushing behaviour and responses to a flushing person is discussed in terms of educational opportunities to change behaviours that could reduce the cancer related risks of this visibly at-risk group. [ABSTRACT FROM AUTHOR]

Abstract: This paper describes a programme, conducted over a 5-year period, that effectively reduced heavy drinking and alcohol-related harms among university students. The programme was organised around strategies to change the environment in which binge drinking occurred and involved input and cooperation from officials and students of the university, representatives from the city and the neighbourhood near the university, law enforcement, as well as public health and medical officials. In 1997, 62.5% of the university''s approximately 16,000 undergraduate student population reported binge drinking. This rate had dropped to 47% in 2003. Similar reductions were found in both self-reported primary and secondary harms related to alcohol consumption. [Copyright &y& Elsevier]

This study explored factors that may predict condom use among college and high school students in Zambia. Using the Social Cognitive Theory, this study examined the relationship of drinking behaviors, alcohol-sexual expectations, education level, and religion to condom use among 961 students. The results of the study show that condom use was low among both drinkers and non-drinkers. The results also showed that drinkers had higher positive alcohol-sexual expectations than non-drinkers. Furthermore, drinkers had lower negative alcohol-sexual expectations than non-drinkers. A logistic regression analysis showed that alcohol-sexual expectancies, gender, education, and religion were not significant predictors of condom use among sexually-active students. However, among drinkers, education and positive alcohol-sexual expectancies were significant predictors. Education, positive alcohol-sexual expectations and religion were also significant predictors of condom use among students who engaged in sexual activities after drinking. We conclude that drinking behavior, alcohol-sexual expectations, educational level and religion are associated with lower use of condom. [ABSTRACT FROM AUTHOR]