A Call to Action:
 

Changing the Culture of
 

Drinking at U.S. Colleges
 

Task Force of the National Advisory Council
 

on Alcohol Abuse and Alcoholism 

National Institutes of Health 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

www.collegedrinkingprevention.gov 
A Call to Action:
 

Changing the Culture of
 

Drinking at U.S. Colleges
 

April 2002
 

National Institute on Alcohol
 

Abuse and Alcoholism
 
Contents
 

Special Thanks to Enoch Gordis, M.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v
 

Comment from the Institute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii
 

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix
 

Task Force Co-Chairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix
 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
 

College Drinking Is a Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
 

The Answer: Change the Culture. The Question: How? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
 

A Snapshot of Annual High-Risk College Drinking Consequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
 

Heavy Episodic Consumption of Alcohol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
 

Alcohol and Adolescent Brain Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
 

Factors Affecting Student Drinking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
 

Living Arrangements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
 

College Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
 

First-Year Students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
 

Other Factors Affecting Drinking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
 

Comparison with Noncollege Peers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
 

Secondhand Consequences of Drinking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
 

Post-College Consequences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
 

Issues Involved in A Call to Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
 

The Challenge for Colleges and Communities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Impact of Inadequate Information 11
 

Problems with Program Design 11
 

Impact on Implementation 11
 

Results of Prolonged Ineffectiveness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
 

Integrating Research Into College Alcohol Program Planning 12
 

Involving Colleges and Universities 12
 

Establishing Administrative Norms 13
 

Obtaining External Support 13
 

A Call to Action: Recommendations for Addressing Excessive College Drinking 14
 

Recommendations for Colleges and Universities 

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Overarching Framework 14
 

Recommended Strategies 15
 

Tier 1: Evidence of Effectiveness Among College Students 16
 

Tier 2: Evidence of Success With General Populations That Could Be Applied to College Environments 17
 

Tier 3: Evidence of Logical and Theoretical Promise, But Require More Comprehensive Evaluation

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Tier 4: Evidence of Ineffectiveness 23
 

A Special Role for College Presidents 25
 

The Need for Student Participation in Prevention Policymaking and Programs 26
 

Recommendations for the Research Community 28
 

Recommendations for NIAAA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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29
 

A Final Word 32
 

References . 33
 

Task Force Members and Participants 45
 

College and University Presidents 45
 

Special Thanks to Other Participating College Presidents 45
 

Researchers . 46
 

Task Force Panel Members 46
 

Students . 47
 

National Institute on Alcohol Abuse and Alcoholism 47
 

Contributors .

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Resources . 48
 

Commissioned Papers 49
 

Panel 1—Contexts and Consequences 49
 

Panel 2—Prevention and Treatment 50
 

Joint Panel Papers

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III 
Special Thanks to Enoch Gordis, M.D.
 

The Task Force wishes to extend a special thank you to Dr. Enoch Gordis for his leadership and dedication. Dr. 

Gordis stepped down as Director of NIAAA on December 30, 2001, after 15 years of outstanding leadership. He 

was the inspiration for this project, citing the lack of research on this important public health problem. “For 

decades, there has been meeting after meeting that offered plausible, intelligent recommendations, all with no 

evaluations. Then, when these programs fail to work, meetings are again convened to ponder the same questions. 

Only through a commitment to research can we truly begin to understand what can and cannot be done, so that in 

five or ten years we don’t find ourselves asking the same questions yet again.” In light of his vision, we offer this 

report as a beginning. 

V 
Comment from the Institute
 

Every year as spring break approaches or when another promising young student dies in an alcohol-related tragedy, 

college drinking becomes a national issue. Although excessive drinking by college students is accepted as a rite of 

passage by many, alcohol-related tragedies never fail to shock us and to prompt calls for immediate action. When 

schools respond with well-intentioned programs, but the problem persists, it is natural to wonder how much we really 

understand about excessive, college student drinking. Is it inevitable? Can we take steps to prevent it or reduce its 

consequences? Why have efforts to date proven ineffective? 

The fact is that since 1976, when the newly created National Institute on Alcohol Abuse and Alcoholism (NIAAA) 

issued its only report on abusive drinking by college students, research advances have transformed our understanding 

of alcohol abuse and related problems. For example, we now know that a broad array of factors affect college student 

drinking behavior. These include an individual’s susceptibility to alcohol, campus norms related to drinking, and 

conditions within the larger community that make alcohol readily accessible and fail to penalize inappropriate use. 

Together these influences contribute to a culture of drinking that is more damaging and deadly than previously 

recognized. 

This report, developed by the NIAAA-supported Task Force on College Drinking after 3 years of intensive 

discussions, describes our new understanding of dangerous drinking behavior by college students and its consequences 

for both drinkers and nondrinkers. Rather than debate how many drink how much, the Task Force focused on the 

consequences. What it found challenges many common assumptions about the size and nature of the problem. Not 

only do some 1,400 college students between the ages of 18 and 24 die every year as a result of hazardous drinking, 

but a half million suffer unintentional injuries under the influence of alcohol. Another 600,000 are assaulted by fellow 

drinking students and more than 70,000 are sexually assaulted. The data on academic achievement, damage to 

facilities, and health problems are equally alarming. The nature of existing data leads to the inference that some 

college students meet the diagnostic criteria for alcohol dependence as currently specified by the American Psychiatric 

Association’s Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), but are not receiving 

treatment. Although most students who exhibit dangerous drinking behavior during their college career mature out of 

heavy drinking, this behavior and its consequences are nonetheless cause for concern. 

In its report, the Task Force outlines a series of recommendations for colleges and universities, researchers, and 

NIAAA. What distinguishes this guidance from others is its firm reliance on scientific evidence and its call for 

collaboration between academic institutions and researchers. In response to the information and recommendations in 

this report, NIAAA is committing an additional $8 million over the next two fiscal years to the issue of college 

drinking. It also is collaborating with several college presidents to determine the effectiveness of policies aimed at 

reducing the problem. 

The chancellor of a university that recently suffered the alcohol-related death of one of its students said, “Our 

children’s lives are at real risk, and universities need to make every effort to prevent any more lives from being 

wasted.” This report underscores the wisdom of that advice and urges us to join forces in changing the culture of 

drinking on our Nation’s campuses from one that fosters destructive behavior to one that discourages it. 

Raynard Kington, M.D., Ph.D., M.B.A. 

Acting Director 

National Institute on Alcohol Abuse and Alcoholism 

VII 
Preface
 

Task Force Co-Chairs
 

The Task Force on College Drinking, a group of 

distinguished educators, alcohol researchers, and 

students, has been meeting for 3 years to respond to the 

persistent and pervasive problem of excessive drinking by 

students on U.S. college campuses. The Task Force was 

established by the National Advisory Council on 

Alcohol Abuse and Alcoholism. Although NIAAA has 

maintained a modest portfolio of grants on college 

drinking for many years, the Task Force represents an 

effort to address the issue in the most coordinated and 

comprehensive way possible. 

The goals of the Task Force are threefold: 

1. Provide research-based information about the 

nature and extent of dangerous drinking to high 

school and college administrators, students, 

parents, community leaders, policymakers, 

researchers, and members of the retail beverage 

industry; 

2. Offer recommendations to college and university 

presidents on the potential effectiveness of current 

strategies to reverse the culture of drinking on 

campus; and 

3. Offer recommendations to the research community, 

including NIAAA, for future research on 

preventing hazardous college student drinking. 

To this end, the Task Force conducted a 

comprehensive review of research on drinking by college 

students and on strategies to prevent it. We established 

two panels that addressed: (1) the contexts in which 

college drinking occurs and its consequences, and 

(2) prevention and treatment. In addition to extensive 

deliberations, the panels commissioned 24 original 

scientific papers intended to synthesize what we know 

and identify research gaps. Most of these papers are 

being published in a special supplement to the Journal of 

Studies on Alcohol. The extent of drinking consequences 

among college students is described in a paper by Ralph 

Hingson et al., being published in the March issue of 

the Journal. (Please visit our Web site: 

www.collegedrinkingprevention.gov for additional 

information.) 

During the course of our deliberations, it became clear 

that three primary constituencies must be addressed to 

change the culture of drinking on campus. They are: 

(1) individuals, including at-risk or alcohol-dependent 

drinkers, (2) the student population as a whole, and 

(3) the college and the surrounding community. To be 

effective, prevention programs must target all three. The 

Task Force devised a simple, but comprehensive, 3-in-1 

Framework to help colleges and universities with this 

process. 

Another theme that emerged repeatedly in our work 

was the need for schools to base their alcohol policies 

and prevention programs on scientific evidence. In 

selecting the prevention strategies that appear in this 

report, we considered feasibility, theoretical rationale, 

and outcomes in noncollege settings as well as 

demonstrated effectiveness on college campuses. 

However, we also found that a number of potentially 

effective strategies have little evidence to support them 

because they have not been thoroughly evaluated. This 

raises a key point. Additional research is needed to 

determine the value of these promising strategies. We 

strongly encourage colleges and universities to 

collaborate with researchers in testing their value on 

campus. 

IX 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

Because the results of the Task Force’s work are 

important to a broad audience, we have summarized our 

information and recommendations in a variety of 

formats. In addition to this report, our products include: 

An alcohol prevention program handbook— 

Reducing Alcohol Problems on Campus: A Guide to 

Planning and Evaluation; 

Brochures for college and university presidents, 

student peer educators, and parents (future 

brochures include community leaders, high school 

guidance counselors, and students); 

The final reports of the Task Force’s two 

panels—High-Risk Drinking in College: What We 

Know and What We Need To Learn and How To 

Reduce High-Risk College Drinking: Use Proven 

Strategies, Fill Research Gaps—that describe each 

panel’s findings in detail; and 

The scientific papers commissioned by the panels 

to supplement the current research literature. 

(Please see the Resources section of this report for 

information on ordering or downloading these 

products.) 

The consequences of drinking on campus are too 

damaging to ignore. Although research alone is 

insufficient to reverse the problem, it will point the way 

to solutions. We are simultaneously confronted with 

statistics that show college drinking worsening and other 

data that suggest the reverse. This underscores the 

conundrum that college drinking-related problems are 

persistent but may change in nature and intensity over 

time. As a result, this report should not be considered 

the final solution. It is the beginning, a call to action, 

involving college presidents, researchers, and students. 

Unless we improve the collection of data and rigorously 

evaluate prevention programs, using the most innovative 

methods available, we will continue to be perplexed by 

these problems and unable to move ahead and make 

appreciable differences. 

We urge college and university presidents to apply the 

recommendations in this report. Moreover, we challenge 

society to no longer ignore the consequences of drinking 

on our Nation’s campuses. Parents, prevention 

organizations, the alcohol beverage and hospitality 

industries, and the Federal government must together 

apply all necessary financial and intellectual resources to 

address this pervasive and persistent problem. 

Edward A. Malloy, C.S.C. 

Task Force Co-Chair 

President 

University of Notre Dame 

Mark Goldman, Ph.D. 

Task Force Co-Chair 

Distinguished Research Professor of Psychology 

University of South Florida 

X 
Introduction
 

“Underage drinking and excessive drinking have negative effects on everything we’re trying to do 

as a university. They compromise the educational environment, the safety of our students, the 

quality of life on campus, town/gown relationships, and our reputation.” 

—Dr. Judith Ramaley, Former President, University of Vermont 

Other than the damage and injuries that occur during 

spring break each year, the only consequences of college 

drinking that usually come to the public’s attention are 

occasional student deaths from alcohol overuse (e.g., 

alcohol poisoning) or other alcohol-related tragedies. 

They prompt a brief flurry of media attention; then, the 

topic disappears until the next incident. In fact, the 

consequences of college drinking are much more than 

occasional; at least 1,400 college student deaths a year are 

linked to alcohol, as new research described in this report 

reveals. High-risk drinking also results in serious injuries, 

assaults, and other health and academic problems, and is 

a major factor in damage to institutional property. The 

relative scarcity of headlines about college drinking belies 

an important fact: that the consequences of excessive 

college drinking are more widespread and destructive 

than most people realize. While only isolated incidents 

tend to make news, many school presidents conclude that 

these pervasive, albeit less obvious, problems are 

occurring on their campuses at the same time. It is a 

persistent and costly problem that affects virtually all 

residential colleges, college communities, and college 

students, whether they drink or not. 

The call to action on campus has to do not so much 

with drinking per se, but with the consequences of 

excessive drinking by college students. Students who 

drink excessively have higher rates of injuries, assaults, 

academic problems, arrests, vandalism, and other health 

and social problems, compared with their nondrinking 

counterparts. They disrupt the studies and threaten the 

health and safety of their peers. 

College Drinking Is a Culture 


The tradition of drinking has developed into a kind of 

culture—beliefs and customs—entrenched in every level 

of college students’ environments. Customs handed 

down through generations of college drinkers reinforce 

students’ expectation that alcohol is a necessary 

ingredient for social success. These beliefs and the 

expectations they engender exert a powerful influence 

over students’ behavior toward alcohol. 

Customs that promote college drinking also are 

embedded in numerous levels of students’ environments. 

The walls of college sports arenas carry advertisements 

from alcohol industry sponsors. Alumni carry on the 

alcohol tradition, perhaps less flamboyantly than during 

their college years, at sports events and alumni social 

functions. Communities permit establishments that 

serve or sell alcohol to locate near campus, and these 

establishments depend on the college clientele for their 

financial success. 

Students derive their expectations of alcohol from their 

environment and from each other, as they face the 

insecurity of establishing themselves in a new social 

milieu. Environmental and peer influences combine to 

create a culture of drinking. This culture actively 

promotes drinking, or passively promotes it, through 

tolerance, or even tacit approval, of college drinking as a 

rite of passage. 

1 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

The Answer: Change the Culture. 

The Question: How? 

When a student dies from intoxication or another 

alcohol-related incident makes headlines, college 

drinking captures the public’s attention, for a while. On 

the campus itself, administrators deal with the 

immediate problem, and campus life soon returns to 

normal. Generally, the incident doesn’t result in effective, 

long-term changes that reduce the consequences of 

college drinking. 

Among the reasons for this seeming inattention to 

long-term solutions is that administrators see college 

drinking as an unsolvable problem. When schools have 

made efforts to reduce drinking among their students— 

and many have made considerable effort—they haven’t 

had significant, campus-wide success. With each failed 

effort, the image of college drinking as an intractable 

problem is reinforced, administrators are demoralized, 

and the likelihood that schools will devote resources to 

prevention programs decreases. 

One reason for the lack of success of prevention efforts 

is that, for the most part, schools have not based their 

prevention efforts on strategies identified and tested for 

effectiveness by research. Research on college drinking is 

a relatively young field, and the data are incomplete. 

Until the recent formation of the Task Force on College 

Drinking, administrators and researchers did not 

typically collaborate on this topic. Without the expertise 

of the research community, administrators were at a 

disadvantage in trying to identify and implement 

strategies or combinations of strategies to address alcohol 

problems specific to their schools. 

Now, the Task Force on College Drinking has brought 

together experienced administrators and scientists, who 

have assessed what both schools and researchers need to 

do to establish effective prevention programs. On the 

basis of their findings, they have made the 

recommendations contained in this report. Their 

recommendations focus not on how to effect some type 

of blanket prohibition of drinking, but on changing the 

culture of drinking on campuses and involving the 

surrounding communities. 

Foremost among their recommendations is that to 

achieve a change in culture, schools must intervene at 

three levels: at the individual-student level, at the level of 

the entire student body, and at the community level. 

Research conducted to date strongly supports this threelevel approach. Within this overarching structure, 

schools need to tailor programs to address their specific 

alcohol-related problems. Underlying each 

recommendation is the Task Force’s understanding that 

no two schools are alike, that environmental influences 

as well as individual student characteristics impact 

alcohol consumption, and that effective strategies extend 

beyond the campus itself to encompass the surrounding 

community. 

The Task Force’s focus is on how to change the culture 

that underlies alcohol misuse and its consequences on 

campus, rather than on simply determining the number 

of negative alcohol-related incidents that occur each year. 

But because data on the consequences of college drinking 

underscore the need for effective prevention strategies, 

these data are included in the section that follows. The 

report offers (1) a general approach to incorporating 

prevention programs on campus, (2) specific interventions 

that schools can combine to meet the needs of their 

campuses, and (3) recommendations for future research 

on college drinking. 

2 
What Can Research Bring to Prevention Programs? 

3 

The research community can provide schools with techniques that will enable them to: 

realistically assess their alcohol-related problems; 

develop research-based programs designed to prevent/ameliorate these problems; 

adjust programs to meet individual schools’ needs; and 

define measurable outcomes that can be used periodically to reflect a program’s success or the 

need for its further adjustment. 

In conducting their work, members of the Task Force on College Drinking relied on the results of 

well-designed empirical studies to formulate their recommendations. They downplayed results of 

methodologically weak studies and assertions that exceeded what the data supported. Studies acceptable to the Task Force followed the principles of the scientific method and met rigorous design and 

execution criteria. 

New techniques have enabled researchers to compare alcohol-related problems in large groups of college students and their noncollege peers and to map the extent of these problems, nationally and 

regionally. Armed with this information, researchers can determine how new laws and policies, alcohol-prevention programs, and trends in the general population affect drinking patterns among college students and their noncollege peers. 

Research shows that a number of personal factors, from family background to alcohol use during 

high school, influence college students’ drinking patterns. In the college environment, additional factors contribute to drinking patterns; for example, membership in fraternities or sororities, sports 

teams, or other social groups and college organizational factors such as size, location, and number of 

commuter students. Recent techniques enable researchers to test models for prevention that encompass a multiplicity of factors. 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

A Snapshot of Annual High-Risk 


College Drinking Consequences
 

The consequences of excessive and underage drinking 

affect virtually all college campuses, college 

communities, and college students, whether they choose 

to drink or not. 

Death: 1,400 college students between the ages of 18 

and 24 die each year from alcohol-related unintentional 

injuries, including motor vehicle crashes (Hingson et al., 

2002). 

Injury: 500,000 students between the ages of 18 and 

24 are unintentionally injured under the influence of 

alcohol (Hingson et al., 2002). 

Assault: More than 600,000 students between the ages 

of 18 and 24 are assaulted by another student who has 

been drinking (Hingson et al., 2002). 

Sexual Abuse: More than 70,000 students between 

the ages of 18 and 24 are victims of alcohol-related 

sexual assault or date rape (Hingson et al., 2002). 

Unsafe Sex: 400,000 students between the ages of 18 

and 24 had unprotected sex and more than 100,000 

students between the ages of 18 and 24 report having 

been too intoxicated to know if they consented to 

having sex (Hingson et al., 2002). 

Academic Problems: About 25 percent of college 

students report academic consequences of their drinking 

including missing class, falling behind, doing poorly on 

exams or papers, and receiving lower grades overall (Engs 

et al., 1996; Presley et al., 1996a, 1996b; Wechsler et al., 

2002). 

Health Problems/Suicide Attempts: More than 

150,000 students develop an alcohol-related health 

problem (Hingson et al., 2002) and between 1.2 and 1.5 

percent of students indicate that they tried to commit 

suicide within the past year due to drinking or drug use 

(Presley et al., 1998). 

Drunk Driving: 2.1 million students between the 

ages of 18 and 24 drove under the influence of alcohol 

last year (Hingson et al., 2002). 

Vandalism: About 11 percent of college student 

drinkers report that they have damaged property while 

under the influence of alcohol (Wechsler et al., 2002). 

Property Damage: More than 25 percent of 

administrators from schools with relatively low drinking 

levels and over 50 percent from schools with high 

drinking levels say their campuses have a “moderate” or 

“major” problem with alcohol-related property damage 

(Wechsler et al., 1995). 

Police Involvement: About 5 percent of 4-year college 

students are involved with the police or campus security 

as a result of their drinking (Wechsler et al., 2002) and 

an estimated 110,000 students between the ages of 18 

and 24 are arrested for an alcohol-related violation such 

as public drunkenness or driving under the influence 

(Hingson et al., 2002). 

Alcohol Abuse and Dependence: 31 percent of 

college students met criteria for a diagnosis of alcohol 

abuse and 6 percent for a diagnosis of alcohol 

dependence in the past 12 months, according to 

questionnaire-based self-reports about their drinking 

(Knight et al., 2002). 

4 
Heavy Episodic Consumption of Alcohol
 

Data from several national surveys indicate that about 

four in five college students drink and that about half of 

college student drinkers engage in heavy episodic 

consumption. Recent concerns have, therefore, often 

focused on the practice of binge drinking, typically 

defined as consuming five or more drinks in a row for 

men, and four or more drinks in a row for women. A 

shorthand description of this type of heavy episodic 

drinking is the “5/4 definition.” Approximately two of 

five college students—more than 40 percent—have 

engaged in binge drinking at least once during the past 2 

weeks, according to this definition. It should be noted, 

however, that colleges vary widely in their binge 

drinking rates—from 1 percent to more than 70 

percent—and a study on one campus may not apply to 

others (Wechsler et al., 1994, 1998, 2000b). 

The U.S. Surgeon General and the U.S. Department of 

Health and Human Services (USDHHS) have identified 

binge drinking among college students as a major public 

health problem. In “Healthy People 2010,” which sets 

U.S. public health goals through the year 2010, the 

Federal government has singled out binge drinking 

among college students for a specific, targeted reduction 

(e.g., from 39 percent to 20 percent) by the year 2010. 

“Healthy People 2010” notes that: “Binge drinking is a 

national problem, especially among males and young 

adults.” The report also observes that: “The perception 

that alcohol use is socially acceptable correlates with the 

fact that more than 80 percent of American youth 

consume alcohol before their 21st birthday, whereas the 

lack of social acceptance of other drugs correlates with 

comparatively lower rates of use. Similarly, widespread 

societal expectations that young persons will engage in 

binge drinking may encourage this highly dangerous 

form of alcohol consumption” (USDHHS, 2000). 

There is evidence that more extreme forms of drinking 

by college students are escalating. In one study, frequent 

binge drinkers (defined as three times or more in the 

past 2 weeks) grew from 20 percent to 23 percent 

between 1993 and 1999. The number of students who 

reported three or more incidents of intoxication in the 

past month also increased (Wechsler et al., 2000b). It 

should be noted, however, that the number of college 

students who do not drink is also growing. In the same 

study, the percentage of abstainers increased from 15 to 

19 percent. 

5 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

Understanding Alcohol Consumption 

6 

The term alcohol consumption encompasses two ideas 

important in characterizing an individual’s drinking behavior: frequency (how often a person drinks) and quantity 

(how much a person drinks). Frequency of consumption 

refers to the number of days or, sometimes, occasions that 

an individual has consumed alcoholic beverages during a 

specified interval (e.g., week, month, and year). Quantity 

of consumption refers to the amount ingested on a given 

drinking occasion. 

Most typically, consumption is assessed using “standard 

drinks”—in the United States, these are 5 ounces of wine, 

12 ounces of beer, or 1.25 ounces of distilled spirits. 

Because individuals do not drink the same amount at every 

drinking occasion, some surveys attempt to assess the frequency with which a person drinks various amounts of 

alcohol (e.g., one to two drinks, three to four drinks, five 

to six drinks) over a specified period of time. Although 

cumbersome, this approach probably provides a fairly accurate assessment of total volume consumed and of variability 

in drinking pattern. 

For many purposes, however, identifying “light” or “moderate” consumption is not the issue, “heavy” consumption 

is. For that reason, it is common to assess heavy consumption on the basis of the frequency of consuming a number 

of drinks meeting or exceeding a certain threshold. When 

describing college drinking, heavy drinking occasions are 

often referred to as “binges.” Based on the influential work 

of Henry Wechsler and colleagues—who define binge as 

five or more drinks in a row for men and four or more 

drinks for women—the prevalence of binge drinking has 

become a key measure in estimating the extent of alcohol 

problems on college campuses. 

Historically, binge drinking has referred to an extended 

period of heavy drinking (for example, a “bender” that lasts 

3 days or more) that is seen in some alcoholic patients. 

Some clinicians believe that using the term binge to refer 

to a less severe phenomenon blurs this important distinction. However, Dr. Wechsler has observed that the term 

binge is now commonly associated with eating and shopping and that its application to alcohol use is consistent 

with the term’s generally accepted meaning. 

Other researchers have voiced concern because the specific 

time period over which the five or four drinks are consumed is not specified nor is the body mass of an individual drinker. For example, after 5 drinks consumed over a 

fixed time span, a man of 240 pounds would have a lower 

blood alcohol level than a man of 140 pounds. Nor would 

a male or female of the same body weight achieve the same 

blood alcohol level following equal consumption because 

of gender-related differences in physiology. Dr. Wechsler 

believes that the phrase “in a row” implies a relatively short 

time frame. He also shows that individuals who consume 

alcohol at these levels increase their likelihood of experiencing a range of negative consequences. 

Whether terms such as heavy drinking, binge drinking, or 

drinking to intoxication are used to describe students’ 

behavior, it is clear that consumption of large quantities of 

alcohol on a single drinking occasion is important in 

assessing alcohol involvement. Also key in evaluating alcohol consumption are the consequences of that consumption which can include academic, personal, social, legal, 

and medical problems as well as dependent symptoms such 

as tolerance, withdrawal, and loss of control. 
ALCOHOL AND ADOLESCENT
 

BRAIN DEVELOPMENT 

Adolescence is a time of transition, physically, socially, 

and emotionally. The adolescent brain is in transition as 

well. Although important structural and functional 

changes take place in the brain from childhood to 

adulthood (Giedd et al., 1999), during adolescence such 

changes are widespread. During adolescence, the brain 

undergoes a major remodeling involving the formation of 

new connections between nerve cells, as well as the 

pruning of existing synaptic connections. These changes 

affect the processes involved in planning and decisionmaking, impulse control, voluntary movement, memory, 

and speech production, among others (Rubia et al., 

2000). Similar changes occur in those parts of the brain 

that seem to affect how a person responds to alcohol and 

other drugs (Spear, 2000; Teicher et al., 1995). As a 

result, alcohol appears to have different effects on 

adolescents than adults (Spear, 2000). 

Animal studies suggest that alcohol may have a greater 

impact on adolescent than adult memory (Markweise et 

al., 1998; Pyapali et al., 1999) and that these effects may 

be long lasting. Preliminary studies suggest that rats 

exposed to high levels of alcohol during adolescence may 

be more sensitive to alcohol-induced memory 

impairments later in life (White et al., 2000). Human 

studies have detected cognitive impairments in adolescent 

alcohol abusers weeks after they stopped drinking (Brown 

et al., 2000). 

Although the causes of these long-lasting changes are 

unclear, they may in some cases involve alcohol-induced 

injury to the nervous system. In rats, exposure to high 

amounts of alcohol produces more extensive brain 

damage in adolescents than adults (Crews et al., 2000). 

In humans, adolescent-onset alcohol abuse has been 

associated with a reduction in the size of the 

hippocampus (DeBellis et al., 2000). 

Research also suggests that adolescents are less sensitive 

than adults to some of alcohol’s effects. For example, 

adolescent rats, on their first exposure to alcohol, are less 

susceptible than adult rats to alcohol’s sedative effects, as 

well as its effects on balance and motor coordination 

(Little et al., 1996; White et al., 2001). It is not known 

whether these differences occur in humans. However, the 

findings suggest that adolescents might be able to stay 

awake and mobile at higher blood alcohol levels than 

adults with an equivalent history of alcohol exposure 

while, at the same time, experiencing greater alcoholinduced cognitive impairments and, possibly, more injury 

to the brain following high alcohol exposure levels. 

7 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

Factors Affecting Student Drinking 

“Decisions about alcohol consumption are not just individual, they can affect the common life 

of the university.” 

Living Arrangements 

The proportion of college students who drink varies 

depending on where they live. Drinking rates are highest 

in fraternities and sororities followed by on-campus 

housing (e.g., dormitories, residence halls) (Presley et al., 

1996a, 1996b; Wechsler et al., 1998, 2000b). Students 

who live independently off-site (e.g., in apartments) 

drink less, while commuting students who live with their 

families drink the least (O’Hare, 1990; Presley et al., 

1996a, 1996b). 

College Characteristics 

Although the existing literature on the influence of 

collegiate environmental factors on student drinking is 

limited, a number of environmental influences working 

in concert with other factors may affect students’ alcohol 

consumption (Presley et al., 2002). Colleges and 

universities where excessive alcohol use is more likely to 

occur include schools where Greek systems dominate 

(i.e., fraternities, sororities), schools where athletic teams 

are prominent, and schools located in the Northeast 

(Presley et al., 1996a, 1996b; Wechsler et al., 1996, 

1997, 1998, 2000b; Werner and Greene, 1992). 

First-Year Students 

Some first-year students who live on campus may be at 

particular risk for alcohol misuse. During their high 

school years, those who go on to college tend to drink 

less than their noncollege-bound peers. But during the 

first few years following high school, the heavy drinking 

rates of college students surpass those of their noncollege 

Edward A. Malloy, President 

University of Notre Dame 

peers, and this rapid increase in heavy drinking over a 

relatively short period of time can contribute to 

difficulties with alcohol and with the college transition in 

general (Schulenberg et al., 2001). Anecdotal evidence 

suggests that the first 6 weeks of enrollment are critical to 

first-year student success. Because many students initiate 

heavy drinking during these early days of college, the 

potential exists for excessive alcohol consumption to 

interfere with successful adaptation to campus life. The 

transition to college is often so difficult to negotiate that 

about one-third of first-year students fail to enroll for 

their second year (Upcraft, 2000). 

A Rite of Passage for All, or a 

Habit for Some That Impacts All?

8 

Although the consequences of campus drinking are a major 

problem, contrary to popular misconceptions, the majority of 

college students drink moderately or abstain (Wechsler et al., 

2000b). For many students, alcohol use is not a tradition. 

Students who drink the least attend: 

Two-year institutions 

Religious schools 

Commuter schools 

Historically Black colleges and universities 

(Meilman et al., 1994, 1995, 1999; Presley et al., 1996a, 1996b). 

Students who drink the most include: 

First-year students (within the first weeks of arrival) 

Males 

Whites 

Members of fraternities and sororities 

Athletes 

(Johnston et al., 2001b; Wechsler et al., 1996, 1997, 1998, 

2000b). 
Other Factors Affecting Drinking
 

Numerous other factors affect drinking behavior among 

college students. These include biological and genetic 

predisposition to use, belief system and personality, and 

expectations about the effects of alcohol (Sher et al., 1999; 

Zucker et al., 1995). In addition to individual student 

characteristics, the size of a student body, geographical 

location, and importance of athletics on campus are also 

associated with consumption patterns as are external 

environmental variables including the pricing and 

availability of alcohol in the area surrounding a campus 

(Chaloupka and Wechsler, 1996; Chaloupka et al., 1998; 

Leichliter et al., 1998; Nelson and Wechsler, 2001; Presley 

et al., 1996a, 1996b; Wechsler et al., 1994, 1997, 1998, 

2000a, 2000b). 

Although some drinking problems begin during the 

college years, many students entering college bring 

established drinking practices with them. Thirty percent of 

12th-graders, for example, report binge drinking in high 

school, slightly more report having “been drunk,” and 

almost three-quarters report drinking in the past year 

(Johnston et al., 2001a). Colleges and universities “inherit” 

a substantial number of drinking problems that developed 

earlier in adolescence. 

Comparison with Noncollege Peers 

College drinking occurs at a stage in life when drinking 

levels are generally elevated. Compared to all other age 

groups, the prevalence of periodic heavy or high-risk 

drinking is greatest among young adults aged 19 to 24; 

and among young adults, college students have the 

highest prevalence of high-risk drinking (Johnston et al., 

2001b; Substance Abuse and Mental Health Services 

Administration, 2001). Although their noncollegiate 

peers drink more often, college students tend to drink 

more heavily when they do drink (O’Malley and 

Johnston, 2002). 

Secondhand Consequences of Drinking 

Students who do not drink or do not abuse alcohol 

experience secondhand consequences from others’ 

excessive use. In addition to physical and sexual assault 

and damaged property, these consequences include 

unwanted sexual advances and disrupted sleep and study 

(Hingson et al., 2002; Wechsler et al., 1995, 2000b). The 

problems produced by high-risk drinking are neither 

victimless nor cost-free. All students—whether they 

misuse alcohol or not—and their parents, faculty, and 

members of the surrounding community experience the 

negative consequences wrought by the culture of drinking 

on U.S. campuses. 

Post-College Consequences 

The consequences of alcohol abuse during the college 

years do not end with graduation. Frequent, excessive 

drinking during college increases the prospects for 

continuing problems with alcohol and participation in 

other “health-compromising or illegal behaviors” 

(Schulenberg et al., 1996). On the other hand, in a 

prospective study of college students, researchers found 

that although fraternity/sorority membership is 

associated with high levels of alcohol consumption in 

college, Greek status did not predict post-college heavy 

drinking levels (Sher et al., 2001). 

Overall, these data indicate that high-risk drinking 

exposes students, either directly or indirectly, to 

unacceptable risks. 

“I’ve lived in college dormitories for much of my adult life, so I know firsthand the impact 

irresponsible drinking has on the quality of residential life...reducing alcohol-related harm is 

clearly central to our mission.” 

Edward A. Malloy, President 

University of Notre Dame 

9 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

Issues Involved in A Call to Action
 

During the course of the Task Force on College 

Drinking’s deliberations, college presidents, students, 

and researchers candidly discussed the dilemmas colleges 

confront when attempting to respond to the persistent 

and pervasive problems related to drinking on campus. 

An understanding of these realities is crucial to 

developing and implementing effective alcohol abuse 

prevention programs. 

The Challenge for 

Colleges and Communities 

The consequences of excessive student drinking have 

historically placed college presidents and administrators 

in untenable positions. When student deaths, injuries, or 

brawls occur on campus, the response tends to be 

immediate and focused largely on the individual 

students and families involved. Once the crisis recedes, 

there is little incentive to consider either the root causes 

of such events or their broader implications, especially 

when other priorities compete for a president’s time and 

attention. In addition, there is little incentive for 

partnerships between the university or college and the 

surrounding community, leaving the university or 

college with the entire problem. 

Data collection requirements 

Lack of information 

Problems with implementation (unrealistic objectives, 

inadequate resources) 

Students’ rights and liability concerns 

Barriers to Implementing 

Research-Based Programs 

A number of other factors related to students’ rights 

and liability concerns also discourage schools from 

exploring the issue further and implementing prevention 

programs. At what point, for example, is a student’s right 

of privacy violated because of the institution’s concerns 

about alcohol abuse? Does a college face legal liability if 

it designates a residence hall substance-free when the 

majority of its students are underage? How does an 

institution respond to the residential requirements of 

students in recovery whose needs are protected by the 

Americans with Disabilities Act? If stepped-up 

enforcement efforts limit the availability of alcohol on 

campus, will students endanger themselves and others by 

driving to off-campus bars? How will alumni react to 

changes in school “traditions” with respect to alcohol? 

Although colleges can resolve each of these concerns, the 

process takes time and requires a substantial 

commitment of leadership and resources. 

“Universities are often afraid to reveal that they have a problem with alcohol, although 

everyone knows it anyway. But we’ve seen important benefits from focusing on the problem and 

taking a tough stand. Applications are up, student quality is up, more students are participating 

in activities like drama and music, and alumni giving has increased. I know that support for 

the University has grown with our reputation for taking strong ethical positions and sticking 

with them.” 

Robert L. Carothers, President 

University of Rhode Island 

10 
On the basis of experience, many schools also tend to 

be justifiably concerned about prevention efforts where 

data collection is a key activity. Data collection efforts 

can be difficult to implement on campus. Legal and 

ethical considerations, such as the necessity of obtaining 

consent from parents and the obligation to protect the 

confidentiality of student responses, impede and 

frequently stop the process completely. Colleges and 

universities that persist despite these barriers sometimes 

find that the resulting data are subjectively interpreted 

and may be used to tarnish a school’s reputation. 

The widespread perception that student-drinking rates 

are immutable is another deterrent to action. Given 

these obstacles, it is not surprising that some colleges are 

reluctant to undertake and sustain rigorous efforts to 

address underage and excessive drinking on campuses. 

Impact of Inadequate Information 

Both college presidents and researchers on the Task 

Force agreed that the perception that underage and 

excessive college drinking is intractable reflects the need 

for more credible research and evaluation to be brought 

to this issue. In general, colleges and universities have 

not applied the methods, techniques, and findings from 

cutting-edge alcohol prevention research to the problem 

of college student drinking. 

Problems with Program Design 

In some cases, campus initiatives have been designed 

without considering the important role of research in 

planning and evaluating a school’s alcohol program. As a 

result, principles useful in selecting effective programs 

have been overlooked. Without this knowledge, colleges 

find it difficult to identify and combine strategies that 

address the particular drinking problems on their 

campuses. The role of science should be emphasized more 

for planning (selecting evidence-based strategies) and 

evaluation (determining effects of any current strategies). 

Steps in Integrating Research 

into College Alcohol Programs 

Involve college and university presidents using prevalence and 

cost data, evidence of research effectiveness, and aspirations 

for a lasting legacy. 

Establish administrative norms acknowledging the need for 

research and mandating evaluation. 

Obtain external support from the surrounding community, 

alcohol beverage and hospitality industries, foundations, and 

other organizations concerned about the consequences of 

student drinking. 

Impact on Implementation 

Implementation is another area where insufficient 

research shortchanges schools. Without a strong research 

base to guide their formulation, program objectives tend 

to be nonspecific or unrealistic. Lack of information also 

affects a college’s capacity to develop a meaningful 

staffing plan and budget, deficiencies that limit program 

success at the outset. When vital information is not 

included in program design, used to guide 

implementation, and monitored through careful 

evaluation, results are likely to be disappointing. 

Results of Prolonged Ineffectiveness 

In addition to poor outcomes, prevention efforts that fail 

to achieve their goals: 

Demoralize the many college administrators who are 

charged with addressing this problem, 

Leave fewer resources available for investment in 

productive programs, and 

Lead to a growing sense of fatalism about the issue. 

With resources committed to ineffective programs, the 

problems associated with underage and excessive college 

drinking—violence, injuries, sexual assaults, vandalism, 

poor academic performance—persist and, in the process, 

derail and sometimes destroy the lives of many of the 

11 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

Nation’s most promising young adults. Reversing this 

situation is crucial and, from the Task Force’s perspective, 

will happen only if every college and university president 

works in conjunction with the alcohol research 

community to implement evidence-based prevention 

strategies. Task Force members also understand that for 

some administrators this step represents a mindset 

change—one that looks to validated research for genuine 

answers rather than quick fixes, which may seem 

appealing when confronted with a crisis. 

Integrating Research 

Into College Alcohol Program Planning 

Integrating research into college alcohol program 

planning requires the active participation of college and 

university presidents; cooperation from the larger 

campus community—including faculty, staff, and the 

surrounding community (e.g., local police, local 

businesses, community leaders), as well as students, 

parents, and alumni; and support from alcohol 

researchers and policymakers. 

Involving Colleges and Universities 

The first step in integrating research into the planning 

and execution of campus alcohol programs is to 

convince college and university presidents of the wisdom 

of supporting long-term research agendas that may not 

produce results during their tenure. Compelling 

arguments for this position can be made on the basis of: 

Data describing the dimensions of the college 

drinking epidemic and its effects on students, 

institutional costs and good will, and the surrounding 

community; 

Why Do It? 

Excessive drinking affects all students, increases 

institutional costs, and hurts town-gown 

relationships. 

Research-based strategies are more effective than 

quick fixes and produce quantifiable results. 

Effective programs improve student health and 

safety and contribute to a meaningful legacy. 

Commit to a long-term, research-based approach. 

Persuade the larger campus community of the 

wisdom of this approach. 

Where To Begin? 

How Do I Take Action? 

Collect basic information about the nature and 

extent of student drinking as a first step. 

Design a comprehensive program using the 

“3-in-1” framework recommended by the Task 

Force. Incorporate strategies that address the 

particular problems on your campus. 

Secure outside support for your program. 

How Can I Sustain Interest in the Program? 

Create administrative norms that help institutionalize 

the program. 

Monitor program results and publicize them. 

Continue the conversation on this issue with all 

members of the campus community, local 

community leaders, and your peers; use this 

dialogue to improve and update the program to 

respond to changing conditions on campus. 

Creating a Research-Based 

Campus Alcohol Program 

12 
Findings indicating that research-based strategies are 

effective in reducing underage and excessive student 

drinking; and 

College presidents’ desires to ensure a legacy that 

includes improved student health and safety as major 

achievements. 

Establishing Administrative Norms 

Once college and university presidents are committed to 

using a research-based approach, the next step is to 

establish administrative norms that: 

Recognize the importance of research, and 

Require inclusion of review and evaluation 

components before institutional resources are 

allocated for program implementation. 

Obtaining External Support 

Support is also needed on a more global level. Schools 

cannot be expected to mount campaigns for or 

implement research-based approaches on their own. 

Commitments are needed from the community 

surrounding the campus, as well as from funding 

sources such as foundations, national organizations, 

and the hospitality and alcohol beverage industries to 

support only comprehensive, research-based strategies 

for addressing underage and excessive college drinking. 

Concerted efforts by State and Federal policymakers 

and leaders from the broad-based alcohol abuse 

prevention and treatment fields are also essential to 

achieving this goal. 

Credible research provides the foundation for making 

solid programming decisions. The sophisticated methods 

employed in contemporary research are producing 

information that: 

Improves the effectiveness of prevention programs 

aimed at adolescents and young adults, and 

Provides much-needed accountability for resources 

expended. 

In the Task Force’s view, the prospects for genuine 

progress in addressing underage and excessive student 

drinking are enhanced substantially when colleges and 

universities can: 

Assess their problems realistically, 

Adopt research-based strategies to confront them, 

Adjust program activities to meet institution-specific 

needs, and 

Define outcomes for drinking programs that reflect 

desired changes and can be measured. 

External resources can help presidents ensure that 

these important activities are integrated within a school’s 

program for addressing hazardous student drinking. 

Defining Credible Research 

Task Force members relied on credible research to understand the 

impact of high-risk drinking on campus and formulate recommendations for addressing it. In contrast to research that is methodologically weak or where more has been inferred than the data allow, 

credible research increases understanding. 

Sound research follows the principles of the scientific method and 

uses as many rigorous methodological techniques as possible when 

designing studies. Among those techniques are randomized assignment of study subjects to control and experimental groups, use of 

pre- and post-observations or multiple observations when feasible, 

and use of probability sampling. 

Whereas findings from inadequately designed, implemented, or analyzed research can lead to erroneous conclusions, credible research 

advances the practice of alcohol problem prevention and treatment 

by generating, methodically applying, and testing new ideas. 

13 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

A Call to Action: Recommendations for
 

Addressing Excessive College Drinking
 

To provide practical assistance to colleges and 

universities, the Task Force on College Drinking 

developed a series of recommendations on integrating 

research-based principles and practices in alcohol 

program planning. The Task Force also prepared 

recommendations specifically for researchers and NIAAA 

on the direction of future research and areas for potential 

collaboration with colleges and universities. All 

recommendations are based on scientific evidence, reflect 

a consensus among Task Force members, and represent 

the most objective guidance currently available on 

preventing risky drinking by college students. As such, 

the Task Force believes that these recommendations 

should serve as the basis for all interventions supported 

by national, state, and local organizations and 

implemented by colleges and communities. 

Recommendations for 

Colleges and Universities 

To change the culture of drinking on campus, the Task 

Force recommends that all colleges and universities 

adopt the following overarching approach to program 

development and then select appropriate strategies from 

among those presented on the following pages to tailor 

programs to the special needs of their schools. 

Overarching Framework 

The research strongly supports the use of comprehensive, 

integrated programs with multiple complementary 

components that target: (1) individuals, including 

at-risk or alcohol-dependent drinkers, (2) the student 

population as a whole, and (3) the college and the 

surrounding community (Hingson and Howland, 2002; 

DeJong et al., 1998; Institute of Medicine, 1989). The 

3-in-1 Framework presented here focuses simultaneously 

on each of the three primary audiences. 

The Task Force members agreed that the 3-in-1 

Framework is a useful introduction to encourage 

presidents, administrators, college prevention specialists, 

students, and community members to think in a broad 

and comprehensive fashion about college drinking. It is 

designed to encourage consideration simultaneously of 

multiple audiences on and off campus. The Task Force 

offers the 3-in-1 Framework as a starting point to 

develop effective and science-based prevention efforts. 

The brief descriptions that follow provide the rationale 

for emphasizing these three targets in prevention 

programs aimed at high-risk student drinking and 

identify alternative prevention strategies that address 

each group. 

(1) Individuals, Including At-Risk or AlcoholDependent Drinkers: The risk for alcohol problems 

exists along a continuum. Targeting only those with 

identified problems misses students who drink heavily or 

misuse alcohol occasionally (e.g., drink and drive from 

time to time). In fact, nondependent, high-risk drinkers 

What does a multivariate 

perspective mean? 

Alcohol research clearly indicates that multiple factors interact 

to produce various drinking patterns. Factors include students’ 

genetic/biological characteristics, family and cultural backgrounds and environments, previous drinking experiences in 

high school, and the particular environment of the college in 

which they are enrolled. Even within one college, patterns may 

be influenced by students’ participation in fraternities/sororities, sports teams, or other social groups. Research now has the 

capacity to bring this enlarged perspective to the problem of 

college drinking and to test models that take into account 

many of these factors. 

14 
account for the majority of alcohol-related deaths, 

disability, and damage (Lemmons, 1995; Kreitman, 

1986). 

It is crucial to support strategies that assist individual 

students identified as problem, at-risk, or alcoholdependent drinkers. Strategies are clearly needed to 

engage these students as early as possible in appropriate 

screening and intervention services—whether provided 

on campus or through referral to specialized 

community-based services. One important effort to 

increase on-campus screening is National Alcohol 

Screening Day, an event that takes place in April each 

year. This program, supported by NIAAA and the 

Substance Abuse and Mental Health Services 

Administration, provides free, anonymous testing and 

health information at a growing number of colleges and 

universities. 

(2) Student Body as a Whole: The key to affecting 

the behavior of the general student population is to 

address the factors that encourage high-risk drinking 

(DeJong and Langenbahn, 1996; DeJong and 

Linkenbach, 1999; DeJong and Langford, 2002; 

Edwards et al., 1994; Perkins, 2002; Toomey and 

Wagenaar, 2002; Toomey et al., 1993). 

They include the: 

Widespread availability of alcoholic beverages to 

underage and intoxicated students, 

Aggressive social and commercial promotion of 

alcohol, 

Large amounts of unstructured student time, 

Inconsistent publicity and enforcement of laws and 

campus policies, and 

Student perceptions of heavy alcohol use as the norm. 

Specific strategies useful in addressing these problem 

areas tend to vary by school. Examples of some of the 

most promising strategies appear in the section 

“Recommended Strategies” (please see below). 

(3) College and the Surrounding Community: 

Mutually reinforcing interventions between the college 

and surrounding community can change the broader 

environment and help reduce alcohol abuse and alcoholrelated problems over the long term. When college 

drinking is reframed as a community as well as a college 

problem, campus and community leaders are more likely 

to come together to address it comprehensively. The 

joint activities that typically result help produce policy 

and enforcement reforms that, in turn, affect the total 

drinking environment. Campus and community 

alliances also improve relationships overall and enable 

key groups such as student affairs offices, residence life 

directors, local police, retail alcohol outlets, and the 

court system to work cooperatively in resolving issues 

involving students (Hingson and Howland, 2002; 

Holder et al., 1997a, 2000; Perry and Kelder, 1992; 

Saltz and Stangetta, 1997). 

Following are specific strategies that can be used 

within the 3-in-1 Framework to create programs 

addressing all three levels. 

Recommended Strategies 

The evidence supporting the substance abuse 

prevention strategies in the literature varies widely. 

These differences do not always mean that one strategy 

is intrinsically better than another. They may reflect the 

fact that some strategies have not been as thoroughly 

studied as others or have not been evaluated for 

application to college drinkers. To provide a useful list 

15 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

that accounts for the lack of research as well as negative 

findings, Task Force members placed prevention 

strategies in descending tiers on the basis of the 

evidence available to support or refute them. 

Tier 1: Evidence of Effectiveness Among 

College Students 

Strong research evidence (two or more favorable studies 

available) supports the strategies that follow. All 

strategies target individual problem, at-risk, or alcoholdependent drinkers. Their efficacy as part of a campuswide strategy has not been tested. 

Strategy: Combining cognitive-behavioral skills with 

norms clarification and motivational enhancement 

interventions. Cognitive-behavioral skills training strives 

to change an individual’s dysfunctional beliefs and 

thinking about the use of alcohol through activities such 

as altering expectancies about alcohol’s effects, 

documenting daily alcohol consumption, and learning to 

manage stress. 

Norms or values clarification examines students’ 

perceptions about the acceptability of abusive drinking 

Assessment of Alcohol Problems 

Within the last generation, researchers have developed semistructured interviews that provide reliable, standardized assessments of alcohol consumption, alcohol problems, and the symptoms of alcohol abuse and dependence. 

These new techniques allow researchers to evaluate the extent of 

various alcohol-related problems among college and noncollege 

samples and to assess their magnitude nationally and regionally. 

They also enable researchers to determine how alcohol-related 

problems change in response to general population trends, new 

laws and policies, and alcohol prevention and programs. 

Influence of Implicit 

Expectations and Thoughts 

Thoughts and motives of which individuals are unaware or barely aware often influence behavioral choices. Research in cognitive psychology and neuroscience has vastly improved capacity to 

assess “implicit” decision making. Recently, this understanding 

has been applied to the problem of college drinking. As a result, 

program planners are developing prevention programs that do 

not assume that every choice college students make has been 

carefully considered before they act on it. 

behavior on campus and uses data to refute beliefs about 

the tolerance for this behavior as well as beliefs about the 

number of students who drink excessively and the 

amounts of alcohol they consume. 

As its name implies, motivational enhancement is 

designed to stimulate students’ intrinsic desire or 

motivation to change their behavior. Motivational 

enhancement strategies are based on the theory that 

individuals alone are responsible for changing their 

drinking behavior and complying with that decision 

(Miller et al., 1992). In motivational enhancement 

interventions, interviewers assess student alcohol 

consumption using a formal screening instrument. 

Results are scored and students receive nonjudgmental 

feedback on their personal drinking behavior in 

comparison with that of others and its negative 

consequences. Students also receive suggestions to 

support their decisions to change. 

Research indicates that combining the three strategies 

is effective in reducing consumption (Larimer and 

Cronce, 2002). One example of such an approach is a 

program using motivational enhancement, developed by 

16 
Marlatt. The program, the Alcohol Skills Training 

Program (ASTP), is a cognitive-behavioral alcohol 

prevention program that teaches students basic 

principles of moderate drinking and how to cope with 

high-risk situations for excessive alcohol consumption 

(Fromme et al., 1994). The ASTP is designed for group 

administration and includes an alcohol expectancy 

challenge component. Controlled outcome studies show 

that the ASTP significantly reduces drinking rates and 

associated problems for both 1-year (Kivlahan et al., 

1990) and 2-year follow-up periods (Baer et al., 1992). 

Strategy: Offering brief motivational enhancement 

interventions. Students who receive brief (usually 45­

minute), personalized motivational enhancement 

sessions, whether delivered individually or in small 

groups, reduce alcohol consumption. This strategy can 

also reduce negative consequences such as excessive 

drinking, driving after drinking, riding with an 

intoxicated driver, citations for traffic violations, and 

injuries (Aubrey, 1998; D’Amico and Fromme, in press; 

Larimer and Cronce, 2002; Marlatt et al., 1998; Monti 

et al., 1999). This approach has been used successfully in 

medical settings (Dimeff, 1999; Monti et al., 1999). An 

effective brief intervention has been developed at the 

University of Washington. This brief intervention for 

high-risk drinkers is based on the ASTP program and is 

known as the BASICS program: Brief Alcohol Screening 

and Intervention for College Students (Dimeff et al., 

1999). BASICS is administered in the form of two 

individual sessions in which students are provided 

feedback about their drinking behavior and given the 

opportunity to negotiate a plan for change based on the 

principles of motivational interviewing. High-risk 

drinkers who participated in the BASICS program 

significantly reduced both drinking problems and 

alcohol consumption rates, compared to control group 

participants, at both the 2-year follow-up (Marlatt et al., 

1998) and 4-year outcome assessment periods (Baer et 

al., 2001). BASICS has also been found to be clinially 

significant in an analysis of individual student drinking 

changes over time (Roberts et al., 2000). 

Strategy: Challenging alcohol expectancies. This 

strategy works by using a combination of information 

and experiential learning to alter students’ expectations 

about the effects of alcohol so they understand that 

drinking does not necessarily produce many of the 

effects they anticipate such as sociability and sexual 

attractiveness (Darkes and Goldman, 1993, 1998; Jones 

et al., 1995). The research conducted to date indicates 

that the positive effects of this strategy last for up to 6 

weeks in men, but additional research is under way to 

verify and extend this approach to women and for 

longer time periods. 

Tier 2: Evidence of Success With General 

Populations That Could Be Applied to 

College Environments 

The Task Force recommends that college presidents, 

campus alcohol program planners, and student and 

community leaders explore the strategies listed below 

because they have been successful with similar 

populations, although they have not yet been 

comprehensively evaluated with college students 

(Hingson et al., 1996; Holder et al., 2000; Saltz and 

Stangetta, 1997; Voas et al., 1997). These environmental 

strategies are not guaranteed to alter the behavior of 

every college student, but they can help change those 

aspects of the campus and community culture that 

support excessive and underage alcohol use. 

17 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

“Student safety is of paramount importance, we simply have to make certain that our [alcohol
 

prevention] program is working.” 

Strategy: Increased enforcement of minimum 

drinking age laws (Toomey and Wagenaar, 2002). The 

minimum legal drinking age (MLDA) law is the most 

well-studied alcohol control policy. Compared to other 

programs aimed at youth in general, increasing the legal 

age for purchase and consumption of alcohol has been 

the most successful effort to date in reducing underage 

drinking and alcohol-related problems. Most studies 

suggest that higher legal drinking ages reduce alcohol 

consumption, and over half found that a higher legal 

drinking age is associated with decreased rates of traffic 

crashes. Studies also indicate that policies are less 

effective if they are not consistently enforced. Moreover, 

the certainty of consequences is more important than 

severity in deterring undesirable behavior. 

The benefits of the MLDA have occurred with 

minimal enforcement, yet studies of the effects of 

increased enforcement show that it is highly effective in 

reducing alcohol sales to minors (Wagenaar and Toomey, 

2002). Increased enforcement—specifically compliance 

checks on retail alcohol outlets—typically cuts rates of 

sales to minors by at least half (Preusser et al., 1994; 

Lewis et al., 1996; Grube, 1997). Efforts to reduce the 

use of false age identification and tighter restrictions on 

“home delivery” of alcohol may also help enhance the 

effectiveness of this law. 

Strategy: Implementation, increased publicity, and 

enforcement of other laws to reduce alcohol-impaired 

driving. Injury and deaths caused by alcohol-impaired 

William Jenkins, President 

Louisiana State University System 

driving and related injuries and deaths can be reduced by 

lowering legal blood alcohol limits to .08 percent for 

adult drivers (Dee, 2001; Hingson et al., 1996a, 2000; 

Schultz et al., 2001; Voas et al., 2000); setting legal 

blood alcohol content (BAC) for drivers under age 21 at 

.02 percent or lower (Hingson et al., 1994; Wagenaar et 

al., 2001); use of sobriety check points (Castle et al., 

1995; Lacey et al., 1999; Schultz et al., 2001); server 

training intervention (Gliksman et al., 1993; Lang et al., 

1998; Russ and Geller, 1987; Saltz, 1989; Schultz et al., 

2001); and administrative license revocation laws (Dee, 

2001; Klein, 1989; Voas et al., 2000; Zador et al., 

1989). Safety belt laws, particularly primary enforcement 

belt laws, have been shown in numerous studies to 

reduce traffic deaths and injuries (Dinh-Zaar et al., 

2001). When California changed from a secondary to a 

primary enforcement belt law that permits police to stop 

vehicles and give a citation simply because an occupant 

was not belted, safety belt use rates increased 39 percent 

among drivers with BAC of .10 percent or higher 

compared to 23 percent overall (Lange and Voas, 1998). 

This indicates that primary enforcement belt laws can 

prevent many alcohol-related traffic fatalities. 

Comprehensive community interventions have also 

shown that increased enforcement and publicity of laws 

to reduce alcohol-impaired driving have produced 

significant reductions in the types of motor vehicle 

crashes most likely to involve alcohol (Holder et al., 

2000) and alcohol-related traffic deaths (Hingson et al., 

1996b). 

18 
Strategy: Restrictions on alcohol retail outlet 

density (Scribner et al., 1995; Gruenewald et al., 1993). 

Studies of the number of alcohol licenses or outlets per 

population size have found a relationship between the 

density of alcohol outlets, consumption, and related 

problems such as violence, other crime, and health 

problems (Toomey and Wagenaar, 2002). One study, 

targeting college students specifically, found higher levels 

of drinking and binge drinking among underage and 

older college students when a larger number of 

businesses sold alcohol within one mile of campus 

(Chaloupka and Wechsler, 1996). Numbers of outlets 

may be restricted directly or indirectly through policies 

that make licenses more difficult to obtain such as 

increasing the cost of a license. 

Strategy: Increased price and excise taxes on 

alcoholic beverages (Godfrey, 1997; Chaloupka and 

Wechsler, 1996; Sutton and Godfrey, 1995; Kenkel, 

1993). The effect of price on consumption has been 

studied extensively. All types of drinkers appear to be 

affected by price. Studies show that when the price of 

alcohol increases, many alcohol-related problems, 

including motor vehicle fatalities, robberies, rapes, and 

liver cirrhosis mortality, decrease (Cook and Moore, 

1993). Although older heavy drinkers seem to be less 

affected by variations in price than other consumers, 

price still appears to have a substantial impact on young, 

heavy drinkers. For this reason, efforts to increase price 

or to prevent reductions in price likely would affect the 

behavior of the full spectrum of drinkers on campus. 

Strategy: Responsible beverage service policies in 

social and commercial settings (Saltz and Stangetta, 

1997; Holder et al., 1997b; Treno and Holder, 1997). 

Studies suggest that bartenders, waiters, and others in 

the hospitality industry would welcome written policies 

about responsible service of alcohol and training in how 

to implement them appropriately. Policies could include 

serving alcohol in standard sizes, limiting sales of 

pitchers, cutting off service of alcohol to intoxicated 

patrons, promoting alcohol-free drinks and food, and 

eliminating last-call announcements. Servers and other 

staff could receive training in skills such as slowing 

alcohol service, refusing service to intoxicated patrons, 

checking age identification, and detecting false 

identification. To prevent sales to underage patrons, it is 

important to back identification policies with penalties 

for noncompliance. 

Strategy: The formation of a campus and 

community coalition involving all major stakeholders 

may be critical to implement these strategies 

effectively. A number of comprehensive community 

efforts have been designed to reduce alcohol and other 

substance use and related negative consequences among 

underaged youth, including college students, and among 

adults (Chou et al., 1998; Hingson et al., 1996b; 

Holder and Treno, 1997; Holder et al., 1997b; Pentz et 

al., 1989; Perry et al., 1996; Saltz and Stangletta, 1997; 

Wagenaar et al., 2000); and their outcomes demonstrate 

the potential effectiveness of this approach in college 

communities. For example, the Community Trials 

Program (Grube, 1997; Holder and Treno, 1997; 

Holder et al., 1997a, b; Holder and Reynolds, 1997; 

Holder et al., 2000; Treno and Holder, 1997; Reynolds 

et al., 1997; Saltz and Stangletta, 1997; Voas et al., 

1997), which focused on alcohol trauma in the general 

population, resulted in a significant decline in 

emergency room admissions for alcohol-related assault. 

Both this program and Communities Mobilizing for 

Change (CMCA) (Wagenaar et al., 1999, 2000), which 

was designed specifically to reduce drinking among 

19 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

young people, resulted in reduced alcohol sales to 

minors. In the CMCA project young people ages 18 to 

20 reduced their propensity to provide alcohol to other 

teens and were less likely to try to buy alcohol, drink in 

a bar, or consume alcohol. The Massachusetts Saving 

Lives Program (Hingson et al., 1996b), designed to 

reduce drunk driving and speeding in the general 

population, produced relative declines in alcohol-related 

traffic deaths among persons 16 to 25 years of age. 

This approach reframes the issue as a community 

problem, not simply a college problem, brings together 

the range of players needed to address it, and sets the 

stage for cooperative action. In addition to college 

presidents and campus administrators, stakeholders in 

campus-community coalitions include student groups, 

faculty, staff, community leaders, law enforcement, and 

representatives from hospitality and alcohol beverage 

industries (Hingson and Howland, 2002). Research 

shows that promoting community ownership of 

programs enhances success (Holder et al., 1997a; Perry et 

al., 1996). On that basis, active campus and community 

coalitions can be expected to build support for addressing 

underage and excessive college drinking; help assure that 

strategies used respond to genuine community needs; 

maintain and, ultimately, institutionalize effective 

strategies; and evaluate and disseminate the results of the 

coalition’s activities to other college communities 

(Hingson and Howland, 2002). 

Tier 3: Evidence of Logical and Theoretical 

Promise, But Require More Comprehensive 

Evaluation 

The Task Force recognizes that a number of popular 

strategies and policy suggestions make sense intuitively 

or have strong theoretical support. Many also raise 

researchable questions that may be crucial in reducing 

the consequences of college student drinking. Although 

the Task Force is eager to see these strategies 

implemented and evaluated, it cautions interested 

schools to assemble a team of experienced researchers to 

assist them in the process. 

The Task Force recommends that schools considering 

any of these strategies incorporate a strong evaluation 

component to test their viability in actual practice. 

Every strategy that appears below targets the student 

population as a whole. 

Strategy: Adopting the following campus-based 

policies and practices that appear to be capable of 

reducing high-risk alcohol use. These activities are 

particularly appealing because straightforward and 

relatively brief evaluations should indicate whether they 

would be successful in reducing high-risk drinking on a 

particular campus. 

Reinstating Friday classes and exams to reduce 

Thursday night partying; possibly scheduling 

Saturday morning classes; 

“Excessive student drinking contributes to failed academic performance ranging from missed 

classes to attrition. At the same time, many colleges and universities unwittingly help create a 

culture of student drinking by scheduling no classes on Friday, thereby creating three-day 

weekends, and by grade inflation which tolerates and even rewards minimal student 

performance.” 

Susan Resneck Pierce, President 

University of Puget Sound 

20 
Implementing alcohol-free, expanded late-night 

student activities; 

Eliminating keg parties on campus where underage 

drinking is prevalent; 

Establishing alcohol-free dormitories; Employing older, salaried resident assistants or hiring 

adults to fulfill that role; 

Further controlling or eliminating alcohol at sports 

events and prohibiting tailgating parties that model 

heavy alcohol use; 

Refusing sponsorship gifts from the alcohol industry 

to avoid any perception that underage drinking is 

acceptable; and 

Banning alcohol on campus, including at faculty and 

alumni events. 

Strategy: Increasing enforcement at campus-based 

events that promote excessive drinking (DeJong, 

1998; DeJong and Langenbahn, 1996; Gomberg, 1999; 

Gulland, 1994; Pittayathikhun et al., 1997). Campus 

police can conduct random spot checks at events and 

parties on campus to ensure that alcohol service is 

monitored and that age identification is checked. It may 

be important for non-students to enforce these campus 

policies. Resident assistants and others charged with 

developing close supportive relationships with students 

might find it difficult to enforce alcohol-related rules 

and regulations consistently and uniformly. 

Strategy: Increasing publicity about and 

enforcement of underage drinking laws on campus 

and eliminating “mixed messages.” As indicated 

previously, active enforcement of minimum legal age 

drinking laws results in declines in sales to minors 

(Grube, 1997; Lewis et al., 1996; Preusser et al., 1994; 

Wagenaar et al., 2000). Lax enforcement of State laws 

21 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

“We dare not let alcohol blemish your bright promise.” 

Thomas K. Hearn, Jr., President 

Wake Forest University 

in a letter to incoming first-year students 

and local regulations on campus may send a “mixed 

message” to students about compliance with legally 

imposed drinking restrictions. Creative approaches are 

needed to test the feasibility of this strategy (DeJong and 

Langford, 2002). 

Strategy: Consistently enforcing disciplinary 

actions associated with policy violations (DeJong and 

Langford, 2002). Inconsistent enforcement of alcoholrelated rules may suggest to students that “rules are made 

to be broken.” To test the effectiveness of this approach 

would likely require staff and faculty training, frequent 

communication with students, and the implementation 

of a research component. 

Strategy: Conducting marketing campaigns to 

correct student misperceptions about alcohol use 

(Berkowitz, 1997; Clapp and McDonnell, 2000; DeJong 

and Linkenbach, 1999; Johannessen et al., 1999; Page et 

al., 1999; Perkins, 1997, 2002; Perkins and Wechsler, 

1996). On the basis of the premise that students 

overestimate the amount of drinking that occurs among 

their peers and then fashion their own behavior to meet 

this perceived norm, many schools are now actively 

conducting “social norming” campaigns to correct many 

of these misperceptions. 

Strategy: Provision of “safe rides” programs 

(DeJong, 1995). Safe rides attempt to prevent drinking 

and driving by providing either free or low-cost 

transportation such as taxis or van shuttles from popular 

student venues or events to residence halls and other safe 

destinations. Safe rides are usually restricted to students, 

faculty, staff, and a limited number of “guests.” Safe 

rides sponsors often include student government, Greek 

Councils, student health centers, campus police, 

Mothers Against Drunk Driving chapters, and other 

local community organizations, agencies, and businesses. 

They have been criticized as potentially encouraging 

high-risk drinking, and this possibly should be 

considered in design, promotion, and monitoring. 

Strategy: Regulation of happy hours and sales 

(Chaloupka and Wechsler, 1996; Toomey and Wagenaar, 

2002). Happy hours and price promotions—such as two 

drinks for the price of one or women drink for free—are 

associated with higher consumption among both light 

and heavy drinkers. Research shows that as the price of 

alcohol goes up, consumption rates go down, especially 

among younger drinkers. Because many bars 

surrounding campuses attract students by promoting 

drink specials, restrictions on happy hours have the 

potential to reduce excessive consumption off campus. 

If colleges and universities have a licensed establishment 

on campus, drink specials could be prohibited or 

promotion of alcohol-free drinks and food specials could 

be encouraged. In nonlicensed settings on campus that 

serve alcohol, event planners could opt to limit the 

amount of free alcohol that is available and eliminate all 

self-service. Schools could also limit alcohol use to 

weekends or after regular class hours in an effort to 

separate drinking from activities more closely aligned 

with the core academic mission. 

22 
Strategy: Informing new students and their parents 

about alcohol policies and penalties before arrival and 

during orientation periods (DeJong and Langford, 2002). 

There is some anecdotal evidence that experiences during 

the first 6 weeks of enrollment affect subsequent success 

during the freshman year. Because many students begin 

drinking heavily during this time, they are unable to adapt 

appropriately to campus life. Alerting parents and students 

to this possibility early on (e.g., through preadmission 

letters to parents and inclusion of information in 

orientation sessions and in presidents’ and student leaders’ 

welcoming speeches) may help prevent the development 

of problems during this critical, high-risk period. 

Tier 4: Evidence of Ineffectiveness 

The Task Force recognizes that it is difficult or 

impossible to “prove” that a specific intervention 

approach is universally ineffective. Nevertheless, when 

there are consistent findings across a wide variety of welldesigned studies, it is possible to conclude that an 

approach is not likely to be effective and that limited 

resources should be used in other ways. Additionally, if 

there is strong evidence that an intervention approach is 

actually harmful or counterproductive, recommendations 

not to use it can be made based on fewer studies. 

The Task Force also notes that some interventions may 

be ineffective when used in isolation, but might make an 

important contribution as part of a multicomponent 

integrated set of programs and activities. However, until 

there is evidence of a complementary or synergistic effect 

resulting from inclusion with other strategies, college 

administrators are cautioned against making 

assumptions of effectiveness without scientific evidence. 

For instance, two strategies sometimes are labeled as 

ineffective—the TIPS server training program and Prime 

for Life! On Campus (Talking About Alcohol), formerly 

known as OCTAA—when not used with other strategies 

(Larimer and Cronce, 2002; Maddock, 1999; Sammon 

et al., 1991). However, there is no scientific evidence 

that these programs actually work well if used in 

conjunction with other complementary strategies. 

Strategy: Informational, knowledge-based, or 

values clarification interventions about alcohol and 

the problems related to its excessive use, when used 

alone (Larimer and Cronce, 2002; Maddock, 1999). 

This strategy is based on the assumption that college 

students excessively use alcohol because they lack 

knowledge or awareness of health risks and that an 

increase in knowledge would lead to a decrease in use. 

Although educational components are integral to some 

successful interventions, they do not appear to be 

effective in isolation. Despite this evidence, 

informational/educational strategies are the most 

commonly utilized techniques for individually focused 

prevention on college campuses (DeJong and Langford, 

2002; Larimer and Cronce, 2002; Ziemelis, 1998). 

Strategy: Providing blood alcohol content feedback 

to students. This strategy uses breath analysis tests to 

provide students accurate information on their BAC. It 

could be used as part of a research evaluation or to 

dissuade students from driving while under the influence 

or continuing to drink past intoxication. Providing this 

information to students who are drinking must be 

approached with caution. Some researchers have found 

that the presence of immediate breath analysis feedback 

can actually encourage excessive drinking when students 

make a contest of achieving high BACs (personal 

communications from Scott Geller, 2002 and Robert 

Voas, 2002). If BAC feedback is to be provided in 

naturalistic settings, the procedure should be carefully 

monitored for adverse effects and adjusted as necessary. 

23 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

3-in-1 Framework 

Level of Operation 

Individuals, including Student Community 

Tier Strategy At-Risk and Population as 

Dependent Drinkers Whole 

1: Effective 

among college 

students 

Combining cognitive-behavioral skills with norms 

clarification & motivational enhancement intervention Yes No No 

Offering brief motivational enhancement interventions 

in student health centers and emergency rooms Yes No No 

Challenging alcohol expectancies Yes No No 

2: Effective 

with general 

populations 

Increased enforcement of minimum drinking age laws No Yes Yes 

Implementation, increased publicity, and enforcement 

of other laws to reduce alcohol-impaired driving No Yes Yes 

Restrictions on alcohol retail density No No Yes 

Increased price and excise taxes on alcoholic beverages No No Yes 

Responsible beverage service policies in social & 

commercial settings No Yes Yes 

The formation of a campus/community coalition No Yes Yes 

3: Promising Adopting campus-based policies to reduce high-risk 

use (e.g., reinstating Friday classes, eliminating keg 

parties, establishing alcohol-free activities & dorms) 

No Yes No 

Increasing enforcement at campus-based events that 

promote excessive drinking No Yes No 

Increasing publicity about enforcement of underage 

drinking laws/eliminating “mixed” messages No Yes Yes 

Consistently enforcing disciplinary actions associated 

with policy violations No Yes No 

Conducting marketing campaigns to correct student 

misperceptions about alcohol use on campus No Yes No 

Provision of “safe rides” programs No Yes Yes 

Regulation of happy hours and sales No Yes Yes 

Enhancing awareness of personal liability Yes Yes No 

Informing new students and parents about alcohol 

policies and penalties Yes Yes No 

4: Ineffective Informational, knowledge-based or values clarification 

interventions when used alone N/A N/A N/A 

24 
A Special Role for College Presidents
 

“It has been my experience, both on campus and in the community, that invitations on 

presidential letterhead result in greater participation in our efforts than otherwise have been 

the case.” 

Susan Resneck Pierce, President 

University of Puget Sound 

In the Task Force’s view, presidential leadership is 

essential to ensure that recommendations relevant to 

each college and university are incorporated into its 

alcohol abuse prevention program planning process. As a 

school’s chief executive officer, educational leader, and 

public spokesperson, a president is expected to set 

priorities, serve as a catalyst for new programs, and 

communicate concern about issues compromising the 

educational environment (DeJong, 1998). By virtue of 

their authority, presidents can pull together all the 

disparate pieces of institutional policy on alcohol from 

student life, athletics, administrative affairs, and 

residence life. Once new or refined policies and practices 

are in place, their position helps ensure that every sector 

of the college implements the new procedures (Mara, 

2000; DeJong, 1998). 

drinking, presidential leadership is crucial to set plans in 

motion and support the actions needed to reverse the 

culture of drinking on campus. 

The Task Force recognizes that although research can 

provide useful guidance to colleges and universities in 

addressing the consequences of high-risk student 

Presidential visibility and influence also lend increased 

importance to prevention efforts on campus and in the 

community and promote student as well as faculty 

investment in and ownership of programs. According to 

the project director of Louisiana State University’s 

Community Coalition for Change, students deem it an 

“honor” to participate on the college prevention task 

force when the school president calls for their 

involvement and conveys personal commitment to the 

issue. 

25 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

The Need for Student Participation in 

Prevention Policymaking and Programs 

Both college presidents and student members of the Task 

Force reiterated the importance of involving students in 

rethinking a school’s approach to high-risk student 

drinking. Students are not only the primary targets and 

beneficiaries of prevention programs, but also key 

contributors to their successful implementation (Mara, 

2000; Presidents Leadership Group, 1997). 

In their discussions about the practical issues involved 

in developing and sustaining workable policies, Task 

Force members described several areas where student 

participation not only improved a school’s policy, but 

also increased campus-wide “ownership” of the 

prevention efforts emanating from it (Mara, 2000). 

These include participation in (Mara, 2000): 

Campus-based task forces to direct prevention 

program efforts and develop specific strategies for 

promoting change in student organizations, 

Joint campus and community coalitions, 

Reviews of proposed policies before they are finalized, 

Judicial reviews by dormitory councils that hear cases 

of first alcohol infractions, and 

Training of student residence hall staff to eliminate 

communication of mixed messages about alcohol use 

on campus and improve consistent enforcement of 

alcohol policies. 

From the Task Force’s perspective, inviting students to 

share in the development and implementation of the 

recommendations outlined above will help ensure that 

the strategies selected meet an institution’s specific needs 

and receive the continued attention required for success. 

26 
Steps That Signal Imminent Change 

in the Culture of Drinking 

27 

College and university presidents will need time to carefully 

consider the implications of the Task Force’s recommendations. 

As they do, the Task Force suggests that they take the following, 

immediate steps to signal their interest in changing the culture of 

drinking on campus: 

Review current alcohol prevention programs, assess 

whether they are working, and consider what could be 

changed. Research-based methods are available to assist 

college presidents with this task. Without an informed 

assessment, colleges and universities cannot fully identify 

needs or structure programs to respond to the particular types 

of drinking problems on their campuses. 

Involve students, the community, and other stakeholders 

in the review and assessment process and in the planning 

and implementation of interventions. Stakeholders can help 

ensure that planned interventions represent and reconcile the 

diversity of perspectives on campus, include appropriate and 

acceptable strategies, and achieve wider buy-in for proposed 

changes. A mix of students and more “permanent” 

stakeholders will help guarantee continuity over time. 

Focus on strategies most likely to make a difference at 

individual institutions and document them in a strategic 

plan. Effective alcohol policies and programs are tailored to 

the specific situation on each campus. Just as there are 

multiple contributing factors to high-risk drinking, there are 

multiple strategies that can be applied to improve identified 

problems. A strategic planning process conducted in 

collaboration with campus and community stakeholders can 

identify strategies appropriate for a given school and 

community. Strategic plans also include ongoing program 

evaluation and campus monitoring components to ensure that 

both needs and progress are assessed at timed intervals. 

Communicate the institution’s position on underage and 

excessive drinking. Students, parents, alumni, community 

leaders, and college faculty and staff are more likely to support 

a school’s efforts to reduce underage and excessive drinking if 

they understand why action is necessary and how student 

health and safety can benefit from the university’s position. 

Orientation and other appropriate gatherings of the university 

community may offer appropriate opportunities to convey 

those messages. 

Commit to addressing the issue over time. Strategies 

effective in reducing underage and excessive drinking require 

substantial time to produce results. Planning efforts 

recognizing this need can help ensure that programs are 

implemented effectively and achieve intended outcomes. 

Collaborate with NIAAA to develop an evaluation plan. 

Practical strategies for beginning and supporting institutional 

initiatives include: 

Using data collection and data extrapolation methods to 

assemble information needed in problem assessment, 

Evaluating campus-based approaches and longer-term 

campus- and community-based environmental approaches, 

and 

Participating in research dissemination initiatives offered 

by NIAAA. 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

Recommendations 

for the Research Community 

As the Task Force explored the role of the research Improve existing data systems such as the Department 

community in supporting college drinking prevention of Transportation’s Fatality Analysis Reporting System 

programs, the need for both new and expanded research­ (FARS) and the Centers for Disease Control and 

oriented activities became clear. Researchers, no matter Prevention’s Vital Statistics Mortality files to more 

their subject specialty or interest, are members of their accurately specify, count, and monitor college student 

college or university community and, as such, have a deaths over time. 

unique knowledge and concern about alcohol-related Collaborate with universities to capitalize on the 

problems. Specifically, researchers need improved “natural” research opportunities that emerge when 

methods for understanding the dimensions of the schools, communities, or States institute a major 

alcohol problem on campus, developing timely answers policy change that affects multiple aspects of the 

to immediate policy questions, and evaluating the academic community—for example, restricting sales 

impact of prevention programs on student drinking. In of alcohol at school-sponsored events. 

the Task Force’s view, enhancing both the methods and Partner with individual institutions to implement 

opportunities for conducting evaluations is a priority. short-term studies to assess the impact of popular, 

Well-designed evaluations increase the likelihood of commonsense strategies for changing campus-based 

program effectiveness, maximize the use of resources, environmental policies and practices that have not yet 

and validate program credibility. Evaluation results also been comprehensively evaluated. The strategies in Tier 

help researchers develop the knowledge needed to 3 could be effectively studied through short and 

inform future policies and programs (Saltz and DeJong, relatively simple campus-based research efforts. 

2002). Offer assistance to colleges and universities in using 

research-based evidence to develop and improve 

To amass the research-based information needed to current alcohol policies. 

improve campus-based prevention policies and 

programs, the Task Force recommends that the research 

community: 

Expand its focus on extracting information from 

existing research databases and studies and produce 

findings that are immediately useful in understanding 

college drinking. 

Develop specific standards and guidelines for assessing 

campus alcohol problems, monitoring trends, and 

evaluating interventions. This should include 

developing more effective screening tools for use by 

clinicians and researchers to facilitate the 

identification of at-risk, problem, and dependent 

drinkers among college students. 

28 
Recommendations for NIAAA 


One of the Task Force’s most important tasks is to 

recommend activities and research that NIAAA could 

sponsor to support colleges and universities in their 

efforts to change the culture of drinking on campus. 

Backed by the NIH reputation for rigorous scientific 

research, NIAAA is in a unique position to foster careful 

studies of underage and excessive college drinking. 

Results from such efforts would enable campus and 

community policymakers to speak with greater 

confidence about the causes and consequences of the 

problem and its possible solutions. The Task Force urges 

NIAAA and the Congress to expand funding to support 

these vital research endeavors on as many campuses as 

possible. 

From the Task Force’s perspective, NIAAA should 

assume primary responsibility for: 

Supporting the research community’s efforts to 

address existing knowledge gaps and alter the culture 

of drinking on campus; 

Facilitating long-term, campus-community research 

aimed at preventing hazardous student drinking; and 

Imparting what is known about the patterns of 

college drinking and the quality of current 

interventions to encourage college presidents, 

administrators, and other campus and community 

leaders to adopt policies and implement strategies 

based on research. 

The Task Force grouped its recommendations for 

NIAAA by these three functional areas. 

(1) Supporting Development of Improved Research 

Methods 

Improved data collection and extrapolation methods will 

help equip college administrators to assess the dimensions 

of the problem on their campuses and understand their 

situation in comparison to others. To support this 

activity, the Task Force recommends that NIAAA: 

Design and implement one national surveillance and 

data system for all colleges and universities to 

establish reliable estimates of the magnitude of the 

problem, provide mechanisms to track nationwide 

changes, assist colleges in monitoring their own 

campuses, and facilitate intercampus research. 

Take the leadership role in working with other 

relevant agencies and organizations, researchers, and 

college administrators to support development of a 

range of state-of-the-art screening and assessment 

measures for use by colleges as well as researchers. 

(2) Facilitating Lengthy and Complex Research 

The Task Force recommends that NIAAA assist colleges 

and universities by providing guidance and consultation 

The overwhelming majority of studies on college student 

drinking assess students at a single point in time. Although these 

"cross-sectional" snapshots provide useful information 

concerning the extent that two factors—such as heavy drinking 

and fraternity membership—are correlated, they cannot specify 

the nature of the causal relationship between the two. For 

example, if heavy drinking is associated with fraternity 

memberships, it could be because: 

Greek residence life facilitates drinking (i.e., socialization), 

Heavier drinkers differentially affiliate with Greek 

organizations because of the drinking opportunities they may 

afford (i.e., selection), or 

Other factors such as personality traits promote both 

affiliation and drinking. 

Only by prospectively following individual students and 

assessing them on multiple occasions can researchers begin to 

uncover the likely direction of influence, if any, between 

drinking behavior and its correlates. 

The Need for Longitudinal Studies 

29 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

on the implementation of longitudinal studies and joint 

campus and community-based initiatives designed to 

alter the larger environment as it affects student 

drinking. Such studies are complicated to implement 

and require a greater commitment of resources than 

those highlighted above. However, they also have the 

potential to change the landscape permanently by 

providing conclusive evidence of the long-term 

consequences of hazardous student drinking and 

reducing tolerance for it at all levels of the campuscommunity environment. 

The Task Force recommends that NIAAA: 

Pursue longitudinal studies of youth—beginning early 

in adolescence (7th grade) and continuing into young 

adulthood—to obtain information about such 

important issues as the development of alcohol 

problems over time and their longer-term consequences. 

Support research on the effectiveness of joint campusand community-based coalitions in reducing 

underage and excessive drinking. Coalitions could 

include alcohol wholesalers and retailers as well as 

college presidents, campus and community leaders, 

and policymakers. Coalition activities could also span 

the continuum of program possibilities from strategies 

designed to address those social norms and 

characteristics of the campus-community 

environment that influence student drinking to the 

provision of alcohol prevention and treatment services. 

Partner with other Federal and State agencies and 

national organizations to support campuses interested 

in implementing joint campus- and community-based 

initiatives. 

Organize multisite campus trials of individual 

campus- and community-based projects that have 

been evaluated favorably. 

(3) Disseminating Research-Based Information and 

Promoting Its Application on Campus 

Outreach efforts are essential to disseminate information 

about existing research-based initiatives to stakeholders 

and persuade colleges and universities to rely on 

research-based strategies in developing campus policies 

and programs. 

The Task Force recommends that NIAAA: 

Share the results of the Task Force’s comprehensive 

review of the current state-of-the-research on college 

drinking with a variety of audiences, including local, 

State, and national organizations interested in the 

issue, to expedite and reinforce the process of 

information exchange. 

Develop a series of regional workshops across the 

United States to share the Task Force’s 

recommendations with college presidents and 

promote campus participation in surveillance 

activities and research trials. 

Expand the dialogue among college presidents and 

administrators, community leaders, and researchers 

“It is not realistic to expect that colleges can eradicate alcohol problems among students, given 

the complexity of the issues and the role of alcohol in the broader social culture. But we can 

work to prevent alcohol-induced behavior that violates our sense of peace and security and that 

makes us passive contributors to the degradation of student lives.” 

Edward A. Malloy, President 

University of Notre Dame 

30 
through annual updates and other mechanisms 

designed to: 

Disseminate research findings to the campus and 

surrounding community and promote two-way 

communication between campus/community 

leaders and researchers, 

Support continued campus and community 


participation in research-based activities, 


Alert researchers to emerging alcohol-related issues 

on campus and within the community, 

Offer practical feedback to researchers on policy 

changes and other intervention efforts that affect 

college drinking, and 

Provide campuses and collaborating communities 

with technical assistance to help them implement 

effective data collection and intervention efforts. 

Continually update informational materials based on 

research for key stakeholders that include brochures 

for college presidents, parents, high school guidance 

counselors, student activists, and community leaders. 

Assist campus planners and their counterparts in the 

community in incorporating research into the 

planning, implementation, and evaluation of campusbased and joint campus- and community-based 

alcohol programs and policies. 

Foster collaborations between campus administrators 

and community leaders to facilitate the process of 

information exchange and ongoing communication. 

Coordinate and cooperate with other Federal agencies 

in providing training on alcohol and drug abuse to 

college student health center personnel. 

31 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

A Final Word
 

The concerns expressed by the members of the Task 

Force on College Drinking reflect the concerns of 

college presidents, students, parents, and college 

communities nationwide about the consequences of 

high-risk student drinking. The culture of drinking on 

contemporary college campuses is antithetical to the 

culture of learning, which is the core of higher 

education. 

As the information in this report clearly demonstrates, 

the fallout from excessive consumption does not 

discriminate. It threatens the health and safety of all 

students, disrupts the academic process, frustrates 

faculty, and disturbs the lives of those in adjacent 

communities. Yet the experience of a growing number of 

colleges and universities offers new hope for changing 

the culture of drinking and reducing its negative 

consequences. We believe the combination of vigorous 

leadership, institutional resolve, and campus-community 

partnerships can make a difference. 

Improvements in research methodology also enhance 

understanding of effective prevention strategies, so that 

schools can begin to design programs that suit their 

needs. At the same time, there is increasing recognition 

that high-risk drinking is not a neatly bounded 

phenomenon that can be addressed solely within the 

borders of the college or university. It frequently begins 

in high school, is sustained by a combination of campus 

and community conditions, and follows a course 

affected by an array of personal, behavioral, biological, 

and genetic as well as social and environmental factors. 

For this reason, the Task Force recommends a 

multidimensional approach to college student drinking 

that acknowledges these diverse but intersecting 

influences. It also recommends that schools commit to 

using research-based strategies in developing their 

programs and emphasize evaluation as an important 

priority. 

Despite the advances that have been made, there is 

little evidence of effectiveness available for many of the 

most appealing prevention strategies identified in this 

report. Because ideas and data fuel the intellectual life on 

campus, the Task Force encourages colleges and 

universities to work collaboratively with NIAAA and the 

research community in planning and assessing those 

strategies. School presidents who served on the Task 

Force observed that it is difficult to mobilize staff and 

direct their energy to implementing programs of 

uncertain efficacy. Results from carefully conducted 

evaluations will enable presidents to allay those concerns 

and ensure administrators, faculty, and students that 

they are investing in strategies with proven value. 

Although there are no easy answers to high-risk college 

drinking, there is reason for optimism. More educators 

at the college/university and, as important, secondary 

school levels are acknowledging the existence of a 

problem. Researchers are discovering new approaches for 

responding, and communities are becoming aware of 

their vital role in prevention. Through committed 

collaborative efforts grounded in research and supported 

by institutional leadership, the Task Force is convinced 

that the culture of drinking at U.S. colleges and 

universities can be changed. 

32 
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44 
Task Force Members and Participants
 

College and University Presidents 

Tomas A. Arciniega, Ph.D. 

President 

California State University at Bakersfield 

Robert L. Carothers, Ph.D. 

President 

University of Rhode Island 

John T. Casteen III, Ph.D. (Co-Chair: Panel on 

Contexts and Consequences) 

President 

University of Virginia 

Edward T. Foote II, LL.B. 

President Emeritus and Chancellor 

and Former President 

University of Miami 

Michael Hooker, Ph.D. (deceased) 

Chancellor 

University of North Carolina at Chapel Hill 

William L. Jenkins, D.V.M., Ph.D. 

President 

Louisiana State University System 

William E. Kirwan, Ph.D. 

President 

Ohio State University 

James E. Lyons, Sr., Ph.D. 

President 

California State University, Dominguez Hills 

45 

Reverend Edward A. Malloy, C.S.C. 

(Task Force Co-Chair) 

President 

University of Notre Dame 

Susan Resneck Pierce, Ph.D. 

President 

University of Puget Sound 

Judith Ramaley, Ph.D. (Co-Chair: Panel on Prevention 

and Treatment) 

Former President 

University of Vermont 

Special thanks to other 

participating College Presidents: 

Marilou Eldred, Ph.D. 

President 

Saint Mary’s College 

Thomas K. Hearn, Jr., Ph.D. 

President 

Wake Forest University 

Shirley H. Showalter, Ph.D. 

President 

Goshen College 

James J. Stukel, Ph.D. 

President 

University of Illinois 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

Researchers 

Marilyn Aguirre-Molina, Ed.D. 

The Joseph L. Mailman School of Public Health 

Columbia University 

Michael Fleming, M.D. 

Department of Family Medicine 

University of Wisconsin–Madison 

Mark S. Goldman, Ph.D. (Task Force Co-Chair) 

Distinguished Research Professor 

Department of Psychology 

University of South Florida 

Ralph Hingson, Sc.D. (Co-Chair: Panel on Prevention 

and Treatment) 

Professor and Associate Dean for Research 

Boston University School of Public Health 

Harold D. Holder, Ph.D. 

Director and Senior Scientist 

Prevention Research Center 

Pacific Institute for Research and Evaluation 

Donald S. Kenkel, Ph.D. 

Office of Policy Analysis and Management 

Cornell University 

G. Alan Marlatt, Ph.D. 

Professor and Director 

Addictive Behaviors Research Center 

University of Washington 

Marcus A. Rothschild, M.D. 

Consultant 

Veterans Administration Medical Center 

Kenneth J. Sher, Ph.D.
 

Curators’ Professor
 

Department of Psychological Sciences
 

University of Missouri–Columbia
 

Henry Wechsler, Ph.D.
 

Lecturer and Director of College
 

Alcohol Studies 

Department of Health and Social Behavior 

Harvard School of Public Health 

Sharon C. Wilsnack, Ph.D. (Co-Chair: Panel on 

Contexts and Consequences) 

Chester Fritz Distinguished Professor 

Department of Neuroscience 

University of North Dakota School of 

Medicine and Health Sciences 

Robert A. Zucker, Ph.D. 

Professor of Psychology 

Director, Division of Substance Abuse, Department 

of Psychiatry 

Director, Alcohol Research Center 

University of Michigan 

Task Force Panel Members 

David Anderson, Ph.D. 

Director 

Center for the Advancement of Public Health 

George Mason University 

William DeJong, Ph.D. 

Director 

The Higher Education Center for Alcohol and 

Other Drug Prevention 

Education Development Center, Inc. 

46 
Ellen R. Gold, Ph.D. 

Director 

University Health Services 

Eastern Michigan University 

Patrick Johnson, Ph.D. 

Fellow 

Division of Health and Treatment and Analysis 

The National Center on Addiction and 

Substance Abuse at Columbia University 

Robert F. Saltz, Ph.D. 

Prevention Research Center 

Pacific Institute for Research and Evaluation 

Students 

Brant Woodrow Grimes 

University of North Dakota 

Michaela Keegan 

University of Rhode Island 

Stacie Lambert 

Louisiana State University 

Chris Linder 

University of Nebraska 

Lindsey Bronwyn Mercer 

University of California at Berkeley 

David Odell 

University of Puget Sound 

Patrick Henry Sweet III 

University of Virginia 

47 

Joan Wehner Masters 

University of Missouri–Columbia 

National Institute on Alcohol Abuse and 

Alcoholism 

Gayle Boyd, Ph.D. (Coordinator: Panel on Prevention 

and Treatment) 

Fred J. Donodeo, M.P.A. (Task Force Coordinator) 

Vivian B. Faden, Ph.D. (Coordinator: Panel on 

Contexts and Consequences) 

Stephen W. Long (Task Force Director) 

Contributors 

Elaine Arkin (Health Consultant) 

Amy Bielski (ORC Macro) 

Gayle Boyd (NIAAA) 

Susan Cahill (NIAAA) 

Mary Lou Dogoloff (Logicon/ROW Sciences) 

Fred Donodeo (NIAAA) 

Peggy Eastman (Author and Journalist) 

Vivian B. Faden (NIAAA) 

Mark Goldman (University of South Florida) 

Ralph Hingson (Boston University) 

Harold Holder (PIRE) 

Stephen Long (NIAAA) 

Joy Mara (Joy R. Mara Communications) 

Alan Marlatt (University of Washington) 

Lisa Patton (Logicon/ROW Sciences) 

Kenneth J. Sher (University of Missouri) 

Linda Spear (Binghamton University) 

Aaron White (Duke University) 

Sharon Wilsnack (University of North Dakota School of 

Medicine and Health Sciences) 

Robert A. Zucker (University of Michigan) 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

Resources
 

The following materials related to college drinking will 

be available from NIAAA by mail or through the 

NIAAA Web site: 

National Institute on Alcohol Abuse and Alcoholism 

6000 Executive Boulevard, Willco Building 

Bethesda, Maryland 20892-7003 

www.collegedrinkingprevention.gov 

Task Force Report 

A Call to Action: Changing the Culture of Drinking at 

U.S. Colleges 

Final Report of the Task Force on College Drinking 

Panel Reports 

High-Risk Drinking in College: What We Know and What 

We Need To Learn 

Final Report of the Task Force on College Drinking’s 

Panel on Contexts and Consequences 

How To Reduce High-Risk College Drinking: Use Proven 

Strategies, Fill Research Gaps 

Final Report of the Task Force on College Drinking’s 

Panel on Prevention and Treatment 

Brochures 

What Presidents Need to Know About College Drinking 

What Parents Need to Know About College Drinking 

What Peer Educators and Resident Advisors (RAs) Need to 

Know About College Drinking 

Future Brochures 

What High School Guidance Counselors Need to Know 

About College Drinking 

What Community Leaders Need to Know About College 

Drinking 

What Students Need to Know About College Drinking 

Planning and Evaluation Handbook 

Reducing Alcohol Problems on Campus: A Guide to 

Planning and Evaluation 

48 
Commissioned Papers
 

Panel 1—CONTEXTS AND CONSEQUENCES 

Studying College Alcohol Use: Widening the Lens, 

Sharpening the Focus 

George W. Dowdall, Ph.D., Professor, Department of 

Sociology, St. Joseph’s University, and 

Henry Wechsler, Ph.D., Lecturer and Director of 

College Alcohol Studies, Department of Health 

and Social Behavior, Harvard School of Public Health 

Epidemiology of Alcohol and Other Drug Use 

among American College Students 

Patrick M. O’Malley, Ph.D., Senior Research Scientist, 

Institute for Social Research, University of Michigan, 

and Lloyd D. Johnston, Ph.D., Distinguished 

Research Scientist, Institute for Social Research, 

University of Michigan 

Student Factors: Understanding Individual Variation 

in College Drinking 

John S. Baer, Ph.D., Research Associate Professor, 

Department of Psychology, University of Washington, 

and Coordinator of Education, Center of Excellence 

in Substance Abuse Treatment and Education, VA 

Puget Sound Health Care System 

A Developmental Perspective on Alcohol Use and 

Heavy Drinking during Adolescence and the 

Transition to Young Adulthood 

John E. Schulenberg, Ph.D., Senior Research Scientist, 

Institute for Social Research, Professor, Department of 

Psychology, and Research Scientist, Center for Human 

Growth and Development, University of Michigan, 

and Jennifer L. Maggs, Ph.D., Associate Professor, 

Family Studies and Human Development, University 

of Arizona 

The Adolescent Brain and the College Drinker: 

Biological Basis of Propensity to Use and Misuse 

Alcohol 

Linda P. Spear, Ph.D., Distinguished Professor and 

Chairperson, Department of Psychology, Center for 

Developmental Psychobiology, Binghamton University 

College Factors That Influence Drinking 

Cheryl A. Presley, Ph.D., Director, Student Health 

Programs and Assistant to the Vice Chancellor for 

Student Affairs for Research, Executive Director, Core 

Institute, Southern Illinois University; Philip W. 

Meilman, Ph.D., Director, Counseling and 

Psychological Services, Courtesy Professor of Human 

Development, Associate Professor of Psychology in 

Clinical Psychiatry, Cornell University; and Jami S. 

Leichliter, Ph.D., Behavioral Scientist, Division of 

STD Prevention, Centers for Disease Control and 

Prevention 

Surveying the Damage: A Review of Research on 

Consequences of Alcohol Misuse in College 

Populations 

H. Wesley Perkins, Ph.D., Professor of Sociology, 

Department of Anthropology and Sociology, Hobart 

and William Smith Colleges 

Alcohol Use and Risky Sexual Behavior among 

College Students and Youth: Evaluating the Evidence 

M. Lynne Cooper, Ph.D., Professor of Psychology, 

Department of Psychology, University of Missouri at 

Columbia 

49 
A Call to Action: Changing the Culture of Drinking at U.S. Colleges 

Alcohol-Related Sexual Assault: A Common Problem 

among College Students 

Antonia Abbey, Ph.D., Associate Professor, 

Department of Community Medicine, Wayne State 

University 

Alcohol-Related Aggression during the College Years: 

Theories, Risk Factors, and Policy Implications 

Peter R. Giancola, Ph.D., Assistant Professor of
 

Psychology, University of Kentucky
 

Today’s First-Year Students and Alcohol 

M. Lee Upcraft, Ph.D., Senior Scientist, Center for 

the Study of Higher Education, Professor Emeritus of 

Higher Education and Assistant Vice-President 

Emeritus for Student Affairs, The Pennsylvania State 

University 

So What Is an Administrator to Do? 

Susan Murphy, Ph.D., Vice President, Student and 

Academic Services, Cornell University 

Panel 2—PREVENTION AND TREATMENT 

A Typology for Campus-Based Alcohol 

Prevention: Moving toward Environmental 

Management Strategies 

William DeJong, Ph.D., Professor, Boston University 

School of Public Health, and Director, U.S. 

Department of Education's Higher Education Center 

for Alcohol and Other Drug Prevention, and Linda 

Langford, Sc.D., Associate Director of Evaluation and 

Assessment, U.S. Department of Education’s Higher 

Education Center for Alcohol and Other Drug 

Prevention 

Identification, Prevention, and Treatment: 

A Review of Individual-Focused Strategies to 

Reduce Problematic Alcohol Consumption by 

College Students 

Mary Larimer, Ph.D., Assistant Professor of Psychiatry 

and Behavioral Sciences, Adjunct Assistant Professor of 

Psychology, Associate Director, Addictive Behaviors 

Research Center, University of Washington, and Jessica 

M. Cronce, B.S., Research Coordinator, Addictive 

Behaviors Research Center, Department of Psychology, 

University of Washington 

Social Norms and the Prevention of Alcohol Misuse 

in Collegiate Contexts 

H. Wesley Perkins, Ph.D., Professor of Sociology, 

Department of Anthropology and Sociology, Hobart 

and William Smith Colleges 

Alcohol Advertising and Youth 

Henry Saffer, Ph.D., Professor of Economics, Kean 

University, and Research Associate, National Bureau of 

Economic Research 

The Role of Mass Media Campaigns in Reducing 

High-Risk Drinking among College Students 

William DeJong, Ph.D., Professor, Boston University 

School of Public Health, and Director, U.S. 

Department of Education’s Higher Education Center 

for Alcohol and Other Drug Prevention 

50 
Environmental Policies to Reduce College Drinking: 

Options and Research Findings 

Traci L. Toomey, Ph.D., Assistant Professor, School of 

Public Health, Division of Epidemiology, University 

of Minnesota, and Alexander C. Wagenaar, Ph.D., 

Professor and Director, Alcohol Epidemiology 

Program, School of Public Health, Division of 

Epidemiology, University of Minnesota 

Effects of Minimum Drinking Age Laws: Review and 

Analyses of the Literature from 1960 to 2000 

Alexander C. Wagenaar, Ph.D., Professor and 

Director, Alcohol Epidemiology Program, School of 

Public Health, Division of Epidemiology, University 

of Minnesota, and Traci L. Toomey, Ph.D., Assistant 

Professor, School of Public Health, Division of 

Epidemiology, University of Minnesota 

Comprehensive Community Interventions to 

Promote Health: Implications for College-Age 

Drinking Problems 

Ralph Hingson, Sc.D., Professor and Chair, Social and 

Behavioral Sciences Department, Boston University 

School of Public Health, and Jonathan Howland, 

Ph.D., M.P.H., Professor and Chair, Social and 

Behavioral Sciences Department, Boston University 

School of Public Health 

The Role of Evaluation in Prevention of College 

Student Drinking Problems 

Robert F. Saltz, Ph.D., Associate Director and Senior 

Research Scientist, Prevention Research Center, 

Berkeley, CA 

View from the President’s Office: The Leadership of 

Change 

Joy R. Mara, M.A., Mara Communications 

JOINT PANEL PAPERS 

The Student Perspective on Alcohol Abuse 

Peggy Eastman, Author and Journalist 

Magnitude of Alcohol-Related Mortality and 

Morbidity among U.S. College Students Ages 18–24 

Ralph Hingson, Sc.D., Professor and Chair, Social and 

Behavioral Sciences Department, Boston University 

School of Public Health; Timothy Heeren, Ph.D., 

Assistant Professor, Biostatistics Department, Boston 

University School of Public Health; Ronda Zakocs, 

Ph.D., Assistant Professor, Department of Social and 

Behavioral Sciences, Boston University School of 

Public Health; Andrea Kopstein, Ph.D., Chief, 

Program Evaluation Branch, Center for Substance 

Abuse Treatment, Substance Abuse and Mental Health 

Services Administration; and Henry Wechsler, Ph.D., 

Lecturer and Director of College Alcohol Studies, 

Department of Health and Social Behavior, Harvard 

School of Public Health 

51 
National Institute on Alcohol 

Abuse and Alcoholism 

NIH Publication No. 02-5010
 

Printed April 2002
 

National Institute on Alcohol Abuse and Alcoholism • National Institutes of Health 


U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES