Gunby et al. BMC Public Health 2012, 12:216 http://www.biomedcentral.com/1471-2458/12/216 all rape cases [13]. Here we show that a third of partici- pants had experienced alcohol-related non-consensual sex, demonstrating the significance of this as a public health issue. Differences between men and women in relation to attitudes and knowledge of sexual events are likely to influence the outcome of dating situations where sex is possible and we show that differences between male and female students exist. While the majority of participants correctly stated that consent involved agreeing to engage in sex through choice, male respondents were less likely to know this or were unsure whether this was reflected in law. Approximately half of respondents incorrectly thought that consent needed to be verbally agreed, with this belief being more likely among women. Men were also less likely to believe that being drunk affects one’s capacity to consent to sex. These differences between men and women may result in situations where drunken non-consensual sex is perceived to be consensual by the man. Male and female students also differed in their atti- tudes towards the cues that they would deem relevant or informative when deciding whether or not a person wanted to have sex with them. The cues which differed significantly in the multivariate comparison of men and women were the relevance of the other person flirting, and the relevance of the other person removing their own, or the respondent’s, clothing (Table 1 and 2). However, a greater proportion of men than women deemed all the cues described in the questionnaire as relevant. This is important given that the effects of alco- hol arise from both alcohol’s impairment of perception and the nature of the environmental cue [19]. Alcohol intoxication disrupts information processing skills and impairs cognitive processes (so called ‘executive func- tioning’) which are important for control of behaviour [39]. In addition, an intoxicated person pays attention to fewer environmental cues, while intoxication also reduces the ability to process the meaning of these cues. As a result, immediate experiences may have a dispro- portionate influence over behaviour and emotion [19]. If a man perceives that the other person is willing to engage in sex, for example they have been flirting, alco- hol-related cognitive disruption may result in them focusing on the prominence of sexual arousal at the expense of less salient cues such as their partner’s pro- tests [40]. In such a situation, alcohol induced disinhibi- tion, coupled with a reduction in self-appraisal and a focus on arousal in response to supposedly encouraging behaviour, have the potential to create a situation where pressure or force is used to obtain sex [41,42]. If the parties do not know each other well, it is possible that supposedly encouraging cues will be deemed even more relevant in negotiating the potential for sex. Page 9 of 12 When presented with three scenarios depicting sex between two intoxicated people the differential level of intoxication between the two parties clearly influenced whether or not a respondent would label the sex as rape (Tables 1 and 2). Both male and female respondents were more likely to label the scenario as rape when the difference in levels of intoxication between the two par- ties was greater. These findings align with previous research showing that people are reluctant to label a situation as rape when both parties are equally intoxi- cated [43-45]. We can hypothesise that respondents felt that the impact of alcohol on cognitive functioning could result in a defendant genuinely believing that con- sent was present even if it was not. In the eyes of the law, alcohol intoxication is not a defence to a charge of rape, yet it may be suggested that respondents viewed comparable drunkenness as a factor that was sufficient to mitigate the defendant’s responsibility for ensuring consent. These findings occur against a backdrop of opi- nion that women who consume alcohol have more culp- ability if they are a victim of a sexual assault than women who do not drink [9,28,43,46-48]. Taken together such findings support a drinking double stan- dard whereby women are blamed more for a sexual offence when they have consumed alcohol whilst drink- ing defendants are viewed as less likely to have perpe- trated a crime [43-45]. Consequently, societal attitudes around alcohol and culpability appear to work in favour of the defendant but against a complainant. Further- more, just over a third of respondents in the question- naire stated that a significant number of rapes reported to the Police are false allegations and that false allega- tions are more likely when people are drunk; beliefs which were more prominent among men (Tables 1 and 2). The premise that women frequently make false alle- gations of rape is not supported by recent evidence [13,49,50] and together these findings highlight the biases that may impact in rape cases. Levels of current drinking were higher among women who had experienced alcohol-related non-consensual sex (Tables 3 and 4) supporting previous findings that demonstrate a link between the amount of alcohol con- sumed in night time environments and experiencing sexual molestation [51]. While the cross-sectional nature of the current study makes it impossible to determine causality or identify the level of drinking at the time of the alleged incident, there is good evidence to show a relationship between alcohol consumption and being a victim of a sexual assault [1,28,52-54]. Here, women who had experienced alcohol-related non-consensual sex were more likely to label a hypothetical sexual sce- nario between two people who were disproportionately intoxicated as rape than women who had not experi- enced alcohol-related non-consensual sex, perhaps