Protective factors and college student drinking patterns in pre and post Katrina New Orleans ()
1. BACKGROUND
In the United States, the rates of heavy drinking, tobacco use, and illicit substance use peak between 18 and 25 years of age and there is some evidence to indicate that protective factors play a role in college students use of alcohol and drugs [1]. Protective factors are attitudes and behaviors that contribute to reducing the risk of illicit drug use by offsetting the correlation between substance use and risk factors [2]. The protective factors identified for the purposes of this article are cultural influences and family values, extracurricular involvement, exercise, academic performance, religious affiliation, housing environment, and work status.
According to the researchers who conducted the Monitoring the Future national survey, “In 2010, college students were modestly higher in lifetime, annual, and 30- day use of alcohol than the non-college group; the difference was largest in the 30-day rate 65% vs. 55% [3]. College students also had a higher prevalence of occasions of heavy drinking (five or more drinks in a row in the past two weeks)—37% versus 28% among their age peers. Nearly half of all college students (44%) were reported to have been drunk in the prior 30 days compared to 29% of the noncollege respondents. The rates of daily drinking were similar for the two groups at 3.6% versus 3.4% of the respondents drinking daily [3].
The Louisiana Higher Education Coalition to Reduce Alcohol, Tobacco and Other Drugs (LaHEC) conducted a statewide survey at all the universities in Louisiana in 2007 and 2009 using the Core Drug and Alcohol Survey (CDAS). Their results were included in the Louisiana Statewide Epidemiology Profile in 2009. The results were compared with an aggregate sample provided by The Core Institute to detect any marked differences in alcohol consumption among college students in Louisiana compared to college students throughout the rest of the United States [3]. In Louisiana in 2007, 78.7 percent of college students drank alcohol in the past year compared to the US average of 84.0. In 2009, the percentages were 79.8 (Louisiana) and 84.2 (US), respectively. Also in Louisiana in 2007, 17.7 percent of college students participated in heavy alcohol use (3 or more times per week) compared to the US average of 23.5 percent. In 2009, the percentages were 17.5 (Louisiana) and 23.0 (US), respectively [4]. The authors concluded that there was not a significant difference in the drinking behaviors among college students in Louisiana compared to college students in the United States based on this sample.
2. PROTECTIVE FACTORS
2.1. Cultural Influences and Family Values
The amount of time and attention given by a parent to a child can affect the child’s risk of alcohol use. Lo et al., [5], surveyed 98,822 students in Alabama that were enrolled for the 2002 spring term. Two variables were used to assess the frequency of alcohol use over lifetime and frequency of alcohol use past 30 days. The research study provided evidence that strong family ties did offer protection against the use of alcohol and other drugs [5]. In a separate study, students from a sample of undergraduate students were almost 1.5 times likely to abstain from alcohol if their mother abstained from alcohol as those whose mother was a drinker [6]. Family factors are indeed associated with higher levels of alcohol use and other problem behaviors. Marital conflict, stressful events, and violence within the family are all associated with increased alcohol use [7].
2.2. Extracurricular Involvement
Laboratory research suggests that an inverse relationship exists between substance use and substance-free reinforcement, but limited research has been conducted on the prevention of substance abuse and substance-free reinforcement. A study was conducted using a sample of college students who had just recently completed an alcohol intervention program to evaluate the relationship between alcohol use and enjoyment from substance-free activities [8]. Regression analyses revealed a negative association between alcohol consumption and substancefree enjoyment for the female college students but not for males [8]. On an interesting note, there was greater average enjoyment from substance-free activities was associated with greater motivation drinking among both males and females. Weinstock [9] also performed a metaanalysis evaluating exercise as an intervention for hazardous drinking. Alcohol consumption has been reported to take the place of participation in substance-free activities, such as exercise. Exercise has numerous physical and mental health benefits and has been shown to help individuals cope with stress [9]. Many college students drink alcohol as a response to stress so it makes perfect sense to replace alcohol use with participation in a substance-free exercise regimen. The summary of the meta-analysis reveals that engaging in alternative substance-free activities appears to be associated with reductions in alcohol use in college students, especially for those who are currently not seeking treatment [9]. The esearch assessing the implications of participation in extra-curricular activities is limited and our current study will help to fill this gap in research.
2.3. Exercise
In our study, the association of protective factors against alcohol consumption in college students in Louisiana was evaluated before and after Hurricane Katrina in 2005. Several studies have addressed protective and risk factors related to drinking among college students. Ward and Gryczynski [10] completed a study that examined alcohol use among students involved in recreational sports. A survey was distributed to 1000 students drawn from a stratified, random sample from undergraduates at a 4-year university [10]. Alcohol use was assessed by self-report and was measured by 7 different variables. The data set included 494 respondents after accounting for cases with missing values and then weighting the data. After completing multivariate regression, a significant positive relationship was found (p < 0.5) between students who participated in organized recreational sports and the number of drinks per day and drinks per month compared to students who did not participate in organized recreational sports, accounting for other variables such as race, sex, and Greek membership [10].
Involvement in physical activity also demonstrates an association in alcohol use. Moore and Werch [11] explored the relationship between physical activity and alcohol, tobacco, and other drug (ATOD) use behaviors among first-year college students who were self-identified as drinkers. The participants were 391 freshman students from a midsized university in Northeast Florida. Physical activity was measured by one question, “During the past 7 days, on how many days did you exercise or participate in physical activity for at least 20 minutes that made you sweat and breathe hard, such as basketball, soccer, running, swimming laps, fast bike riding, fast dancing, or similar aerobic activities?” [11]. Frequent exercisers reported drinking significantly more often, consumed a significantly greater quantity of alcohol, and engaged in heavy drinking significantly more often than did infrequent users (p = 0.05 and 0.001, and 0.05 respectively) [11]. These findings were confirmed by Huang et al. who found that non athletes were found to be almost 2 times as likely to abstain as athletes [6]. Another study by Martens and Martin [12] also performed a study on college athletes drinking motives and competitive seasonal status using the Athletic Drinking Scale (ADS). Results supported other findings that athletespecific drinking motives increased during the athlete’s competitive seasons. Therefore, the athlete’s drinking patterns may be most strongly influenced by their sport and teammates during the competitive season, whereas during the off-season, athletes may be more influenced by the drinking tendencies and general drinking motives of the typical non-athlete [12].
2.4. Academic Performance
The role of posttraumatic stress (a possible outcome for people who experienced the devastation of hurricane Katrina) and problem drinking has been examined in its relationship to university academic performance [13]. The transition from high school to college is met with increased responsibilities but also freedom from parental control which may lead to increased risk taking [13]. Two risks that are frequently experienced by university students are heavy drinking and traumatic events [13]. A study conducted by Bachrach and Read further explored the relationship between post-traumatic stress disorder during the first year of college to academic performance and whether alcohol behavior mediates the relationship between Posttraumatic Stress Disorder (PTSD) and poor academic outcomes [13]. PTSD is a mental health difficulty that can occur after a person experiences a traumatic event such as war, assault, or disaster [14]. Initial screening surveys were sent to incoming freshmen from two universities in the summer prior to arriving on campus. The recruitment took place in three cohorts during the fall of 2006 and 2007. A portion of the subset sample was targeted for longitudinal follow-up based on responses to trauma-related questions where 649 students had endorsed at least one symptom in each PTSD cluster. To measure alcohol use, respondents were given a standard drink conversion chart to ensure accuracy in reporting the number and amount of alcohol consumed. According to the CDC, a standard drink is equal to 14.0 grams (0.6 ounces) of pure alcohol which is usually found in 12-ounces of beer, 8-ounces of malt liquor, 5- ounces of wine, or 1.5-ounces or a “shot” of 80-proof distilled spirits or liquor [15]. Relative to participants who never had PTSD, those who developed PTSD over the course of the year had lower end-of-year GPA (p = 0.001), but when and additional ANCOVA was performed, there was not a statistically significant finding in the use of alcohol (p = 0.78) [13].
2.5. Religious Affiliations and Practices
Another protective factor addressed in our study was the effect of religiosity as it pertains to alcohol use on college campuses. Religious groups can be considered to be social reference groups for many students and provide a set of standards for social acceptance and the control of alcohol consumption [16]. Wells conducted a study on religiosity and campus culture in relationship to alcohol consumption among college students using the reference group theory. The sample included students (N = 250) attending a religiously affiliated private college and students (N = 280) enrolled at a large secular state university. A convenience sample was chosen based on the length of the survey and the willingness of faculty to facilitate the survey during classes. The College Alcohol Survey was used to study alcohol consumption and was the dependent variable. Religiosity was the independent variable and was measured by the “The Religiosity Measure”. The mean alcohol consumption for the students at the religious institution was 11.9 (SD = 27.6) drinks in the 30 days prior to the survey, which was significantly lower than the 26.9 (SD = 53.1) drinks per 30 days for students attending the secular university (U = −7.55, p < 0.5) [16]. The relationship between level of religiosity and alcohol was also examined and demonstrated a negative correlation showing that as religiosity increased, alcohol consumption decreased.
In another study, Harden used twin and sibling pairs drawn from the National Longitudinal Study of Adolescent Health to test whether religious adolescents had a later age at first drink than their non-religious co-twins and/or co-siblings [17]. Contrary to the study by Wells, the religious adolescents did not differ from their nonreligious siblings in their mean age at first drink. Family or cultural environments play more of a role in early drinking rather than religiosity. However, when comparing unrelated teenagers, religious involvement was associated with a six-month delay in initiating alcohol use [17]. In addition, students who spent 6 or more hours per week in religious group practices, compared with those who did not participate, were approximately 7 times as likely to abstain. Religious group participants who spent 1 - 2 or 3 - 5 hours per week were not significantly different from those who did not participate [6].
2.6. Housing Environment
The type of college housing environment that students live in was also evaluated against risk-taking behavior. The sample consisted of 510 unmarried, undergraduate students who lived in on-campus housing. The participants were recruited from five different colleges across the United States during the 2004-2005 academic school year [18]. College housing was assessed by one question that asked, “Where do you live now? That is, where do you stay most often?” The options were gender-specific dorms (n = 68) or co-ed dorms (n = 442) [18]. The participants’ alcohol use was assessed by measuring the frequency of binge drinking and alcohol consumption using a 6-point scale. Results indicated that students living in gender-specific housing were less likely to consume alcohol (F = 13.03, p < 0.01) and engage in binge drinking (F = 6.41, p < 0.05) than students living in coed housing [18].
2.7. Work Status
Approximately 57% of college students work while attending [19]. The authors in this study examined a college student cohort to evaluate the association between hours worked and binge drinking. A random sample of 1700 undergraduates was acquired from a southeastern university in the United States. The students’ work hours were categorized in three categories for analyses: low (< 10 hours), medium (10 - 19 hours), and high (≥20 hours) [19]. Binge drinking was a dependent variable and was measured by self-reported data. After logistic regression analyses, those who worked more than 20 hours per week were 1.56 times more likely to be binge drinkers (p = 0.023) [19]. Binge drinking is considered having five or more drinks in a two-hour period for males, and having four or more drinks in a two-hour period for females [15]. The results revealed an association between number of hours worked (>20) and the odds of binge drinking. Compared with students who worked 1 - 9 hours per week for salary/wages, those who did not work were almost two times as likely to abstain from the use of alcohol [6].
3. RESULTS
On average, the participants in both surveys had about 2 protective factors (see Table 1). Each participant could have a minimum of zero to a maximum of 7 protective factors. Overall, spring 2006 semester participants drank more than 4 drinks per week compared to only 3 drinks per week among spring 2005 participants. This difference in average consumption of alcoholic drinks among the two study groups was statistically significant. The mean age of participants among 2005 spring semester was 22 years (ranging from 18 years to 63 years of age). The mean age of participants in 2006 spring semester was 23 years with youngest participant of 17 yr of age and oldest participants of 51 yr of age. This difference in age among two groups was also statistically significant.
Research question one: What are the relationships between age, gender, race/ethnicity, and the selected protective factors (i.e., Cultural Influences and Family Values; Extracurricular Involvement; Exercise; Academic Performance; Religious Affiliation and Practices; Housing Environment; and Work Status), and alcoholic drinks consumed per week among study participants?
Null hypotheses:
1) There is no effect of age of the participant on number of alcohol drinks consumed per week by the participants after adjusting for effect of gender, race/ethnicity, number of protective factors and semester.
2) There is no effect of gender of the participant on the number of alcohol drinks consumed per week by the participants after adjusting for effect of age, race/ethnicity, number of protective factors and semester.
3) There is no effect of race/ethnicity of the participant on the number of alcohol drinks consumed per week by the participants after adjusting for effect of age, gender, number of protective factors and semester.
4) There is no effect of the number of protective factors available to the participant on the number of alcohol drinks consumed per week by the participants after adjusting for effect of age, gender, race/ethnicity and semester.
Table 2 shows the results of simple and multiple linear regression models. With each year increase in age of the participant, alcohol use was reduced by 0.01 drinks per week. The effect of age doubled after adjusting for effects gender, race and number of protective factors. So for each 1 year increase in age of the participant alco-