Alcohol Use Among College Students: An International Perspective

Elie Karama,b,c; Kypros Kyprid,e; Mariana Salamounc

Disclosures

Curr Opin Psychiatry. 2007;20(3):213-221. 

In This Article

Abstract and Introduction

Purpose of Review: The present review of published articles during 2005-2006 on alcohol use among college students in Africa, Asia, Australasia, Europe and South America assesses the prevalence of alcohol use, hazardous drinking and related problems, and reviews the effectiveness of intervention methods and implications for future research.
Recent Findings: Research on alcohol use and related problems in college students is lacking in many regions of the world. We identified 26 papers in peer-reviewed journals, from Australia, Brazil, Ecuador, Egypt, Germany, Hong Kong, Ireland, Lebanon, New Zealand, Nigeria, Sweden, The Netherlands and Turkey.
Summary: More comprehensive studies with systematic methodologies in the world regions reviewed here are needed to yield representative results on alcohol use and related risk and protective factors in college settings. College students in many countries are at elevated risk for heavy drinking, with serious immediate health risks, such as drink-driving and other substance use; and longer term risks, such as alcohol dependence. The prevalence of hazardous drinking in Australasia, Europe and South America appears similar to that in North America, but is lower in Africa and Asia. Alcohol policies should be reviewed and prevention programmes initiated in light of research evidence, for this high-risk population.

Public health concern about alcohol consumption and associated risk behaviours in young people is increasing, especially among college students who, in some countries, appear to be at particularly high risk. Indeed, the leading cause of injury and death among college students and young adults in the USA is reported to be binge drinking.[1]

Studies from different parts of the world have shown that college students have a higher prevalence of alcohol drinking and alcohol-use disorders, than noncollege youth.[2,3,4] This could be attributed to the well established developmental phase college students go through, in which they are away from home, family and longstanding friendships. Throughout their college years, students pass through a phase of vulnerability (intellectually, emotionally and socially), in a new environment characterized by considerable peer influence, and often aggressive promotion of alcoholic beverages. In addition to the college setting being a unique environment to which a large proportion of young people are exposed en masse, nearly all of the world's future leaders, policy-makers, and healthcare providers will have passed through the college system as young people.

College student drinking has been studied extensively in North America (for example[5,6,7]), the problem receiving frequent media attention, research funding and intervention programming.[8,9,10] Several factors have been found to be associated with alcohol use, abuse and dependence, such as genetic factors, environmental factors, emotional and psychological instability, gender, sexual identity, cognitive factors, peer pressure, family history and achievement.[4,11] Although the problem of alcohol use is evident in most countries of the world, there is a comparatively small amount of research from a few European countries[12,13] and from Australasia.[14,15,16] Until recently little was known about the patterns of college student drinking in many parts of the world, most notably in the Arab region[4,17] where cultural and religious affiliations of students have theoretically an important impact on alcohol use: not only does the religion of Islam (most common in the Arab region) forbid the use of alcohol, but in addition many Arab countries forbid alcohol use by law. Despite these norms and legal restrictions, studies have revealed the presence of problems related to alcohol use among college students in Arab countries, especially in men,[4,17] such as the use of other substances, unsafe sex, low academic achievements and conduct problems.[4]

Intervention during the formative college years may present an opportunity to attenuate the risk of long-term drinking problems. Accordingly, the present review has an international focus; it includes studies of prevalence, risk factors, and intervention from Africa, Asia, Australasia, Europe and South America.

A Medline (PubMed) search was conducted using the keywords student, college or university, drinking or alcohol, and covering all published articles in 2005 and 2006. An initial list of 132 abstracts was reviewed, and 24 articles were identified and retrieved as relevant to this paper. The present review mainly tackles the prevalence and gender differences of alcohol use in the past year across the different countries, students' knowledge and attitudes towards alcohol, risk factors and treatment of alcohol use. The articles included in this review concern student populations in Africa (n = 2), Asia (n = 2), Australasia (n = 10), Europe (n = 5), and South America (n = 5). For the sake of completeness, we have included two studies from 2004 from two Arab countries.

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