Background: The ALDH2*2 allele (A-allele) at rs671 is more commonly carried by Asians and is associated with alcohol-related flushing, a strong adverse reaction to alcohol that is protective against drinking. Social factors, such as having friends who binge drink, also contribute to drinking in Asian youth. Objectives: This study examined the interplay between ALDH2*2, peer drinking, and alcohol consumption in college students. We hypothesized that the relationship between ALDH2*2 and standard grams of ethanol per month would vary based on the level of peer drinking. Methods: Subjects (N = 318, 63.25% female) were East Asian college students in the United States who reported drinking alcohol. Data were from the freshman year of a university survey that included a saliva DNA sample. ALDH2*2 status was coded ALDH2*2(+) (A/G and A/A genotypes) and ALDH2*2(−) (G/G genotype). Peer drinking was students’ perception of how many of their friends “got drunk”. Results: Main effects of ALDH2*2(−) and having more friends who got drunk were associated with greater alcohol consumption. The ALDH2*2 × peer drunkenness interaction showed a stronger positive association with alcohol consumption for ALDH2*2(−) versus ALDH2*2(+) at increasing levels of peer drunkenness. Follow-up comparisons within each peer drunkenness level identified significantly higher alcohol consumption for ALDH2*2(−) compared to ALDH2*2(+) at the all friends got drunk level.Conclusion: There was evidence of a stronger effect for ALDH2*2(−) compared to ALDH2*2(+) with greater alcohol use when students were more exposed to peer drinking. Findings contribute to a growing literature on the interrelationships between genetic influences and more permissive environments for alcohol consumption.

Objective: Alcohol-related facial flushing occurs in individuals who are unable to metabolize ethanol effectively and is associated with increased cancer risk. This study describes college students' understanding of the meaning of flushing for how much alcohol a person should drink and their use of over-the-counter medications and other strategies to reduce its visible effects. Participants:The sample includes 335 White and Asian college students who reported facial flushing after an alcoholic drink. Methods:Students completed an online survey in the spring of their junior year.Results: Most students reported that flushing had no special meaning for drinking or that they did not know what it meant. Six percent reported ever using strategies to hide facial flushing; they were mostly Asian, and those using these strategies drank more alcohol.Conclusions: Findings identify a need for targeted alcohol education with Asian college students who drink alcohol despite experiencing the flushing response.