Hazardous Drinking among Students over a Decade of University Policy Change: Controlled Before-and-After Evaluation

Abstract

Background: Responding to high levels of alcohol-related harm among students, a New Zealand university deployed a security and liaison service, strengthened the Student Code of Conduct, increased its input on the operation of alcohol outlets near campus, and banned alcohol advertising on campus. We estimated the change in the prevalence of alcohol consumption patterns among students at the university compared with other universities. Methods: We conducted a controlled before-and-after study with surveys in residential colleges at the target university in 2004 and 2014, and in random samples of students at the target university and three control universities in 2005 and 2013. The primary outcome was the prevalence of recent intoxication, while we analysed drinking per se and drinking in selected locations to investigate mechanisms of change. Results: The 7-day prevalence of intoxication decreased from 45% in 2004 to 33% in 2014 (absolute difference: 12%; 95% CI: 7% to 17%) among students living in residential colleges, and from 40% in 2005 to 26% in 2013 (absolute difference: 14%; 95% CI: 8% to 20%) in the wider student body of the intervention university. The intervention effect estimate, representing the change at the intervention university adjusted for change at other universities (aOR = 1.30; 95% CI: 0.89 to 1.90), was consistent with a benefit of intervention but was not statistically significant (p = 0.17). Conclusion: In this period of alcohol policy reform, drinking to intoxication decreased substantially in the targeted student population. Policy reforms and coincidental environmental changes may each have contributed to these reductions.

Alcohol Harms over a Period of Alcohol Policy Reform: Surveys of New Zealand College Residents in 2004 and 2014

“…The lack of a control setting limits the strength of inference one can make about the impact of changes at the university on alcohol consumption and harms in the colleges. However, the reductions in this study are consistent with those in the wider University of Otago population, and contrast with what appears to have occurred at other New Zealand universities [5].…”

“…Our previous research showed that drinking in the wider student population decreased at Otago compared with other universities from 2005 to 2013 [5]. We also found that student drinking and harms among Otago students decreased after the introduction of Campus Watch and other policy changes [6].…”

“…In 2004 and 2014 the Dunedin colleges housed a similar proportion of students who had consumed alcohol in the preceding calendar year (i.e., before they became residents); however, in 2014, a smaller proportion had consumed alcohol hazardously in the preceding year. This may reflect the greater proportion of 16-17 year-olds in the colleges in 2014 [5]. While New Zealand law does not prohibit alcohol consumption per se at any age, students under 18 years of age cannot legally purchase alcohol, and there is evidence that this law is effective in reducing alcohol-related harm [20].…”

“…In a previous paper we estimated changes in drinking at a New Zealand university with a long history of risky drinking and related social disorder, finding no change in the prevalence of drinking per se, but large reductions in risky consumption over a 10 year period [5]. For example, the 7-day prevalence of drinking to intoxication decreased from 45% in 2004 to 33% in 2014 (absolute difference: 12%; 95% CI: 7%, 17%) among students living in residential colleges.…”

“…For example, the 7-day prevalence of drinking to intoxication decreased from 45% in 2004 to 33% in 2014 (absolute difference: 12%; 95% CI: 7%, 17%) among students living in residential colleges. We cautiously attributed these changes to a combination of deliberate efforts by the university to reduce the promotion of alcohol and student misconduct [6], and market conditions that caused the closure of student pubs in the area surrounding campus [5]. These efforts and conditions were independent of more recent alcohol policy reforms in New Zealand that are unlikely to have significantly affected student drinking in 2013-2014 due to the phased implementation of the reforms (several came into effect after the 2014 survey) and the absence of a local alcohol policy in Dunedin until 2019 [7,8].…”