Global Status Report On Alcohol and Health

Introduction

Alcohol consumption is acknowledged worldwide as a major health issue and is often recognised as one of the major causes of avoidable mortality and morbidity in Western society (Wechsler, Dowdall, Davenport, & Castillo, 1995). Almost 4% of all deaths are attributed to alcohol (World Health Organization, 2009) and in relation to other causes of death, alcohol can be considered as a significantly higher contributor. For example, HIV/AIDS accounted for 3.5% of deaths worldwide, violence for 1% and tuberculosis for 2.5% (World Health Organization, 2004). This is reflected in increased cost for health care systems. In 2008, it was estimated that alcohol harm cost the National Health Service in England $2.7 billion, this was a significant increase from estimates for 2003 of $1.7 billion (National Health Service, 2010).

The harmful effects of high alcohol intake have been well documented (Hingson, Heeren, Winter, & Wechsler, 2005) (Schulenberg, Wadsworth, O’Malley, Bachman, & Johnston, 1996). Individuals who drink too much can suffer from physical problems, such as liver cirrhosis, heart failure and certain cancers, but also from social issues, such as interpersonal violence, sexual assault, vandalism, and driving accidents (Anderson & Baumberg, 2006) (Rehm, Room, Graham, Monteiro, Gmel, & Sempos, 2003). Definitions of alcohol abuse have also focused on social issues related to drinking; the Diagnostic and Statistical Manual of Mental disorders (American Psychiatric Association, 2000) defines abuse as “a maladaptive pattern of substance use leading to clinically significant impairment or distress, often manifested as a failure to fulfil obligations, use in physically hazardous situations and related legal, social or interpersonal problems”.

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The Government recommends that adult men should not regularly drink more than 3-4 units of alcohol per day and adult women should not regularly drink more than 2-3 units a day. However, in Great Britain, 31% of men and 20% women drink more than the advised weekly limits. Furthermore, 8% of men and 2% of women drink above the levels regarded as harmful, namely 50 units a week for men and 35 units for women (Office of National Statistics, 2008).

Age is an important variable contributing to alcohol consumption, with the highest intake recorded in young adults (Nolen-Hoeksema, 2004) particularly in those between 18 and 20 years old (May, 1992) (Webb, Ashton, Kelly, & Kamali, 1996). Drinking as a young adult has significant health consequences (Ham & Hope, 2003). The prevalence of drinking amongst young people does not only pose serious issues to the young people involved, but the consequences of their drinking can also have an effect on a their family and society as a whole (Oei & Morawska, 2004).

Alcohol consumption is a significantly greater problem within the student population because alcohol forms part of the university culture (Crundall, 1995). Drunken behaviour is accepted as normal at many student events (Davey & Clark, 1991). It has been found that alcohol is the most likely substance to be abused amongst the student population (Prendergast, 1994) and in comparison to non-university peers worldwide, students engage in riskier alcohol-related behaviour (Johnston, O’Malley, & Bachman, 2001) (O’Malley & Johnston, 2002) (Wiki, Kuntsche, & Gmel, 2010) (Kypri, Cronin, & Wright, 2005), drink more heavily (Kypri, Cronin, & Wright, 2005) (Dawson, Grant, Stinson, & Chou, 2004) and exhibit more clinically significant alcohol-related problems (Slutske, 2005).

It has been recorded that student consumption of alcohol is consistent with the rates of the general population in the UK, which is estimated to include 90% of adults consuming alcohol weekly (Department of Health, 2003). However, the amount of alcohol that is consumed by students has been suggested to pose significant risks.

Sociability has been identified as the major benefit to alcohol use. Specifically young people indicated that the reasons why they drink are for fun, to be happy, to gain confidence, to be cool and simply for something to do (Oei & Morawska, 2004). However, for students, hangovers were featured as the most negative aspect of drinking large amounts rather than longer term risks (Crundall, 1995). The students are also aware of the negative impact alcohol can have on their studies and finances (Bewick, Mulhern, Barkham, Trusler, Hill, & Stiles, 2008).

In America, one third of students were classified as suffering from alcohol abuse according to the DSM-IV-TR definition (as stated above) (Clements, 1999) and 6% reported symptoms of alcohol dependence (Knight, Wechsler, Kuo, Seibring, Weitzman, & Schuckit, 2002). Fewer than 4% of those students who met the DSM-IV-TR criteria for alcohol abuse or dependence were found to be willingly to pursue treatment (Clements, 1999) (O’Hare, 1997). Within the United Kingdom, a review of studies measuring undergraduate drinking concluded that 52% of men and 43% of women reported drinking above the recommended limits (Gill, 2002). Webb, Ashton, Kelly, & Kamali (1996) also found that 15% of a UK student sample drank at hazardous levels. For men this exceeded 51 units per week and 36 units for women.

Increased alcohol consumption and binge drinking are not only related to health issues, but also could result in negative consequences for the individual, such as academic failure, unintended pregnancy, sexually transmitted diseases, property damage, and criminal consequences that jeopardize future job prospects (Berkowitz & Perkins, 1986) (Hingson, Heeran, Zakocs, Kopstein, & Wechsler, 2002) (Wechsler, Dowdall, Davenport, & Castillo, 1995).

Students do not only experience consequences of their own drinking but often experience consequences of others drinking (Rhodes, et al., 2009). In addition to harmful effects on the individual, there are second-hand consequences for fellow students, ranging from disrupted study and sleep, to physical and sexual assault (Donovan, Jessor, & Costa, 1993) (Hingson, Heeran, Zakocs, Kopstein, & Wechsler, 2002) (Perkins, 2002) making students more at risk of negative consequences from alcohol consumption.

The hazardous consequences of binge drinking felt by many students arise from the disabling effects of consuming a large amount of alcohol over a short period (Oei & Morawska, 2004). The National Institute on Alcohol Abuse and Alcoholism advisory council approved the following definition for binge drinking: “A ‘binge’ is a pattern of drinking alcohol that brings blood alcohol content to about 0.08 gram-per cent or above. For the typical adult, this pattern corresponds to consuming 5 or more drinks (male), or 4 or more drinks (female) in about 2 hours” (National Institute on Alcohol Abuse and Alcoholism, 2004). Adams, Barry, and Fleming (1996) identified that while the number of drinks consumed per occasion was an important risk factor for death from injury, but that frequency of consumption was not. Binge drinking students are more likely to suffer from negative consequences related to than non-bingers such as academic problems, engage in high risk sex, sustain injuries, overdose on alcohol and drive while intoxicated (Wechsler, Dowdall, Davenport, & Castillo, 1995) (Wechsler, Lee, Kuo, & Lee, 2000) (Wechsler, Kuo, Seibring, Nelson, & Lee, 2002) (Jennison, 2004) (Vik, Carrello, Tate, & Field, 2000). Despite negative alcohol effects, research suggests that a large proportion of students are placing themselves at risk by engaging in binge drinking.

There are notable gender differences in binge drinking, as women are more likely to initiate drinking when they feel angry or worthless and as an escape from their troubles. On the other hand, for men incentives are to gain peer approval or not to show fear (Oei & Morawska, 2004). In Europe, Kuntsche, Rehm, & Gmel (2004) concluded that men were more likely to binge drink and that peer pressure was one of the strongest influencing factors. Similar findings have been reported for UK undergraduates, (Wechsler, Dowdall, Davenport, & Rimm, 1995) recorded 50% of male students to be binge drinking (around 8 UK units per session) and 39% of women (?6.5 units) at least once in the preceding fortnight. Pickard et al (2000) also found that 50% of men binge drink. However, they found more women were likely to binge drinking (63%).

Research suggests that heavy drinking among students is most likely to occur in positive social contexts as opposed to negative contexts (Carey, 1995) (Carey, 1993). There are again gender differences in these consumption patterns. For example, University men tend to drink more often than their female peers in positive situations, such as those involving cues to drink and pleasant times with friends (Carrigan, Samoluk, & Stewart, 1998). Other findings suggest that social contexts can discriminate between heavier and lighter male student drinkers, whereas the strongest predictor of discrimination between heavier and lighter drinking university women is emotional pain (Thombs, Beck, & Mahoney, 1995). Such gender differences suggest that drinking behaviour may be motivated by different subjective beliefs regarding the consequences of alcohol consumption for men and women.

The beliefs people hold about the effects of consuming alcohol are referred to as alcohol outcome expectancies (AOE) (Goldman, Del Boca, & Darkes, 1999) and include areas such as assertion, affective change and tension reduction (Young, Connor, Ricciardelli, & Saunders, 2006). According to social-learning theory, drinking is a goal-directed behaviour that ranges from abstinence to alcohol dependence, and the initiation, maintenance, and development of drinking patterns is assumed to be directed by similar learning principles (Abrams & Niaura, 1987) (Bandura, 1969) (Jones, Corbin, & Fromme, 2001) (Maisto, Carey, & Bradizza, 1999).

Within this theoretical framework, alcohol outcome expectancies are considered to be critical determinants of different consumption patterns and a result of indirect and direct drinking experiences. These beliefs are particularly important when experiences with alcohol are less developed. For instance, young children’s expectancies of alcohol are best described as indeterminate and diffuse and their beliefs “crystallize” with age (Miller, Smith, & Goldman, 1990). These expectancies influence not only present behaviour, but also the perceptions of later experiences with alcohol, which may strengthen the original expectancies (Oei & Morawska, 2004).

AOE have been shown to be better predictors of various drinking patterns that demographics and background variables (Brown, 1985) (Christiansen & Goldman, 1983). Expectancies have consistently been found to be associated with current alcohol consumption in students (Leigh & Stacy, 1993), community samples (Brown, Goldman, Inn, & Anderson, 1980) and adolescents (Christiansen, Smith, Roehling, & Goldman, 1989). Expectancies were found to predict future drinking in adolescents after 1 year (Christiansen, Smith, Roehling, & Goldman, 1989), 2 years (Smith, Goldman, Greenbaum, & Christiansen, 1995) and 9 years (Stacy, Newcomb, & Bentler, 1991).

Research has shown that individuals with positive alcohol expectancies drink more alcohol and are at risk of misusing alcohol (Connor, Young, Williams, & Ricciardelli, 2000) (Young & Oei, 1996). Other research has provided evidence that expectancies partially mediate other variables (e.g. temperament, alcohol knowledge, etc.) that influence alcohol consumption (Smith, Goldman, Greenbaum, & Christiansen, 1995) (Kline, 1996) (Scheier & Botvin, 1997), the extent to which other variables influence drinking through expectancy ranges between 17% and 50% (Greenbaum, Brown, & Friedman, 1995).

The belief about alcohol’s power to change behaviour, rather than its true physical effects determine the behavioural effects of alcohol (Leigh, 1989) and also expectancies concerning the use of may operate differently in different social situations (Bot, Engels, & Knibbe, 2005).

Lee, Greely, and Oei (1999) found that drinking was related not only to positive expectancies, but also to negative expectancies regarding its effects and it is now well established that people hold both positive and negative alcohol-related expectancies (Fromme, Stroot, & Kaplan, 1993) (Leigh & Stacy, 1993) (Chen, Grube, & Madden, 1994) (McMahon, Jones, & O’Donnell, 1994).

Positive alcohol outcome expectancies refer to peoples’ motives for drinking and their perceptions of the positive outcomes associated with drinking alcohol. They have been shown to be causally related to alcohol consumption in both adults and adolescents (Christiansen, Smith, Roehling, & Goldman, 1989) (Dunn & Goldman, 1998) (Smith, Goldman, Greenbaum, & Christiansen, 1995) and also to problem drinking (Lewis & O’Neil, 2000). Negative expectancies refer to peoples’ motives to abstain from drinking alcohol or to limit consumption. Earleywine (1995) found that only positive, not negative, expectancies were related to intentions to drink and drinking behaviour. However, Werner (1993) found both positive and negative outcome expectancies and their subjective evaluations accounted for a significant portion of the variability in drinking patterns and health problems reported by students. Further support has been found, using a variety of different instruments, that negative expectancies significantly improve the ability to predict current drinking (Fromme, Stroot, & Kaplan, 1993) (Leigh & Stacy, 1993) (McMahon, Jones, & O’Donnell, 1994). These inconsistent findings might be attributable to different explanations of negative expectancies. For example, Leigh (1989) suggested that expectancies can separated into short-term, direct effects and longer-term negative effects of drinking. The comparison between positive and negative expectancies is also confounded by the fact that the expected positive effects are more proximal than the expected negative effects. For example, positive expectations, such as feeling more sociable, happen at the time of drinking compared to negative expectations (such as hangovers) which happen as a consequence of drinking. These expectancies follow the pattern of actual alcohol effects (Earleywine & Martin, 1993).

While the vast majority of research has focused on participants’ expectancies for the effect alcohol has on themselves, the alcohol-related expectancies that a person has for others have been shown to influence drinking behaviour as well (Borjesson & Dunn, 2001). Participants consistently expected alcohol to affect other people more than themselves for both positive effects (such as social or sexual enjoyment) and negative effects, such as impairment. However, moderate and heavy drinkers expected as much social/physical pleasure from alcohol as they expected others to receive (Rohsenow, 1983). Men expected themselves to become calmer and happier in comparison to others when drinking, but also that others would become more disinhibited and to generally misbehave compared to themselves (Gustafson, 1989). Sher, Walitzer, Wood, & Brent (1991) found that men reported significantly stronger outcome expectancies than women for social lubrication, activity enhancement, and performance enhancement in other women. These findings were replicated with a separate sample of men and women in a subsequent longitudinal study (Sher, Wood, Wood, & Raskin, 1996).

This study is aimed to investigate the relationship between participants AOEs and those they hold for their friends further in a student population. It is, also, aimed to investigate the relationship between AOEs and alcohol consumption.

The Alcohol Use Disorders Identification Test (AUDIT) is a simple ten-question test developed by the World Health Organization as a simple method of screening for excessive drinking. The first edition of this manual was published in 1989 and was subsequently updated in 1992. Questions 1 to 3 concern alcohol consumption, 4 to 6 relate to alcohol dependence and 7 to 10 consider alcohol related problems. A score of more than 8 for men or more than 7 for women indicates a strong likelihood of hazardous alcohol consumption and a score of 20 or more is suggestive of alcohol dependence.

Alcohol outcome expectancies were measured using the Comprehensive Effects of Alcohol Questionnaire (CEOA) (Fromme & Stroot, 1993). This questionnaire assesses both positive and negative discrete expectancies of alcohol’s effects on physiological, psychological, and behavioural outcomes. Participants rated 38 items on a four-point Likert scale ranging from “disagree”  to “agree” based on their expectation of the likelihood that the outcome will occur whilst they are drinking alcohol. Expectancies are divided into subscales, four of which address positive outcomes (Sociability, Tension Reduction, Courage, and Sexuality) and three addressing negative outcomes (Cognitive and Behavioural Impairment, Risk and Aggression, and Self-Perception). Examples of positive outcome expectancy items include: “I would feel energetic” or “I would feel unafraid”. Examples of negative outcome expectancy items include: “I would be clumsy;” “I would take risks” or “I would feel guilty”.

Scores for expected outcomes are determined by summing relevant subscale responses, allowing two overall scores to be calculated for each participant: positive expectations, negative expectations, and a total score for all expectations. The CEOA was found to have adequate internal consistency and temporal stability, and criterion and construct validity in a student sample (Fromme & Stroot, 1993).

For the purpose of the present experiment, individual alcohol outcome expectancies were assessed using the standard CEOA questionnaire, additionally, participants were asked to respond to CEOA items on the basis of answering for a chosen friend. Examples of friend’s outcome expectancy items included: “They would act sociably” or “Their senses would be dulled“.

This study found no significant differences in gender in AUDIT scores. Therefore the null hypothesis can be accepted. With regards to gender and alcohol consumption, findings from this study found only slight but non-significant differences between the consumption of men and women, with women drinking only slightly more than men. Although similar results were found in the study by (Labrie, Migliuri, Kenney, & Lac, 2010), their study was focused on participants with a family history of excessive alcohol consumption. It was only within participants with a family history of excessive alcohol consumption that gender differences were found. The findings in the present study were inconsistent with the findings of (Prendergast, 1994) who found it more likely for men to abuse alcohol than women. However, this study was a review of previous literature (1980 to 1994) and more recent research evidence would suggest that gender differences are decreasing (Keyesa, Grantic, & Hasin, 2007). In addition, this study used an American sample and findings may not be applicable to those in the UK. This suggests that women are at greater risk of alcohol disorders, with 6.4% of men compared to 11.3% of women identified as being dependent on alcohol according to AUDIT score.

In comparison to the general population men in this study were less likely to be classed as drinking above hazardous levels (8% vs. 6.4%) whereas many more women were drinking at these levels (2% vs. 11.3%) (Office of National Statistics, 2008). This suggests that the population used in this study is not representative of the general population in regards to dependent levels of drinking which could result in unique findings.

Participant’s alcohol expectations were found to significantly affect AUDIT score and therefore we can reject the null hypothesis. This is similar to the results of (Leigh & Stacy, 1993). It was also found that positive and negative outcome expectancies accounted for a significant portion of the variability in drinking patterns, similarly to other previous research (Werner, Walker, & Greene, 1993). As with previous research, it has been found that increased positive AOEs relate to higher consumption. Alternatively, in this sample, negative AOEs also appear to be related to increased alcohol consumption. It has been suggested that positive expectancies are immediately accessible and therefore contribute to initiation of alcohol use. Whereas, negative expectancies are delayed and shaped by subsequent drinking, therefore their influence may be related to persistent drinking (Sher, Wood, Wood, & Raskin, 1996) (Bauman, Fisher, Bryan, & Chenoweth, 1985) (Kuntsche, Knibbe, Engels, & Gmel, 2007). In this study, participants were drawing on memories of drinking experience to shape their expectancies. This could have allowed them to evaluate AOEs equally, with proximal and distal effects playing a less important role. The findings underscore the importance of attitudes and strength of beliefs, particularly in identifying those at high risk for problem drinking and adverse health consequences.

A multiple regression indicated that a person’s AOEs for the Risk and Aggression subscale are a significant predictor of AUDIT score and also expectancies explained 21.6% of the variance in scores. This appears consistent with the findings of Fromme and D’Amico (2000) who found AOEs explained 28% of the variance in quantity of alcohol consumed, and 15% of the variance in frequency of drinking. Ham, Stewart, Norton, & Hope (2005) found the Risk and Aggression subscale of AOEs to be related to alcohol consumption in adolescents, specifically drinks per week. However, they found this was not the only subscale related to alcohol consumption but also an association was found with Liquid Courage, Sociability and Sexuality expectations. Alcohol consumptions relationship with expectancies seems to be especially true for the expectancies of both physical and social pleasure, relaxation and tension reduction and possibly enhanced sexual functioning (Gustafson, 1989). This suggests that the relationship between expectancies and AUDIT score is mediated by the population being studied and what is specifically been measured. Due to different measures of expectancies it is difficult to compare results directly. Measurements can relate to a range of expectancies; from general expectancies to specific expectancies. This is also true for measures of alcohol consumption. The AUDIT does not only address participant’s consumption but also alcohol dependence and alcohol related problems. It is also possible that some drinkers use expectancies as a justification for drinking, rather than solely associated with drinking. Gustafson (1989) found a positive correlation between the strength of expectancies and how desirable it was rated as an outcome of drinking. Therefore people could be drinking to achieve expectations rather than expecting certain consequences of drinking.

A logistic regression indicated that the Sexuality, Risk and Aggression, and Self-Perception subscales reliably predicted using alcohol at risky levels. Expectancies explained between 22.3% and 32% of the variance in risk classification, and 83% of the predictions were correct. Ham, Stewart, Norton, & Hope (2005) found that 44% of the variance in high level drinking to be attributed to AOEs. This higher level could be due to the sample population used in the study. For the current sample, there were no effects of AOEs on AUDIT score for men (see below), and therefore the variance in risk classification reflects upon women’s expectations for alcohol. Similarly this could explain why Ham, Stewart, Norton and Hope (2005) found that greater the expectancies for Self-Perception and Cognitive and Behavioural Impairment, the more likely participants were to have alcohol related problems, this was consistent with findings of Lee, Greely, & Oei (1999). Also Gustafson (1989) found that high consumers have stronger AOE and that all expectancies, bar Sexuality, were related to higher levels of alcohol consumption. These results suggest that certain expectancies are related to risky drinking, however, the expectancies that reliably predict risk is determined by the population that is being investigated. Further to this, some research has found that expectancies did not appear to be related to consumption in problem drinkers (Oei, Fergusson, & Lee, 1998) this suggest that further research needs to be conducted into the relationship between level of alcohol consumption and AOEs.

There was no effect of AOEs on AUDIT score for men. However, there was an effect for women, therefore we can reject the null hypothesis. This does not follow previous research as it has been found expectations that alcohol would improve social situations had the highest correlations with actual alcohol use in men. Men’s alcohol use corresponded to the belief that men in general have positive personality changes due to drinking, and that men drink to relieve social anxiety (Borjesson & Dunn, 2001). These findings appear inconsistent with research by (Brown, Goldman, Inn, & Anderson, 1980), who found that women expected more positive social consequences from drinking alcohol, whereas men were more likely to expect potentially aggressive behaviour and more negative expectations. This difference could be because of gender differences within the population used. Although the sample population is similar to the UK populations with more men than women (UK; 51% women, Study; 62% women) (Office of National Statistics, 2008), it is inconsistent with that of Loughborough University (62% men) (The Complete University Guide, 2011). The choice of women to attend a predominantly male University may have affected the results as University choice may be determined by personal characteristics and lifestyle choices.

There was a relationship between participants and friends AOEs, specifically for the same type of expectations (positive to positive and negative to negative), and therefore the null hypothesis can be rejected. A modified version of the CEOA was used to identify friend’s expectations and therefore its individual validity and reliability has not been tested. This means that the data can only be indicative of a relationship, but similar results have been found before (Rohsenow, 1983). Participants expected alcohol to affect other people more than themselves. However, this was more pronounced for negative effects. People typically drink more or less in response to the consumption rates of others in their drinking environment (Caudill & Marlatt, 1975) (Lied & Marlatt, 1979), especially when people are friendly (Collins, Parks, & Marlatt, 1985). The belief that others will experience more AOEs effects than themselves, a person’s own alcohol consumption could be effected. Individuals could be drinking more than to others because they underestimate the effect alcohol is having on themselves in regards to others. Research has identified social context and peer influence as risk factors for problematic student drinking (Ham & Hope, 2003). The current study is limited because it does not investigate the relationship of specific expectancy subscales. It has previously been found, however, that, others who consumed large amounts of alcohol were seen as more relaxed, less inhibited, more aggressive, and less attractive than those who drank none or little (Edgar & Knight, 1994). And those who themselves drank less were more likely to expect others to become more aggressive and relaxed than their moderate or heavy drinking counterparts (Rohsenow, 1983).

When looking at different levels of alcohol consumption, it was found that there was no relationship between participants and friends expectations for those not drinking at risky levels. For those classified as hazardous drinkers there was only a relationship between the same type of expectancies (positive and positive, negative and negative). In opposition to this there was a relationship between opposite expectations for those classified as dependent drinkers. Therefore the null hypothesis can be rejected. Alcohol expectancies have been shown to correlate with all levels of drinking (Goldman, 1999). The lack of defining an specific amount of alcohol in this study, instead specifying to base assumptions on a friend consuming the same amount as the participant, could have affected the results. Therefore those drinking low levels of alcohol are also rating their friends drinking low levels which may not be representative of normal drinking. Those drinking at dependent levels may have been more aware of drinking large amounts because they had previously completed the AUDIT. Specifically those drinking at dependent levels expected that their friends would have more negative expectations than themselves. Students are suggested to be aware of the negative consequences of drinking (Bewick, Mulhern, Barkham, Trusler, Hill, & Stiles, 2008), but choose to ignore them in relation to their own drinking. More research needs to be conducted into the relationship between this relationship, specifically in respect to reducing high drinking levels by making people fully aware of the negative effects of drinking.

There was no overall significant effects of men expectations for their self and friends expectations, however there was an effect of positive AOEs on friends positive AOEs. For women there was an effect of total expectations on friends expectations, specifically participants own negative AOEs and friends negative AOEs. Therefore the null hypothesis can be rejected. Expectancies of alcohol use are theorised to develop through learning from repeated experience with alcohol, either personally or observed. Therefore, an individual’s own perception of the consequences of drinking becomes an important factor in the associations (Bauman, Fisher, Bryan, & Chenoweth, 1985) (Jones & McMahon, 1992). In most cultures and societies, one of the most secure observations is that consequences surrounding consumption are tolerated more in men than in women (McMahon, Jones, & O’Donnell, 1994). This suggests that alcohol behaviours would generally be judged more by the individual if they were female than if they were male. These differences could be due to the population being sampled with women being less influenced by the way alcohol behaviour is perceived. Also it has been observed that women in the population score higher on the AUDIT than men, contrary to that of the general population.

It is important that future research takes into account other variables that affect the relationship between alcohol use and AOEs. This can then be used to better understand of why so many people drink risky levels despite the knowledge that it can be harmful. Specifically it is suggested that the desirability of AOEs is an important factor in understanding the relationship of expectancies to drinking (Leigh, 1987).

Conclusion

The aim of this study was to investigate relationship between participants AOEs and those they hold for their friends in a student population. It was, also, aimed to investigate the relationship between AOEs and alcohol consumption. Participant’s AOEs were found to significantly affect AUDIT score (F(46,71) = 1.651, p < 0.005, partial ?? = 0.517). There was no effect of AOEs on AUDIT score for men(F(31,15) = 0.821, p = 0.690, partial ?? = 0.629). However, there was an effect for women (F(36,34) = 1.818, p < 0.05, partial ?? = 0.658). There was a relationship between participants and friends AOEs (F(46,71) = 3.009, p < 0.005, partial ?? = 0.661).

The findings of the present study are consistent with previous studies that have shown AOEs to be significant predictors of alcohol consumption (Fromme, Stroot, & Kaplan, 1993). This highlights the importance of investigating the effects of AOEs within specific populations, and how AOEs can be controlled to effect alcohol consumption.

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