Alcohol use contexts (social settings, drinking games/specials, and locations) as predictors of high-intensity drinking on a given day among U.S. young adults.

BACKGROUND
This study examined whether variability in young adult drinking social settings, drinking games/drink price specials, and locations differentiated daily high-intensity drinking (HID) likelihood; whether contexts varied by legal drinking age and college status (attending a 4-year college full-time); and whether legal drinking age and college status moderated drinking context/intensity associations.


METHODS
Participants (n=818 people, 46.3% female) were part of the Young Adult Daily Life Study in 2019-2022, originally selected because they were past 30-day drinkers from the 2018 U.S. national probability Monitoring the Future 12th grade sample and because they reported one or more days of alcohol use during 14-day data collection bursts across the following four years (n=5,080 drinking days). Weighted multi-level modeling was used to estimate drinking context/intensity associations. Drinking intensity was defined as moderate (females 1-3, males 1-4 drinks), binge (4-7, 5-9 drinks), or HID (8+, 10+ drinks). Models controlled for other within-person (weekend, historical time period) and between-person (sex, race/ethnicity) covariates.


RESULTS
Contexts differentiating HID and binge drinking days included drinking with large groups, strangers, pre-gaming, drinking games, and more drinking locations. Legal drinking age was associated with lower odds of free drinks but greater odds of drinking at bars/restaurants. College status was associated with lower odds of drinking alone or free drinks, but greater odds of drinking with friends, large groups, pre-gaming, drinking games, discounted price drinks, at bars/restaurants, at parties, and more drinking locations. Legal drinking age and college status moderated some context-intensity associations.


CONCLUSIONS
Social settings, pre-gaming, drinking games, and drinking at more locations were associated with increased risk of HID on a given day. Legal drinking age and college status were associated with specific drinking contexts and moderated some context/intensity associations. Incorporating contexts associated with HID into interventions may be a promising approach to reducing HID and related consequences.