Alcohol, Tobacco, and Other Drugs
The health and safety consequences related to alcohol, tobacco, and other drug use remain significant concerns on college and university campuses across the country, including NYU. The behaviors of college students place them at high risk for unprotected sex, sexual assault, physical injury, and death resulting from substance use. Rates of heavy episodic (or binge) drinking have remained high and the misuse of additional substances, particularly prescription medications, has risen sharply in the past decade on college campuses, increasing overall risks associated with substance use in this population. Cigarette smoking, with its serious long-term health consequences, is reported at intermittent or at daily rates of nearly 20% among NYU students. Given the serious consequences of substance-using behaviors, NYU must focus on implementing a comprehensive approach to prevention beyond individually focused health education programs to include strategies designed to change the campus and community environment in which students make decisions about alcohol, tobacco, and other drug use.
- The binge drinking rate at NYU is 34%,49 which is lower than the national average. 5
- Almost 1 in 4, or 1.8 million, college students meet the medical criteria for substance abuse or dependence, almost triple the proportion in the general population.2
- College students aged 18 to 29 were almost twice as likely as adults 30 years of age or older to meet criteria for current alcohol abuse and more than 4 times as likely to meet criteria for current alcohol dependence.3,4
- Studies show students more than double their drinking during study abroad, and those who drank at heavier levels while abroad returned home drinking at significantly elevated levels.5
- An estimated 400,000 students between the ages of 18 and 24 had unprotected sex and more than 100,000 students between the ages of 18 and 24 report having been too intoxicated to know if they consented to having sex.7
- “Heavy and frequent” drinkers are approximately 5 to 6 times more likely than “non-heavy” drinkers to report that they had missed class and that they had performed poorly on a test or other project because of drinking.8
- The phenomenon of perceived social norms – or the belief that “everyone” is drinking and drinking is acceptable – is one of the strongest correlates of drinking among young adults.9
Misuse of Prescription Drugs
- NYC Department of Health reports a steady increase in ER visits related to prescription misuse.10
- Prescription painkillers cause more overdose deaths than cocaine and heroin.11
- From 1993 to 2005, the proportion of students who abused prescription painkillers like Percocet, Vicodin and OxyContin, increased 343% to 240,000 students; stimulants like Ritalin and Adderall, 93% to 225,000; tranquilizers like Xanax and Valium, 450 % to 171,000; and sedatives like Nembutal and Seconal, 225% to 101,000.2
- From 2002-2009, self-reported, non-medical prescription opioid use increased by 40% among adults in New York City.10
- Tobacco use is the leading cause of premature and preventable death in the world.12
- Each year, an estimated 443,000 people in the U.S. die prematurely from smoking or exposure to secondhand smoke, and another 8.6 million live with a serious illness caused by smoking.13
- Coupled with an enormous health toll is the significant economic burden of tobacco use—more than $96 billion a year in medical costs and another $97 billion a year from lost productivity.13
- Every day, nearly 4,000 young people try their first cigarette and approximately 1,000 will become daily smokers. More than 80% of adult smokers started before their 18th birthday.14
- During their years at college, 11.5% of nonsmokers will become occasional smokers and 14.4% of occasional smokers will become daily smokers.15
- The typical nonsmoker’s net worth is roughly 50% higher than light smokers and roughly twice the level of heavy smokers.16
- Increase student use of alcohol “risk reduction” practices.
The use of "protective" behavioral strategies – such as avoiding drinking games, eating before drinking, or counting drinks – has been associated with students drinking less and experiencing fewer alcohol-related negative consequences.17-19 Several evidence-based interventions or strategies – including brief motivational interviewing,20 cognitive-behavioral skills training,21 incorporating trained student peers on intervention teams,22,23 Internet based interventions,24-27 and judicial mandated programming25 – have been shown to increase student knowledge about and use of protective behavioral strategies.
- Increase visibility and access to NYU and community-affiliated substance-free social options.
Large amounts of unstructured student time and student perceptions of heavy alcohol use can contribute to increased alcohol use and binge drinking.28 Alcohol-free social programming may be an effective strategy for decreasing alcohol use on days when students attend alcohol-free events rather than alcohol-related events or gatherings29,30 and is a primary policy goal of the National Institute on Alcohol Abuse and Alcoholism (NIAAA).1, 28 Substance-free social options may also contribute to changing the sociocultural environment on campus by demonstrating that the university supports alcohol-free activities and limiting access to alcohol during events. In addition, students who attend are exposed to peers who are more likely to value alcohol-free entertainment, which may affect their beliefs about drinking norms on campus.31
- Promote consistent and interdependent enforcement of alcohol policies.
Heavy drinking rates among college students are higher than those of their non-college peers.32 Characteristics of the college environment contribute to this phenomenon,33 but aggressive and consistent policy enforcement has been associated with reductions in student drinking rates over time.34 NYU currently has in place a comprehensive set of evidence-based policies; for example, responsible beverage service in social and commercial settings; enforcement at University-based events that have been associated with excessive drinking; personal liability; and disciplinary actions associated with policy violations.35 As a large and decentralized university, it is necessary to regularly examine and if necessary adjust current alcohol policies and their implementation to ensure consistent application and understanding throughout the NYU global network.
- Strengthen policies and resources in support of a smoke free campus.
Second-hand smoke has serious negative consequences;36 thus, federal, state, and city entities support the establishment of smoke-free zones. For several years, NYU has been striving toward a smoke-free campus.37 Because many college students are social or intermittent smokers,38 smoke-free campus policies are particularly effective at reducing cigarette consumption and promoting broad normative changes;39-42 these policies provide physical barriers to smoking, which may motivate students to attempt to quit or not to start.43 Additionally, students with access to smoking cessation aides are more likely to use them and more likely to quit smoking.43
- Develop a University-wide strategy to address prescription drug misuse and abuse.
University-wide strategies involving all major stakeholders have been shown to be highly effective, and critical, in reducing binge drinking,28 suicide,44 and other high-risk behaviors or outcomes on college campuses.45 The significant rise in the misuse of prescription drugs nationally11 and in NYC,46 makes it imperative for college communities to better understand the trends in prescription drug misuse among college students;47 implement new policies to reduce inappropriate access to prescription drugs; and develop educational campaigns about appropriate and safe medication use and disposal practices targeting students and stakeholders.48 NYU should seek to adopt such strategies.
Indicator Technical Notes
a) Alcohol-associated serious negative consequences
- Data Source: ACHA #16C-16I
- Survey Question: Within the last 12 months, have you experienced any of the following as a consequence of your drinking: got in trouble with the police; had sex with someone without giving your consent; had sex with someone without getting their consent; had unprotected sex; physically injured yourself; physically injured another person; seriously considered suicide?
- Definition: proportion who responded yes on any consequence (includes N/A, don’t drink in denominator)
b) Students who avoid drinking games
- Data Source: ACHA #15B
- Survey Question: Within the last 12 months, when you “partied”/socialized, how often did you: avoid drinking games?
- Definition: proportion who responded “most of the time” or “always” (includes N/A, don’t drink in denominator)
c) Student taking prescription drugs that were not prescribed
- Data Source: ACHA #18C-18E
- Survey question: Within the last 12 months have you taken any of the following prescription drugs that were not prescribed to you: pain killers, sedatives OR stimulants?
- Definition: proportion answering yes to pain killers OR sedatives OR stimulants (18C-18E)
d) Students who currently smoke tobacco
- Data Source: ACHA # Q8A1
- Survey question: Within the last 30 days, on how many days did you use cigarettes?
- Definition: proportion who smoked within last 30 days (any amount)
- DeJong, W., Langford, & L.M. (2002). A typology for campus-based alcohol prevention: Moving toward environmental management strategies. Journal on Studies of Alcohol (Supplement), 14, 140-147.
- Wasting the best and the brightest: Substance abuse at America’s colleges and universities. The National Center on Addiction and Substance Abuse. ( 2007). Retrieved from http://www.casacolumbia.org/templates/publications_reports.aspx
- Dawson, D.A, Grant, B.F, Stinson, F.S, & Chou, P.S. (2004). Another look at heavy episodic drinking and alcohol use disorders among college and non-college youth. Journal of Studies on Alcohol, 65, 477–488.
- Grant, B.F., Dawson, D.A., Stinson F.S., Chou, P.S., Dufour, M.C., & Pickering, R.P. (2004). The 12-month prevalence and trends in DSM–IV alcohol abuse and dependence: United States, 1991–1992 and 2001–2001. Journal of Drug and Alcohol Dependence, 74, 223–234.
- Pedersen, E.R., LaBrie, J.W., Hummer J.F., Larimer, M.E., & Lee, C.M. (2010.) Heavier drinking American college students may self-select into study abroad programs: An examination of sex and ethnic differences within a high-risk group. Addictive Behaviors, 35(9), 844-7.
- White, A.M., Hingson R.W., Pan, I.J., & Yi ,H.Y. (2011). Hospitalizations for alcohol and drug overdoses in young adults ages 18-24 in the United States, 1999-2008: Results from the nationwide inpatient sample. Journal of Studies on Alcohol and Drugs.
- Hingson, R.W., & Howland J. (2002) Comprehensive community interventions to promote health: Implications for college-age drinking problems. Journal of Studies on Alcohol (Supplement), (14), 226-240
- Presley, C.A., & Pimentel E.R. (2006). The introduction of the heavy and frequent drinker: A proposed classification to increase accuracy of alcohol assessments in postsecondary educational settings. Journal of Studies on Alcohol, 67, 324-331.
- Patrick, M.E., Maggs J.L., & Osgood, D.W. (2010). Late night Penn State alcohol-free programming: Students drink less on days they participate. Prevention Science, 11(2), 155–162. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063607/
- Paone D, Bradley O’Brien D, Shah S, Heller D. Epi Data Brief: Opioid Analgesics in New York City: Misuse, Morbidity and Mortality Update. New York City Department of Health and Mental Hygiene. April 2011, No. 3.
- Centers for Disease Control and Prevention. (2010, July). Unintentional Drug Poisoning in the United States. Atlanta, GA: National Center for Injury Prevention and Control.
- WHO REPORT on the global TOBACCO epidemic, 2011: Warning about the dangers of tobacco. World Health Organization.
- Centers for Disease Control and Prevention. (2011). Tobacco Use: Targeting the Nation’s Leading Killer, At a Glance 2011. Atlanta, GA: National Center for Chronic Disease Prevention and Health Promotion.
- U.S. Department of Health and Human Services. (2009, September). Results from the 2008 national survey on drug use and health: Detailed tables. Substance Abuse and Mental Health Services Administration. SAMSHA, Office of Applied Studies.
- Wetter, D.W., Kenford, S.L., Welsch, S.K., Smith, S.S., Fouladi, R.T., Fiore, M.C., & Baker, T.B. (2004). Prevalence and predictors of transitions in smoking behavior among college students. Health Psychology, 23, 168–177.
- Zagorsky, J.L. (2004). Does smoking harm wealth as much as health? Consumer Interests Annual, 50. Retrieved May 6th, 2005, from http://www.consumerinterests.org/files/public/Zagorsky_Does_Smoking_Harm_Wealth.pdf
- Araas, T.E., & Adams, T.B. (2008). Protective behavioral strategies and negative alcohol-related consequences in college students. Journal of Drug Education. 38(3), 211-24.
- Borsari, B., & Carey, K.B. (2006). How the quality of peer relationships influences college alcohol use. Drug and Alcohol Review, 25(4), 361-70.
- Martens, M.P. (2011). Changes in protective behavioral strategies and alcohol use among college students. Journal of Drug and Alcohol Dependence. doi:10.1016/j.drugalcdep.2011.04.020
- Schaus, J.F., Sole, M.L., McCoy, T.P., Mullett, N., & O’Brien, M.C. (2009). Alcohol screening and brief intervention in a college student health center: A randomized controlled trial. Journal of Studies on Alcohol and Drugs, (16), 131-141.
- National Institute of Alcohol Abuse and Alcoholism. National Advisory Council. (2002). A call to action: Changing the culture of drinking at U.S. colleges (NIH Publ. No. 02–5010). Retrieved from http://www.collegedrinkingprevention.gov/media/TaskForceReport.pdf
- Cimini, M.D., Martens, M.P., Larimer, M.E., Kilmer, J.R., Neighbors, C., & Monserrat, J.M. (2009). Assessing the effectiveness of peer-facilitated interventions addressing high-risk drinking among judicially mandated college students. Journal of Studies on Alcohol and Drugs (Supplement), (16), 57-66
- Fromme, K., Corbin, W. (2004). Prevention of heavy drinking and associated negative consequences among mandated and voluntary college students. Journal of Consulting and Clinical Psychology, 72, 1038–1049. PMID: 15612850
- Walters S., Hester, R.K., Chiauzzi, EM, & Miller, E. (2005). Demon rum: High-tech solutions to an age-old problem. Alcoholism: Clinical and Experimental Research, 29, 270–277. PMID: 15714050
- Walters, S.T., & Neighbors, C. (2005). Feedback interventions for college alcohol misuse: What, why and for whom? Addictive Behavior, 30, 1168–1182. PMID: 15925126
- Saitz, R., Palfa, T.P., & Freedner, N. (2006). Screening and brief intervention outline for college students: The iHealth study. Alcohol and Alcoholism, 23(1), 28–26.
- National Institute on Alcohol Abuse and Alcoholism. National Advisory Council. (2007). What Colleges Need to Know Now: An Update on College Drinking Research (NIH Publication No. 07-5010). Washington, DC: U.S. Department of Health and Human Services.
- National Institute on Alcohol Abuse and Alcoholism. National Advisory Council. (2002). A call to action: changing the culture of drinking at U.S. colleges (NIH Publication. No. 02-5010). Washington, DC: U.S. Department of Health and Human Services.
- Patrick M.E., Maggs, J.L., & Osgood, D.W. (2011). Late night Penn State alcohol-free programming: Students drink less on days they participate. Prevention Science, 11(2), 155–162. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063607/
- Murphy, J.G., Barnett, N.P., & Colby, S.M. (2006). Alcohol-related and alcohol-free activity participation and enjoyment among college students: A behavioral theories of choice analysis. Experimental and Clinical Psychopharmacology, 14(3), 339–349.
- Perkins, H.W. (2002). Social norms and the prevention of alcohol misuse in collegiate contexts. Journal of Studies on Alcohol and Drugs (Supplement), (14), 164-72.
- O'Malley, P.M., & Johnston, L.D. (2002). Epidemiology of alcohol and other drug use among American college students. Journal of Studies on Alcohol (Supplement), (14), 23-39.
- Wechsler, H., & Nelson, T.F. (2008). What we have learned from the Harvard School of Public Health College Alcohol Study: Focusing attention on college student alcohol consumption and the environmental conditions that promote it. Journal of Studies on Alcohol and Drugs, 69(4), 481-490.
- Harris, S.K., Sherritt, L., Van Hook, S., Wechsler, H., & Knight, J.R. (2010). Alcohol policy enforcement and changes in student drinking rates in a statewide public college system: A follow-up study. Substance Abuse Treatment, Prevention, and Policy, 5,18.
- Office of the Vice President for Student Affairs. New York University Policies on Substance Abuse and Alcoholic Beverages 2011‐2012. New York University. Retrieved from http://www.nyu.edu/content/dam/nyu/studentAffairs/documents/sabuse2011.pdf
- Centers for Disease Control and Prevention (2004b). Secondhand smoke: Fact sheet. Retrieved February 20, 2008, from http://www.cdc.gov/tobacco/data_statistics/Factsheets/SecondhandSmoke.htm
- Office of Compliance and Risk Management. New York University Smoke Free Campus Policy 2010. New York University. Retrieved from http://www.nyu.edu/content/dam/nyu/compliance/documents/SmokeFreeCampusPolicyFinal.9.16.10.pdf
- Moran, S., Wechsler, H., & Rigotti, N.A. (2004). Social smoking among U.S. college students. Pediatrics, 114, 1028.
- Doubeni, C.A., Li, W., Fouayzi, H., & DiFranza , J.R. (2008). Perceived Accessibility as a Predictor of Youth Smoking. Annals of Family Medicine 6, 323-330.
- Tauras, J.A. (2005). Can public policy deter smoking escalation among young adults? Journal of Policy Analysis and Management, 24(4).
- Borders, T.F., Xu, K.T., & Bacchi, D. (2005). College campus smoking policies and programs and students' smoking behaviors. BMC Public Health, 5, 74. [CrossRef] [Medline]
- Sutfin, E.L., Reboussin, B.A., & McCoy, T.P. (2009). Are college student smokers really a homogeneous group? A latent class analysis of college student smokers. Nicotine Tobacco & Research, 11, 444–54.
- Murphy-Hoefer, R., Griffith, R., Pederson, L.L., Crossett, L., Iyer, S.R., & Hiller, M.D. (2005). A review of interventions to reduce tobacco use in colleges and universities. American Journal of Preventive Medicine, 28(2), 188-200.
- Suicide Prevention Resource Center. (2004). Promoting mental health and preventing suicide in college and university settings. Newton, MA: Education Development Center, Inc. Retrieved July 30, 2011, from: http://www.sprc.org/library/college_sp_whitepaper.pdf
- Hingson, R.W., & Howland J. (2002) Comprehensive community interventions to promote health: Implications for college-age drinking problems. Journal of Studies on Alcohol and Drug Use (Supplement), (14), 226-240.
- Epi Data Tables. Opioid Analgesics in New York City: Misuse, Morbidity and Mortality Update. New York City Department of Health and Mental Hygiene. April 2011, no. 3.
- McCabe, S.E., Knight, J.R., Teter, & C.J., & Wechsler, H. (2005) Non-medical use of prescription stimulants among U.S. college students: prevalence and correlates from a national survey. Addiction, 99, 96–106.
- National Prevention Council. Office of the Surgeon General. National Prevention Strategy. (2011). Washington, DC: U.S. Department of Health and Human Services.
- American College Health Association. (2011). American College Health Association – National College Health Assessment 2011 NYU Data. Hanover, MD: Author.
- American College Health Association. (2010). American College Health Association – National College Health Assessment 2012 National Data. Hanover, MD: Author.