Collateral damage from college drinking: A conceptual framework for alcohol’s harms to others among US college students

Abstract

Background: A growing literature shows that drinkers can harm bystanders through alcohol-related harms to others (HTO). The burden of HTO is particularly consequential in college environments, where heavy alcohol consumption and related harms are highly prevalent. A key limitation to the current literature on HTO among college students is that the determinants of HTO in college settings are not well-described. Objective: This article presents an evidence- and theory-based conceptual framework of HTO among United States college students. Methods: This study used a literature review in Embase, PsycInfo, PubMed, and Web of Science to determine the prevalence of HTO among college students and literature gaps. Researchers supplemented college HTO literature with broader HTO literature to develop a conceptual framework. Results: Prevalence estimates for HTO among college populations range from 59% to 84%. Literature on HTO among college students is mostly confined to brief sections of larger surveys. The college HTO literature lacks the level of detail necessary to support methodologically rigorous research. Conclusions: HTO are prevalent among college populations but their prevalence and etiology are not well understood. This likely leads to systematic undercounting of the impact of alcohol in college settings, exacerbating the “translation” gap between what the research says is effective and what colleges actually do. Better understanding of HTO mechanisms through which drinkers harm those around them would inform alcohol research and policy on college campuses, and lead to more accurate assessments of the degree to which stronger alcohol policies could benefit all students, regardless of their drinking patterns.

Keywords:

• Alcohol
• alcohol policy
• alcohol-related harms to others
• colleges

Disclosure statement

The project described was supported by Award Numbers T32AA007240, Graduate Research Training in Alcohol Problems: Alcohol-related Disparities and P50AA005595, Epidemiology of Alcohol Problems: Alcohol-Related Disparities from the National Institute on Alcohol Abuse and Alcoholism. The content is solely the responsibility of the authors and does not necessarily represent the official view of the National Institute on Alcohol Abuse and Alcoholism or the National Institutes of Health.