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COMMENTARY
Commentary on Kuntsche & Labhart (2013): When and why does pre-gaming occur?
We greatly enjoyed reading Kuntsche & Labhart’s paper [1], and as is often the case with innovative research, the authors’ findings raise some questions about the nature of pre-drinking in young adults (also known as pre-gaming, pre-partying or frontloading). First and foremost, we found the use of the Internet-based Cell phone-optimized Assessment Technique (ICAT) method to be extremely innovative, especially in the alcohol research field. This methodology is in line with experienced sampling methods [2] and telephone monitoring work [3] with adolescents. The ICAT is superior to current field assessment practices, and we were very pleased to see that the authors examined pre-drinking behaviors within hours of their occurrence. This approach greatly informs our understanding of when pre-drinking occurs; our work with adolescents suggests that more flexible assessment strategies are needed, as pre-drinking does not always occur at the weekend evenings and individuals are not always available to complete surveys. In the United States and other countries, pre-drinking can occur earlier in the day for special events, including sporting events and concerts [4]. Therefore, early day-drinking (e.g. 11 a.m.) might not be captured accurately using Kuntsche & Labhart’s methodology, where assessments began at 8 p.m. Improvements in technology may combine event-level assessment with biological measures of intoxication (e.g. breathalyzers built into the phone assessment process), providing compelling evidence of the interplay of intoxication with implicit and explicit cognitive functioning in real-life settings. Given the dichotomous nature of the authors’ predrinking assessment, its modest prevalence in their sample (endorsed by about 12%) and the link between pre-drinking and heavy alcohol use and consequences, we were left wondering why do French-speaking Swiss students engage in this behavior? The authors found that conformity and coping motives seemed to play a moderating role, contrasting previous research that often indicates that social and enhancement motives seem to be more influential (see Table 1 in their paper). How to explain this? As the authors examined general drinking motives over the past year, we posit that examination of pre-drinking-specific motives may be more informative. In most cases, particularly in studies where researchers specifically select alcohol users in their sample to examine drinking motives, the need to conform in routine drinking situations with peers is less likely to be frequently endorsed. In contrast, a non© 2013 Society for the Study of Addiction
drinker, or perhaps even a light drinker, may feel the need to conform because they are disconnected from a social circle that does not drink nearly as much (e.g. a light-drinking student athlete who goes out with their team and their team pre-drinks). Relatedly, the lower levels of endorsement of conformity and coping motives is also consistent with findings in our work with college students [5] and high school students [6], perhaps indicative of their relative rarity. In the absence of pre-drinking-specific motives, why else would these students engage in this activity? Legal issues also do not appear to be a major factor. It is our understanding that in Switzerland, 16-year-olds can purchase beer and 18-year-olds can purchase any alcoholic beverages. This study was conducted with college students with a mean age of 23 years, which is considerably older than the majority of the students in our and other researchers’ high school and college samples. Traditional US college students are between the ages of 18–22 and cannot purchase alcohol legally until they are 21. Perhaps financial reasons are at play, with the students wanting to avoid the expense of consuming numerous drinks at a bar or other drinking establishment [7]. Availability may also play a role; many students pre-game due to limited alcohol access at the site to which they are going due to being under age, going to a ‘dry event’ or difficulty obtaining drinks, for instance at a crowded party [5]. Lastly, as soccer and hockey are very popular in Switzerland, perhaps consumption before these sporting events may also contribute to this phenomenon as football does in the United States. Overall, we are excited by the international research on pre-drinking and hope that future pre-drinking research examines the influence of rate of consumption, state (e.g. stressed) and trait variables (e.g. personality), as well as any specific motives for pre-drinking, to understand pre-drinking and associated harms more clearly. It is our hope that these efforts can be translated into practice to inform future interventions designed to reduce the harms associated with this risky drinking practice.
Acknowledgements B.B.’s contribution to this manuscript was supported by the National Institute on Alcohol Abuse and Alcoholism grant R01-AA017874 and VISN1 Career Development Award V1CDA2012-18. J.H.’s contribution to this manuscript was supported by National Center for Research Resources and the National Center for Advancing Addiction, 108, 1756–1757
Commentary
Translational Sciences, National Institutes of Health (NIH), through grant UL1RR033184 and KL2TR000126 (Principle Investigator: Larry Sinoway). The contents of this manuscript do not represent the views of the National Institute of Health, the Department of Veterans Affairs or the United States Government. Declaration of interests None. Keywords
Adolescents, alcohol, pre-drinking. BRIAN BORSARI1,2, NADINE R. MASTROLEO2, JOHN T. P. HUSTAD3 & BYRON L. ZAMBOANGA4
Mental Health and Behavioral Sciences Service, Department of Veterans Affairs Medical Center, Providence, RI, 1 USA, Brown School of Public Health, Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA,2The Pennsylvania State College of Medicine, Department of Medicine and Public Health Sciences, Hershey, PA, USA3 and Smith College, Department of Psychology, Northampton, MA, USA.4 E-mail:
[email protected]
© 2013 Society for the Study of Addiction
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References 1. Kuntsche E., Labhart F. Drinking motives moderate the impact of pre-drinking on heavy drinking on a given evening and related adverse consequences—an event-level study. Addiction 2013; 108: 1747–55. 2. Larson R. Beeping children and adolescents: a method for studying time use and daily experience. J Youth Adolesc 1989; 18: 511–30. 3. Collins R. L., Kashdan T. B., Gollnisch G. The feasibility of using cellular phones to collect ecological momentary assessment data: application to alcohol consumption. Exp Clin Psychopharmacol 2003; 11: 73–8. 4. Neal D. J., Fromme K. Hook ’em horns and heavy drinking: alcohol use and collegiate sports. Addict Behav 2007; 32: 2681–93. 5. Zamboanga B. L., Casner H. G., Olthuis J. V., Borsari B., Ham L. S., Schwartz S. J. et al. Knowing where they’re going: destination-specific pregaming behaviors in a multiethnic sample of college students. J Clin Psychol 2013; 69: 383–96. 6. Borsari B., Zamboanga B. L., Correia C., Olthuis J. V., Van Tyne K., Zadworny Z. et al. Characterizing high school students who play drinking games using latent class analysis. Addict Behav 2013; 38: 2532–40. 7. Wells S., Graham K., Purcell J. Policy implications of the widespread practice of ‘pre-drinking’ or ‘pre-gaming’ before going to public drinking establishments—are current prevention strategies backfiring? Addiction 2009; 104: 4–9.
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