Implications of state alcohol policy for college students' binge drinking, suicidal behavior, and sexual assault victimization

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Project Summary/Abstract The proposed research examines the extent to which more restrictive state alcohol policy environments are associated with binge drinking in diverse subgroups of young adult college students, and with two alcohol use- related outcomes: suicidal behavior and sexual assault victimization. This research will be accomplished using repeated cross-sectional National College Health Assessment (NCHA) data. NCHA was administered twice yearly from 2008-2019 to an estimated 921,000 18-24 year old undergraduates from more than 500 four-year colleges in 48 states. NCHA data will be merged with time- and state-specific data on alcohol policy and state population estimates of per capita alcohol use and binge drinking. The primary predictor is the Alcohol Policy Scale (APS), a state-specific time-varying measure based on 29 policies, weighted by efficacy and degree of implementation, with subscales grouped by policy domain and mechanism. Analyses will account for individual and institutional covariates and clustering of respondents within institutions within states. In Aim 1 we will specify the extent to which alcohol policy restrictiveness and state population drinking measures predict college students’ binge drinking. A focus will be identifying differences in policy effects by students’ race/ethnicity, sex, age (minors vs. age ≥ 21), and sexual orientation. In Aim 2 we will estimate the statistical effects of more restrictive alcohol policies on suicidal ideation, self-harm, and suicide attempt via (mediated by) binge drinking. For Aim 3 we will quantify associations between more restrictive state alcohol policy environments and respondents’ sexual victimization, which we hypothesize will be only partially mediated by respondents’ binge drinking. Partial mediation is expected given the potential for alcohol policies to affect campus and community drinking contexts and alcohol use by perpetrators and bystanders. Identifying how alcohol policy relates to binge drinking in understudied subgroups and to young adults’ suicide and sexual assault risk is consistent with NIAAA’s Strategic Plan Goal 3 to improve strategies to prevent alcohol misuse and alcohol-related consequences. Findings on state-level protective contexts will inform planning and prioritization of distal and proximal (e.g., individually-oriented) prevention at national, state, and campus levels.