E Cahill, M Byrne
Student Health Department, UCC, Ardpatrick, College Road, Cork
Abstract
Alcohol and drug use amongst 3rd level students in Ireland is a concern and has been reported previously in the CLAN Survey1. The aim of our study was to determine the alcohol and drug use and any alcohol associated adverse consequences amongst students attending the health centre of University College Cork (UCC). 178 (98.3%) of the 181 students who replied reported having ever drunk alcohol. 157 (91.3%) students drank spirits in the past year v 148 (86.5%) who drank beer/cider v 135 (78.5%) who drank wine. 81 (44.8%) students reported binge drinking at least once weekly. 48 (26.5%) students used cannabis in the past year v 12 (6.9%) who used cocaine and 7 (4%) who used ecstasy. All students who drink reported at least one adverse consequence. 114 (63%) of students report adverse consequences of other peoples drinking. The changing drinking behaviour of female students is of particular concern.
Introduction
In the academic year 2002/2003, UCC and 20 other 3rd level institutions took part in the first national lifestyle survey (CLAN) among undergraduate students1. The CLAN survey provided invaluable information on student life and the health of students in Ireland, however, the results for each individual institution were not published as a matter of policy. We undertook this study to determine the alcohol and illegal drug use of students in University College Cork (UCC), and to explore the adverse consequences experienced by students as a result of their own drinking and that of others.
The CLAN Survey confirmed that drug use among 3rd level students was much higher than in the general population based on the national drug prevalence study2. Since the CLAN Survey was completed, the percentage of young adults (15 to 34) in the southern region of Ireland who have used any illegal drugs in past year and in their lifetime has increased slightly3. UCC students have been reported to drink more than graduates of UCC4. The SLAN survey in 2007 showed that 12% of 18 - 29 year olds drink more than the recommended weekly amount5. This is worrying as Irish drinkers suffer more adverse consequences as a result of their drinking than other EU countries6. Irish students are therefore at risk of both increased alcohol consumption and adverse consequences as a result of it.
Hazardous patterns of binge drinking are also common in Ireland6 particularly in younger age groups5. Much of the alcohol related harm in Ireland is due to the large numbers of people who drink to excess occasionally7. The high levels of alcohol consumed in Ireland are likely to have consequences. Alcohol ranked third in a WHO study as a risk factor for ill health and premature death8 and in addition, there is an abundance of social issues and problems associated with its abuse7. In this context, it is important to determine the current level of drug and alcohol use in UCC students and the adverse consequences that arise from drinking.
Methods
Students aged 18 and over, who attended University College Cork’s Student Health Department over 2 days in November 2008 were invited to complete an anonymous alcohol and drugs use questionnaire. The questions were based on existing items used in the CLAN survey, with minor changes. Data were analysed using SPSS Statistics 17.0 package.
Results
Demographics
181 of 198 questionnaires were returned completed, a response rate of 91.4%. Three quarters (n=137) of the respondents were female. This mirrors the reported attendance rate for the UCC Student Health Department, where the ratio of female to male visits is 3:1. Just over half (n=96) of the participants were under 21 years of age.
Illegal drugs
Cannabis was the most common illegal drug used by students, 49.2% (n= 89) of students had used cannabis at some stage in their lives, with 26.5% (n=48) reporting use in the previous year. Of those that used cannabis in the past year, 43.8% (n=21) used it on more than 10 occasions. In the last 30 days, 12.7% (n = 23) of students had used cannabis. Male users used cannabis significantly more than female users for that period (26.3% v 11%, p<.05). Approximately 15% (n=24) of students gave no reply to the question re cannabis use. Cocaine was the second most common illegal drug used by students, 6.9% (n=12) reporting use in the previous year with ecstasy in 3rd place at 4.0%. Ecstasy use was confined to female students. Eight students declined to answer the questions re cocaine and ecstasy. Nobody in the study had ever used heroin, drugs by injection, or crystal meth (see Table 1).
Alcohol Use overall
A high percentage, 98.3% (n=178) had ever drank alcohol and students began drinking at an average age of 15.9 years. (Range 1 - 30 years). Just over three quarters (n=138) had consumed an alcoholic drink in the last week. The order of preference for females was spirits 95.6% (n=131), beer/cider 77.4% (n= 106) and wine 75.2% (n= 103). The male order of preference was beer/cider 95.5% (n= 42), spirits 93.2% (n= 41) and wine 72.7% (n= 32).
Spirits including premix spirit drinks
As mentioned, spirits were the most popular drink with 91.3% (n=157) of students drinking them in the past year. Of those that drank spirits, 52.2% (n=82) drank them once a week or more. When females drink measures of spirits, they consume an average of 5 per drinking session, while males consume 4.7. The median number was 4 for males and 4.5 for females.
Beer/cider
Beer is also popular with 86.5 % (n= 148) of students drinking beer/cider in the past year (Males v Females 95.5% v 77.4% p < .05) Of those that drank beer/cider, 50.1% (n=75) drank it once a week or more. When students consume pints of beer/cider, males on average consume 4.5 pints, females consume 3.7. The median number was 4 for males and 3 for females.
Wine
Just over three quarters (n=135) of students drank wine in the past year. Of those that drank wine in the past year, 23.7% (n=32), drank it once a week or more. When students consume glasses of wine both males and females consume on average two glasses. The median number was 2, for both males and females.
Binge drinking
As per the CLAN survey a binge was defined as drinking at least four pints of beer/cider or a bottle of wine or its equivalent, on a single drinking occasion. Binge drinking was a frequent occurrence, 83.4% (n=151) of students admitted to having had a binge in the previous 12 months. A significant number of students binge drink once a week or more, 44.8% (n=81) had a binge once weekly. Some students binge drink even more frequently, 45.5% (n=20) of males v 44.5% (n=61) of females. Seventy students (38.7%), binge drank less than once a week. Close to 10% (n=15) of students never binge drank in the past year, while 1.6% (n=3) of students did not know how often they binge drank in the past year. 5.4% (n=12) of students did not answer this question.
Reasons students gave for drinking
The “positive” reasons students gave for drinking were sociability, enjoyment and as a means of relaxation, across both sexes. As many as one in 20 students drank because they were lonely or depressed (see Table 2).
Experience of adverse consequences as a result of own alcohol use
All students who drank reported suffering at least one adverse consequence as a result of their own drinking, with the mean number of 3.4 reported (3.4 male v 3.3 female). The commonest adverse consequences reported were regretting something said or done, feeling adverse effects whilst at college, missing days from college, or harm to college studies or work. Nearly 1 in 4 male drinkers had been in a fight as a result of their drinking and approx 1 in 10 students reported unintentional or unprotected sex as a result of alcohol (see Table 3).
Experience of adverse consequences of someone else’s drinking
The majority of students 63% (n=114), report suffering adverse consequences of someone else's drinking. There were statistically significant differences between the genders for 3 possible adverse consequences, with females more likely to report arguments with family/friends about drinking (21.9% v 6.8%) whereas males were more likely to have been verbally abused (38.6% v 21.9%) or physically assaulted (25.0% v 8.0%). Over 1 in 10 students had been a passenger in a car driven by someone under the influence of alcohol and 1.5% (n=2) females reported being sexually assaulted as a consequence of another person’s drinking.
*significant between gender (p<.05)
Discussion
Concerning levels of illegal drug use and alcohol consumption amongst Irish 3rd level students have been reported previously1. Our study suggests that these remain a concern for UCC students. UCC students report a lifetime ever use of cannabis of 49.2% compared to 20% of the 15-34 age group in the general population in the Cork-Kerry region3, with 26.5% of UCC students reporting use in the past year compared to 8.6% of the young adults in the general population. However, the level of cannabis use reported amongst UCC students was less than reported for all students in the national 2002-03 CLAN survey1, where 37% of students had reported cannabis use in the previous year. Cocaine was the second most common illegal drug used in the past year in this study, reflecting national trends3, unlike the CLAN survey1 where ecstasy was the second most common illegal drug used.
The average age to start drinking was higher in the UCC Students compared to students in the CLAN survey, but fewer UCC students were non-drinkers. In the CLAN survey, the most popular drink was beer1. The preferred drink for students appears to be changing, although this may be due to the higher percentage of females in the UCC group (75%) compared to CLAN (62%). Our study found that more students drank spirits in the past year than any other drink. UCC students drink to be sociable, because they enjoy it and to relax, but a concerning number do so because they are anxious or depressed. Males suffer more verbal and physical abuse as a result of alcohol whereas females argue with friends and family. A considerable number of students report difficulties with their studies as a result of alcohol, which may have implications for future retention and completion rates at university if alcohol consumption continues to rise. A number of concerning trends appear to have emerged for the female students in this UCC study. The female students appear to be binge drinking at least as often as their male counterparts, unlike in the CLAN survey1 where male students reported binging at a 60:40 ratio compared to females. Females are drinking similar numbers of measures of drinks as males which is a particular concern given that the recommended maximum weekly alcohol intake for females is only 2/3 that recommended for males (14 units v 21 units/week).
Specific actions should be considered. We propose the development of an alcohol and drug group in each university/college, to develop, implement and monitor the effectiveness of local college alcohol/drugs policies as well as promoting a healthier lifestyle for students. Universities/colleges need to highlight the effects of alcohol on the individual, their family, their college performance and their health, so that the attitudes and behaviour of students change. Evidence based interventions which reach as many students as possible should be introduced including wider availability of brief intervention therapy and novel on-line alcohol education and behaviour modification programmes such as E-PUB9. Undergraduate university students are an important resource, the basis for our well-touted knowledge-based economy and the potential future leaders of our society. We need them to be healthy and well adjusted, with an insight into the hazards of risk-taking behaviour and its adverse consequences. Leadership is needed to tackle the issue of alcohol and drug misuse in our 3rd level institutions. If we don’t act, it is us who will have failed.
Acknowledgements
Cindy Dring (Health Promotion Officer Student Services, NUI, Galway). Adriana Dineen (Receptionist at UCC Student Health Department).
Correspondence: E Cahill
Gortahoonig, Muckross, Killarney, Co Kerry
Email: [email protected]
References
1. Hope A, Dring C, Dring J (2005). College Lifestyle and Attitudinal National (CLAN) survey. In The Health of Irish Students. Dublin: Department of Health and Children.
2. National Advisory Committee on Drugs (NACD) & Drug and Alcohol Information and Research Unit (DAIRU). Drug use in Ireland and Northern Ireland [Online] 2002/2003. [cited 2009 Jan 30]; Available from: URL:http://www.dhsspsni.gov.uk/drug_use_bulletin2.pdf
3. National Advisory Committee on Drugs (NACD) & Public Health Information and Research Branch (PHIRB). Drug Use in Ireland and Northern Ireland 2006/2007 [Online] 2008. [cited 2008 Jan 30]; http://www.nacd.ie/publications/44524_NACD_Bulletin_No2(Screen).pdf
4. N O’Connor, M O’Connor, CP Bradley. Alcohol – How much is too much? Ir Med J. 2008 Jul-Aug;101:200-2
5. Morgan K, McGee H, Dicker P, Brugha R, Ward M, Shelley E, Van Lente E, Harrington J, Barry M, Perry I and Watson D. (2009) SLÁN 2007: Survey of Lifestyle, Attitudes and Nutrition in Ireland. Alcohol use in Ireland: A profile of drinking patterns and alcohol-related harm from SLÁN 2007, Department of Health and Children. Dublin: The Stationery Office.
6. Ramstedt M and Hope A. The Irish drinking habits of 2002: Drinking and drink related - harm, a European comparative perspective. Journal of Substance Use. 2005 Oct 01;10:273-283.
7. Mongan D, Hope A and Nelson M (2009) Social consequences of harmful use of alcohol in Ireland. HRB Overview Series 9. Dublin: Health Research Board.
8. World Health Organisation. (2002) The World Health Report 2002: Reducing risks, promoting healthy life. Geneva:World Health Organisation.
9. E-PUB UCC can be accessed at https://interwork.sdsu.edu/echug/ie/?id=UCC&hfs=true