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Journal of Ethnicity in Substance Abuse Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/wesa20

Drinking Games Participation Among Female Students at a Regional Australian University a

Sera Murugiah & John Scott

b

a

Department of Preventive and Social Medicine , University of Otago , Dunedin , New Zealand b

School of Behavioural, Cognitive and Social Science , University of New England , Armidale , Australia Published online: 22 May 2014.

To cite this article: Sera Murugiah & John Scott (2014) Drinking Games Participation Among Female Students at a Regional Australian University, Journal of Ethnicity in Substance Abuse, 13:2, 139-157, DOI: 10.1080/15332640.2014.892462 To link to this article: http://dx.doi.org/10.1080/15332640.2014.892462

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Journal of Ethnicity in Substance Abuse, 13:139–157, 2014 Copyright # Crown Copyright ISSN: 1533-2640 print=1533-2659 online DOI: 10.1080/15332640.2014.892462

Drinking Games Participation Among Female Students at a Regional Australian University SERA MURUGIAH Downloaded by [North Dakota State University] at 10:55 13 October 2014

Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand

JOHN SCOTT School of Behavioural, Cognitive and Social Science, University of New England, Armidale, Australia

Participation in drinking games (DGs) by university students is often associated with heavy drinking and negative social and health impacts. Although research in Australia indicates that university students tend to drink at risky levels, there is paucity of literature on DGs among students, especially those residing at regional universities. This research examined drinking among female college students of white background. Eighteen female students participated in face-to-face in-depth interviews to describe their DG experiences. Most women played DGs for social and monetary reasons, with many drinking high volumes of alcohol during the game. Excessive drinking was linked with the type of beverage consumed. Despite knowing the health risks associated with DGs, there was a strong social imperative for these young women to play these games. Research and public health initiatives to better understand and address problematic drinking activities in rural and regional Australia have tended to ignore women and the dominant white populations whose heavy drinking has been largely restricted to private spheres. KEYWORDS Australia, drinking games, female, qualitative, university

Address correspondence to Sera Murugiah, Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand. E-mail: [email protected] 139

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BACKGROUND Several factors promote alcohol use among university students, such as to facilitate socializing, celebratory events, rites of passage, and sports (Glindemann, Wiegand, & Geller, 2007; Kypri, Langley, McGee, Saunders, & Williams, 2002; Lederman, 2006). Among these factors, drinking games (DGs) were also popular activities that fostered heavy alcohol use (Borsari, 2004; Borsari, Bergen-Cico, & Carey, 2003; Kenney, Hummer, & LaBrie, 2010; Pedersen & LaBrie, 2006; Zamboanga, Leitkowski, Rodriguez, & Cascio, 2006; Zamboanga et al., 2010). Heavy drinking during DGs had been associated with a variety of short- and long-term negative consequences, such as alcohol-related violence and crime, alcohol poisoning, and dependence, as well as death (Ahern & Sole, 2010; Chikritzhs et al., 1999; Hingson, Heeren, Winter, & Wechsler, 2005). DGs can be categorized into six types: gambling games, consumption games, cognitive skills games, motor skills games, media games, and team games (Borsari, 2004) (Table 1), and the primary aim=rule of these games is to foster intoxication within a short time span (Ahern & Sole, 2010; Ham, Zamboanga, Olthuis, Casner, & Bui, 2010; Simons, Lantz, Klichine, & Ascolese, 2005). Motives for partaking in these games tend to include social camaraderie, meeting new people, competing with others, intoxicating oneself and others, thrill seeking, and boredom (Ahern & Sole, 2010; Borsari,

TABLE 1 Categories of Drinking Games Category

Description

Gambling games

Played with card, dice, and chance. Winners are not required to drink; however, the losers have to consume a designated amount. These games have no strategies or rules. The objective is to drink as much as possible in the shortest amount of time. Players are required to repeat long or complex words or sentences. The person who makes a mistake has to drink. Players have to perform a certain task, such as flipping a coin into a glass. Failing to complete task requires the player to drink. Players drink upon listening=seeing a certain cue or phrases. For example, a person drinks every time he or she hears a TV character say ‘‘Hello.’’ Players compete against one another, often in two or more teams.

Consumption games Cognitive skills Motor skills

Media games

Team games

Sources: (Ahern & Sole, 2010; Borsari, 2004).

Types . . .

King’s Cup Beer Checkers Three Man Up

. .

100s Clubs Beer Bongs

. . . . .

The Fuzzy Duck Animal I Have Never Ever Quarters Cardinal Puff

.

Can be from any form of media, such TV shows, songs, or movies

. . .

Beer Pong Flip Cup Drinking Twister

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2004; Borsari et al., 2003). Although it is documented that men were likely to drink more than women (Chen, Dufour, & Yi, 2005; Kuntsche, Rehm, & Gmel, 2004; O’Malley & Johnston, 2002; Wechsler, Lee, Kuo, & Lee, 2000), recent research indicates that many young women are drinking as much as their male counterparts (Livingston, 2008; Roche & Deehan, 2002; Young, Morales, McCabe, Boyd, & D’arcy, 2005). Some researchers found that women tend to drink as much as or more than men during DGs participation (Johnson, Wendel, & Hamilton, 1998; Pedersen & LaBrie, 2006). Women, particularly, are more at risk than men because they are more vulnerable to the negative effects of alcohol (MacAskill, Cooke, Eadie, & Hastings, 2001; Spooner & Hetherington, 2005). However, research on DGs largely comes from the United States (Ahern & Sole, 2010; Borsari, 2004; Engs & Hanson, 1993; Johnson & Sheets, 2004; Simons et al., 2005). We only found one study based in Australia (Polizzotto, Saw, Tjhung, Chua, & Stockwell, 2007). Findings from this study indicated some similarities between American and Australian students, such as the rationales for participation (e.g., social camaraderie) and heavy consumption during these games (Polizzotto et al., 2007). This suggests that participation in DGs is not a problem unique to Australia; however, research remains scarce. It is also important to mention that although U.S. research has been informative about DGs, these studies may not be relevant to Australia due to the differences in legal drinking=purchasing age (21 years in the United States and 18 years in Australia) and drinking practices (e.g., there are no fraternities or sororities in Australia).

ALCOHOL USE IN AUSTRALIA In Australia, alcohol is one of the leading causes of death, injury, and hospitalization (Chikritzhs et al., 1999). Drinking is prevalent across all age groups; however, youth aged 18 to 29 years tend to drink at riskier levels than other age groups (Australian Institute of Health and Welfare, 2011; National Health and Medical Research Council, 2009). Particularly, researchers have reported many university students partaking in risky drinking patterns=behaviors (Davey, Davey, & Obst, 2002; Gilchrist, Smith, Magee, & Jones, 2012; Hallett et al., 2012; Johnston & White, 2004; Reavley, Jorm, McCann, & Lubman, 2011; Rickwood, George, Parker, & Mikhailovich, 2011; Utpala-Kumar & Deane, 2010). Nonetheless, alcohol consumption, when considered to be a social problem, tends to be associated with specific groups in Australian society, notably young people, men, and Indigenous Australians. What these groups have in common is a tendency to consume alcohol in public spaces, such as bars or outdoors, making their alcohol consumption conspicuous and vulnerable to social reactions, such as the policing of negative behaviors associated with high levels of alcohol consumption, especially violence.

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Outdoor consumption of alcohol can be prevalent in rural and remote Australian communities owing to a range of factors, including climate, limited recreational space, and restrictions on access to venues. The tighter social integration and surveillance of such communities also means that non-normative consumption of alcohol is likely to policed and sanctioned. Although much attention to the social control of social problems (i.e., violence) relating to alcohol focuses on the public sphere, research indicates that socially problematic behaviors associated with alcohol are more likely to occur in private or domestic spaces, regardless of whether considering rural or urban contexts (Williams, 1999). People living outside major cities in Australia are more likely to use alcohol than those residing in major cities. Alcohol has also been identified as the substance of most concern among rural and regional health workers. In Australia, rural youth have been identified as being more likely than their urban counterparts to consume alcohol and to consume it at hazardous levels. The National Drug Research Institute (2004) found that, compared with urban youth, rural youth were 1.7 times more likely to die from alcohol consumption, 1.9 times more likely to be admitted to hospital from an alcohol related assault, and 1.5 times more likely to be victims of alcohol caused violence. A high proportion (over two thirds) of Indigenous people live outside of major cities. The geographic distribution of the Indigenous population is roughly the reverse of the non-Indigenous Australians, with two thirds living in rural, regional, and remote localities. This population is also relatively young compared with the non-Indigenous population due to differences in mortality and fertility. Despite the perception of high levels of alcohol use among Indigenous people, the levels are actually comparable with or below levels in the non-Indigenous community. The misperception relates to the disproportionate level of harm (individual and community) by those Indigenous people drinking at high levels in public (Barclay, Hogg, & Scott, 2007; Bull, 2007). Given the factors cited above, alcohol consumption among young rural women from a non-Indigenous background has been relatively invisible in public discourse. Despite this, some research examining alcohol consumption among Australian women indicates risky patterns of drinking (Gilchrist et al., 2012; Johnston & White, 2004; Livingston, 2008; National Health and Medical Research Council, 2009). The current research, which was part of a larger study on women’s drinking experiences and perceptions of binge drinking (Murugiah, 2012), uses a qualitative approach to further explicate university students’ motivations toward DG participation. The current article redirects attention away from the drinking experiences of minority ethnic and=or socially disadvantaged groups to focus on mainstream populations who engage in socially and physically harmful levels of drinking.

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METHOD

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Setting The study was conducted at a regional university in Armidale, New South Wales, Australia. The town has a population of 24,473 people and, as with many Australian rural and regional centers, is relatively ethnically homogenous, with more than 80% of the population identifying as being of white descent. According to the 2011 Australian census, more than 80% of the local population was born in Australia and 88% speak English as their first language (Australian Bureau of Statistics, 2011). Approximately 6% of the population are Indigenous (2.5% of the overall Australian population are Indigenous). In terms of the broader Australian population, more than 92% of the population is of Europeans descent, with white groups comprising 74% of the Australian population (Babacan & Singh, 2010). In Armidale, there are some cultural and heritage interests and social entertainments (e.g., cinema, bowling center); however, it lacks nightlife entertainment. There are no facilities, such as 24-hour cafeteria and gaming arcades. As with many Australian rural and regional towns, licensed venues are the main source of social interaction and provide the main source of entertainment and sponsorship for community activities, such as sports. Limited infrastructure and opportunities for young people in such communities may be a source of problem drinking behaviors, such as those related to boredom. Limited health services and reduced operating hours also limit treatment and support (Bull, 2007). As noted above, the use of unprogrammed public spaces for hanging around and doing nothing is seen as anti-social behavior. This is especially a problem in distinct socio-spatial contexts, such as rural Australia, where great value is placed on productive activity and loitering is viewed as part of an indulgent consumption-oriented culture associated with city life (Barlcay et al., 2007). The University of New England (UNE), where the research was conducted, was established in 1938 as Australia’s first regional university. The university has approximately 20,000 students, most of who are distance learners and reside off-campus. The campus contains seven residential colleges and a village of self-contained units, housing approximately 2,000 students. More than 80% of on-campus students are between ages 18 and 24 years and three quarters are from rural and regional backgrounds. Approximately 60% of on-campus students are women, and approximately 5% of internal students identify as Indigenous. Although there is a vibrant drinking and college culture in Armidale, research on alcohol use among UNE students is dearth. The current study was approved by the UNE Human Ethics Committee (HE08=072).

Study Design Given that drinking habits among the study population remains relatively unknown, an exploratory framework was adopted. A grounded theory

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methodology (Glaser & Strauss, 1967) using in-depth interviews allowed for a detailed examination the students’ DG experiences, which allowed the researcher to gain deep insights to the phenomena under study from the participants’ voices. In addition, face-to-face interviews offered the flexibility for the participants to express their thoughts freely (Esterberg, 2002; Johnson, 2002). Two questionnaires were designed for this study: a screening=recruitment sheet and the main interview schedule. The screening=recruitment sheet was the initial questionnaire used to recruit=select potential participants for the study. It consisted of four questions: (a) Which age group do you belong to? (b) Do you drink? (c) How often do you drink? and (d) Did you consume more than four drinks in the past 6 months? The main interview schedule comprised a series of semistructured questions inquiring about students’ drinking experience, social behaviors, negative consequences, and perception of binge drinking. Of these questions, 12 specifically inquired their DG experience, such as the types of games played, their rationale for participation, what they drink, how much they drank, and the frequency of their participation.

Recruitment and Selection Criteria Purposive sampling was used to recruit participants (Maxwell, 2005), meaning we only sought to recruit those who could offer insights to the phenomenon of binge drinking and DGs. Students’ understanding of binge drinking was discussed in another article (Murugiah, 2012). Recruitment sheets were issued to first- and second-year social science students during class and collected at the end of the lesson. Potential participants were then contacted either by phone or e-mail for an interview session. The study had three selection criteria. First, we only aimed to recruit students who were between ages 18 and 25 years because research has shown that youth in this age group were more likely to drink at at-risk levels than other groups (Hingson et al., 2005; Ministry of Health, 2009). Second, only female participants who consumed more than four standard drinks during a drinking session in the past six months were recruited. The notion of a standard drink varies internationally, with it being defined as 10 g of alcohol in Australia (equivalent of 12.5 mL of pure alcohol) (National Health and Medical Research Council, 2009). In Australia, all market products containing alcoholic beverages are required by law to state on the label the number of standard drinks they contain. According to the Australian National Health and Medical Research Council (NHMRC, 2009), the consumption of more than four standard drinks on a single occasion doubles the risk of an injury in the 6 hours after the drinking occasion. The NHMRC (2009) guideline advises both men and women to drink no more than two standard drinks per day to reduce their health risks over a lifetime. Increasing consumption from two to four standard drinks daily increases the lifetime risk of death from alcohol-related disease by five-fold

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for men and more than six-fold for women (NHMRC, 2009). For this reason, the more than 4 drink cutoff mark was used as one of the recruitment criteria because it provided a quantifiable measure of risk taking or dangerous behavior. Finally, only women were eligible to participate. The Australian National Drug Strategy Household Survey (2005) explored awareness of health risks related to alcohol consumption among Australian men and women. The survey found that perceptions concerning level of consumption in the longer term varied significantly between men and women. For example, approximately 36% of men perceived that they could consume three to four standard drinks per day before putting their long-term health at risk, whereas only 13% of women had this perception (Australian National Drug Strategy Household Survey, 2005).

Interview Process and Analysis In total, 20 women aged between 18 and 21 years were recruited for the study. Although we did not intend to restrict the sample according to ethnicity, all participants were of white and=or European ethnicity. Among these 20 students, 2 indicated not playing DGs and they were asked their reasons for nonparticipation. All of the other women were asked to describe their experiences with DGs, such as the types of games they played, their frequency of playing such games, the types of beverages consumed, and whether they keep track of their drinks. Before commencing each interview, the participants were asked to read the information sheet and sign a consent form should they agree to participate in the study. All interviews were conducted in a central location (private room) in the department by the primary researcher, S.M. Each interview lasted between 30 and 50 minutes and was tape-recorded and transcribed verbatim. Thereafter, the transcripts were proofread thoroughly and then coded and thematically analyzed (Braun & Clarke, 2006) by both authors without the use of computer software. All women were given a t-shirt and a pen as incentives.

FINDINGS Frequency and Types of Games Participation in DGs appeared to be a highly gendered activity. The women often played DGs every 2 to 4 weeks, typically at a social gathering or before going out (e.g., bars). The DGs were typically played spontaneously during a drinking session with both male and female companions. The frequency of DGs participation tended to increase during the university semester break= vacation, with more than half of the women playing them at least once per week. During the interviews, we identified three types of DGs: I Have Never Ever, King’s Cup, and Drinking Twister (Table 2 contains descriptions of the

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In this game, players have to say something they have never done, and those who had participated in this activity have to drink. If no one has engaged in the activity=behavior, the announcer has to drink. King’s is played with a deck of cards, a list of rules, and a cup. Each card represents a certain task (e.g., Jack’s could mean that everyone has to drink). In addition, some King’s game incorporated IHNE as one of the rule cards. Generally, the King’s card is often designed to be the King’s cup whereby one has to pour some of his or her beverage into the cup. The player who picks the last King card has to consume all the contents from the cup. DT is a modification of the game Twister1, which is played on a mat with different colored circles and spinner as a die (Hasbro, 2011). In DT, the player holds a drink in one hand and whenever the spinner points to that hand, he or she has to take a sip from his or her drink. Although both sexes tended to play King’s and DT, IHNE was generally a female-orientated game within this sample.

Description

.

. . . . . .

Southern Comfort (Spirits)

Ready-to-Drink Spirits Midori Cask=Boxed wine Passion Pop Punch

Type of alcohol consumed

Once a month or less

Every 2 to 4 weeks. Participation is often spontaneous during drinking session.

Frequency of participation

Note: Although both sexes tended to play King’s and DT, IHNE was generally a female-orientated game within this sample.

Drinking Twister (DT)

King’s Cup (King’s)

I Have Never Ever (IHNE)

Name of DG

TABLE 2 Drinking Game (DG) Rules and Participation

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No

Yes

Keeping track of drinks during DGs

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games). All three DGs were either played in a single sex or mixed-gender group; however, I Have Never Ever was generally perceived as a women’s game. Although the first two DGs were popular among the participants, only one student reported playing Drinking Twister.

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Rationale for Participation We found three key reasons the women play DGs: (a) to bond with others, (b) to achieve a certain level of intoxication faster, and (c) to minimize cost when going out to town (e.g., bars). As such, motivations for engaging in drinking games could be summarized as social, physical, and economic, and these reasons often overlapped with one another. All participants reported that DGs were good social and bonding experiences. Often during DGs, several conversations occur, which include telling and listening to funny stories and jokes, random conversations, and comments about previous drinking games. I think it is a good way for everyone to drink together, especially when they are going out. Everyone gets together and play drinking games, and everyone gets pumped to go out. [P016] I like them, and I think they are fun and social. It is something we do before going out. It’s not only about talking and drinking, but trying to pick on people and try[ing] not to get picked on. There’s a lot of crazy talking and it gets people closer. [P007]

Many women also participated in DGs to attain a certain level of intoxication before going out to the bars=pubs in town. These women claimed that it was not enjoyable if they went to town or other social events sober. We would play them to get drunk. So you start like maybe with one drink, and then someone would be like, ‘‘Why not play a drinking game?’’ . . . the point of which is to get really drunk before we go to the pub. [P015] Often when you are heading to the pub, you don’t want to go to the pub sober . . .. I think a lot of people drink to get a little tiddly and get to the pub and top up a little bit. [P019]

In addition to the above comment, many women mentioned that purchasing alcoholic beverages from on-licensed premises (e.g., pubs, bars) were costly. Hence, the students found it economical to drink with peers in a private premise (e.g., flat, college) and play DGs and then go to the bars in town. As one student described: Because we are all poor uni [university] students, we don’t wanna spend a lot of money when we are out. It gets us kinda drunk enough to able to go out and stay drunk for the rest of the night. [P017]

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Choice of Beverage Generally, most women preferred drinking relatively inexpensive beverages with high alcohol content during DGs. Although a variety of beverages are consumed during DGs (e.g., ready-to-drink products, wine), cask=boxed wine (colloquially known as ‘‘goon’’) and punch were the two most commonly consumed beverages. Only one participant stated that she preferred drinking Southern Comfort (spirits), although she occasionally consumed other beverages. A goon cask typically comes in 2 or 4 liters and costs between AUS$10 and AUS$20. A punch is usually made in a large quantity (typically in a container, such as bucket) by mixing different alcoholic beverages (often including goon) with fruit juice or soft drinks. Most participants favored goon or punch because it could cater for a large group of peers, as well as get everyone relatively drunk. We mix everything together like vodka, Passion Pop [wine-based beverage], and goon. When you have a bit of punch left and you are about to go out, then everybody will scull whatever is left. It’s consumed really quickly. [P001]

The ingredients of a punch may also vary according to individuals=groups. It’s usually punch, spiked with something, mostly like vodka or Midori [sweet liqueur]. They are consumed in large amounts; a large tub filled two sacks of goon and lemonade, ridiculous amount. [P010]

When this student said ‘‘spiked with something,’’ she meant that a few different types of beverages could be used when making a punch, thus the ingredients in a punch may differ or even be unknown to the consumer.

Peer Pressure A majority of the students reported experiencing minimal peer pressure to play DGs. Almost all of them exhibited readiness and enthusiasm to participate in DGs. I am very willing to play them [DGs] . . . . They let you learn about different things with who you are playing with, like in I [Have] Never [Ever], you get pretty juicy gossips. [P015] I am the one that usually initiates these games. There is no pressure. Everyone usually wants to play drinking games. [P001]

Although the women were not under any extensive pressure to play DGs, many of them experienced overt pressure to drink heavily. Often, the participants consumed their beverages in big sips; however, sometimes

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they were peer-pressured by their mates to drink quickly or even scull the whole beverage.

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There is more pressure put on people, because if you are playing a game, sometimes you are the one who gets picked on and you have to drink and try to keep up with everyone. [P003] When you play King’s and stuff and you pick a card, they go, like, ‘‘okay, you can have four drinks,’’ just because they are mean and just because they like you to be drunker than them. [P017]

Some players also tended to team up to make other players drink more, especially the lightweight drinker. Because everyone is watching, escape from excessive drinking is virtually impossible. According to these women: The consequence of every rule is that you have to drink. If you are not a big drinker or if you don’t drink very often, then people will target you. [P012] Let’s say they allocate five drinks to you, that means you take five big sips . . .. People watch you when you are drinking. [P013]

In addition, when a player designates a certain number of drinks to another person, he or she may, in return, get assigned back the same number of drinks or even double the amount by other players. As one student explained: I think there is more pressure put on people because if you are playing a game, it’s, like, okay, I will allocate three drinks to this person and four to this person. However, sometimes you are the one who gets picked on and you have to drink and try to keep up with everyone. [P003]

Everyone is a target in drinking games, and it is sometimes used for settling old scores; for example, the targeted person may take revenge by allocating a ridiculous amount of drinks to the person who previously targeted him or her.

Keeping Track The students were asked whether it was possible for them to keep count of how much they had drunk during DGs. All except one woman was unable to keep count because of the fast-paced nature and rules of DGs, especially during King’s. Once I get past three drinks, I stop counting because the games are usually fast-paced, and I don’t realize how much I have drank. [P002] I tried to, but I can’t. I found this useful website on the Internet— Drink Diary. It gave the amount of calories there was and how it affects

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your body. I read it 50 times to remember, but when we have a big night we forget everything. [P005]

Among these women, the consumption of punch was a major contributing factor for not allowing them to keep track of their drinking. One participant commented:

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When we are playing drinking games, we get drunk pretty quickly, and if it’s punch, usually it will be in a big bowl or bucket or something, so we have no idea how much we have drunk. [P002]

Nevertheless, some women did not even think about counting their drinks because they believed that it defeated the purpose of playing DGs. I don’t know, good question really. I guess you are having fun, get caught-up and drink whatever is in front of you. You don’t really think about it. [P016] I don’t count my drinks. It doesn’t come to my mind that I should count. [P003]

Only one participant reported keeping count of how much she drank. This was because she had not played King’s Cup or I Have Never Ever. This participant had only played Drinking Twister with her close peers. Although she was able to keep count of her drinks during DGs, she too consumed four or more standard drinking units in one sitting on several occasions.

Reasons for Not Playing Two students reported not playing DGs. There were two different reasons for these women to not play. For one student, not living in a residential hall or being around the college environment was her main reason for not playing. I don’t go to college. I just don’t know anything about drinking games. I don’t know any of them. [P004]

As for the other participant, although she lived in a college, she had little or no interest in DGs because she likes to be in control of her drinking pace. I have not played drinking games, only sang a drinking song. I don’t like drinking games; I don’t like people telling me what to drink, and when to drink. I like to drink at my own time and pace. [P014]

Despite these two different reasons, both women had the universal consensus that DGs involves drinking high volumes of alcohol and often there is overt pressure to drink more when playing these games.

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DISCUSSION Most research on excessive alcohol consumption has focused on either urban or suburban populations, with little attention paid to rural populations. When attention is given to problem drinking in rural areas, the focus is typically on disadvantaged social groups, whose consumption of alcohol is more likely to occur in public or open contexts, rendering it socially problematic. Through the interviews, it was identified that excessive drinking, in the form of DG participation, was a popular activity within a sample of women living in a rural college environment. Consistent with (Polizzotto et al., 2007), most participants played these games to socialize and promote a sense of camaraderie. Research has previously indicated risk and protective factors associated with alcohol use are closely associated with peer influences (friends engaging in substance-use behaviors), peer and parental attitudes towards substance use, and, to a lesser extent, self-control (Botvin, Malgady, Griffin, Scheier, & Epstein, 1998). As such, alcohol use is associated with interplay between social and personal factors and is learned through observation, imitation, and reinforcement (Botvin et al., 1998). These factors were relevant to the current study and may have been the more significant given the college context. Certainly, the college environment encourages competition among students and the presentation of excessive drinking in the context of a game may normalize what might otherwise be considered anti-social and risk-taking behavior. Although Polizzotto et al. (2007) reported that many of their participants were peer pressured to play DGs, almost all of the women in this study expressed readiness to and interest in playing them. Participants identified positive incentives to participate in DGs. Many of them considered DGs to be an attractive activity, even though they were likely to be aware that they had to consume high volumes of alcohol when playing these games. Most women in this study also participated in DGs to attain a certain level of intoxication before going out, typically to the bars in town and for monetary reasons (i.e., to spend less=cut cost at on-license premises). However, it is also possible that predrinking sessions may occur without DGs (Borsari et al., 2007). Nevertheless, there is a need for more research to explore the activity of predrinking among Australian university students. In addition, there seems to be a general belief among the women that being sober in town was not enjoyable. There was an expectation among the participants that they should drink at least to the level of being tipsy before heading out to the bars. Notably, excessive drinking among this group of students occurs largely in the private and relatively secluded spaces of the colleges. In this way, the excessive drinking of these students is not open to public scrutiny. In contrast, the public nature of drinking among some groups in rural environments renders then more open to surveillance and social control. For example, the drinking practices of young people and Indigenous people are especially vulnerable to

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scrutiny. Antisocial practices associated with excessive drinking, such as violent behavior, may be more contained within a college environment. If such activities are to be managed, interventions tend to be in-house or informal and involving peers. In addition, consistent with other research (Borsari et al., 2007; Grossbard, Geisner, Neighbors, Kilmer, & Larimer, 2007; Pedersen & LaBrie, 2006; Zamboanga et al., 2006), heavy alcohol use during DG participation was common and popular within this sample of women. Often, drinking high volumes of alcohol during DGs was associated with the type of beverages consumed, the manner of consumption, and the nature of DGs. Some research has also indicated that heavy episodic drinking during DGs was linked with the type of beverage consumed (Zamboanga et al., 2006). Many women in this study chose to consume boxed wine (goon) or punch because it was cost-effective. For example, the cost of goon was relatively cheaper than other alcoholic beverages, as well as containing a high percentage of alcohol. Furthermore, it is sold in large quantities; thus, it could cater for a large group of peers and get relatively everyone drunk. Although this purchasing pattern may save money, it promotes drinking high volumes of alcohol and riskier drinking patterns=behavior. The consumption of punch also imposes another risk; that is, the players might be unaware of what is actually being consumed and how much they are drinking. As such, almost all participants were unable to keep track of how much they drank, with only one participant able to keep count of her drinks, which was due to the nature of Drinking Twister (the game she played). Unlike King’s Cup or I Have Never Ever, Drinking Twister is meant for a smaller group of players, and thus there is less competition or peer-pressure to drink compared with the other two games. Therefore, this suggests that group size (the number of players) and the competitive nature of DGs could alter a person’s attitude toward drinking. As noted previously, DGs present as a highly gendered activity, as evident with regard to both the game type and the beverage consumed. Although public health measures of hazardous drinking rely on the notion of a standard drink, DGs discourage ready quantification of alcohol consumed. The consumption of mixed or spiked drinks among this group, especially punches, renders it impossible to quantify and monitor the drinking of oneself or others. Although alcohol labeling allows for measurement of alcohol consumption, much of what is drunk in drinking games may be shared and unlabeled. In such circumstances, physical, social, and economic measures of problem drinking may be better applied because these are often motivating factors for participation in DGs. An issue is that it is not clear to what extent current etiological and management models of alcohol abuse are generalizable to rural populations (Botvin et al., 1998). Moreover, the management of drinking problems has focused on the drinkers themselves in the form of counseling or treatment and on imposing sanctions in terms of antisocial conduct. Features of the environment or the social context

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promoting heavy drinking use, such as the college community and specific practices of alcohol consumption, have received less attention (Wechsler et al., 2002). For example, male colleges traditionally exhibit higher levels of alcohol misuse, but research has indicated gender convergence between all-men and all-women’s and coeducational colleges (Wechsler et al., 2002). Efforts to discourage and reduce problem drinking need to focus more on the environment. For example, the greater density of social embeddedness and acquaintanceship in colleges and rural settings can be more generally seen as both a positive and negative with regard to hazardous drinking because peer networks often play a role in alcohol misuse, limiting opportunities to facilitate change.

FURTHER RESEARCH AND LIMITATIONS Although heavy drinking affects women more than men (MacAskill et al., 2001; Spooner & Hetherington, 2005), a majority of the female students in this study displayed a strong imperative to play DGs, despite knowing the harms= risks associated with such activity. There is a need for more ongoing research to further understand DG participation among Australian students and their attitudes and behaviors toward risky drinking, given the paucity of research in this area. Although strategies such as alcohol screening (Schaus, Sole, McCoy, Mullett, & O’Brien, 2009), brief intervention (Moyer, Finney, Swearingen, & Vergun, 2002), and educating young people about the risk of DGs may be effective in reducing alcohol-related consequences (e.g., sexual risks) (Borsari, 2004), such approaches might not be effective if the students are already well aware of the risks associated with drinking high volume of alcohol. As such, there is a need for more complex thinking and more innovative interventions aimed at reducing risky drinking among this population. This study is not without limitations. Because the exploration on DGs was only a small part of the whole study, we did not examine several issues related to DGs, such as duration of game, drinking expectancies, and negative consequences. In addition, the study only focused on Caucasian female students at one particular university; therefore, the findings may not be relevant to other populations (e.g., male students, women from other university, and students living in other parts of Australia). Despite these limitations, the study aimed to offer a better understanding of the female students’ drinking behaviors at this regional university.

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Drinking games participation among female students at a regional Australian university.

Participation in drinking games (DGs) by university students is often associated with heavy drinking and negative social and health impacts. Although ...
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