Pregame Heavy Episodic Drinking and Its Association With Negative Consequences and Other Risky Substance Use Behaviors

Objective: Pregaming, or drinking before going out, is common among college students and has been linked with greater alcohol use and experiencing more negative consequences. This study tested within- and between-person associations between pregame heavy episodic drinking (Pregame HED; 4+/5+ drinks for women/men while pregaming) and high-intensity drinking (8+/10+ drinks), negative consequences, and three risky behaviors.

Method: College students at a large, public university in the Northeast United States who participated in a longitudinal measurement-burst design study completed a longer survey and up to 14 daily surveys in up to four consecutive semesters ( days = 4,706; persons = 547). Hypotheses were primarily tested using logistic and Poisson multilevel models.

Results: Pregame HED was reported by 41% of drinkers and on 15% of drinking days and 38% of pregaming days. Students were more likely to engage in high-intensity drinking on Pregame HED days than on moderate pregaming (1-3 and 1-4 pregaming drinks for women and men, respectively) or no pregaming drinking days. Students experienced more negative consequences on Pregame HED days than moderate or no pregaming drinking days, but there was no unique daily-level association between Pregame HED and negative consequences after alcohol intake was controlled. Students were more likely to use marijuana on Pregame HED days than on moderate and no pregaming drinking days.

Conclusions: Pregame HED appears to be a characteristic of extremely heavy drinking days and fundamentally different from moderate pregaming and no pregaming drinking days. Findings highlight the importance of accounting for amounts of alcohol consumed while pregaming and the notion that drinking episodes can be dynamic.