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BioMed Central
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BMC Public Health
Open Access
Research article
Changes in undergraduate student alcohol consumption as they
progress through university
Bridgette M Bewick*1, Brendan Mulhern1, Michael Barkham2, Karen Trusler1,
Andrew J Hill1 and William B Stiles3
Address: 1Leeds Institute of Health Sciences, University of Leeds, UK, 2Centre for Psychological Services Research, University of Sheffield, UK and
3Department of Psychology, Miami University, USA
Email: Bridgette M Bewick* - b.m.bewick@leeds.ac.uk; Brendan Mulhern - b.m.mulhern@leeds.ac.uk;
Michael Barkham - m.barkham@sheffield.ac.uk; Karen Trusler - ugmkt@leeds.ac.uk; Andrew J Hill - a.j.hill@leeds.ac.uk;
William B Stiles - stileswb@muohio.edu
* Corresponding author
Abstract
Background: Unhealthy alcohol use amongst university students is a major public health concern.
Although previous studies suggest a raised level of consumption amongst the UK student
population there is little consistent information available about the pattern of alcohol consumption
as they progress through university. The aim of the current research was to describe drinking
patterns of UK full-time undergraduate students as they progress through their degree course.
Method: Data were collected over three years from 5895 undergraduate students who began
their studies in either 2000 or 2001. Longitudinal data (i.e. Years 1–3) were available from 225
students. The remaining 5670 students all responded to at least one of the three surveys (Year 1
n = 2843; Year 2 n = 2219; Year 3 n = 1805).
Results: Students reported consuming significantly more units of alcohol per week at Year 1 than
at Years 2 or 3 of their degree. Male students reported a higher consumption of units of alcohol
than their female peers. When alcohol intake was classified using the Royal College of Physicians
guidelines [1] there was no difference between male and females students in terms of the
percentage exceeding recommended limits. Compared to those who were low level consumers
students who reported drinking above low levels at Year 1 had at least 10 times the odds of
continuing to consume above low levels at year 3. Students who reported higher levels of drinking
were more likely to report that alcohol had a negative impact on their studies, finances and physical
health. Consistent with the reduction in units over time students reported lower levels of negative
impact during Year 3 when compared to Year 1.
Conclusion: The current findings suggest that student alcohol consumption declines over their
undergraduate studies; however weekly levels of consumption at Year 3 remain high for a
substantial number of students. The persistence of high levels of consumption in a large population
of students suggests the need for effective preventative and treatment interventions for all year
groups.
Published: 19 May 2008
BMC Public Health 2008, 8:163 doi:10.1186/1471-2458-8-163
Received: 25 October 2007
Accepted: 19 May 2008
This article is available from: http://www.biomedcentral.com/1471-2458/8/163
© 2008 Bewick et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
BMC Public Health 2008, 8:163 http://www.biomedcentral.com/1471-2458/8/163
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Background
Heavy alcohol intake amongst the student population has
implications for the individual, educational institutions,
and wider society [2-4]. Students have been reported to
drink at higher levels than non-student peers [5-9], mak-
ing this an issue of public health concern given the nega-
tive social and health consequences of heavy intake [10]
and the link with other unhealthy behaviours (e.g. ciga-
rette smoking [11] and recreational drug use [12]).
Across the world it has been reported that university stu-
dents' levels of alcohol consumption are higher than that
of their non-university peers [5,13,14]. Within the United
Kingdom, a review of studies measuring undergraduate
drinking concluded that 52% of males and 43% of
females reported drinking above the recommended limits
of 21 units per week for men and 14 units per week for
women [15]. The comparable figures for 16–24 year olds
in the general population are 37% and 33% respectively
[16]. Furthermore, 15% of a UK sample of 3075 students
drank at hazardous drinking levels of 51 or more units per
week for men and 36 or more units per week for women
(within the study 1 unit (10 ml ethanol) was taken as 1/2
pint beer/one glass wine/one measure spirits) [17].
The alcohol consumption of university (i.e. college) stu-
dents in the US has been extensively studied [4,18] and it
is generally agreed that, while the trajectories of groups of
students differ during their time at university [19-21], the
overall trend in consumption is one of increase from high
school to university, followed by a decline post-gradua-
tion. In contrast with their North American peers, the
drinking patterns of students from the UK, and Europe in
general, have been less extensively investigated [22].
Unlike in the US, where the minimum purchase age is 21
years, United Kingdom students can legally purchase alco-
hol from the age of 18, thereby creating a different context
for alcohol consumption. Despite research consistently
highlighting high consumption levels within the UK stu-
dent population [15] there is uncertainty regarding
whether/how these alcohol consumption patterns change
over academic stay.
The majority of UK studies that have considered year of
study have utilised a cross-sectional approach, restricted
their samples to medical and/or dental students and have
shown contradictory patterns [8,23]. The one available
longitudinal study of alcohol consumption was also com-
plicated by differences between medical and dental stu-
dents [24]. There was no overall change in mean alcohol
consumption among dental students but an increase
among medical students, from second year to final year.
In addition, the percentage of dental students drinking
more than the recommended limits decreased while it
increased in medical students. Academic performance of
medical students at UK universities may be adversely
affected by heavy alcohol intake [7,25]. However, it is
unclear what students think about how their alcohol con-
sumption may be affecting their studies.
As levels of alcohol intake increase, so does the prevalence
of a variety of risky behaviours, including unsafe sexual
activity [4,26], behaviour leading to injury [27,28] and
damage to property [29], violence [30] and illegal behav-
iour [28]. Increased frequency of injury and assault [31]
inevitably leads to increased strain on care and emergency
services, and links between alcohol consumption and
hospital admissions are well established [32]. Heavy alco-
hol intake has also been linked to depression and liver
damage [33]. In the city where the current study took
place, it is estimated that alcohol misuse costs 275 million
pounds per year, the majority of which is spent on polic-
ing, repairing damage and injury and alcohol-related ill-
ness treatment [34].
The present investigation aimed to examine the patterns
of alcohol consumption of two cohorts of students over
the course of their undergraduate education at a university
in the UK, using both cross-sectional and opportunistic
longitudinal study designs. It also investigated student
perceptions of the consequences of their alcohol con-
sumption.
Method
Data set
Data were drawn from the UNIversity Quality of Life and
Learning (UNIQoLL) dataset collected at a city-based Uni-
versity in the UK [35]. UNIQoLL was series of cross-sec-
tional surveys examining students' perceptions of
university life that covered a variety of issues including
mental health, alcohol consumption and the perceived
effect of alcohol intake on aspects of student life.
Pen and paper questionnaires were delivered to students
via their university department. Departments were asked
to distribute a copy of the questionnaire to all undergrad-
uate full-time students. The mode of delivery varied
between departments and included: distributing ques-
tionnaires in lectures, asking students to collect question-
naires from a designated point, posting a questionnaire to
students via the internal mail. Students could also request
a copy of the questionnaire directly from the UNIQoLL
project team; contact details were provided on promo-
tional posters that were displayed prominently through-
out the University.
The project ran from 2000 until 2006 with students being
asked to complete a survey at seven time points over their
three undergraduate years. On each survey students were
asked to provide their student identification number.
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Where valid student identification numbers were availa-
ble student responses could be linked across time if stu-
dents responded to more than one survey. Questions
pertaining to alcohol consumption were asked during the
spring of semester two of each academic year. Where stu-
dents responded to all three surveys the linking process
provided an opportunistic longitudinal dataset for exam-
ining changes in alcohol consumption. Where students
completed less than three surveys their data were included
in the cross-sectional dataset. This dataset included partic-
ipants who had responded to only one or two of the three
surveys.
Survey questionnaire
Alcohol consumption and attitude measures
Students were asked to record confidentially how many
units of alcohol they drank per week, on average (1 unit =
10 ml ethanol). Students were advised that one unit was
approximately 1/2 pint of lager, 1 small glass of wine or 1
measure of spirits [36].
Attitudes towards alcohol consumption were assessed by
four questions. Students were asked 'To what extent do
you believe that your alcohol consumption is having a
negative impact on your (i) studies, (ii) finances, (iii) per-
sonal life, and (iv) physical health'. Each question was
answered on a 5-point Likert scale (1 = definitely not, 2 =
probably not, 3 = not sure, 4 = probably, 5 = definitely).
Classification of level health risk according to reported alcohol
consumption
Current UK government guidelines recommend no more
than 4 units of alcohol a day for men and 3 units of alco-
hol per day for women suggesting upper limits of 28 and
21 units of alcohol per week (u/w) for men and women
respectively [36]. These guidelines represent a 33%
increase for men and a 50% increase for women on the
previous recommended limits [37]. The current recom-
mendations have been criticised, however, by Edwards
[38], and the Royal College of Physicians [1] and the Brit-
ish Medical Association [39] have advised men and
women to follow the earlier limits of less than 21 and 14
u/w, respectively.
For the present study, weekly alcohol consumption was
classified into the following four categories: (1) 'low level
drinking' (Low; male 0–21 u/w, female 0–14 u/w) [1,39],
(2) 'medium level drinking' (Medium; male 21–28 u/w,
female 14–21 u/w) [36], (3) 'high level drinking' (High;
male 28–50 u/w, female 31–35 u/w) [30a], and (4) 'Very
high level drinking' (Very high; male 50+ u/w, female 35+
u/w) [40]. These classifications were chosen to allow com-
parisons with previous research that has used both sets of
guidelines. They also relate directly to the 'sensible limits'
(corresponds to 'low level drinking') and 'hazardous
drinking (corresponds to 'very high level drinking') cut
points that are currently used within UK governmental
reports [40].
Participants
At each time-point approximately 20% of registered full-
time undergraduate students returned a completed survey
(year 1 n = 3068, 17%; year 2 n = 2444, 20%; year 3 n =
2030, 20%). In total, 5895 (34%) students who started
their degree in either 2000 or 2001 completed at least one
of the three second-semester surveys during their three
year undergraduate programme. Of these, 225 students
provided data for all of the three academic years (i.e. an
opportunistic longitudinal sample). Of the remaining
cross-sectional sample (n = 5670), 674 students provided
data at both year 1 and year 2, 230 participants provided
data at both year 1 and year 3, and 293 at year 2 and year
3.
Overall, 52% of participants were female, 38% were male
and in 10% sex was unknown. Eighty four percent were
aged under 21 on entry to university and 84% were stu-
dents from the United Kingdom. The mean age at year 1
was 19.49 yrs (sd = 2.40). The majority of participants
(80%) were white/white British. Participants were drawn
from all university faculties with the largest percentages
from Biological Sciences (15%), Joint Honours (15%),
and Faculty of Arts (13%). No statistical differences were
observed between the longitudinal and cross-sectional
samples in terms of sex (Mann-Whitney U = 534592.5, p
> 0.05), age at year 1 (t = 1.56, df = 2839. p = 0.12), age at
year 2 (t = 1.70, df = 2243, p = 0.10) or alcohol consump-
tion (Y1 t = 0.31, df = 3.66, p = 0.76; Y2 t = -0.32, df =
2442, p = 0.75' Y3 t = -0.75, df = 300.01 (equal variance
not assumed), p = 0.46). A small (longitudinal mean
21.13 SD 2.13; cross-sectional mean 21.70, SD = 2.67)
but statistical difference of age was observed between the
two samples at year 3 (t = -3.66, df = 1866, p < 0.01). The
demographics of participants were similar to those of the
wider student population.
Data analysis
The means and standard deviations reported in the text
and tables of this article are based on the raw data. How-
ever, alcohol consumption (in units/week) for both the
longitudinal and cross-sectional samples were positively
skewed, and therefore all inferential analyses used square-
root transformations of the data. To analyse the longitudi-
nal sample, repeated measures ANOVA was employed to
investigate the change in units of alcohol consumed over
time. Changes, within the longitudinal sample, in percep-
tions of the negative impact of alcohol were analysed
using repeated measures ANOVA. Year differences in units
of alcohol consumed were investigated within the cross-
sectional sample using ANOVA. For the purposes of this
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analysis the independent variable was time (i.e. Year) and
alcohol consumed (in units) was the dependent variable.
For both the longitudinal and the cross-sectional samples
the percentage of students drinking above the low con-
sumption level was calculated at each time-point. Chi-
squared analysis was used to investigate differences in the
percentage of male and female participants exceeding the
sensible limits guidelines. Independent t-tests were used
to compare reported weekly units between males and
females each time point.
For the longitudinal sample, odds ratios were calculated
to investigate the likelihood of those students drinking
above low levels at Year 1 continuing to report this level
of drinking at Years 2 and 3. Similarly, odds ratios were
calculated to investigate the likelihood of year 2 and year
3 students drinking above low levels compared to stu-
dents in year 1.
Within both the longitudinal and cross-sectional samples
the percentage of students who reported that alcohol was
having a negative impact (i.e. definitely or probably) on
each of the four life areas were calculated, and odds ratios
were used to determine the likelihood of those students
drinking above low levels reporting a negative impact
compared to their peers who reported little or no negative
impact.
Results
Units of alcohol consumed per week
Taken across samples and time points, some 90% of the
sample measured at each time point indicated that they
consumed at least 1 u/w. Repeated measures ANOVA
identified a significant decrease in alcohol consumption
for students in the longitudinal sample over time (Huynh-
Feldt adjustment F = 38.17, df = 1.97, 440, p < 0.01) but
no sex by time interaction (Huynh-Feldt adjustment F =
1.173, df = 1.97, 440, p > 0.05). A priori mean compari-
son tests showed significant differences (p < 0.01)
between each time point with consumption consistently
decreasing overtime (see Table 1).
Students in the cross-sectional sample also reported a sig-
nificant difference in their alcohol consumption between
year groups (F = 71.64, df = 2, 6864, p < 0.01). A priori
mean comparison tests showed significant differences (p
< 0.01) between each year group with consumption
decreasing from Year 1 to Years 2 and 3 (see Table 1).
Classification of health risk by level of alcohol
consumption
At Year 1, 50% (n = 1297) of students in the cross-sec-
tional sample reported consumption levels that exceeded
the 21/14 u/w low level threshold. The corresponding fig-
ures for Years 2 and 3 were 42% (n = 804) and 32% (n =
502) respectively (Table 2). At Year 1, 53% (n = 120) of
students in the longitudinal sample reported consump-
tion levels that exceeded the 21/14 u/w low level thresh-
old. This proportion reduced to 38% (n = 85) during Year
2 and 30% (n = 68) at Year 3.
There was a significant (p < 0.01) difference in alcohol
consumption between male and female participants at
each time point with males consistently reporting con-
suming more units per week (see Table 1). However, no
differences were found in the proportions of males and
females exceeding the low level threshold (see Table 2).
Chi-squared analysis revealed no significant differences in
the percentages of men and women exceeding the low
level threshold in either the cross-sectional (Y1 χ2 = 0.52,
df = 1, p = 0.47; Y2 χ2 = 0.86, df = 1, p = 0.36; Y3 χ2 = 0.74,
df = 1, p = 0.39) or the longitudinal sample (Y1 χ2 = 0.04,
df = 1, p = 0.85; Y2 χ2 = 0.26, df = 1, p = 0.61; Y3 χ2 = 0.93,
df = 1, p = 0.34).
Those students who reported drinking above the low limit
cut off at Year 1 had 9 times the odds of being above low
levels when they progressed to Year 2 (longitudinal sam-
ple odds ratio 9.42 CI 4.82, 18.41). A similar result was
found when comparing students within the cross-sec-
tional sample at Year 1 with students in Year 2 (cross-sec-
tional sub-sample odds ratio 8.88 CI 6.20, 12.70). For the
longitudinal sample the ratio increased to 14 times the
odds of remaining above the low level cut off at Year 3
(odds ratio 14.47 CI 6.21, 33.74) and the comparative fig-
Table 1: Units per week and effect sizes between genders for both longitudinal and cross-sectional
Longitudinal Cross-sectional
Total Male Female Total Male Female
MSDMSDMSD tdfMSDMSDMSD tdf
Year 1 19.11 13.94 24.69 15.60 16.03 11.91 -3.38* 223 18.94 14.45 24.04 16.16 15.49 11.89 -12.22* 2097a
Year 2 15.49 12.53 20.21 12.97 12.89 11.52 -3.80* 223 16.06 13.36 21.09 15.60 12.65 10.09 -10.56* 1420a
Year 3 12.62 9.99 16.34 12.14 10.57 7.91 -2.72* 128a13.89 12.52 18.42 14.17 10.71 9.79 -10.88* 1296a
a = Levene's test p < 0.05 test statistics reported do not assume equal variances
*p < 0.01
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ure for those in the cross-sectional sub-sample was 10.46
(CI 5.12, 21.38). Of those students in the longitudinal
sample who reported drinking above low levels at Year 3,
89% were also above sensible limits at Year 1 (the corre-
sponding figure when comparing Year 3 with Year 1 stu-
dents within the cross-sectional sub-sample was 88%).
Negative impact of alcohol consumption
From the overall sample of students who reported con-
suming alcohol, 34% agreed that their alcohol consump-
tion was having a negative impact on their studies, 77% of
students sampled agreed that their alcohol consumption
was having a negative impact on their finances, and 48%
agreed that their alcohol consumption was having a neg-
ative impact on their physical health. As would be
expected, these figures decreased by academic year as the
proportion engaged in heavy drinking also fell.
At each time-point those students who consumed higher
than low levels of alcohol had at least 3 times the odds of
reporting that alcohol was having a negative impact on
their studies. They were also had at least 4 times the odds
of reporting a negative impact on their finances and at
least 2 times the odds of reporting that alcohol was having
a negative impact on their physical health compared to
students who drank at low levels (see Table 3). In contrast,
only 9% of students agreed that their alcohol consump-
tion was having a negative impact on their personal life.
Students who reported drinking at low levels were as
Table 2: Classification of alcohol consumption by year of study by sample and gender
Cross-sectional Longitudinal Cross-sectional Longitudinal Cross-sectional Longitudinal
Male Male Female Female Total Total
N (%) N (%) N (%) N (%) N (%) N (%)
1st years
Low level drinking (low) 553 (51) 38 (48) 746 (49) 67 (46) 1299 (50) 105 (47)
Medium level drinking (medium) 91 (8) 7 (9) 420 (28) 40 (28) 511 (20) 47 (21)
High level drinking (high) 313 (29) 28 (35) 225 (15) 28 (19) 538 (21) 56 (25)
Very high level drinking (very high) 130 (12) 7 (9) 118 (8) 10 (7) 248 (10) 17 (8)
2nd years
Low level drinking (low) 442 (57) 48 (60) 682 (59) 92 (63) 1124 (58) 140 (62)
Medium level drinking (medium) 67 (9) 8 (10) 302 (26) 26 (18) 369 (19) 34 (15)
High level drinking (high) 203 (26) 21 (26) 121 (11) 19 (13) 324 (17) 40 (18)
Very high level drinking (very high) 63 (8) 3 (4) 48 (4) 8 (6) 111 (6) 11 (5)
3rd years
Low level drinking (low) 443 (67) 59 (74) 629 (69) 98 (68) 1072 (68) 157 (70)
Medium level drinking (medium) 48 (7) 4 (5) 194 (21) 36 (25) 242 (15) 40 (18)
High level drinking (high) 137 (21) 16 (20) 62 (7) 10 (7) 199 (13) 26 (12)
Very high level drinking (very high) 34 (5) 1 (1) 27 (3) 1 (1) 61 (4) 2 (1)
Male Low = 0–21 u/w, Medium = 21–28 u/w, High = 28–50 u/w, Very high = 50+ u/w
Female Low = 0–14 u/w, Medium = 14–21 u/w, High = 21–35 u/w, Very high = 35+ u/w
Table 3: The odds of negative consequences in students reporting consumption above low levels relative to students reporting low
levels of consumption
Studies Finance Personal Physical Health
Odds ratio (95% CI) Odds ratio (95% CI) Odds ratio (95% CI) Odds ratio (95% CI)
Year 1 Longitudinal 3.02 (1.54, 5.90) 6.44 (3.08, 13.49) 0.96 (0.71, 1.30) 2.49 (1.33, 4.67)
Cross-sectional 3.33 (2.73, 4.07) 6.16 (4.91, 7.72) 1.40 (0.53, 3.68) 3.15 (2.61, 3.80)
Year 2 Longitudinal 3.91 (2.05, 7.45) 4.50 (2.15, 9.43) 1.75 (0.70, 4.35) 3.54 (1.86, 6.75)
Cross-sectional 4.59 (3.65, 5.78) 6.57 (5.07, 8.51) 1.99 (1.40, 2.81) 4.37 (3.51, 5.44)
Year 3 Longitudinal 9.44 (4.36, 20.45) 8.08 (3.57, 18.27) 1.33 (0.49, 3.61) 3.81 (1.90, 7.64)
Cross-sectional 3.53 (2.70, 4.61) 7.01 (5.16, 9.53) 1.61 (1.10, 2.36) 3.44 (2.67, 4.43)
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likely to report a negative impact on their personal life as
those who reported drinking at higher levels.
Within the longitudinal sample there was a significant dif-
ference in the perceived negative impact of drinking over
time on studies (F = 5.62, df = 2, 434, p < 0.01), finance
(Huynh-Feldt adjustment F = 14.02, df = 1.85, 402, p <
0.001), and physical health (F = 10.76, df = 2, 428, p <
0.001), with the perceived negative impact decreasing as
students progressed through their studies. There was no
significant effect of time with regard to impact on per-
sonal life (F = 1.78, df = 2, 216, p = 0.17).
Discussion
The current observation that around 90% of students con-
sume alcohol at least weekly is in line with the rates in the
general UK population [41]. The percentage of students
consuming alcohol above the recommended sensible lim-
its is broadly in line with the UK research cited earlier
[8,9,24]. Importantly, the present study found a signifi-
cant reduction in the number of units per week consumed
over the three-year undergraduate time span, in both the
longitudinal and cross-section samples. Research in the
US suggests that alcohol consumption peaks at around 21
years and then declines over time [42,43]. In the present
study the consumption of UK students was highest in
their first year (mean age 19 years). While we do not have
pre-university alcohol consumption data this timing dif-
ference is likely to be related to the differences in mini-
mum purchase age between the two countries. Despite the
apparent difference in age of peak consumption, the cur-
rent results are in line with the US literature in suggesting
a 'maturing out' of high levels of consumption for many
students. By their final year, around 70% of students
reported drinking within low levels of consumption.
The difference in outcome between the present study and,
for example, those of File et al. [23] and Newbury-Birch et
al. [24] could reflect changes in student drinking patterns
since 1994/1995. Alternatively, the alcohol consumption
of medical and/or dental undergraduates may not reflect
that of the wider student population. In addition, the tim-
ing of data collection during the academic year may also
influence reported alcohol consumption [15]. It should
be noted that, as in the current study, Newbury-Birch et al
[24] collected during the Spring while File et al.'s [23] data
were collected during the week following Freshers' (intro-
ductory) week, a time when higher alcohol intake has
been observed.
Despite the significant reduction across year of study,
nearly a third of students were still drinking above recom-
mended levels in Year 3 and those who reported drinking
within the high risk category during year one were more
likely to still be at high risk in subsequent years. Students
who maintain high levels of alcohol consumption
throughout their undergraduate studies might benefit
from interventions to moderate this behaviour. Research
from the US suggests that understanding the developmen-
tal/time trajectories of alcohol consumption is important
in determining the potential health outcomes of differing
patterns of consumption over time [44,45]. While under-
standing the 'normative' pattern of behaviour can be help-
ful, this approach is limited in identifying problematic
consumption patterns over time. Future research within
the UK would therefore benefit from attention to trajecto-
ries of student consumption and patterns of binge drink-
ing. This information could then be used to target
interventions at students most at risk of negative health
consequences.
In line with previous findings, males reported drinking
more units per week on average than females [8,23,24].
However, there was no significant difference in the pro-
portion drinking at low levels (as the limits are lower for
females). This implies that in terms of potential health
consequences female students are drinking at levels com-
parable to their male peers and suggests a need for inter-
ventions for both sexes.
The current study also shows that students are aware of
the negative impact that alcohol consumption has on
their studies and their finances. This finding has the
potential to inform future intervention strategies, as it
would suggest that the negative impact of alcohol on the
financial and academic aspects of university life is more
salient to students and therefore they may be more recep-
tive to interventions emphasising these areas of their lives.
In terms of strengths and limitations, the current study is
the first to investigate changes in alcohol consumption in
a University-wide UK student population using a longitu-
dinal design and including participants from all Faculties.
The combination of longitudinal and cross-sectional sam-
ples, the latter including many participants, was a valua-
ble methodological feature. However, it is important to
note that 1197 participants (21%) in the cross-sectional
sample responded to more than one of the three surveys
meaning that the data for each year were not completely
independent. Although the demographic characteristics
of both the longitudinal and cross-sectional samples were
representative of the student population as a whole, it is
possible that the behaviour of students who chose repeat-
edly not to respond may be different from those that
engaged. In addition, participants were asked only to
record the number of units of alcohol they consumed per
week. Research suggests it is common for individuals to
underestimate personal consumption when asked to self-
report an average value using standard alcoholic units
[46], so it is likely that our results underestimate the abso-
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lute level of alcohol consumption within the student pop-
ulation. Future research might increase the accuracy of
self-reported alcohol consumption by investigating in
more detail the daily and weekly consumption levels of
each person. This might be achieved by asking partici-
pants to record how many of each type of alcoholic drink
was consumed over the last week using a retrospective
daily diary approach.
The current study did not investigate when or where
drinking occurred, the frequency of alcohol free days per
week, or the occurrence of heavy episodic drinking. Given
the potential health implications of heavy episodic drink-
ing [3,6] it will be necessary for future research to investi-
gate how heavy episodic drinking changes across the
undergraduate course of study. A further study limitation
was the use of a single item scale to measure the perceived
negative impact of alcohol. While this provided some
crude baseline information future research would benefit
from using a more comprehensive and standardised
measure of negative consequences.
Conclusion
In conclusion, the observation that full-time undergradu-
ate students' consumption of alcohol declined over the
three-year course of undergraduate study is of value in
directing the limited resources available for preventive
interventions. Introductory weeks for first year students in
UK Universities often have social events associated with,
or centred on, alcohol. This is often a time when cam-
paigns for drinking in moderation are also at their peak.
Later identification, e.g. in semester two, of higher level
drinkers would be of current and future benefit. However,
the persistence of high levels of alcohol consumption in a
large proportion of students suggests the need for effective
preventative and treatment interventions for all year
groups. Poor physical health, financial hardship and
declining academic achievement are likely indicators of
this need, albeit ones not exclusively related to problems
with alcohol.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
All authors read and approved the final manuscript. BMB
managed the wider UNIQoLL project, managed the data
collection, designed the current study, developed the anal-
ysis plan and lead the writing of the paper. MB designed
the wider UNIQoLL project, obtained funding and
assisted in writing the paper. BM and KT assisted in ana-
lysing the data and writing the paper. AJH and WBS
assisted in developing the analysis plan and writing the
paper.
Acknowledgements
UNIQoLL was funded by the University of Leeds. We thank past members
of the UNIQoLL project team Kerry Audin, Margaret Bradley, Dr Richard
Cooke, Dr Judith Slaa, and John Davy. We also thank members of the Steer-
ing Group, Departmental representatives, and successive Union Executive
members for their encouragements and constructive criticism. Thanks
must also go to all those who participated in this study. Authors affiliated
to LIHS were also partially funded by R & D Levy from Leeds Community
and Mental Health Teaching Trust, Artemis Trust and the European
Research Advisory Board.
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