'Pregaming' linked to risky substance use among college students

New research from Texas A&M University School of Public Health suggests that college students who "pregame," or participate in tailgating and similar activities before athletic events, are also more likely to take part in unsafe alcohol and other substance use.

Alcohol use has long been associated with American college students and the college sports culture. Pregaming frequently involves exposure to alcohol and increases participation in high-risk drinking. This, in turn, can lead those involved to participate in other risky behaviors with harmful consequences.

The researchers who conducted this new study, which was published in Substance Use and Misuse, say their findings could help universities generate risk-management policies and provide targeted, event-specific prevention and intervention programming to help reduce these consequences.

The study investigated possible relationships between pregaming behaviors and how often students drink alcohol, and whether students who pregamed were more likely to engage in polysubstance use (ingestion of more than one substance in a single time period). Researchers Dr. Benjamin Montemayor, and Dr. Adam Barry of the Department of Health Behavior at the Texas A&M School of Public Health, used data from a survey of students at a large university who had violated the university's alcohol policy between September 2019 and July 2021.

The online survey asked 816 students whether they had participated in pregaming before a live sporting event in the previous year and collected data on their substance use in addition to important demographic information such as gender, race and ethnicity, classification in school, and Greek organization affiliation.

The researchers asked respondents if and how often they pregamed or drank before a live university sporting event that they attended in person, and asked participants to self-report on their drinking frequency (number of days) over the past month. The survey also measured how frequently they used cannabis or other drugs over the same period and the percentage of their peer students the participants believed also used alcohol recently (descriptive norms).

Pregaming and heavy drinking can result in harmful physical, social and academic outcomes. Although universities have sought to reduce drinking among students for decades, the percentage of students who engage in high-risk drinking during a given month has remained unchanged at around 30 to 40%. Additionally, cannabis use among college students in the United States is at historic highs, and around 25% of students who consume alcohol report also using cannabis or other drugs while drinking.

The researchers found that pregaming was associated with alcohol use by college students who had violated their university's alcohol policy, accounting for important demographic factors. Although this is not in itself surprising, the analysis also found a two-day increase in alcohol use frequency for each separate pregaming event. Montemayor and Barry also found that students who pregamed were around 2.5 times more likely to use cannabis or other drugs with alcohol. These findings reinforce previous research on polysubstance use.

Although the findings paint a convincing picture of pregaming and the co-use of alcohol and drugs, the researchers note a few limitations to this study. First, the study sample did not reflect the overall student population in racial and ethnic makeup. Furthermore, all participants had violated their university's alcohol policy, and research has found that these students typically use alcohol and drugs more frequently and in greater quantities and are more likely to engage in other risky behaviors.

Additionally, the survey captures a fairly short timeframe, so the researchers could not determine whether pregaming makes hazardous alcohol use more likely. Future work that examines subjects over a longer period would be beneficial.

Despite the limitations noted, the findings of this study point to an association between pregaming and unsafe alcohol use and other risky behaviors, including drug use and polysubstance use.

Future research into programs and policies limiting pregaming and reducing harms related to pregaming would therefore be crucial, the researchers say. They said such efforts could take the form of gameday text-message-based interventions and the implementation and consistent enforcement of policies to mitigate excessive alcohol use and associated harms. These include restricting alcohol consumption to certain areas, limiting the amount of time allowed for tailgating, implementing hydration stations, active security patrolling of tailgating areas, displaying the policies throughout tailgating areas and restricting access for visibly intoxicated individuals.

Pregaming is a part of life on many college campuses, yet it is associated with greater risk for causing alcohol-related harm, Montemayor says.

"Throughout the nation, students come to large campuses in the fall and immerse themselves in their college's sport culture. Some gameday cultures may lead to a perceived view of alcohol use around campus that normalizes the behavior," Montemayor said. "This sends mixed messages to students on campus about alcohol use policies and further complicates a university's aim to protect the health and well-being of their students."

Improved understanding of how pregaming and high-risk drinking relate could help with the development of interventions, regulations and policies that could reduce those risks and improve student safety.