Young adults' reasons not to drink point to potential for more effective prevention, treatment interventions

Young adults (aged 18–25) who use alcohol have varying personal reasons for not drinking on some days—reasons that could be harnessed to improve the effectiveness of programs preventing and treating alcohol use disorder (AUD), a new study suggests.

Although alcohol use is declining among young adults, rates of hazardous drinking and its harmful consequences remain high. In this age group, daily drinking patterns fluctuate. The bulk of relevant research has focused on motivations for drinking, with scant attention to motivations for not drinking.

In addition, previous studies have not represented both the college and noncollege young adult population. For the new study published in Alcohol: Clinical and Experimental Research, investigators explored young adults' day-to-day reasons for not using alcohol and whether those differed by demographic factors, days of the week, typical drinking motivations, and participants' recent alcohol consumption.

Researchers in the U.S. worked with 614 young adults who, in the last month, had consumed alcohol but gone at least one day without drinking. Their average age was 21, and 54% were men; 22% were Hispanic, 64% non-Hispanic white, and 13% were other races/ethnicities; 65% were 4-year college students.

The participants filled out an online survey about their past-month alcohol use and typical motives for drinking. Alcohol use was categorized as binge drinking (having five or more drinks in a row) (31%), high-intensity drinking (having 10 or more drinks in a row) (19%), or moderate drinking (fewer than four drinks in a row) (50%).

Motives for drinking were social (e.g., to socialize), coping (e.g., to forget problems), enhancement (e.g., for a pleasant feeling), and conformity (e.g., to fit in). Over the next two weeks, the participants filled out daily surveys on the previous day's alcohol use and their motives for not drinking.

The surveys offered 12 motives for not drinking. The researchers used statistical analysis to look for links between participants' stated reasons for not drinking on any given day and factors that might influence those decisions.

The surveys yielded 5,546 reports of nondrinking days. The participants' most common reasons for not drinking (expressed in 84%–49% of those daily reports) were, in decreasing order, a lack of interest in alcohol, not wanting to get drunk, not usually drinking on that night of the week, not wanting alcohol to interfere with school or work, and needing money for other things.

Less common motivations included using another drug instead (overwhelmingly cannabis), a recent hangover, and medical reasons. These reasons not to drink were linked in varying ways to biological sex, race/ethnicity, weekend (vs. weekday), and typical drinking motives. For example, women were more likely than men to report a lack of interest in drinking, not wanting to get drunk, and recent hangovers.

Hispanic participants and 4-year college students were more likely to not drink because of possible negative consequences, including alcohol interfering with school or work. Non-Hispanic white people were more likely to express a lack of interest in alcohol that day.

People who engaged in binge drinking or high-intensity drinking were more likely than moderate drinkers to report recent hangovers. On weekends, participants were more interested in drinking and less concerned about its negative consequences.

People who reported stronger social motives for drinking were more likely to report a lack of interest in alcohol and were less concerned about consequences, and people who reported stronger coping motives for drinking were more likely to be dissuaded by possible negative consequences, e.g., upsetting family and friends.

People who reported stronger enhancement motives were more likely to report using other drugs instead. People who reported stronger conformity motives were more likely to report situational barriers (e.g., having no one to drink with).

The study enhances our understanding of young adults' reasons for not drinking. It could inform interventions that address motivations to drink and not to drink, potentially strengthening public health messaging and providing opportunities to tailor prevention and treatment strategies to certain groups or individuals.

The vast majority of participants said that on some days, they weren't interested in drinking and didn't want to get drunk. Programming could, for example, emphasize this lack of interest in alcohol while also highlighting the benefits of avoiding negative consequences (such as getting drunk) and the value of self-imposed situational barriers (such as saving money).