Alcohol and Tertiary settings
Three environmental factors are strongly linked with tertiary student drinking; living in halls of residence, drinking at on-licences and living in neighbourhoods with high numbers of liquor outlets.
Halls of residence and on-licence drinking
University halls of residence have been found to be common places for tertiary student binge drinking to occur [1,2]. Kypri et al.  examined the risk of intoxication by drinking in pubs, halls of residence and other places. Pubs accounted for 51% of all alcohol consumed, 34% by halls of residences, 9% by student flats and 6% among other locations. Drinking in pubs was associated with intoxication among males. Therefore, addressing drinking in licensed premises and halls of residence are interventions that should be considered.
McEwan  investigated the relationship between student culture and binge drinking behaviour amongst halls of residence students at a medium-sized New Zealand university. Male residents drank more heavily and more frequently than female residents. Two-third of residents (total = 404) reported that the halls of residence was the place where they drank most often and most heavily . Moreover, they often drank in halls of residence to a “pre-meditated state of intoxication” before they travelled on to the city . They consumed alcohol to an intoxication threshold that still allowed them entry into bars where they drank no more than two drinks of alcohol
Living near high numbers of liquor outlets
Kypri  suggests that the higher prevalence of heavy drinking among students is due to being exposed to an ‘alcogenic’ environment – where students are targeted with alcohol marketing, alcohol is cheap to buy and promotions of alcohol are common. Tertiary students’ drinking level and alcohol-related problems has been found to be higher among those living in communities with a high concentration of alcohol outlets. The effects were largest for off-licences outlets within a kilometre from students’ homes .
In New Zealand, the high prevalence in drinking among tertiary students may also be due to the lowering of the minimum legal purchase age (MPA) from 20 to 18 years in 1999 . The lowered MPA has changed drinking contexts, which has led to more frequent drinking at pubs or nightclubs for people aged 18 to 19 years as well as greater consumption at home .
Alcohol-related harm among tertiary students
Alcohol-related harm is also widespread among university students, causing harm to the drinker and to others . Acute alcohol-related harms are usually caused by intoxication, resulting in accidents, injuries and acute social problems . In addition, drinking is related to educational difficulties, psychosocial problems, physical harm including overdoses, and sexual high-risk behaviours.
The harms experienced by tertiary students has been described, which follows below :
Harms associated with own drinking
Harms associated with others’ drinking
Physically aggressive to someone
Inability to pay bills as a result of drinking
Had unprotected sex
In a sexual situation that unhappy about
A sexual encounter that was later regretted
Stealing public property
Committing an act of vandalism
Removed or banned from a pub/bar
Arrested for drunken behaviour
Missed a class
Failed to complete an assignment
Impairment at a test or exam
Physically hurt self
Being pushed, hit or assaulted
Unwanted sexual advance
A serious argument
Babysat a drunken student
Found vomit in hallway or bathroom
Been a victim of a crime
Driven in car with drunk driver
According to a survey of 2548 university students in New Zealand in 2005 , a high proportion had experienced alcohol-related problems in the previous 4 weeks. Almost half (55%) of drinkers reported having a hangover, 33% had a blackout, 21% vomited, 6% had unprotected sex, 5% were physically aggressive and 10% reported drink driving or riding with a drink driver .
a) Sexual harms
In a sample of 1564 Otago university students, 16% of women and 19% men reported having sex that they later regretted, and 34% of women and 25% of men reported unwanted sexual advances due to someone else’s drinking in the past 3 months . Hazardous drinkers were five times more likely than moderate drinkers to experience risky sexual behaviour as a result of drinking alcohol and harmful drinkers were 14 times more likely than moderate drinkers, after adjusting for age, sex, ethnicity, and type of residence of respondents . More female students experienced sexual assaults and unwanted sexual advances as a result of others’ drinking alcohol than male studentsA .
Cashell-Smith et al.  found that there was a strong relationship between university heavy drinking and risky sexual behaviour. They found that, in the last 4 weeks, 5% of women and 8% of men reported unsafe sex due to drinking, 3% of women and 4% of men had sex they were unhappy about at the time, and 8% of women and 9% of men had sex they later regretted. Unwanted sexual advances due to someone else’s drinking affected 21% of women and 12% of men. The authors concluded that these harms could only be partly explained by the level of current drinking and stated that “binge drinking at high school and early drinking onset are highly predictive of drinking patterns at university and this seems to explain much of the relationship with sexual experiences.”
b) Drink driving
Tertiary students are exposed to considerable risk as drink-drivers and as passengers of someone who has been drinking. Male students who drink alcohol are more likely to speed, drink-drive and ride as a passenger with someone who has been drinking. In one study, it was estimated that around 3% of women and 8% of men reported drink-driving in the past 4 weeks. The good news from a public health perspective is that most respondents dramatically underestimated how much they were able to drink to stay under the legal limit [1,10].
c) Academic performance
Research studies suggest that excessive alcohol consumption may lead to negative impacts on academic performance in college [11-14]. According to one study , the number of drinks typically consumed is a strong predictor of academic performance. The study found that the likelihood of being an A-grade student decreased with each drink consumed and frequency of binge drinking .
Another US study of over 30,000 college students showed that both first-year and senior students who reported binge drinking were more likely to have semester grades significantly lower than their peers who reported never binge drinking . The long-term consequences of under-achievement and reduced qualification attainment has considerable impact on future labour market success .
d) Long-term effects of Tertiary student drinking
Findings from a US study in 2004 found that binge drinking in college posed significant risks for alcohol dependence and abuse 10 years later . Binge drinking in college among a segment of students was also found to have a negative impact on educational attainment as well as an equally negative impact on post-college occupational careers and wages .
- McAnally HM, Kypri K. Alcohol and road safety behaviour among New Zealand tertiary students. Int J Adolesc Med Health 2004;16(3):229-238.
- Cashell-Smith ML, Connor JL, Kypri K. Harmful effects of alcohol on sexual behaviour in a New Zealand university community. Drug Alcohol Rev 2007;26(6):645-651.
- Kypri K, Paschall MJ, Maclennan B, Langley JD. Intoxication by drinking location: A web-based diary study in a New Zealand university community. Addict Behav 2007;32(11):2586-2596.
- McEwan BJ. Student Culture and Binge Drinking. (Doctoral Dissertation, Doctoral Thesis, University of Waikato, Hamilton, New Zealand) 2009.
- Kypri K, Cronin M, Wright CS. Do university students drink more hazardously than their Non‐student peers? Addiction 2005;100(5):713-714.
- Connor JL, Kypri K, Bell ML, Cousins K. Alcohol outlet density, levels of drinking and alcohol-related harm in New Zealand: a national study.Journal of Epidemiology & Community Health 2010: jech. 2009.104935.
- Gruenewald PJ, Treno AJ, Ponicki WR, Huckle T, Yeh L, Casswell S. Impacts of New Zealand's lowered minimum purchase age on context‐specific drinking and related risks. Addiction 2015 Nov;110(11):1757-1766.
- Kypri K, Paschall MJ, Langley J, Baxter J, Cashell‐Smith M, Bourdeau B. Drinking and alcohol‐related harm among New Zealand university students: Findings from a national web‐based survey. Alcoholism: Clinical and Experimental Research 2009;33(2):307-314.
- Towl D. Alcohol Use and Tertiary Students in Aotearoa-New Zealand. Wellington: ALAC; 2004.
- Kypri K, Stephenson S, Langley J, Cashell-Smith M, Saunders J, Russell D. Computerised screening for hazardous drinking in primary care.The New Zealand Medical Journal (Online) 2005;118(1224).
- Piazza-Gardner AK, Barry AE, Merianos AL. Assessing drinking and academic performance among a nationally representative sample of college students. J Drug Iss 2016; 46(4):347-353.
- Thombs, D. L.Olds, R. S., Bondy, S. J., Winchell, J., Baliunas, D., & Rehm, J., Thombs DL, Olds RS, Bondy SJ, Winchell J, Bailunas D, et al. Undergraduate drinking and academic performance: A prospective investigation with objective measures. Journal of Studies on Alcohol and Drugs. 2009;70(5):776-785.
- Pascarella ET, Goodman KM, Seifert TA, Tagliapietra-Nicoli G, Park S, Whitt EJ. College student binge drinking and academic achievement: A longitudinal replication and extension. Journal of College Student Development 2007;48(6):715-727.
Ham LS, Hope DA. College students and problematic drinking: A review of the literature. Clin Psychol Rev 2003;23(5):719-759.
 Alcogenic is a term that used to describe all the physical and social environmental factors that reflect and promote a culture of excess drinking