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Report from Sweden: Alcohol interventions that teach practical skills work best with high-risk university students

January 3, 2007
Johnsson , K.; Berglund, M.

Johnsson , K.; Berglund, M.   (February 2007).   Two-year outcome of alcohol interventions in Swedish university halls of residence.   A cluster randomised trial of a brief skills training programme, twelve-step influenced intervention and controls.  Alcoholism: Clinical & Experimental Research (ACER).   31(2):

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Heavy drinking among university students appears to be a universal problem.  Although most universities have alcohol policies, it is unclear which interventions can effectively reduce alcohol consumption.   A new Swedish study indicates that students who engage in high-risk alcohol consumption benefit the most from a skills-training program.  

Results are published in the March issue of Alcoholism: Clinical & Experimental Research.

“Most studies of the drinking habits of university students are conducted in the United States, but one can also find studies from Europe and Australia/New Zealand,” said Henriettæ Ståhlbrandt, a physician in the department of clinical alcohol research at Lund University in Sweden, and corresponding author for the study.   The consequences are clear, she added: in the short term, a greater incidence of violence, illness, skipped classes, etc.; and in the long term, risk of permanent damage to the body and brain and alcohol dependence.

“Almost all universities have alcohol policies, and interventions greatly differ from one university to another,” said Ståhlbrandt.   “The skills-training program used in our study is … based on cognitive-skill intervention and motivational techniques.  Personalized drinking feedback has also been found effective.”

In the year 2000, Ståhlbrandt and her colleagues began an analysis of 556 students living in 98 university halls of residence who were participating in one of two alcohol-intervention programs.  “Although Swedish university halls of residency have long been rumored to be where the greatest amount of drinking occurs at Swedish universities,” she said, “this has never been put to the test.”

One program, a brief skills-training program (BSTP) with interactive lectures and discussions (n=178), was derived from the University of Washington’s Brief Alcohol Screening and Intervention for College Students.   The second program, a 12-step influenced program (TSI), provided lectures by therapists trained in the 12-step approach (n=172).   Study authors also created a control group of students (n=206).   All participants completed a baseline assessment, as well as follow-up questionnaires one, two and three years following the baseline year.

Findings indicate that all three groups significantly reduced their Alcohol Use Disorders Identification Test (AUDIT) scores from baseline assessment to the two-year follow-up questionnaire.  

“Maturity could very well be a factor,’ said Ståhlbrandt.  “It is well-known that on average, university students decrease their alcohol consumption as they grow older and eventually leave college.  Yet another factor could be that inclusion in the study made all of the students more aware of their alcohol consumption and so they subconsciously drank less.”  

However, among those students deemed to engage in high-risk alcohol consumption – defined as AUDIT scores of eight or above for men and four or above for women – the BSTP appeared to be more effective.

“The at-risk students – those with a higher AUDIT score and in greater danger of having negative consequences from alcohol consumption – in the brief skills-training program reduced their consumption more than the other two groups,” said Ståhlbrandt.   “By concentrating alcohol-intervention efforts on this group, a lot of benefits can be attained on both individual and public levels, meaning less of an economic burden and wasted personal time.”