Cigarette, waterpipe, and electronic cigarette use among college fraternity and sorority members and athletes in the United States.

OBJECTIVE: To examine the association between fraternity/sorority membership and athlete status with tobacco use by tobacco product type. Participants: Undergraduate college students who participated in the Spring 2017 National College Health Assessment-II Survey (n = 47,821). Methods: Prevalence of current (past-30 day) cigarette smoking, waterpipe tobacco smoking (WTS), and e-cigarette (ECIG) use was examined. Logistic regressions examined associations between fraternity/sorority membership and participation in collegiate athletics with tobacco use. Results: Fraternity/sorority members had the highest current use rates for cigarettes, waterpipe tobacco, and ECIGs and were nearly twice as likely to report cigarette smoking, WTS, and ECIG use relative to non-fraternity/sorority members. Relative to non-varsity athletes, varsity athletes were less likely to report cigarette smoking and WTS, but not ECIG use. Conclusions: Fraternity/sorority members appear to be at risk for use of multiple tobacco products. Varsity athlete status may be protective for some tobacco products, but does not appear no for ECIG use. ECIGs may appeal to groups typically at low risk for other tobacco products.

Underage drinkers' first experience consuming a popular brand of supersized alcopop.

BACKGROUND: Supersized alcopops are sugar sweetened beverages with high alcohol concentration; Four Loko is the most commonly consumed brand among underage drinkers. OBJECTIVES: The current study examined the prevalence and correlates of Four Loko consumption, as well as drinking location, beverage source, quantity consumed, and alcohol-related consequences among students who consumed the product before age 21. METHODS: Undergraduate drinkers (n = 1,019; 53.5% female) attending public universities in Florida, Montana, and Virginia completed a classroom survey. Multivariable logistic regression models examined first-time Four Loko experiences among students under age 21 at the time of the drinking episode (n = 336). RESULTS: Among drinkers, 46% had consumed Four Loko. The vast majority (93%) drank the product before age 21. During their first Four Loko drinking episode, 57% consumed at least one can and 10% drank two or more cans. Among underage drinkers, being male (AOR = 6.8), paying for the Four Loko (AOR = 3.1), and earlier age of alcohol initiation (AOR = 0.8) were associated with greater odds of drinking at least one can. Among underage drinkers who finished at least one can, 36% blacked out and 21% vomited. The odds of blacking out and vomiting were greater if the participant drank at least one can (AOR = 6.0, AOR = 4.0). Students in states that sold Four Loko with higher alcohol-by-volume were more likely to blackout (AOR = 2.0) and vomit (AOR = 2.5). CONCLUSIONS: Delaying the age of first alcohol use may have protective effects on supersized alcopop consumption. Increased enforcement of existing laws is needed to prevent underage access to Four Loko. Further, laws that reduce the alcohol content of Four Loko may reduce negative consequences associated with its consumption.

The Federal Trade Commission's mandated Four Loko labeling fails to facilitate accurate estimation of alcohol content by college students.

BACKGROUND: Four Loko, the leading supersized alcopop brand, is a pre-mixed alcoholic beverage containing up to 5.5 standard alcoholic drinks in a can. In 2013, the Federal Trade Commission (FTC) mandated the addition to Four Loko cans of a label indicating its alcohol content in standard drinks, presented as "alcohol per serving" and "servings per container." OBJECTIVE: The current study investigated whether college students accurately estimate the alcohol content in cans of Four Loko bearing the FTC mandated labels. METHOD: Undergraduate student drinkers (n = 833; 51.6% women) in three states (Florida, Montana, and Virginia) were provided an empty Watermelon Four Loko can and asked to determine the number of standard drinks it contained, using 12-ounce regular beer (Budweiser) equivalents. In Florida and Virginia, Watermelon Four Loko contains 4.70 standard alcoholic drinks; in Montana, it contains 3.13. RESULTS: More than 60% of Florida students and more than 70% of Virginia students underestimated Four Loko's alcohol content by one or more standard drinks, compared to 45% of Montana students. Multivariable logistic regression analysis found the following variables were associated with greater odds of underestimating Four Loko's alcohol content by one or more standard alcoholic drinks: being female (AOR = 2.2), having never seen nor heard of Four Loko (AOR = 1.9), and residing in Florida (AOR = 1.7) or Virginia (AOR = 2.8) versus Montana. CONCLUSIONS: Students were far less likely to underestimate alcohol content for 8% alcohol-by-volume (abv) cans compared to those with higher alcohol concentrations. Thus, policies restricting supersized alcopops' abv may help consumers better estimate their alcohol content.