Harvard School of Public Health College Alcohol Study Essay

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The Harvard School of Public Health College Alcohol Study (CAS) conducted four large surveys of American college students in the spring semesters of 1993, 1997, 1999, and 2001. Over 80 publications based on CAS data explore the role of alcohol in college life, including its role in interpersonal violence. Among its most important findings about interpersonal violence is that 1 in 20 college women reported experiencing rape in the 7 or so months since the beginning of the school year, with most of the rapes (72%) occurring when the woman was too intoxicated to give consent.

Questions about rape are included in the 1997 and later surveys. Women were asked to respond to three questions about whether (since the beginning of the school year) they had sexual intercourse against their wishes because they had been forced or threatened, or when they were so intoxicated that they were unable to consent to sex. The items conform to the legal definition of rape in many states and have been used in other studies. Several factors were associated with the risk of rape, most importantly the level of binge drinking at the college, being underage, residing in a sorority house, having engaged in binge drinking in high school, and using illicit drugs. Women who attend colleges with high rates of binge drinking (rates of 50% or more) were significantly more likely to be raped while intoxicated than women who attend schools with low rates of binge drinking (where 35% or fewer students engage in binge drinking).

The findings suggest that substance abuse prevention (for both potential perpetrators and victims) should place a significant role in rape prevention. While the perpetrator is always responsible legally and morally for rape, identifying the factors that place women at increased vulnerability to rape (such as binge drinking) remain important. The CAS data identified binge drinking and its overall rate on campus as such a factor. Far from being an innocent rite of passage, college binge drinking is a risk factor in violence against women. Men need to know what constitutes rape, and that intoxication is a stop sign for sex.

Binge drinking has been the focus of the CAS since its inception. The CAS defines it as five or more drinks in a row for men and four or more drinks for women, at least once in the 2 weeks before the survey was completed. Roughly two in five college students meet that definition, with one in five a frequent binge drinker with three or more episodes during the 2 weeks. These results remained largely stable from 1993 to 2001, despite increased attention to this issue by colleges. One in three colleges had 50% or more of students defined as binge drinkers.

The methods used in the CAS distinguish it from other attempts to measure excessive drinking by college students. The CAS was funded by the Robert Wood Johnson Foundation. A representative sample of 179 four-year colleges was selected, with probability proportionate to enrollment sampling. Each of the 140 institutions that initially participated in the study provided the CAS with a list of full-time students, from which a random sample was drawn. Institutions were located in 40 states and the District of Columbia and represented a cross-section of American higher education. The principal investigator of CAS, Henry Wechsler of the Harvard School of Public Health, designed a 20-page questionnaire based on his own previous college studies and other large-scale surveys. Questionnaires were mailed to students in the spring semester of each year, with four separate mailings as well as a drawing for a cash award designed to increase participation. An initial response rate of 69% was achieved, with over 17,000 students completing the questionnaire in the first survey year.

Binge drinking is associated with higher risks of alcohol-related problems for the individual drinker, including missing classes, getting behind in schoolwork, doing something one regrets, and arguing with friends. Binge drinkers have higher rates of engaging in unplanned sexual activity, not using protection during sex, and getting hurt or injured. Almost half of the frequent binge drinkers surveyed had experienced five or more different alcohol-related problems since the beginning of the school year.

In addition to the effects of binge drinking, the CAS also explored secondhand binge effects, problems that affect nonbingeing students who live in residence halls or a fraternity or sorority house. Nonbingeing students at schools with higher rates of binge drinking are more likely than students at schools with     lower rates to have experienced secondhand binge effects as the result of others’ drinking, such as experiencing an unwanted sexual advance or being pushed, hit, or assaulted.

The CAS helped call attention to binge drinking and associated problems such as intoxicated rape and has led to considerable research and prevention efforts. A special task force on college drinking was created by the National Institute of Alcohol Abuse and Alcoholism. Its 2002 report used CAS and other data to present a snapshot of the problems associated with binge drinking, including 1,400 student deaths, over 70,000 sexual assaults or date rapes, and 600,000 assaults each year. The report urges colleges to change the culture of college binge drinking, and provides information about prevention efforts that have been proved to be effective among college students and the general population, as well as programs that hold promise for changing behavior.


  1. Dowdall, G. W., & Wechsler, H. (2002). Studying college alcohol use: Widening the lens, sharpening the focus. Journal of Studies on Alcohol, Supplement, 14, 14–22.
  2. Kuo, M., Dowdall, G. W., Koss, M. P., & Wechsler, H. (2004). Correlates of rape while intoxicated in a national sample of college women. Journal of Studies on Alcohol, 65, 37–45.
  3. Task Force of the National Advisory Council on Alcohol Abuse and Alcoholism. (2002). A call to action: Changing the culture of drinking at U.S. colleges. Rockville, MD: National Institute of Alcohol Abuse and Alcoholism.
  4. Wechsler, H., Davenport, A., Dowdall, G., Moeykens, B., & Castillo, S. (1994). Health and behavioral consequences of binge drinking in college: A national survey of students at 140 colleges. Journal of the American Medical Association, 272, 1672–1677.
  5. Wechsler, H., Dowdall, G., Davenport, A., & Rimm, E. (1995). A gender-specific measure of binge drinking among college students. American Journal of Public Health, 85, 982–985.
  6. Wechsler, H. W., & Wuethrich, B. (2002). Dying to drink: Confronting binge drinking on college campuses. New York: Rodale.

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