The Combined Impact of Campus and State Alcohol Policies on College Drinking and Harms.

Abstract

Little is known about what policies and practices may prevent alcohol-related harms to others. This study tested whether campus alcohol policies were associated with alcohol use and alcohol-related harms to others among college students and whether these associations differ in states with weak versus strong alcohol policies. This cross-sectional study used data from a 2021 probability-based survey of U.S. college students. The main predictor was a campus alcohol policy score that combined 33 policies. Alcohol use outcomes included past 30-day volume and binge drinking frequency, and analyses with alcohol use outcomes included 968 students who drink. In 2024, models with alcohol-related harms to other outcomes used data from 1,737 students (comprising abstainers and those who drink alcohol) and 3 alcohol-related harms to others: verbal, physical, and sexual. Models also assessed interactions between campus and state alcohol policy scores. Stronger campus alcohol policy scores were associated with lower alcohol volumes (incidence rate ratio=0.91; 95% CI=0.86, 0.97; p=0.003) and lower odds of verbal alcohol-related harms to others (AOR=0.86; 95% CI=0.75, 0.98; p=0.022). Associations between campus alcohol policy scores and binge frequency, verbal alcohol-related harms to others, and sexual alcohol-related harms to other were only significant in states with weak policies, whereas the association between campus alcohol policy scores and alcohol volumes held across state policy environments. Student drinking and rates of alcohol-related harms to others were lower on campuses with stronger alcohol policies. Campus alcohol policy scores were associated with lower volume overall and with reduced binge drinking and verbal and sexual alcohol-related harms to others in states with weaker policies. Findings highlight the importance of campus alcohol policies in such states.