untitled
Alcohol and other drug use at school leavers’ cele
ations
Tina Lam, Wenbin Liang, Tanya Chikritzhs, Steve Allsop
National Drug Research Institute, Curtin University, Perth, WA 6845, Australia
Address co
espondence to Tina Lam, E-mail: XXXXXXXXXX
ABSTRACT
Background A significant proportion of adolescents who attend cele
atory events often engage in substantial alcohol and other drug use. We
examined patterns, influences and impacts of drug consumption at an end of schooling life cele
ation.
Methods Seventeen- to 18-year-old Australians who intended to attend (n ¼ 541) and who attended the cele
ation (n ¼ 405), respectively,
completed pre- and post-event surveys.
Results Males consumed 18.44 and females 13.24 Australian standard drinks on an average day during the school leavers’ event. Compared
with their last social event, there was greater alcohol (P , XXXXXXXXXXand ecstasy use (P , 0.046 for Day 1 and P , 0.008 on Day 3). However, the
number of drinks consumed per hour appeared to be similar across contexts. Most (87%) experienced at least one negative outcome attributed to
alcohol and other drug use. Safety strategies were frequently used and appeared to be protective against some of the most common harms
(hangover, vomiting, black out and unprotected sex).
Conclusions The use of alcohol and other drugs at this cele
atory event appears to be reflective of the greater than usual number of drinking
hours that are available to participants. The use of safety strategies can be successful in mitigating some of the most common drug-related harms.
Keywords alcohol consumption, cele
ation, health promotion, large event, leavers, protective behavioral strategies, risky single occasion
drinking, schoolies, young people
Introduction
Adolescent alcohol use in countries such as the USA, UK and
Australia, is typified by episodic consumption, which commonly
occurs to the point of intoxication.1 – 4 This style of ‘risky
drinking’ means that young people are frequently affected by
lackouts (memory loss), hangovers and violence.5,6
Adolescent alcohol and other drug (AOD) use appears to
peak at ‘special events’.7,8 For many young adults in Western
countries, the milestone of school completion is marked by
festive events. These multiple day cele
ations are a much
anticipated occasion for frivolity with fellow alumni; and, in
Australia, up to half of all Year 12 graduates attend some form
of these school leavers’ (also known as ‘Schoolies’ or ‘Leavers’)
cele
ations.9,10
Compared with the significant press coverage each year,11
there has been relatively little formal research into the phe-
nomenon. The common theme of existing studies is that for a
significant proportion of attendees, the event revolves around
heavy alcohol use, some consumption of other drugs and
engagement in other risky behaviours such as unprotected casual
sex.12–20 Similar scenarios occur at other multiple-day peer-based
cele
atory events such as Spring Break in the USA,21,22 and
ussefeiring, a 17-day Norwegian graduation party.23
These risky behaviours are partially attributed to the
‘holiday effect’, a phenomenon where individuals on holiday
tend to engage in risky behaviours not otherwise attempted at
home.13,18,24 – 27 These elements include the temporary sus-
pension of social codes, such as responsibility and account-
ability; time away from usual authority figures; a peer-based
environment and a reputation for AOD experimentation.
Also, heavier drinkers appear to ‘self-select’ to attend party
destinations with a reputation for AOD use.28 – 31
Tina Lam, Research Associate
Wenbin Liang, Research Fellow
Tanya Chikritzhs, Professor and Project Leade
Steve Allsop, Professor and Directo
408 # The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: XXXXXXXXXX.
Journal of Public Health | Vol. 36, No. 3, pp. 408–416 | doi:10.1093/pubmed/fdt087 | Advance Access Publication 27 August 2013
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Cu
ently, there are few international and no Australian peer-
eviewed published studies which provide quantity-specific esti-
mations that reliably gauge the extent of AOD use at school
leavers’ cele
ations (especially alcohol), and provide a fulsome
view of its influence on behaviour.
The aims of this study were therefore to (i) compare the
levels of AOD use at an end of school cele
ation and use at
other peer-based social events and (ii) relate the experience
of harms experienced at the cele
ations to levels of use and
engagement in harm-minimization strategies.
Methods
Design
Core data for this project were gathered using a two-part
survey design with a self-report methodology. The majority of
the respondents were aged 17 (legal purchase age for alcohol
in Australia is XXXXXXXXXXRespondents intended to, and/or had
attended the 2009 school leavers’ cele
ations on Rottnest
Island. This Island is located 20 km off the west coast of
Perth and is a popular location for the event in Western
Australia. This location was chosen as the bulk of the visitors
entered and exited via a single fe
y terminal. This ‘bottle-
necking’ facilitated survey administration.
The first survey sampled young people who intended to
attend the event (n¼ 541; 56% female; 91% 17 years and 9%
18 years of age; 87% enrolled in an independent school). This
pre-cele
ation survey was available both online and face to face.
Half (52%) were conducted online from 2 months to the day
prior to the cele
ation. The mean online completion time was
15.64 min [95% CI (14.79, 16.49), n¼ 215 (outliers removed)].
The remaining paper surveys were disseminated on the first day
of the cele
ations on five fe
ies travelling to Rottnest Island.
Project information forms and blank surveys were provided
en route, and completed surveys collected as the boat docked.
The post-cele
ation survey was completed by XXXXXXXXXX%
female; 94% 17 years of age and 6% 18 years and over; 92%
attended an independent school). While this second survey
was also available online, most (86%) were conducted face to
face. On the last day of the event, a team of 27 researchers
distributed surveys around the island’s accommodation, com-
mercial areas and fe
y terminal. Researchers remained within
a visible distance to participants to encourage serious attempts
and to collect surveys. Face-to-face response rates were esti-
mated at 90% and the completion time at 15 min. Survey
modality (online versus face-to-face) was controlled for multi-
factorial analyses, and Wilcoxon–Mann–Whitney tests did
not reveal any significant differences in intended or reported
actual alcohol use across the modalities.
The two surveys were designed to be analysed primarily as
separate components—one assessing intentions and the
other what happened at the cele
ations. As the total numbe
of cele
ants on the island was 1466, �37% of the popula-
tion was surveyed with the pre-cele
ation survey and 28%
for the post-cele
ation survey. Although recapture was not a
central method of the study, a self-generated anonymous
code was incorporated into both instruments to pair an indivi-
dual’s data where possible.33,34 Not all participants completed
the code and the pre- and post-event surveys of 120 par-
ticipants were eventually linked (62% female). Due to the
modest known paired sample size, most analyses focus on
‘within-survey’ data (combining both paired and unpaired
espondents).
Confectionaries (‘lollies’) were provided as a minor incen-
tive with face-to-face surveys. Participants of both survey mo-
dalities were able to enter a voucher prize draw. Prize-draw
email addresses were detached from or collected in separate
databases to the survey data. Consent was implied by survey
completion.35 This study was approved by Curtin University
(HR135/2008) and the Rottnest Island Authority (2008/13;
2009/110328).
Measurements
Both surveys contained psychometrically validated and novel
items in Likert and free response form. The pre-cele
ation
survey included quantity-specific expectations of personal and
peer AOD use at the event; expectations of how permissive the
cele
ation context would be; parental discussions about
alcohol use and AOD use at their last social event. This ‘last
event’ was the last social occasion attended with friends prio
to the school leavers’ cele
ation. As adolescent alcohol use
tends to be episodic and increase in ‘party’ contexts,5,36 the
more frequently used survey reference period of the last 7
days37 may or may not include a peer-based social event. The
school leavers’ cele
ation and the last event were comparable
in that they were both social and peer based, and assessed a
similar subset of young people who had self-selected as intend-
ing to/attended the end of school cele
ations.19,38 That is, the
‘last event’ served as a proxy for ‘usual’ AOD behaviour.
The post-event survey investigated AOD use, perceptions
of peer AOD use, experience of AOD-conducive conditions,
negative consequences and harm reduction strategies employed
at the cele
ations.
Alcohol consumption was estimated using validated tools
from the National Drug Strategy Household Survey—the
everage-specific and the standard drink (SD) approach.39,40
The beverage-specific method requires the respondent to
specify their drink (e.g. mid-strength beer), the size of thei
SCHOOL LEAVERS’ CELEBRATIONS 409
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drink receptacle (e.g. a 330 ml bottle) and the number of each
type consumed, in table labelled with the most common bev-
erage types and sizes. The SD method requires the respond-
ent to convert their intake into SDs and then to record a
figure that summarized daily consumption. The SD question
‘how many standard drinks did you have on Day 1?’ was
supplemented by a visual guide. In Australia, a ‘standard
drink’ contains 10 g of alcohol. Piloting confirmed that com-
prehension of the ‘SD’ concept was high, as it was a part
of many schools’ syllabus. The beverage-specific response
method is one of the most valid self-report measures of
alcohol quantity—however, its higher and more accurate esti-
mates are offset by a considerably lower response rate.41
Both estimates were presented in Table 1, but only the
everage-specific estimates have been discussed. The beverage-
specific method was used for the last event and cele
ation esti-
mates, whereas the SD method was only used in the cele
a-
tion estimates.
Analysis
A series of Wilcoxon signed rank tests were performed to
compare AOD use between the contexts of the last event and
an average day at the leavers’ cele
ations (paired respondents).
Logistic regression analyses were performed to assess the
impact of six factors on the likelihood of reported experience
of 17 negative consequences. Independent variables were
chosen to assess the ability of safety strategies to attenuate ex-
perience of a variety of harms. The six variables contained in
each model were as follows: (i) an average quantity of alcohol
used on a single day at the event; (ii) use of drugs other than
alcohol; (iii) use of alcohol-related safety strategies, as assessed
using the Protective Behavioural Strategies Survey (PBSS).
The PBSS is a psychometrically validated list of behaviours that
minimize alcohol use and related acute harm42–48 (iv) gender;
(v) accommodation location and (vi) survey administration
modality (online or face to face).
Results
Alcohol use at leavers’ cele
ations and the
last event
A significantly greater proportion of respondents used
alcohol during the cele
ation period (93%) and on each cele-
ation day (an average of 88% across the 3 days), compared
with