Who pre-drinks before a night out and why? - Alcohol Action Ireland

http://informahealthcare.com/jsuISSN: 1465-9891 (print), 1475-9942 (electronic)J Subst Use, Early Online: 1–10! 2013 Informa UK Ltd. DOI: 10.3109/14659891.2013.784368ORIGINAL ARTICLEWho pre-drinks before a night out and why? Socioeconomic status andmotives behind young people’s pre-drinking in the United KingdomJeanette Østergaard 1 and Stefan Bastholm Andrade 21 SFI – The Danish National Centre For Social Research, Copenhagen, Denmark and 2 Department of Sociology, University of Copenhagen,Copenhagen, DenmarkJ Subst Use Downloaded from informahealthcare.com by 80.198.89.98 on 07/15/13For personal use only.AbstractAim: To examine young people’s main motive for pre-drinking in the United Kingdom, howmuch they drink on an event-specific night out, and whether motives or socioeconomic status(particularly their income level) explain the alcohol quantities they drink. Methods: Multilevellogit and Poisson models were used on a survey of 628 people (aged 18–35) conducted on-sitein 26 bars, clubs and pubs in four cities and towns. Results: Young males drink on average 9.8and females 7.4 standard units of alcohol before a night out. Saving money is the mostprevalent motive for pre-drinking. Although lower income levels cannot explain whether ayoung person will pre-drink on an event-specific night out, young people’s income level andtheir motives explain the quantities they consume. Lower-earning males who pre-drank to savemoney consumed larger quantities of alcohol at home and lower-earning females also predranklarger quantities either because they wanted to get out of control or because theywanted to be social. Conclusions: Prevention strategies likely to be effective in reducing thealcohol quantities that young people pre-drink should take into account both socioeconomicstatus and motives for pre-drinking.IntroductionThe act of drinking before going out to a pub, bar or club hasdrawn increasingly more attention amongst alcohol and drugresearchers in the UK (Hughes et al., 2007; Wells et al.,2008), Switzerland (Labhart et al., 2013) and the US(Pedersen & LaBrie, 2007; Pedersen et al., 2009). Thisphenomenon – also known as ‘‘pre-loading’’, ‘‘pre-gaming’’,‘‘front-loading’’ or ‘‘prinks’’ – involves heavy consumptionof alcohol within a short period, usually at a private residence,causing great concern for both short-term and long-termhealth risks. Short-term risk factors include sudden highalcohol levels in the blood, increasing the risk of blackouts(LaBrie et al., 2011), alcohol poisoning (LaBrie & Pedersen,2008) and violence (Borsari et al., 2007). Pre-drinking beforegoing to a main event (e.g. clubs, bars or concerts) is alsocorrelated with heavier drinking later in the evening(Pedersen & LaBrie, 2007).Qualitative studies suggest that young people pre-drinkbefore a main night out with the explicit intention ofintoxication (DeJong & DeRicco, 2010; Forsyth, 2010).This finding has led researchers to define pre-drinkingas ‘‘rapid consumption of alcohol done with the intentionCorrespondence: Jeanette Østergaard, SFI – The Danish National CentreFor Social Research, Copenhagen, Denmark. E-mail: jea@sfi.dkKeywordsAlcohol, binge-drinking, motives, policy(policies), pre-drinkingHistoryReceived 3 September 2012Revised 17 February 2013Accepted 19 February 2013Published online 12 July 2013of reaching a sufficient level of intoxication to carryone through the main event of the evening with minimalfurther spending on alcohol’’ (Wells et al., 2009, p. 10).The definition assumes that pre-drinking is primarily drivenby young people’s motives to save money by not havingto buy as much expensive alcohol in bars and club.However, no survey study has yet examined whether ornot young people’s primary motive for pre-drinking is tosave money.This study investigates young people’s motives for predrinkingin a convenient sample of 18-to-35-year-old visitorsto 26 bars, pubs and clubs in four different cities and towns inthe UK, a nation famous for its very high level of alcoholconsumption amongst young people (Eurobarometer, 2004,2007; Robinson & Harris, 2011). The survey features thelargest number of venues and the biggest sample sizecollected in one single UK study that targets the hard-toreach-groupof pre-drinking club- and bar-goers in fourdifferent regions: North West England, East of England,South East England and London. Our aim is also to examinewhether young people’s socioeconomic status is a significantfactor in explaining whether young people pre-drink and howmuch alcohol they consume pre-drinking. As research on theassociations between socioeconomic status and people’sdrinking patterns has been inconsistent (Caldwell et al.,2008; Jefferis et al., 2007; Laatikainen et al., 2003),the analysis controls for socioeconomic status according to2013

2 J. Østergaard & S. B. Andrade J Subst Use, Early Online: 1–10J Subst Use Downloaded from informahealthcare.com by 80.198.89.98 on 07/15/13For personal use only.three separate factors (employment status, education andincome level).The prevalence of pre-drinking amongst young people inthe UK has been documented in several studies. In a study infour cities and towns in the Lancashire area, 66% of femalesand 49% of males aged 16–51 reported pre-drinking on thenight of the survey (Measham et al., 2011b). Likewise, in arecent study from Liverpool, also in the same region,researchers found that 70% of females and 51% of maleswere pre-drinking on the night of the survey (Hughes et al.,2011). However, a study from London revealed that only 28%of females and 27% of males reported pre-drinking on thenight of survey (Hadfield et al., 2010). The three studies usedsimilar questions to capture pre-drinking – namely whetheryoung people had been drinking alcohol at home or at afriend’s house before going out – and thus they suggest theprevalence of regional differences in terms of how widespreadpre-drinking is in the UK.In the US, pre-drinking has been studied mainly as aphenomenon prevalent amongst college students under thelegal drinking age of 21 (DeJong & DeRicco, 2010). A studyconducted in a student-dominated downtown area in Virginiafound that amongst randomly selected late-night pedestrians,69% reported pre-drinking, and that pre-drinking was mostprevalent amongst under-age drinkers (Glindemann et al.,2006). A study of American psychology students showedthat 64% reported pre-drinking before going out to a mainevent and that social motives – drinking with friendsand room-mates in a social setting – explained only about15%–21% of the young people’s pre-drinking. Youngpeople’s motives, however, could not explain the quantityof alcohol consumed during pre-drinking (Pedersen &LaBrie, 2007). A focus group discussion amongstAmerican college students revealed that many students sawthemselves as drinking more heavily before going out ifalcohol would be less accessible or too costly later in theevening (DeJong & DeRicco, 2010).That young people consume alcohol for different motives,depending on the social context (Cox & Klinger, 1988;Edwards et al., 1973; Jung, 1977), is well established. Studieshave revealed how enhancement motives (e.g. drinking to feelgood or enhance confidence) are most strongly associatedwith heavy drinking; social motives (to be sociable and havea good time), with moderate drinking; and coping motives(to escape, relieve stress or avoid social rejection), withproblematic drinking (Kuntsche et al., 2005). However, youngpeople’s motives for drinking are likely to differ acrossdifferent setting in which they drink, and these differentmotives have rarely been surveyed. One exception is a studyof young Hungarian adults, finding that social motives are themain reason for young people’s consuming alcohol at festivals(Németh et al., 2011).For creating new prevention strategies, a further understandingof young people’s event- and context-specificdrinking patterns is necessary (Neighbors et al., 2007).Different recreational settings (e.g. a concert, house party,club or bar) are most likely to be associated with differenttypes of motives for drinking, just as young people’s predrinkingmotives are likely to be affected by the characteristicsof the main event of the evening. Qualitative studieshave suggested that a number of different motives are at stakein explaining young people’s reason for pre-drinking: savingmoney, getting a buzz or getting wasted; socializing withfriends; or reducing the pressure, stress and anxiety of goingout with friends (DeJong & DeRicco, 2010; Forsyth, 2010).Other studies amongst heterosexual males have found that themain motive for pre-drinking is to establish male bonding(Grazian, 2007). Individual-focused prevention interventionsfocusing on event-specific heavy alcohol consumption such asmotivational interviewing (Cronce & Larimer, 2011) couldbenefit from assessments of young people’s event-specificpre-drinking motives, especially as the pre-drinking phenomenonis becoming more widespread, particularly in NorthWest England (Hughes et al., 2007, 2011).Young people’s increased interest in pre-drinking (largeamounts of alcohol) must be approached within the context ofan expanding UK night-time economy, in which upgradedcorporate night-life spaces such as the café and ‘‘style bars’’target professionals, higher- and lower-level service sectorworkers (e.g. social workers and nurses, or hairdressers andclerical workers, respectively), and students (Chatterton &Hollands, 2002). Whilst traditional pubs serve the purpose of‘‘going out for a drink’’, many of the new corporately ownedmainstream bars, pubs and nightclubs encourage the idea ofdrinking to intoxication. With promotions such as ‘‘happyhour’’, ‘‘all-you-can-drink (for £10)’’ and inexpensive alcohol(Meier, 2011), these mainstream places have grown inpopularity as young people drink alcohol with the explicitintention of reaching high levels of intoxication, also definedas ‘‘determined drunkenness’’ (Brain et al., 2000; Measham,2006; Measham & Brain, 2005).If determined drunkenness has become young people’sperceived norm for how to consume alcohol on a night out,pre-drinking larger quantities of alcohol should be moreprevalent amongst lower-income young people who, despitehappy hour and all-you-can-drink-offers, will have fewermeans of participating in on-premises intoxication-relateddrinking. No study has yet examined the association betweenyoung people’s pre-drinking quantities and their level ofincome, and few studies have examined the associationbetween young people’s overall drinking patterns and theirsocioeconomic status. One exception is a longitudinal studyby Casswell et al. (2003), which followed young people’soverall drinking patterns (i.e. not surveyed in situ) at ages 18,21 and 26. It found that at all ages, less educated youngpeople were drinking larger quantities on specific drinkingoccasions, whereas the frequency of drinking was associatedwith high income levels. That less well-educated youngpeople are more likely to drink larger quantities during adrinking session suggests that the less well-educated youngpeople are the more sensation-seeking and risk-orientedalcohol consumers. Thus, pre-drinking heavily not only maybe a question of available funds for drinking but may alsodepend on the drinking pattern prevalent at different educationalinstitutions.This study examines young people’s primary motives forpre-drinking on an event-specific (i.e. pub or club) night out.Who were the pre-drinkers on this occasion, and how are thequantities they consume whilst pre-drinking associated withtheir socioeconomic status and pre-drinking motive?

DOI: 10.3109/14659891.2013.784368 Pre-drinking and motives 3J Subst Use Downloaded from informahealthcare.com by 80.198.89.98 on 07/15/13For personal use only.MethodProcedure and participantsThe survey was conducted in licensed bars, pubs and clubs infour different cities and towns in the UK: a university city inthe North West England, a seaside town in the South EastEngland, a military town in East England and London (thefirst three remain unnamed because of promises of totalanonymity to the bar owners and managers). The criteria forvenue selection were upmarket mainstream drinking locations(often) with a dance floor or corporately owned ‘‘chain pubsor bars targeting younger people by offering inexpensivealcohol’’ (Chatterton & Hollands, 2002). Super clubs (Purcell& Graham, 2005) – defined as having more than one dancefloor on a typical Friday or Saturday night – were avoided,because the focus of our study was designated drinkinglocations. A list of eligible bars and clubs was made for eachcity and town, and bar owners and managers were contacted.The survey was conducted in 26 bars and clubs over fourweeks in October 2011. Six venues were either unwilling orunable to accommodate the interviews in an enclosed (oftensmoking) area. In these cases, with the manager’s or owner’sapproval, the survey was conducted outside the bar or club orat another venue with a similar profile. The survey wasconducted by 4 to 6 researchers on Friday and Saturday nightsbetween 9 p.m. and 2 a.m., with the purpose of recruitingnightlife users participating in recreational drinking duringpeak times. Young people who appeared to be between theages of 18–35 were approached, informed of the study, toldthat their participation was voluntary, and told that anyinformation they gave would be treated with the highestconfidentiality.The study was approved by the committee of the DanishCouncil for Independent Research and reported to the DanishData Protection Agency. Furthermore, before the night of theinterview, local police were informed about the study(although not the names and bars of the research venues),giving the researchers a police contact number in case of anincident. The researchers were instructed not to approachoverly intoxicated respondents, to always ensure their ownsafety, to work in teams of two, and to establish good contactwith security and bouncers.In total, the researchers approached 628 people, 36 ofwhom refused to participate and 11 of whom the researchersnoted as too intoxicated for interviewing (47/628 ¼ 7.5%).Of the 11 intoxicated respondents, 10 were males, and insix cases the interview was ended after the third or fourthquestion, whereas in five cases the interview was endedright after initial contact. Data was manually entered intoSPSS, and incomplete answers and outliers reported for totalpre-drinking units consumption and time pre-drinking werere-examined. Before the analysis, one respondent wasexcluded for being a non-drinker, 20 respondents wereexcluded for being underage or over 35, while 94 respondentswere excluded for incomplete answers (i.e. about half theanswers were incomplete, due to responses such as ‘‘don’tknow’’ or ‘‘don’t want’’ to answer average monthly income).The sample used for the following analysis consists of 466interviews (466/581 ¼ 80.2%). Descriptive statistics areshown in Table 1.The questions on occupation and pre-drinking wereadapted from the Lancashire Drug and Alcohol ActionTeam Phase One report (Measham et al., 2011a, 2011b). 1In addition, our survey asked about the young people’sincome, educational level, frequency of going to a nightcluband frequency of feeling intoxicated in the 30 days precedingthe interview. Occupation was measured by asking the youngpeople whether they were (a) students (in school/colleges/university), (b) employed, (c) unemployed, or (d) other.Education was measured by asking ‘‘What is your highestqualification level and if presently under education, whichof the following apply: (a) Secondary School (GCSE),(b) Further Education/Six Form College (A/AS Level),(c) Diploma/Degree (BA), (d) Higher Degree (MA/PhD)?’’Income was measured by asking ‘‘What is your averagemonthly income before tax and other deductions? Pleasesay the letter which comes closest: (a) Under £1200,(b) £1200–1799, (c) £1800-3000, (d) More than £3000,(e) Don’t know or (f) Don’t want to answer’’.The measure for club frequency and frequency of intoxicationwas formulated as follows: ‘‘Think about the last30 days. How many times did you visit a night club ordisco?’’ and ‘‘How many times have you been drunk in thelast 30 days (so you were not able to speak properly or stagedwhen walking)?’’ Pre-drinking was measured by asking theyoung people ‘‘Have you had any alcohol to drink before youcame out tonight, either at your home, friend’s house/park/train etc.?’’ And, if yes, ‘‘what time did you start and stopyour pre-drinking?’’ – with answer categories coded in hourlyintervals. Finally, the young people were asked to identifyhow much alcohol they had consumed pre-drinking by listingthe size, brand and number of alcoholic beverages, such asbeer, wine, hard cider or hard liquor (Hammersley, 2005;Hammersley & Ditton, 2005; see also Hughes et al., 2011 fora similar definition of pre-drinking). Total pre-drinkingalcohol units was summed to a continuous variable with astandard unit defined as 8 g of pure ethanol. Thus, one pint ofordinary-strength beer (4.6% vol.) equals 2.6 units; one pint ofpremium-strength beer (5.8% vol.) equals 3.3 units; one pintof cider ordinary-strength (6% vol.) equals 3.4 units; onebottle of wine (12% vol.) equals 9 units; one large glass ofwine (250 ml) equals 3 units; one bottle of alcopops equals 1.4units; and one single-measured drink equals 1.4 units (Ritchieet al., 2009). Respondents pre-drinking more than 40 unitshad been drinking longer than 7 hours and their answers weretherefore considered valid.All respondents, despite pre-drinking or not on the surveynight, were asked about their one main motive for predrinking.The researchers conducting the interviews werespecifically instructed not to immediately present any of theanswer categories to the respondents but to let the respondentpresent her or his primary motives first. The researchers thencoded the answers according to the following categories:(a) to save money, (b) to get wasted or out of control, (c) to be1 The questionnaire was piloted one night at a bar in London in summer2011. The answers themselves led to our modification of a small numberof answer categories on motives. Otherwise, the pilot study resulted ingood completion and consistency.

4 J. Østergaard & S. B. Andrade J Subst Use, Early Online: 1–10Table 1. Sample characteristics by gender.J Subst Use Downloaded from informahealthcare.com by 80.198.89.98 on 07/15/13For personal use only.All Male Femalen ¼466 n ¼ 272 n ¼194Categorical variables Sig.Occupation –Student 23.2 22.4 24.2Employed 74.3 75.4 72.7Unemployed 2.9 2.2 3.1Education –Secondary 9.4 9.2 9.8Upper secondary education 26.4 25.7 27.3Diploma/Bachelor degree 49.1 46.7 52.6Graduate degree 15.0 18.4 10.3Income ***Less than £1200 39.9 34.9 46.9£1200–1799 25.8 22.4 30.4£1800–3000 25.3 28.3 18.6Above £3000 10.1 14.3 4.1Regional area –London 42.9 41.5 44.9University city 20.0 21.3 18.0Seaside town 19.7 18.8 21.1Military town 17.4 18.4 16.0Attend clubs –No 4.5 4.4 4.61–3 times 38.2 34.2 43.84–8 times 39.1 40.8 36.6More than 9 times 18.2 20.6 15.0Motives –No motive 14.4 14.7 13.9Save money 35.8 31.3 42.3Out of control 7.1 7.7 6.2To be social 25.3 28.7 20.6Not go out sober 5.4 4.4 6.7Part of going out 12.0 13.2 10.3Pre-drink –Yes 59.9 57.4 63.4No 40.0 42.6 36.6Continuous variablesSig. M SD Min Max M SD Min Max M SD Min MaxAge – 23.2 4.0 18 35 23.4 4.2 18 35 23.0 3.8 18 35Average age on location – 23.3 2.4 19.7 28.4 23.2 2.5 19.7 28.4 23.4 2.4 19.7 28.4Frequency drunk *** 4.9 3.7 0 11 5.6 3.8 0 11 3.9 3.5 0 11Units pre-drinkingy ** 8.7 7.3 0 45.2 9.8 8.5 0 45.2 7.4 5.9 0 30Hours pre-drinkingy ** 2.6** 1.8 0 7 2.4 2.1 0 7 1.7 1.2 0 7M ¼ Mean, SD ¼ Standard deviation; ***p 5 0.001; **p 5 0.05.yEstimated for pre-drinkers only.social, (d) to not go out sober, (e) as part of going out, and(f) not identifying any motives at all.AnalysisWe divided our analysis by gender because previous researchhas documented differences in males’ and females’ motivesfor drinking (Cooper, 1994; Gire, 2002) and alcohol quantityintake (Wilsnack et al., 2000). We also examined whetheryoung people’s pre-drinking was influenced by the type of baror club they planned to go to later in the evening (e.g. bar withhigh-priced alcohol) by calculating the interclass correlation(ICC). We found that 15.9% of the variation in males’ predrinkingand 29.1% of females’ pre-drinking depended on aspecific bar or club.Due to the high ICC, we use a multilevel logit model toestimate the likelihood of pre-drinking and a multilevelPoisson model to estimate the likelihood of consuming largerquantities of alcohol amongst those who pre-drank on thenight of the survey. The multilevel models divide the variationin data into two levels: a higher level that accounts for thevariation between the different locations, and a lower levelthat accounts for individual variation within each location.When analyzing the location-specific variance in the drinkingpatterns, we include two higher ordered variables: city andaverage age at bar/club/pub location. To analyze individualvariation, we include the variables: age, occupation, education,income, frequency of intoxication, frequency of clubbingand motives for pre-drinking.Because the quantities young people consume could beinfluenced by the length of time they pre-drink (Hammersley,2005), the Poisson regression estimates are adjusted byincluding a variable measuring time exposure (over how manyhours the person was pre-drinking). We conduct two multilevelPoisson models – one without and one with aninteraction term – between motives and low income level to

DOI: 10.3109/14659891.2013.784368 Pre-drinking and motives 5J Subst Use Downloaded from informahealthcare.com by 80.198.89.98 on 07/15/13For personal use only.test whether the identification of lower-earning males andfemales with specific motives is associated with the consumptionof larger quantities of alcohol. We set ‘‘savingmoney’’ as the reference category for the motive variablebecause, according to previous qualitative studies (DeJong &DeRicco 2010), it is one of the main pre-drinking motives.Odds ratios (OR) and incidence rate ratios (IRR) arecalculated with Stata’s Poisson regression estimationprograme.ResultsMore males (58.4%) than females participated in the surveystudy, consistent with other bar and club studies (Hugheset al., 2007; Measham et al., 2011a; Ravn, 2010) (seeTable 1). The mean age was 23.2 years (23.4 for males and23.0 for females, t ¼ 1.00, p ¼ 0.320). Most of the youngpeople were either employed (74.3%) or students (23.2%). Anotably large percentage – 9.4% – reported having completedonly secondary education as their highest degree and 26.4%had completed or were completing upper secondary school(i.e. the education of 14-to-19-year-olds, such as A-levels andGSCS). About half (49.1%) of the interviewees had, or werecompleting, a national diploma or bachelor degree, and 15.0%were currently completing, or had completed, post-graduateschool (MA and PhD).Before taxes, 39.9% reported average earnings less than£1200 ($1850) per month. Twenty-five per cent earnedbetween £1200 and £1799 ($1850–2750), 25% earnedbetween £1800 and £3000 ($2750–4650), and only 10%earned more than £3000. Males reported significantly higheraverage monthly incomes than females (Chi ¼ 23.032, df. ¼ 3,p50.000).Amongst the young people, 62.5% reported either regularor party smoking. More than half of the 18-to-35-year-oldshad gone clubbing at least four times a month during thepreceding 30 days. The average number of times therespondents felt intoxicated during the preceding 30 dayswas 4.9, with males more likely to report intoxication thanfemales (5.6 males versus 3.9 females, t ¼ 5.02, p50.001).More than half (59.9%) of the sample had been predrinkingon the night of the interview. Amongst those whopre-drank (n ¼ 279), an average of 8.7 units of alcohol wasconsumed before a night out. Males who pre-drank had ahigher average unit consumption than females (9.80 malesversus 7.42 females, t ¼ 2.72, p50.01). Pre-drinkers beganto consume alcohol 2.1 hours before their night out, and malespre-drank for a longer period than females (2.36 h malesversus 1.68 h females, t ¼ 3.29, p50.001).The young people’s main motive for pre-drinking was‘‘saving money’’ (35.8%), a reason that more females (42.3%)than males (31.3%) reported. The second most reported motivewas ‘‘to be social’’, with which more males (28.7%) identifiedthan females (20.6%). The third motive most mentioned byboth males (14.7%) and females (13.9%) was ‘‘not identifyingwith any reason for pre-drinking’’ (either because therespondents did not see themselves as regular pre-drinkers orbecause they had no motive). Pre-drinking ‘‘to avoid going outsober’’ and ‘‘drinking to get wasted or out of control’’ was theleast common main motive for both males and females.Table 2. Results for pre-drinking (Y1). Coefficients are shown in oddsratio.MalesFemalesOR Std. OR Std.Level 2: locational variationRegional areaLondon Ref. Ref.University city 0.331** (0.169) N.S. –Seaside town N.S. – N.S. –Military town N.S. – 5.780* (0.993)Average age on location 0.692** (0.068) N.S. –Level 1: individual variationAge N.S. – 0.864** (0.037)OccupationStudent Ref. Ref.Employed 0.280** (0.126) N.S. –Unemployed N.S. – N.S. –EducationUpper secondary Ref. Ref.Diploma/Bachelor N.S. – N.S. –Graduate degree N.S. – N.S. –Secondary N.S. –IncomeLess £1200 Ref. Ref.£1200–1799 N.S. – N.S. –£1800–3000 N.S. – N.S. –Above £3000 N.S. – N.S. –Times drunk 1.092** (0.047) 1.195** (0.090)Clubbing N.S. – N.S. –Obs. 272 194Number of groups 27 27Obs. per group avg. 10.3 7.2ICC (before/after) 15.9%/40.0% 29.1%/.17.8%*p 5 0.10; **p 50.05.Table 2 shows the result of the logit multilevel models formales and females, respectively. The models estimate theinfluence of sociodemographic and socioeconomic factors onwhether males and females pre-drink before the event-specificnight. When the explanatory variables were included in themultilevel logit model, the ICC decreased from 15.9% to lessthan 0.0% for males and from 29.1% to 17.8% for females (i.e.by 38.8%). Thus, when we included a multilevel design thatcontrols for higher ordered variables, almost all locationspecificvariation disappeared for males and was reducedsignificantly for females.For males, the multilevel logit model revealed a higherordered association between age and location of bar, club andpubs, meaning that males who pre-drink before a night outattend venues where people on average are younger. It alsoshowed that students, compared to the employed, were morelikely to report pre-drinking and that for each time that themales felt intoxicated during the preceding 30 days, thelikelihood of pre-drinking also increased. Females, however,were more likely to pre-drink if they were younger, andfemales partying in the military town were more likely to predrinkthan their London counterparts. Frequent intoxicationduring the preceding 30 days also increased the likelihood offemales’ pre-drinking larger quantities before a night out.The Poisson models, shown in Table 3, estimate whethersociodemographic, socioeconomic status and pre-drinkingmotives influence how many units of alcohol, males andfemales consume when they pre-drink before an event-

6 J. Østergaard & S. B. Andrade J Subst Use, Early Online: 1–10Table 3. Results for multilevel Poisson models results for predictors of number of alcohol units when pre-drinking (Y 2 ).J Subst Use Downloaded from informahealthcare.com by 80.198.89.98 on 07/15/13For personal use only.MalesFemalesI II I IIIRR Std. IRR Std. IRR Std. IRR Std.Locational levelRegional areaLondon Ref. Ref. Ref. Ref.University city 0.483** (0.181) 0.457*** (0.163) N.S. – N.S. –Seaside town 0.544** (0.174) 0.568* (0.174) N.S. – N.S. –Military town N.S. – N.S. – N.S. – N.S. –Average age on location 0.869*** (0.047) 0.861*** (0.045) 0.907* (0.048) 0.899** (0.047)Individual levelAge N.S. – N.S. – N.S. – 1.042** (0.020)OccupationStudent Ref. Ref. Ref. Ref.Employed N.S. – N.S. – N.S. – 1.211* (0.132)Unemployed 1.313* (0.215) 1.372** (0.229) 0.340**** (0.079) 0.393**** (0.094)EducationUpper secondary Ref. Ref. Ref. Ref.Diploma/Bachelor 0.834** (0.065) N.S. – 0.540**** (0.055) 0.551**** (0.056)Graduate degree N.S. – N.S. – 0.684** (0.124) N.S. –Secondary N.S. – N.S. – 0.759** (0.098) 0.671*** (0.091)IncomeLess £1200 Ref. Ref. Ref. Ref.£1200-1799 N.S. – 0.744*** (0.096) 0.759*** (0.078) N.S. –£1800-3000 N.S. – 0.691*** (0.102) 0.487**** (0.077) 0.503**** (0.087)Above £3000 0.783** (0.099) 0.563**** (0.084) N.S. – N.S. –Times drunk 1.021** (0.009) 1.024*** (0.009) N.S. – N.S. –Clubbing 1.124** (0.046) 1.159*** (0.050) N.S. – N.S. –MotivesSave money Ref. Ref. Ref. Ref.Out of control N.S. – N.S. – 3.025**** (0.429) N.S. –To be social 0.741**** (0.063) N.S. – N.S. – 0.688** (0.110)Not go out sober 0.662** (0.093) N.S. – N.S. – N.S. –Part of going out N.S. – 1.500*** (0.214) 1.312*** (0.168) 1.490** (0.273)No motive N.S. – N.S. – 0.427*** (0.179) 0.413* (0.211)Motive incomeSave money low income Ref. Ref.Out of control low income N.S. – 3.610*** (1.379)To be social low income 0.627*** (0.104) 1.764*** (0.360)Not go out sober low income N.S. – N.S. –Part of going out low income 0.438**** (0.086) N.S. –No motive low income N.S. – N.S. –Obs. 156 156 123 123Number of groups 26 26 24 24Obs. per group avg. 6.1 6.1 5.2 5.2MIRR (before/after) 1.629/1.577 1.629/1.532 1.443/1.527 1.443/1.512*p 5 0.10; **p 50.05; ***p5 0.01; ****p 5 0.001.specific night out. To test for a heterogeneous effect of youngpeople’s motives and income level, we estimated twomultilevel Poisson models for each gender: one without(model I) and one with (model II) the interaction termbetween motives and low income.We follow Rabes-Hesketh & Skrondal (2008) and calculatethe median incidence rate ratio (MIR), which measures theheterogeneity of the amount of alcohol that young people predrink,depending on the club or bar. Less heterogeneity meansthat less variation in young people’s quantities is due tosample selection at the bars and clubs. When we included theexplanatory variable in model I, the heterogeneity in drinkingpatterns amongst males’ MIR decreased from 1.629 to 1.577,whilst amongst the females the MIR increased from 1.443 to1.527. In model II (with the interaction term), the MIRdecreased for males to 1.532 and for females to 1.512. Alikelihood ratio (LR) test between model I and II showed thatmodel II gave the best fit for both males ( 2 ¼ 20.77,p50.000) and females ( 2 ¼ 25.22, p50.000). We thereforeinterpret the result from model II but evaluate the coefficientsagainst model I to see the influence of heterogeneous effects.For both males and females we found that bars, clubs andpubs characterized by a higher average age had participantswho pre-drank fewer units before their night out. Themultilevel Poisson model II for males showed that city/town, occupation, income, frequency of intoxication, frequencyof clubbing, income level and motive influenced howmany standard units that males pre-drank on the night of theinterview. Unemployed males pre-drank more units than malestudents. Males earning less than £1200 a month pre-drankmore units than males earning between £1200 and £1799,between £1800 and £3000 and much more than those males

DOI: 10.3109/14659891.2013.784368 Pre-drinking and motives 7J Subst Use Downloaded from informahealthcare.com by 80.198.89.98 on 07/15/13For personal use only.earning above £3000 a month. Males going out in Londonpre-drank more units before a night out than males interviewedin the university or seaside town. Frequent clubbingand intoxication during the preceding 30 days also increasedthe likelihood of males’ pre-drinking excessively before anight out.Pre-drinking was also highly influenced by the males’motives. Model I showed that males who pre-drank to besocial consumed less alcohol than males who pre-drank tosave money. Model II, however, suggested that this resultapplied only to low-income males. Thus, lower-earning (lessthan £1200 a month) males whose main pre-drinking motivewas to save money would pre-drink larger quantities thanlower-earnings males whose primary pre-drinking motive wasthe desire to be social. Lower-earning males also differedfrom other males, because when lower-earning males’ mainpre-drinking motive was driven by their viewing pre-drinkingas part of going out rather than as a way to save money, theywould pre-drink fewer quantities. In contrast, other maleswould pre-drink larger quantities if their pre-drinking motivewas that pre-drinking was part of going out.The multilevel Poisson model II for females showed thatthe number of units they consumed before a night out wasattributable to their age, occupation, education, income andmotivation. Female students would pre-drink larger quantitiesthan the unemployed females but fewer units than employedfemales. Females with an upper secondary educationconsumed larger quantities than females with either a nationaldiploma/bachelor degrees or females who had completedsecondary education. Females earning less than £1200 amonth pre-drank more units than females with higher incomes(between £1800 and £3000).As with the males, we found heterogeneous effects forfemales when including the interaction between low-incomeand pre-drinking motives. Both models I and II showed thatfemales consumed larger quantities of alcohol if their primarymotive for pre-drinking was that it was part of going out asopposed to saving money. However, whilst model I showedthat females whose main pre-drinking motive was to becomeout of control were more than three times as likely to drinklarger quantities than females whose primary motive wassaving money, model II showed that this effect applied only tolower-earning females. Lower-income females who reportedthat their main pre-drinking motive was to be social were alsomore likely to consume more units than those who pre-drankto save money.DiscussionThe finding from our event-specific survey collected in 26 barsand clubs in four different regions of the UK showed that morethan half of the females and males pre-drank before their nightout, and that when they pre-drank, they consumed an average ofabout 7–10 standard units of alcohol within one to two hours.Thus, even before they began their night out, these youngpeople by far exceeded the UK government’s recommendedsafe limit for alcohol consumption (for males no more than 3 to4 units of alcohol per day and for females no more than 2 to 3units per day (Robinson & Harris, 2011)). According to theyoung people interviewed in the survey, the most popularreason for pre-drinking on an event-specific night out is to savemoney. Thus, our finding corroborates with previous qualitativestudies, in which young people explain that their predrinkingprimarily concerns saving money by not having to buyexpensive alcohol later in the evening.We used a multi-level Poisson model to examine whetherwhen we control for socioeconomic status the quantities thatyoung people pre-drink on an event-specific night out areactually motivated by saving money. The results showed thatif lower-earning males loaded themselves with alcohol beforea night out, their motivation was clearly to save money. Thisfinding most likely results from their lacking the means toparticipate – but still having the interest in participating – inintoxication-led drinking practices on-premises. If, however,lower-earning males considered pre-drinking as a part ofgoing out or a way to be social, they would pre-drink less thanthose who identified with saving money as their mainmotivation. In contrast, males at a higher income scale predrinkheavily because they consider it part of going out.This finding suggests that the pre-drinking phenomenon isstrongly embedded in bar and club culture, where participatingwithout drinking to intoxication is difficult for males.Financially better-off males may drink heavily prior to anight out because they find it the way to start their night out.But males who lack the funds – either because they areunemployed or they earn less than £1200 a month – and wantto take part in this determined drunkenness are very aware ofhaving to pre-drink to reach a sufficient level of intoxicationwithout having to spend too much money on buying alcoholin bars and clubs.Amongst the females, pre-drinking heavily was notmotivated by saving money, because lower-earning females’consumption of larger alcohol quantities was motived by theirwanting to become out of control or to be social. Females alsopre-drank heavily if they considered pre-drinking as part ofgoing out. However, in contrast to our findings for lowerearningmales, our study found no reduced effect on lowerearningfemales’ alcohol consumption when they considereddoing so as part of going out as opposed to saving money.Thus, the interpretation of the result amongst females is lessobvious, and the complexity is heightened by the inclusionof older females and employed females – not the younger orthe unemployed females who pre-drink heavily. So althoughfemales’ consumption of larger quantities of alcohol before anight out is also associated with their low-income level, theirmotivation is more likely connected not with their beingunemployed but with their being in lower-paying jobs(probably a result of their low educational level) wheredetermined drunkenness has become the expected way ofsocialising with friends.This article also reveals that socioeconomic statuscontributed very little to explaining why some young peopleengage in the practice of pre-drinking before a night out. Formales pre-drinking was more popular amongst students, andfor females participating in pre-drinking was related to beingyounger. However, for both males and females, frequency ofintoxication was associated with the practice of pre-drinking,thus suggesting that pre-drinkers may have a higher overallconsumption of alcohol. The different impact of sociodemographicand socioeconomic status in explaining who

8 J. Østergaard & S. B. Andrade J Subst Use, Early Online: 1–10J Subst Use Downloaded from informahealthcare.com by 80.198.89.98 on 07/15/13For personal use only.the pre-drinkers are, as opposed to how much alcohol the predrinkersconsume, suggests that policy measurement tacklingthe pre-drinking phenomenon may need to formulateprogrames that distinguish between targeting the prevalenceand targeting the amount of alcohol that young peopleconsume when pre-drinking. In targeting the prevalence ofpre-drinking, public measures could be aimed at reducing theoverall frequency of drinking (intoxication) amongst theyoungest drinkers (e.g. those in secondary schools). Inreducing the amount of alcohol, young people consumewhen pre-drinking, a combination of price policy (Boothet al., 2008) and programes directed at changing youngpeople’s belief that pre-drinking is part of going out could beone method of reducing the amount of alcohol consumed on anight out.In March 2012, the UK government suggested aminimum alcohol price of 40 pence per unit in off-licensedstores in England (Home Office, 2012). Although inNovember, it was raised to 45 p per unit, from the verybeginning the practice was strongly criticized by academics,who argued that a minimum alcohol price of 50 p a unit, asintroduced in Scotland, is necessary for a significant impact(Adams & Beenstock, 2012). Our study points in thedirection that increased off-premises prices would mostaffect young people with less income, particularly the males,as both their lower socioeconomic position and personalmotive of saving money drives them to pre-drink largequantities. According to our findings, increased off-premisesprices may have a slightly different effect on the females’pre-drinking pattern, because it is not driven by personalmotives of saving money and because the heavy pre-drinkingfemales are older and already in the labor market, albeit aslower earners. Furthermore, minimum off-licensed pricingmay have a limited effect amongst wealthier young peoplewho pre-drink heavily, because pre-drinking is their way ofstarting an evening out and because they have the financialmeans for achieving determined drunkenness in bars, pubsand clubs.One UK study, found that alcohol price regulationson-licensed and off-licensed have different effects on moderateand heavily drinking youth (Meier et al., 2010). Whereincreased off-licensed alcohol prices did not producedecreased consumption among heavily drinking youth,increased on-licensed prices resulted in reduced consumptionamongst heavily-drinking youth but had no effect onmoderately-drinking youth. Moreover, a recent study of 40European and North American countries suggests that wherealcohol prices are high, young people may drink lessfrequently on weekdays, but during weekends they drink toachieve determined drunkenness (Gilligan et al., 2012). Thus,raising minimum prices off-premises may not prevent youngpeople from spending a larger proportion of their income ondrinking to intoxication. If on-premises prices remainunchanged, lower-earning males and females may have aneven stronger inclination to load themselves with as muchalcohol as possible before a night out, resulting in their goingto the bars and clubs in a state of high intoxication andincreasing the likelihood of physical injuries, public disturbanceand property damage, unwanted encounters with thepolice and violence.Furthermore, previous research suggests that pre-drinkersdo not reduce their alcohol intake on-premises (Pedersen &LaBrie, 2007). In a recent study from Switzerland whereyoung people were monitored through innovative mobilesurveys, researchers found ‘‘that alcohol consumption wasalmost twice as high on pre-drinking evenings as on eitheroff- or on-premises-only evenings’’ (Labhart et al., 2013,p. 6). Thus, if a person pre-drinks before a night out, doing soincreases the total amount of alcohol drinking during thenight out because the pre-drinker does not subsequentlyreduce his or her alcohol intake on-premises.One limitation of this study is that we did not examine howthe pre-drinkers continue to drink during their night out, ascompared to non-pre-drinkers. Although our results suggestthat heavy pre-drinking males are also more frequentlyintoxicated, we have not included information on whetherthey also drink intensively when they are at bars or clubs, orwhether their night out might end earlier than for those whodo not pre-drink. Thus, the question of whether heavy predrinkers’total alcohol consumption on a night out is heavierthan that of light pre-drinkers or non-pre-drinkers remainsto be answered by studies that can measure young people’stotal alcohol consumption, including when their night comesto a close.Another limitation of our study is that it is a non-randomsample and that overly intoxicated respondents were notapproached for interview. However, to minimize any possibleselection bias, we applied a multilevel model that significantlyreduced the location-specific variance in the youngpeople’s pre-drinking patterns. This design enabled us toaccount for drinking patterns specific to the city and the bar orclub, including whether the guests were predominatelyyounger or older. Furthermore, information from highlyintoxicated people could create inaccurate measurements,because very intoxicated people likely remember neither howmany drinks they consumed pre-drinking nor the times theystarted and stopped pre-drinking. Approaching highly intoxicatedpeople would also be unethical and could createunnecessary danger for the researchers conducting theinterviews. However, had we been able to obtain accurateinformation on highly-intoxicated people’s alcohol consumption,it would most likely have increased young people’saverage pre-drinking units and also enhanced socioeconomicdifferences of the alcohol intake.A third limitation of our study is that young people mayhave reported motives that corresponded best to their drinkinghabits on the night of the interview. For example, femalesheavily intoxicated on the night of the interview might havebeen more inclined to answer that their overall motive for predrinkingwas to get wasted or out of control because thesemotives corresponded to their experiences on that particularnight. Similarly, lower-earning males who responded thattheir main pre-drinking motive was to be social may haveidentified most strongly with that particular reason because itwas what they did on the particular night they were askedabout it and because they were not drinking intensively.Future studies could benefit from the comparison ofintentional pre-drinking motives collected in national representativesurveys in which young people are asked aboutevent-specific nights out. This way, varied insights into

DOI: 10.3109/14659891.2013.784368 Pre-drinking and motives 9J Subst Use Downloaded from informahealthcare.com by 80.198.89.98 on 07/15/13For personal use only.whether young people’s pre-drinking motives depend on themain event of the evening could also be established. However,analyses based on national representative surveys may sufferfrom recall bias and miscalculation and, as research suggests(Del Boca & Darkes, 2003), may result in reduced estimatesof alcohol consumption. Finally, future studies should examinewhether the pre-drinking phenomenon in other countriesis associated with lower income and with young people’sinterests in participating in an intoxicated-related drinkingculture.AcknowledgementsDr Østergaard would like to thank Professor Fiona Meashamand Lecturer Karenza Moore for theoretical and methodologicalinsights into conducting on-site surveys in the night-timeeconomy.Declaration of interestThe authors report no conflicts of interest. The authors aloneare responsible for the content and writing of this article.This work was supported by grants from The DanishCouncil for Independent Research (DFF) and by SFI – TheDanish National Centre for Social Research.ReferencesAdams, J., & Beenstock, J. (2012). Price discounts on alcohol in a city inNorthern England. Alcohol and Alcoholism, 47, 187–190.Booth, A., Meier, P., Stockwell, T., Sutton, A., Wilkinson, A., & Wong,R., (2008). Independent Review of the Effects of Alcohol Pricing andPromotion. Part A: Department of Health.Borsari, B., Boyle, K. E., Hustad, J. T. P., Barnett, N. P., O’LearyTevyaw, T., & Kahler, C. W., (2007). Drinking before drinking:Pregaming and drinking games in mandated students. AddictiveBehaviors, 32, 694–705.Brain, K., Parker, H., & Carnwath, T. (2000). Drinking with design:Young drinkers as psychoactive consumers. Drugs EducationPrevention & Policy, 7, 5–20.Caldwell, T. M., Rodgers, B., Clark, C., Jefferis, B. J., Stansfeld, S. A., &Stansfeld, C., (2008). Lifecourse socioeconomic predictors of midlifedrinking patterns, problems and abstention: Findings from the 1958British Birth Cohort Study. Drug Alcohol Dependence, 95, 269–278.Casswell, S., Pledger, M., & Hooper, R. (2003). Socioeconomic statusand drinking patterns in young adults. Addiction, 98, 601–610.Chatterton, P., & Hollands, R. (2002). Theorising urban playscapes:Producing, regulating and consuming youthful nightlife city spaces.Urban Studies, 39, 95–116.Cooper, M. L. (1994). Motivations for alcohol use amongst adolescents:Development and validation of a four-factor-model. PsychologicalAssessment, 6, 117–128.Cox, W. M., & Klinger, E. (1988). A motivational model of alcohol use.Journal of Abnormal Psychology, 97, 168–180.Cronce, J., & Larimer, M. (2011). Individual-focused approaches to theprevention of college student drinking. Alcohol Research & Health,34, 210–221.DeJong, W., & DeRicco, B. (2010). Pre-gaming: An exploratory study ofstrategic drinking by college students in Pennsylvania. The Journal ofAmerican College Health, 58, 307–316.Del Boca, F. K., & Darkes, J. (2003). The validity of self-reports ofalcohol consumption: State of the science and challenges for research.Addiction, 98, 1–12.Edwards, G., Hensman, C., & Peto, J. (1973). A comparison of femaleand male motivation for drinking. The International Journal of theAddictions, 8, 577–587.Eurobarometer. (2004). Young People and Drugs, Flash Eurobarometer158. June 2004. Available from: http://ec.europa.eu/public_opinion/flash/fl158_en.pdf [last accessed 5 May 2012].Eurobarometer. (2007). Attitudes Towards Alcohol. Eurobarometer 66.2.March 2007. Available from: http://ec.europa.eu/health/ph_determinants/life_style/alcohol/documents/ebs272_en.pdf [last accessed 5May 2012].Forsyth, J. M. (2010). Front, side, and back-loading: Patrons rationalesfor consuming alcohol purchased off-premises before, during or afterattending nightclubs. Journal of Substance Abuse, 15, 31–41.Gilligan, C., Kuntsche, E., & Gmel, G. (2012). Adolescent drinkingpatterns across countries: Associations with alcohol policies. Alcoholand Alcoholism, 48, 1–6.Gire, J. T. (2002). A cross-national study of motives for drinking alcohol.Substance Use & Misuse, 37, 215–223.Glindemann, K. E., Ehrhart, I. J., Maynard, M. L., & Geller, S. (2006).Alcohol front-loading amongst college students: Exploring the needfor prevention intervention. Journal of Alcohol & Drug Education, 50,5–13.Grazian, D. (2007). The girl hunt: Urban nightlife and the performance ofmasculinity as collective activity. Symbolic Interaction, 30, 221–243.Hadfield P, Noga H, Large J, & Jones R. (2010). Visitor Drinking, LatenightRefreshment and Transportation in the Camden Special PolicyAreas: Final Report to the London Borough of Camden. August 2010.Available from: http://www.camden.gov.uk/ccm/navigation/business/business-regulations/licensing-andpermits/general-licensing-information/[last accessed 5 May 2012].Hammersley, R. (2005). Unthinking drinking. The Scottish Journal ofCriminal Justice Studies, 11, 64–79.Hammersley, R., & Ditton, J. (2005). Binge or bout? Quantity and rate ofdrinking by young people in the evening in licensed premises. DrugsEducation Prevention & Policy, 12, 493–500.Home Office. (2012). The Government’s Alcohol Strategy. HMGovernment. Drugs and Alcohol Unit. Available at: http://www.homeoffice.gov.uk/publications/alcohol-drugs/alcohol/alcoholstrategy?view¼Binary[last accessed 5 May 2012].Hughes, K., Anderson, Z., Morleo, M., & Bellis, M. A., (2007). Alcohol,nightlife and violence: The relative contributions of drinking beforeand during nights out to negative health and criminal justiceoutcomes. Addiction, 103, 60–65.Hughes, K., Quigg, Z., Bellis, M., Van Hasselt, N., Calafat, A., Kosir,M., Juan, M., Duch, M., & Voorham, L., (2011). Drinking behavioursand blood alcohol concentration in four European drinking environments:A cross-sectional study. BMC Public Health, 11, 918–929.Jefferis, B. J. M. H., Manor, O., & Power, C. (2007). Social gradients inbinge drinking and abstaining: Trends in a cohort of British adults.Journal of Epidemiology & Community Health, 61, 150–153.Jung, J. (1977). Drinking motives and behavior in social drinkers.Journal of Studies on Alcohol, 38, 944–952.Kuntsche, E. N., Knibbe, R., Gmel, G., & Engels, R. (2005). Why doyoung people drink? A review of drinking motives. ClinicalPsychology Review, 25, 841–861.Laatikainen, T., Manninen, L., Poikolainen, K., & Vartiainen, E. (2003).Increased mortality related to heavy alcohol intake pattern. Journal ofEpidemiology & Community Health, 57, 379–384.Labhart, F., Graham, K., Wells, S., & Kuntsche, S. (2013). Drinkingbefore going to licensed premises: An event-level analysis ofpredrinking, alcohol consumption and adverse outcomes.Alcoholism: Clinical and Experimental Research, 37, 284–291.LaBrie, J. W., Hummer, J.. Kenney, S., Lac, A., & Pedersen, E.,(2011). Identifying factors that increase the likelihood for alcoholinducedblackouts in the prepartying context. Substance Use &Misuse, 46, 92–1002.LaBrie, J. W., & Pedersen, E. R. (2008). Prepartying promotesheightened risk in the college environment: An event-level report.Addictive Behaviors, 33, 955–959.Measham, F. (2006). The new policy mix: Alcohol, harm minimisationand determined drunkenness in contemporary society. InternationalJournal of Drug Policy, 17, 258–268.Measham, F., & Brain, K. (2005). ‘Binge’ drinking, British alcoholpolicy and the new culture of intoxication. Crime, Media, Culture, 1,262–283.Measham, F., Moore, K., & Østergaard, J. (2011a). Mephedrone,‘Bubble’ and unidentified white powders: The contested identities ofsynthetic ‘legal highs’. Drugs and Alcohol Today, 11, 137–147.Measham, F., Moore, K., & Østergaard, J. (2011b). Emerging DrugTrends in Lancashire. Night Time Economy Surveys. Phase OneReport. Lancaster University and Lancashire Drug and Alcohol

10 J. Østergaard & S. B. Andrade J Subst Use, Early Online: 1–10J Subst Use Downloaded from informahealthcare.com by 80.198.89.98 on 07/15/13For personal use only.Action team. April 2011. Available from: http://www.ldaat.org/files/emerging_trends_report.pdf [last accessed 5 May 2012].Meier, P. S. (2011). Alcohol marketing research: The need for a newagenda. Addiction, 106, 466–471.Meier, P. S., Purshouse, R., & Brennan, A. (2010). Policy options foralcohol price regulation: The importance of modelling populationheterogeneity. Addiction, 105, 383–393.Neighbors, C., Walters, S. T., Lee, C. M., Vader, A. M., Vehige, T.,Szigethy, T., & DeJong, W., (2007). Event-specific prevention:Addressing college student drinking during windows of risk. AddictiveBehaviors, 32, 2667–2680.Németh, Z., Kuntsche, E., Urban, R., Farkasi, J., & Demetrovics, Z.,(2011). Why do festival goers drink? Assessment of drinking motivesusing the DMQ-R SF in a recreational setting. Drug and AlcoholReview, 30, 40–46.Pedersen, E. R., & LaBrie, J. (2007). Partying before the party:Examining prepartying behavior amongst college students. Journal ofAmerican College Health, 56, 237–245.Pedersen, E. R., LaBrie, J., & Kilmer, J. R. (2009). Before you slip intothe night, you’ll want something to drink: Exploring the reason forprepartying behavior amongst college student drinkers. Issues inMental Health Nursing, 30, 345–363.Purcell, J., & Graham, K. (2005). A typology of Toronto nightclubs at theturn of the millennium. Contemporary Drug Problems, 32, 131–167.Rabes-Hesketh, S., & Skrondal, A. (2008). Multilevel and LongitudinalModeling Using Stata (2nd ed). College Station, TX: Stata PressPublication.Ravn, S. (2010). Natklubber og stofbrug. In: Järvinen, M., Demant, J.,Østergaard, J., (Eds.), Stoffer og natteliv (pp. 49–75). Copenhagen:Hans Reitzels.Ritchie, C., Ritchie, F., & Ward, R. (2009). A good night out: Alcoholrelated behaviours in young adults. Worldwide Hospitality andTourism Themes, 1, 169–193.Robinson S, & Harris H. (2011). Smoking and Drinking Amongst Adults.A Report on the 2009 General Lifestyle Survey. London: Office forNational Statistics. Available from: http://www.statistics.gov.uk/downloads/theme_compendia/GLF09/GLFSmoking-DrinkingAmongstAdults2009.pdf [last accessed 5 May 2012].Wells, S., Graham, K., & Purcell, J. (2008). Policy implications of thewidespread practice of ‘pre-drinking’ or ‘pre-gaming’ before going topublic drinking establishments – Are current prevention strategiesbackfiring. Addiction, 104, 4–9.Wells, S., Graham, K., & Purcell, J. (2009). Commentary: When theobject is to get drunk, pre-drinking matters. Addiction, 104, 11–12.Wilsnack, R. W., Vogeltanz, N. D., Wilsnack, S. C., &Harris, TR. (2000). Gender differences in alcohol consumptionand adverse drinking consequences: Cross-cultural patterns.Addiction, 95, 251–265.