See

discussions, stats, and author profiles for this publication at:

https://www.researchgate.net/publication/232490913

Drinking games in the college

environment: A review

Article in Journal of alcohol and drug education September 2004

CITATIONS READS

79 865

1 author:

Brian Borsari
University of California, San Francisco
122 PUBLICATIONS 4,633 CITATIONS

SEE PROFILE

Some of the authors of this publication are also working on these

related projects:

R01AA015518: Stepped Care for Mandated Students View

project

NIAAA R21: Technical, Relational, and Conditional Process

Model of MI Efficacy - Meta-Analysis View project

All content following this page was uploaded by Brian Borsari on 31 March 2015.

The user has requested enhancement of the downloaded file.

 DRINKING GAMES

Drinking Games in the

College Environment: A Review

Brian Borsari
The Centerfor A.kohol and Addiction Studies
Bronm University

Abstract
Drinking games among American college students, although popular,
contribute significantly to excessive drinking and alcohol-related problems.
Drinkinggames appear tofacilitate sodali^tion, and are especially preva-
lent amongjounger students. This article reviews the qualitative and quan-
titative research on drinkinggames. Findingsfrom qualitative studies sug-
gest that students participate in drinking games to intoxicate themselves
and others, to facilitate sodali^tion, and for competition. Quantitative
studies have identified motives for initiating and stopping drinkinggames,
as well as age and gender differences in participation, ^search findings
highlight the importance of educating students about therisksassociated
with playing drinkinggames. Specifically, students should be alerted about
the heightened risk of extreme intoxication and consequences that can
result from playing drinking games. Women are at particular risk for
experiencing sexual assault in the drinking game context. Alternative
socialisation opportunities should be provided to the students to counteract
the inherent social advantages of drinking game participation.

29
30 DRINKING GAMES

DRINKING GAMES IN THE

COLLEGE ENVIRONMENT: A REVIEW

D
ritiking games have emerged as a considerable influence on
college alcohol use in the past 20 years. They have become
increasingly popular since the 1950s and 1960s (Douglas,
1987), and have been the subject of books (Griscom, Rand, Johnson
& Rand, 1988) and even television shows (Vranica, 2002). Currently,
there are well over 150 different drinking games popular on college
campuses, and prevalence estimates of self-reported drinking game
participation in the past month range from 47% to 62% (Borsari,
Bergen-Cico & Carey, 2003; Johnson, Wendel & Hamilton, 1998;
Nagoshi, Wood, Cote & Abbit, 1994). Drinking games all have a
common goal: to get the participants intoxicated (Douglas, 1987;
Green & Grider, 1990; Newman, Crawford, & NeUis, 1991). Refusal
to drink during a game frequently results in heckling and disapproval
from fellow players. As a result, large quantities of alcohol are often
consumed by players (Green & Grider, 1990).

Research on drinking games indicates that they contribute sig-

nificantly to the heavy college drinking that has generated a great
deal of concern over the past decade. Excessive alcohol use on col-
lege campuses increases the chances of accidents and fatalities, and
results in destructive behaviors such as damaging property, interper-
sonal conflicts (e.g., arguments or fights), and risky or unplanned
sexual activity. In addition, students that drink heavily often miss
more classes, fall behind in schoolwork, and receive poor grades
(see Perkins, 2002, for a review of alcohol-related consequences).
The students that must share the college environment with such
heavy drinkers also experience problems ranging from minor incon-
veniences such as having their sleep or studies disturbed to such
criminal acts as sexual assault (Wechsler, Dowdall, Maenner, GledhiU-
Hoyt & Lee, 1998).

Overall, the adverse effects of heavy alcohol use on college cam-

puses necessitated the formation of a National Task Force on College
 DRINKING GAMES 31

Drinking comprised of researchers, educators and students (National

Institute of Alcohol Abuse and Alcoholism, [NIAAA], 2001a, 2001b).
After a detailed review of the literature on college drinking, the Task
Force recommended that more research be performed on individual
level factors (e,g,, drinking game participation) that "are potentially
modifiable [and] use this information to point to opportunities for
intervention" (NIAAA, 2001a, p, x). This review of qualitative and
quantitative research adheres to the Task Force's recommendation in
three ways. First, qualitative research provides a detailed description
of popular drinking games as well as frequently cited reasons for play-
ing. Second, quantitative research demonstrates the unique influence
of drinking games on college student drinking and alcohol-related
consequences, as well as the motives and interpersonal differences
associated with game participation. Third, specific recommendations
are provided for educating students about the risks associated with
drinking games. Promising areas for future research are also discussed.
It is hoped that this review will both educate the reader regarding
drinking games and provide information to be used in interventions
aimed at reducing game participation.

Standard literature search techniques were utilized to conduct

an exhausdve search for studies evaluating drinking games. Specifi-
cally, on-line computer searches of Psychlit, Psychlnfo and PubMed
were performed using the Boolean combinations of the words alcohol,
college, student, drinking, and games. Ancestry and descendancy
approaches were also used, in addition to correspondence with
researchers active in the domain (the "invisible coUege"; see MuUen,
1989 for literature search techniques). Articles published as of Feb-
ruary 2004 were eligible for inclusion. The literature search located
seven qualitative (Douglas, 1987; Dundes & Pagter, 1975; Green &
Grider, 1990; Martin & Hummer, 1989; Newman et al., 1991; Rabow
& Duncan-Schill, 1994; West, 2001) and twelve quantitative (Adams
& Nagoshi, 1999; Borsari et al, 2003; Clapp et al., 2003; Engs, Diebold
& Hanson, 2001; Engs & Hanson, 1993; Johnson, 2002; Johnson &
Cropsey, 2000; Johnson, Hamilton & Sheets, 1999; Johnson et al.,
1998; Johnson & Sheets, in press; Nagoshi et al, 1994; Pederson,
1990) articles on drinking games.
32 DRINKING GAMES

QUALITATIVE RESEARCH
Interviews with students have revealed a number of common
themes about drinking games and tbeir participants. Through this
literature, information has been gathered about the types of games
students play and the social environment in which drinking games
occur. In all drinking games, participants can consume a large amount
of alcohol in a short time. Once players start consuming alcohol,
their cognitive and motor processes are affected; as a result, they
start making mistakes repeatedly, and in turn drink more and more
alcohol. The process has been labeled the "reversal of competence"
the longer the game is played, players become more intoxicated,
decreasing their skills (Green & Grider, 1990, p. 129). This process
can result in players consuming larger amounts of alcohol than
intended.

Types of Games
Drinking games can be classified according to their unique fea-
tures and tend to fall into the following six categories: motor skills,
verbal skills, gambling games, media games, team games, and con-
sumption games (for more detailed descriptions of a variety of games,
see Green & Grider, 1990; Griscom et al., 1988; Griscom, Rand,
Johnson & Balay, 1994).
Motor skills. In these games, certain motor tasks have to be
performed. Failure to do the task adequately results in being forced
to drink alcohol. For example. Quarters requires the player to bounce
a quarter into a shot glass. The student's failure to flip quarters into
the glass at the required pace results in having to drink. Other
examples of skill games include chandeliers., thumper., and cardinalpuff.

Verbal skills. These games require the players to repeat long

sequences of nonsense words or difficult phrases, which become
more difficult to do as the individual becomes more intoxicated. For
example. Animal is played by having the players go around a circle,
repeating a certain phrase. If everyone is able to say tbe phrase
without error, a new (and more difficult) phrase is added. If a player
 DRINKING GAMES 33

makes a mistake on any of these phrases, he or she must drink and

the recital starts again. There may be regional differences in the
phrases, but the rules remain the same. Other examples of verbal
skill games include add-a-word, fu^ duck, and the name game.

Gambling games. One of the more common types of drinking

games, gambling games are based on chance and use cards or dice.
Often, the stakes of the game are the amounts one has to drink.
Winners of the game do not have to drink; losers must consume a
pre-determined amount (e.g., a chug, sip or shot glass fuU of beer).
Because chance is often an integral part of the game, it can be difficult
to avoid becoming intoxicated. A common gambling game is three
man, in which two dice are used. The game starts with one person
rolling the dice undl someone rolls a three. This person is designated
the three man, and continues to roU the dice. The three man must
drink whenever a 3 is rolled: this is a very risky position to be in, as
there may be many consecutive rolls when one of the dice is a 3.
Every time the numbers on the dice equal 7, the person on the right
of the roller drinks. If they equal 11, the person on the left of the
roller drinks. Rolling doubles allows the roller to choose someone to
drink. Double 3's require the person designated as the three man to
drink twice, and the roller can make someone else drink. The three
man's turn continues undl no one is made to drink; then, the dice
are passed to the person on the right. The person who is three man
continues to be so undl he or she rolls a three; then the next person
to roU a 3 becomes the new three man. Such dice games have a long
history of being played in bars (Dundes & Pagter, 1975). Other
gambling games include up and down the river,presidents, kings, beer checkers,
and beer hunter.

Media games. These games tend to be more passive than other

drinking games, requiring the pardcipants to drink at a certain cue in
a movie or song. For example, in "Hi Bob," students watch the Bob
Newhart Show and must drink whenever a character says "Pli, Bob."
Media games can also involve songs. In have a drink on me, pardcipants
drink whenever the phrase "have a drink on me" is sung in the song
of the same dtle by AC/DC (which totals 20 drinks in four minutes).
34 DRINKING GAMES

Almost any song or movie can be adapted to this type of drinking

game; all one needs is a key word or phrase.
Team games. These types of drinking games pit two or more
teams of pardcipants against each other, usually in a very raucous
atmosphere. Perhaps the most popular game on college campuses
at this dme is beer pong (or Beirut). This game is played on college
campuses around the country, and there are over 100 websites devoted
to explaining the rules and even providing "official" equipment. There
are many variadons of this game, but the basic premise involves
playing ping-pong (with or without a paddle) with cups of beer on
the table. When a ball hits a cup (or goes in), the player must drink
the contents of the cup. As cups are empded, they are removed
from the table the first team to have all its cups removed loses the
game.

Consumption games. These games do not have much strategy

or rules; instead, they are designed to make the student drink as
much alcohol as possible in the shortest amount of dme. For example,
in the 100 Minute Club, pardcipants are required to drink one shot of
beer every minute for 100 minutes; most often, individuals drop out
as they vomit, become too bloated, or pass out. Chug-offs, shotguns,
beer bongs, and 100 Beer Club are variadons on this theme.

Reasons for Playing Games

Qualitadve research provides insight about the experience and
modvadons for playing drinking games. Through interviews with
students, four common reasons for playing drinking games emerge:
intoxicadng oneself, intoxicadng others, to meet new people, and
compeddon.
Intoxicating self. Getdng drunk quickly is seen by many players
as advantageous (Newman et al., 1991), and this may be especially
true for individuals that do not enjoy the taste of alcohol. Because
such individuals are often forced to drink quickly (or "slam") their
drinks during games, they do not have much dme to taste their drinks.
However, this drinking often results in getting much drunker than
 DRINKING GAMES 35

originally intended: players observed over a 15 minute period

consumed twice as much alcohol (18 oz,) than non-players (Newman
et al,, 1991),
Getting intoxicated while playing drinking games can happen in
a variety of ways, either through failing at the game (e,g,, reversal of
competence) or being forced to drink considerable amounts. For
example, in team drinking games (e,g,, chug-offi, or boat races), teammates
encourage each other to drink a large quantity of alcohol faster than
the other team. Because players, especially men, take pride in being
able to "hold their liquor" (Green & Grider, 1990), players often
drink much more than they normally would.
Intoxicating others. Many games allow winning players to
"assign" drinks to other players. Therefore, drinking game partici-
pants can combine their efforts by "teaming up" on someone and
forcing him or her to drink great amounts (Newman et al,, 1991),
This can occur for a couple of reasons. First, the player being teamed
up upon may have committed an infraction against another player
in the group. This infraction may not be game-related; it is possible
that issues and conflicts from other areas of Ufe may be avenged
during the drinking game. For example, the player may have boasted
about his or her ability to drink. As a result, the rest of the players
may have decided to challenge that statement by making the indi-
vidual drink repeatedly. Second, newcomers are often made to drink
as an initiation to game play. As they are likely to be more sober than
the other participants, so they will often be made to drink in order
to "catch up" to the others. To accomplish this, other players will
often assign drinks to new players. Some games even require the
new player to be the focus of attention. For example, in three man,
new players must roll the dice, increasing the odds that they will
have to consume a considerable amount of alcohol before passing
the dice to the next player.

Motives to get other players intoxicated may be more malevolent:

anecdotal evidence suggests that players have, on occasion, gotten
female players drunk in order to facilitate sexual contact (Newman et
36 DRINKING GAMES

al., 1991). In a study on fraternity rape on campus, Martin and Hum-

mer (1989) noted that alcohol was often used as a way to "gain sexual
mastery over women" (p. 264). Drinking games may provide a con-
text for such behavior. There is an established literature linking alco-
hol use and sexual assault in college students (Abbey, 2002), and
purposely getting women drunk in order to have sex is a common
pracdce reported by college rapists (Kanin, 1985; Sanday, 1991). In-
deed, drinking games may be a common way to introduce women to
drinking in college (Douglas, 1987), as there do not appear to be many
reported incidents of all women drinking games. Instead, games tend
to be played in male or nriixed groups (Green & Grider, 1990), and
women are ofiien bystanders (Rhoads, 1995).
Meeting new people. Drinking games appear to provide a
"socially defined drinking pattern" in which students can interact
(Rabow & Duncan-Schill, 1994, p. 55) and students repeatedly
mendon the social advantages of playing (Newman et al., 1991; West,
2001). Inidally, it appears that drinking games are started among
groups of friends that know each other and are familiar with the
rules of the game. A student may know as many as 20 games to be
played with friends or acquaintances at pardes or informal get-
togethers in dormitories or apartments (Douglas, 1987). Due to the
wide variety of games (and accompanying rules), it can be difficult
to start a game among a group of complete strangers. Instead, feUow
partygoers will observe the game and eventually join in.

A specific set of rules is one of the attracdons of drinking games

in social situadons (Douglas, 1987). Such rules allow a group of players
to focus on the game, and not on more personal topics. In addidon,
students report that the hilarity and fun that often result during such
games can foster a low-key and enjoyable atmosphere. As players
become intoxicated, inhibidons tend to be reduced, facilitadng a
sense of friendship and camaraderie. In team games, novices may
be "adopted" by more experienced players, further facilitadng social
integradon. In addidon, should players want to continue to interact
with one another after the game is over, the drinking game experience
provides them with a common topic of conversadon.
 DRINKING GAMES 37

Competition. Drinking games often simulate a competitive

environment, replete with winners, losers and spectators. Although
drinking games are frequently played in mixed groups (Nagoshi et
al., 1994), the most intense competition appears to occur in all-male
contexts. Indeed, there are structured competitions in beer pong,
often involving teams from different campuses. Students that play
drinking games may take them very seriously, even considering them
to be a sport (Douglas, 1987). Winning a drinking game can occur in
two ways. First, participants can actually win the game (e.g., in
gambling games). Second, making the other person drink too much
and rendering them severely intoxicated and incoherent is also viewed
as a victory. However, these two are not mutually exclusive: as a
player gets more intoxicated, the less likely he or she will be able to
win the drinking game. Establishing one's dominance as a drinker is
very desirable to some players, and these games may be a way in
which men can establish their dominance over other players in the
context of a shared, social drinking environment (Green & Grider,
1990; Newman et al., 1991). Men have described drinking games as a
way to "outdo" other players and to impress females, thus establishing
one's masculinity and a maintaining hierarchical power structures in
close groups (e.g., fraternities; West, 2001).

QUANTITATIVE RESEARCH
Quantitative studies have attempted to quantify the relationships
described in the qualitative literature, including the relationship
between drinking game participation and alcohol consumption and
consequences, motives for playing, and interpersonal differences that
may predict those that decide to play.

Drinking Games and Alcohol Consumption

Drinking game participation is consistently related with excessive
alcohol consumption (Clapp et al., 2003). For example, in a large-
scale survey of heavy drinkers (defined for men and women as
38 DRINKING GAMES

consuming five or more drinks at one sitting at least once a week;

= 1028), 94% reported playing drinking games in the past 12
months. In contrast, only 66% of 2802 Hght drinkers (consuming
no more than 3-4 drinks once a week or 5 drinks no more than once
a month) reported playing drinking games during the same period
(Engs & Hanson, 1993), In addition, it appears that even after
controlling for other influences on drinking (e,g,, consumption of
peer group), drinking game participants drink more than other
students (Pedersen, 1990),
Other trends linking game participation to alcohol consumption
are noteworthy. First, men tend to play drinking games more often
than women (Engs et al,, 1996; Engs & Hansen, 1993; Johnson et
al,, 1998; Pedersen, 1990), Second, men and women appear to drink
similar amounts while playing drinking games (Johnson & Sheets, in
press; Nagoshi et al,, 1994), Third, women drink more during drinking
games than during other drinking occasions (Johnson et al,, 1998),
Fourth, younger students also appear to play games more often, and
drink more while playing games, then older students. For example,
Adams and Nagoshi (1999) found that over the course of the
semester, changes in alcohol consumption for students under 19
years old were signiflcandy predicted by participation in drinking
games. This trend was not evident for students over 19, These
findings, combined with the finding that many students arrive at
school with experience playing drinking games (Borsari et al,, 2003),
suggest that students may come to college, experiment with drinking
games, and then moderate their participation.

Drinking Games and Consequences

Participation in drinking games is also associated with a higher
risk of experiencing negative consequences as a result of drinking
(Adams & Nagoshi, 1999; Johnson & Cropsey, 2000), For example,
Engs and Hanson (1993) found that drinking game participation
was associated with the increased experience of a wide variety of
consequences for all students, ranging from getting into trouble with
the law to being criticized by a date. For heavy drinkers, however.
 DRINKING GAMES 39

playing drinking games was associated with more severe consequences

such as getting hangovers, vomiting, missing class because of drink-
ing, damaging property, and getting into a fight. Johnson et al. (1998)
also found that over half the variance predicting adverse conse-
quences from drinking was associated with drinking game participa-
tion. Therefore, drinking game participation significantiy increases
the risk that one will experience alcohol-related problems. For ex-
ample, adolescents charged with drinking under the influence of
alcohol are more likely to report drinking game participation than
non-offenders (Farrow, 1987).

Age and drinking experience may also be an important determi-

nant of risk. In a longitudinal study, a relationship between negative
consequences and drinking game participation was detected only among
students 18 years old and younger (Adams & Nagoshi, 1999). Thus,
consequences resulting from drinking games may be more common
when students first arrive at school, perhaps because many are learn-
ing new games. Then, as students get older, they may become more
responsible drinkers, more proficient at the games, and/or reduce the
frequency of play. Any of these changes would lower the risk of ex-
periencing adverse consequences from drinking game participation.

The consumption of alcohol during drinking games appears to

uniquely contribute to the experience of alcohol-related conse-
quences. For example, Nagoshi et al. (1994) discovered that getting
drunk mediates the relationship between drinking games and alcohol-
related problems. Therefore, simply playing drinking games does
not lead to consequences, but drinking heavily while playing them
does. In addition, hierarchical regression revealed that drinking game
participation was found to predict getting drunk, even with alcohol-
related expectancies, perceived norms, and reasons for drinking
accounted for in the model (Nagoshi et al., 1994). Subsequent research
has confirmed these findings, indicating that "drinking games
appeared more likely than drinking in general to lead to several specific
negative alcohol-related consequences" (Johnson et al., 1998, p. 76).
For example, the percentages of students reporting hangovers were
nearly identical to those reporting playing drinking games.
40 DRINKING GAMES

Motives for Playing Drinking Games

Given the current popularity of drinking games on campus,
efforts have been made to quantify the motives for playing these
games. Surveys have identified motives of typical drinking game
participants. Nagoshi et al. (1994) reported that both social lubrication
and getting drunk were influential motives for playing drinking games.
More recently, in a survey of over 1200 incoming freshmen, Borsari
et al. (2003) found that over half reported getting drunk and
socialization as their motives to play drinking games, while 2 1 % of
the sample reported playing drinking games to control others or to
get someone else drunk.
To expand this research, Thomas Johnson and his colleagues
have factor analyzed a variety of reported positive and negative
reasons for playing drinking games (Johnson et al., 1998,1999). For
motives to play drinking games, a four-factor structure was created,
including fun and celebration (e.g., to get drunk), relaxation and
disinhibition (e.g., to feel more comfortable around others),
conformity (e.g., to fit in), and sexual manipulation (e.g., in order to
have sex with someone). However, analyses of these factors revealed
some problematic issues including low internal consistency and
inconsistent factor loadings in different samples. Recent research
Qohnson & Sheets, in press) has evaluated a motives measure with
much improved internal consistency (aU a's > 0.70). This measure
indicates that competition and thrills (e.g., because I want to win)
are associated with greater levels of consumption, consequences,
and irresponsible behavior. In addition, sexual manipulation motives
(e.g., in order to have sex with someone) were associated with sexual
activity consequences. Interestingly, novelty (e.g., it is a new
experience) and conformity (e.g., to blend in with the crowd) motives
were significantly associated with less alcohol use, consequences, and
irresponsible behavior. It is currently unclear whether these motives
act as protective factors: students playing drinking games for novelty's
sake or to fit may drink differently than students endorsing other
motives for playing.
 DRINKING GAMES 41

Motives for stopping games

Motives for stopping drinking games (Johnson 2002) have also
been examined. Although the internal consistency for these scales
ranged from adequate to poor, some findings deserve mention. First,
it appears that students frequently stop playing drinking games due
to intoxication, especially men, confirming that these games provide
a context for excessive consumption. Second, there does appear to
be sexual manipulation occurring in the context of these games, as
suggested by qualitative research. Specifically, men are more likely to
endorse quitting because they have gotten someone else drunk, gotten
someone to have sex with them, or if another person shows sexual
interest in them. Third, the study suggests that some women may be
effectively self-monitoring their alcohol use, as they are more likely
to endorse "I decide I have had enough to drink" as a reason for
quitting than men. Whether this finding represents an increased sense
of risk inherent in drinking game participation has yet to be
established.

Interpersonal Differences
Differences between students that play games and those that
do not have also been examined. Although the research
differentiating players from non-players is stiU in its infancy, it has
promising implications for interventions aimed at reducing drinking
game participation on campus. For example, high levels of
disinhibition are associated with higher levels of participation in
drinking games, suggesting that students use drinking games as a
way to facilitate disinhibition (Johnson & Cropsey, 2000), High
levels of social anxiety are also predictive of lower rates of drinking
game participation and amount of alcohol consumed while playing
games (fohnson et al,, 1998), This relationship is evident even when
students expect alcohol to reduce anxiety, suggesting that other
factors (e,g., game experience) may influence participation instead.
Thus, it is possible that socially anxious students avoid drinking
games for fear of being embarrassed.
42 DRINKING GAMES

RECOMMENDATIONS AND FUTURE DIRECTIONS

Drinking games present a recurring problem to university officials
attempting to control alcohol use on campus. One of the desired
outcomes of these games, to get drunk, challenges any effort to
reduce alcohol use and make the campus safe for all students. Some
colleges have attempted to ban drinking games from campus
("Williams College," 2000): if security patrols find evidence of
drinking games (e.g., a beer pong table), students can face sanctions
or suspension. Such an approach may not be practical for all schools.
Instead, educating students about the risks associated with drinking
games may be more effective. The research suggests three promising
components of a program designed to highlight the risks associated
with drinking games and decrease the risk of experiencing alcohol-
related consequences.

Educate Students About Risks

Associated with Drinking Games
Instructing students regarding the relationship between drinking
games and high levels of intoxication would allow for a greater
appreciation of the risks involved in drinking games. Specifically,
teaching students the concept of reversal of competence may make
them realize that drinking games can often result in much higher
than intended blood alcohol levels (BALs). Discussion of the rules
of specific games would demonstrate how participation can lead to
very high levels of intoxication over a short period of time. Students
could also be informed about the specific impairments associated
with different BALs, demonstrating the link between game play and
alcohol-related consequences.

The timing of intervention may be crucial in reducing students'

participation in drinking games. A majority of students come to
college as experienced game players (Borsari et al., 2003). In addi-
tion, younger students tend to play drinking games more frequently
and experience more alcohol-related consequences as a result of
their participation (Adams & Nagoshi, 1999). Students arriving at
school are attempting to establish their college identity, and part of
 DRINKING GAMES 43

this process involves observing the behavior of other, more estab-

lished students. The high rate of exposure to drinking games evi-
dent in the research indicates that drinking games are a part of many
students' initiation to college social life. Students who do not know
how to play drinking games and may be exposed to a "trial by fire"
when more experienced players intentionally get these novices drunk.
Therefore, freshmen are an important target for group interven-
tions addressing the risks associated with drinking games.
On an individual level, educational information about drinking
games can also be provided in the context of brief motivational
interventions (BMIs) aimed at reducing risky alcohol use, BMI
recipients are frequently students that have been identified as "high
risk" during large alcohol screenings or as a result of violating school
alcohol policy, BMIs typically consist of one to three sessions, each
session ranging from 30 minutes to an hour (Babor, 1994), They
also incorporate motivational interviewing, which is a directive, client-
centered counseling style that brings about change by having stu-
dents explore and resolve ambivalence (Miller & Rollnick, 2002),
BMIs have been adapted for college students (Dimeff, Baer, Kivlahan
& Marlatt, 1999), and highlight drinking games as particularly high
risk behaviors. Several studies have demonstrated effectiveness of
BMIs in reducing alcohol use and problems in college students (Baer
et al,, 1992; Baer, Kivlahan, Blume, McKnight & Marlatt, 2001; Borsari
& Carey, 2000; Larimer et al,, 2001; Murphy et al,, 2001), In fact,
Larimer and Cronce (2002) found BMIs to be more effective for
reducing alcohol use in college students than education (Garvin,
Alcorn & Faulkner, 1990), values clarification (teaching students to
incorporate responsible decision making; Barnett, Far, Mauss &
Miller, 1996) and normative education (providing accurate informa-
tion regarding peer alcohol use and approval of drinking; Schroeder
& Prentice, 1998),

Provide Social Alternatives to Drinking Games

Drinking games are viewed by adolescents as a way to fit in with
a social group (Pedersen, 1990), Games provide students with
44 DRINKING GAMES

Opportunities to meet new people and spend time with current

friends. Peer friendships are vital in the process of establishing one-
self at school, as they "facilitate the freshman's transition to college
by furnishing role models, validations, and socialization opportuni-
ties for the adoption of the new college student identity" (Hays &
Oxley, 1986, p, 312), Matriculating students will immediately seek to
establish a peer network that can be a source of support and inti-
macy (Johnson, Staton, & Jorgensen-Earp, 1995), and the majority
of lasting peer friendships are formed during the first year of col-
lege (Paul & KeUeher, 1995), Thus, providing other ways of socializ-
ing may further reduce the perceived need to play drinking games to
meet others. It is important those students are made aware of non-
drinking related activities on campus, activities that may be part of a
larger alcohol prevention program (Dejong & Langford, 2002). Hav-
ing a variety of opportunities to make friends without drinking may
decrease the attraction of drinking games.

Emphasize Sexual Risks of Drinking Games

Female students are an important target group for education
regarding the risks involved in drinking games. Many participants
view drinking games as a way to facilitate romantic interactions
(Nagoshi et al,, 1994), and sexual encounters are often associated
with drinking game participation (Martin & Hummer, 1989),
However, women report drinking more alcohol than usual when
playing drinking games (Johnson et al,, 1998; Nagoshi et al., 1994).
Because women tend to be smaller than men, this suggests that
women reach a higher BAL after playing drinking games. For example,
if a 150 pound man and a 110 pound female both consume 5 standard
drinks over 3 hours, they will attain a BAL of 0.08 and 0,16,
respectively. Such heightened BALs place females at higher risk of
sexual assault. There is much anecdotal (Sanday, 1991) and empirical
(Johnson 2002; Johnson & Sheets, in press) evidence that males
intentionally intoxicate females in order to have sexual contact.
Alcohol use has been linked to an increase in participation in
indiscriminant sexual behaviors (e.g., having casual sex; Cooper, 2002)
 DRINKING GAMES 45

and being raped (Mohler-Kuo, Dowdall, Koss & Wechlser, 2004).

Therefore, unwelcomed sexual advances are likely to heighten female
students' risk of unprotected sex, which can result in pregnancy and
the contraction of sexually transmitted diseases such as HIV. In
addition, it should be emphasi2ed that playing games with friends
does not ensure safety: a survey of over 6,000 students at 32 schools
revealed that 84% of assault victims knew their assailant (Koss, 1988).
In sum, women must be encouraged to avoid the drinking game
environment.

There is little question that drinking games contribute to exces-

sive alcohol use and negative consequences from drinking; however,
much still needs to be learned. For example, it would be valuable to
gather information about the immediate motives, alcohol use, and
consequences experienced during a specific drinking game. Quanti-
tative diaries, which would allow students to record such informa-
tion soon after the fact, would be a valuable tool (Wheeler, Reis, &
Nezlek, 1983). Observation of actual drinking games (Newman
et al., 1991) cotild also help establish the relative influence of such
factors as group size, gender makeup of group, and type of bever-
age being consumed. In addition, only one of the studies reviewed
was longitudinal in nature (Adams & Nagoshi, 1999). Recent inno-
vations in the statistical modeling of longitudinal data (Moskowitz
& Hershberger, 2002) could be used to develop precise trajectories
of drinking behaviors and drinking game participation. Many pre-
dictor variables could be included in these models; however, effec-
tive analyses require multiple assessment points over a long follow-up
period. Such an approach would help determine whether drinking
game participation is a transitional phase or whether it places stu-
dents on a trajectory of heavy alcohol use and consequences.

In addition, although heavy alcohol use is consistentiy associ-

ated with academic problems (Perkins, 2002), no studies have exam-
ined the relationship of drinking games and grades. Longitudinal
research could examine the degree to which drinking games con-
tribute to academic impairment. Finally, many of the studies were
performed at Indiana State University (Johnson et al., 1998). Research
46 DRINKING GAMES

performed in other locales would increase the confidence in the

findings and identify regional differences in drinking game partici-
pation. Specifically, there may be ethnic and cultural differences in
the motivation to play drinking games and the resulting consequences.
This information could then be used to further tailor interventions
addressing drinking games.
In summary, drinking games are a very popular but high-risk
activity with college students, especially younger ones. Students cite
a variety of reasons for playing, but quantitative and qualitative
research indicates that drinking games provide a context in which to
form and solidify peer friendships. Therefore, incoming students
should be educated regarding the risks associated with playing drinking
games, either in group or individual contexts. Incoming students
may especially benefit from such education. Women are also
important recipients of this information, as participation in drinking
games places them at particular risk for experiencing sexual
consequences. Providing alternative social activities that do not involve
alcohol may lessen the attractiveness of these games as a way to
foster peer relationships.

References
Abbey, A, (2002), Alcohol-related sexual assault: a common problem
among college students. Journal of Studies on Alcohol, 14 (Suppl.),
118-128,
Adams, C, E., & Nagoshi, C, T. (1999), Changes over one semester in
drinking game playing and alcohol use and problems in a college
student sample. Substance Abuse, 20, 97-106,
Babor, T, F. (1994), Avoiding the horrid and beastly sin of drunkenness:
Does dissuasion make a difference? Journal of Consulting and Clinical
Psychology, 62, 1127-1140,

Baer, J. S,, Kivlahan, D, R,, Blume, A, W, McKnight, P, & Marlatt, G, A,

(2001), Brief intervention for heavy-drinking college students:
4-year follow-up and natural history, American Journal of Public
Health, 91, 1310-1316,
 DRINKING GAMES 47

Baer, J. S., Marlatt, G. A., Kivlahan, D. R., Fromme, K., Larimer, M. E.,
& Williams, E. (1992). An experimental test of three methods of
alcohol risk reduction with young adults, journal of Consulting and
Clinical Psycholog)!, 64, 974-979.

Barnett, L. A., Far, J. M., Mauss, A. L., & Miller, J. A. (1996). Changing
perceptions of peer norms as a drinking reduction program for
college students, journal of Alcohol and Drug Education, 41, 39-62.

Borsari, B., Bergen-Cico, D., & Carey, K.B. (2003). Self-reported drink-
ing game participation of incoming college students, journal of
American College Health, 51, 149-154.

Borsari, B., & Carey, K. B. (2000). Effects of a brief motivational

intervention with college student drinkers, journal of Consulting and
Clinical Psychology, 68, 428-433.

Clapp, J. D., Lange, J., Min, J. W, Shillington, A., Johnson, M., & Voas,
R. (2003). Two studies examining environmental predictors of
heavy drinking by college students. Prevention Science, 4, 99-108.
Cooper, M. L. (2002). Alcohol use and risky sexual behavior among
college students and youth: Evaluating the evidence, journal of
Studies on Alcohol, 14 (Suppl), 101-107..

Dejong, W., & Langford, L. M. (2002). A typology for campus-based

alcohol prevention: Moving toward Environmental Management
s. journal of Studies on Alcohol, 14 (Suppl), 140-147.

Dimeff, L. A., Baer, J. S., Kivlahan, D. R., & Marlatt, G. A. (1999) Brief
alcohol screening and intervention for college students: A harm reduction
approach. New York: GuHford Press.
Douglas, P. (1987). Bizz-buzz, turtles, quarters, and one horse club: The
role of drinking games among high school and college students.
Alcohol Health and Research World, 11, 54-57.

Dundes, A., & Pagter, C. R. (1975). Bar dice in the San Francisco bay
area. Kroeber Anthropological Sodety Papers, 51i&52, 1-18.

Engs, R. C , Diebold, B. A., & Hanson, D. J. (1996). The drinking

patterns and problems of a national sample of college students:
1994. journal of Alcohol and Drug Education, 41, 13-33.
48 DRINKING GAMES

Engs, R. C , & Hanson, D. J. (1993). Drinking games and problems

related to drinking among moderate and heavy drinkers. T'sychological
Reports, 73, 115-120.
Farrow, J. A. (1987). The use of vignette analysis of dangerous driving
situations involving alcobol to differentiate adolescent DWI
offenders and high school drivers. American Journal of Drug and
Alcohol Abuse, 13, 157-174.
Garvin, R. B., Alcorn, J. D., & Faulkner, K. K. (1990). Behavioral
strategies for alcohol abuse prevention with high-risk college males.
Journal of Alcohol and Drug Education, 36, 23-34.
Green, T. A., & Grider, S. A. (1990). Reversal of competence in
drinking games. Plaj and Culture, 3, 117-132.
Griscom, A., Rand, B., & Johnson, S., & Balay, M. (1994). Beer games II:
The exploitative sequel. New Haven: Mustang Publishing.
Griscom, A., Rand, B., Johnson, S., & Rand, R. (1988). The complete book
of beer drinking games (and other really important stuff). New Haven:
Mustang Publishing.
Hays, R. B., & Oxiey, D. (1986). Social network development and
functioning during a life transition. Journal of"Personalityand Social
Psychology, 50, 305-313.
Johnson, T. J. (2002). College students self-reported reasons for why
drinking games end. Addictive Behaviors, 27, 145-153.
Johnson, T. J., & Cropsey, K. L. (2000). Sensation seeking and drinking
game participation in heavy-drinking college students. Addictive
Behaviors, 25, 109-116.
Johnson, T. J., Hamilton, S., & Sheets, V. L. (1999). College students'
self-reported reasons for playing drinking games. Addictive Behaviors,
24, 279-286.
Johnson, T. J., & Sheets, V. L. (in press). Measuring college students'
motives for playing drinking games. Psychology of Addictive Behaviors.
Johnson, G. E., Staton, A. Q., & Jorgensen-Earp, C. R. (1995). An
ecological perspective on the transition of new university freshmen.
Communication Education, 44, 336-352.
 DRINKING GAMES 49

Johnson, T. J., Wendel, J., & Hamilton, S. (1998), Social anxiety, alcohol
expectancies, and drinking-game participation. Addictive Behaviors,
23, 65-79.
Kanin, E. J, (1985). Date rapists: Differential sexual socialization and
relative deprivation. Archives of Sexual Behavior, 14, 219-231,
Koss, M, P, (1988). Hidden rape: Sexual aggression and victimization in
a national sample in higher education. In A, W. Burgess (Ed.), Rape
and sexual assault 11 (pp. 3-25). New York: Garland,
Larimer, M. E., & Cronce, J. M, (2002). Identification, prevention, and
treatment: A review of individual-focused strategies to reduce
problematic alcohol consumption by college students, journal of
Studies on Alcohol, 14 (Suppl), 148-163.
Larimer, M. E., Turner, A. P., Anderson, B, K., Foder, J. S., Kilmer, J, R.,
Palmer, R, S,, & Cronce, J, M. (2001), Evaluating a brief alcohol
intervention with fraternities, journal of Studies on Alcohol, 62,
370-380,
Martin, P. Y, & Hummer, R. A. (1989), Fraternities and rape on campus.
Gender & Society, 3, 457-473,
Miller, W R,, & Rollnick, S, (2002). Motivational interviewing: "Preparing
people for change {2nd ed.). New York: Guilford Press,
Mohler-Kuo, M., DowdaU, G. W, Koss, M., & Wechsler, H, (2004).
Correlates of rape while intoxicated in a national sample of college
women. Journal of Studies on Alcohol, 65, 37-45.
Moskowitz, D. S,, & Hershberger, S, L. (2002). Modeling intra-individual
variability with repeated measures. Mahwah NJ: Erlbaum,
Mullen, B. (1989), Advanced BASIC meta-analjsis. Hillsdale NJ: Hove and
London.
Murphy, J. G., Duchnick, J. J., Vuchinich, R E., Davison, J. W, Karg, R.
S., Olson, A. M,, et al. (2001), Relative efficacy of a brief motiva-
tional intervention for college student drinkers. Psychology of Addictive
Behaviors, 15, 373-379,
50 DRINKING GAMES

Nagoshi, C T , Wood, M. D., Cote, C. C , & Abbit, S. M. (1994). CoUege

drinking game participation within the context of other predictors
of other alcohol use and problems. Psychology of Addictive Behaviors, 8,
203-213.
National Institute on Alcohol Abuse and Alcoholism. (2001a). What we
know and what we need to learn. Retrieved February 16, 2004 from
http: / /www.collegedrinkingprevention.gov/reports /#task
Nadonal Institute on Alcohol Abuse and Alcoholism. (2001b). Use
proven strategies, fill research gaps. Retrieved February 16, 2004 from
http://www.collegedrinkingprevRntion.gov/reports / #task

Newman, I. M., Crawford, J. K., & Nellis, M. J. (1991). The role and
funcdon of drinking games in a university community. Journal of
American College Health, 39, 171-175.
Paul, B. L., & Kelleher, M. (1995). PrecoUege concerns about losing and
making friends in college. Journal of College Student Development, 36,
513-521.
Pedersen, W (1990). Drinking games adolescents play. British Journal of
Addiction, 85, 1483-1490.
Perkins, H. W (2002). Surveying the damage: A review of research on
consequences of alcohol misuse in college populations. Journal of
Studies on Alcohol, 14(Suppl.), 91-100.
Rabow, J., & Duncan-Schill, M. (1994). Drinking among college stu-
dents. Journal of Alcohol and Drug Education, 40, 52-64.
Rhoads, R. A. (1995). Whales tales, dog piles, and beer goggles: An
ethnographic case study of fraternity life. Anthropology and Education
Quarterly, 26, 306-323.
Sanday, P. R. (1991). Fraternity gang rape: Sex, brotherhood and privilege on
campus. New York: New York University Press.
Schroeder, C. M., & Prentice, D. A. (1998). Exposing pluralistic igno-
rance to reduce alcohol use among college students. Journal of
Applied Social Psychology, 28, 2150-2180.
Vranica, S. (2002, May 31). 'Beer games' a network headache. The Wall
Street Journal, p. A6.
 DRINKING GAMES 51

Wechsler, H., DowdaU, G. W, Maenner, G, Gledhill-Hoyt, J., & Lee, H.

(1998). Changes in binge drinking and related problems among
American college students between 1993 and \997. Journal of
American College Health, 47, 57-68.
West, L. A. (2001). Negotiating masculinities in American drinking
subcultures. Journal of Men's Studies, 9, 371-392.
Wheeler, L., Reis, H., & Nezlek, J. (1983). Loneliness, social interaction,
and sex roles. Journal of Personality and Social Psychology, 45, 943-953.
Williams College bans all drinking games. (2000, October 13). The
Chronicle of Higher Education, 47, p. A71.

Author Note
Brian Borsari, The Center for Alcohol and Addiction Studies,
Brown University.
This work was supported in part by NIAAA grant F31-AA05571
to Brian Borsari.
Special thanks to C. Teal Pedlow for her thoughtful comments
during the preparation of the manuscript.
Correspondence concerning this article should be add-
ressed to Brian Borsari, Center for TVlcohol and Addiction Studies,
Brown University, Box G-BH, Providence RI 02912. E-mail:
Brian_Borsari(^brown.edu.
View publication stats