Drug and Alcohol Review (September 2007), 26, 469 – 475

Fluid skills: drinking games and alcohol consumption among

Australian university students

MARK N. POLIZZOTTO1, MELANIE M. SAW2, IRENE TJHUNG2, EU HUA CHUA1, &

TIMOTHY R. STOCKWELL3,4
1
Department of Medicine, St Vincent’s Hospital, Melbourne, Australia, 2Department of Medicine, Fremantle Hospital,
Fremantle, Australia, 3Centre for Addictions Research of British Columbia, University of Victoria, British Columbia, Canada,
and 4National Drug Research Institute, Curtin University, Perth, Australia

Abstract
The objective of this study was to assess participation in drinking games among Australian university students; to determine the
range of games played, their context and participant motivations; and to analyse the impact of games on alcohol consumption
and its adverse consequences. We used a cross-sectional survey incorporating structured interviews and a self-administered
questionnaire with students between 18 and 25 years of age at the University of Western Australia. This was a qualitative
assessment of drinking game typology and contexts and participant motivation. Quantitative outcomes were rate and frequency
of participation in drinking games; amount and rate of alcohol consumption during games; incidence of adverse outcomes
following participation. Twenty-seven interview responses and 256 questionnaire responses were analysed for qualitative and
quantitative outcomes, respectively. The qualitative analysis enabled categorisation of drinking games by skill and competitive
nature, with varying influence on hazardous drinking. Common reported motivations for play included boredom, social pressure
and social unease. The associated heavy drinking and possible hazards were well recognised but did not affect the decision to
play. In the quantitative arm, most drinkers (74%) reported having participated in a drinking game. Game players reported
playing an average of four drinking games in the previous 6 months. An average of six standard drinks was consumed during
the most recent game. Pressure to participate from others was reported by 60% of game participants, while 50% reported that
they had placed pressure on others to participate. Half (51%) reported an adverse outcome following participation. Loss of
consciousness due to drinking was experienced or witnessed by 89% of game players, of whom 63% reported that the person was
put to bed, while 54% reported that the person was watched. Participation in drinking games was common, and plays an
important social role in this group. Drinking games were associated commonly with binge drinking and adverse outcomes.
Future harm minimisation strategies targeting this group should address the particular risks of these games. [Polizzotto MN,
Saw MM, Tjhung I, Chua EH, Stockwell TR. Fluid skills: drinking games and alcohol consumption among
Australian university students. Drug Alcohol Rev 2007;26:469 – 475]

Key words: Alcohol consumption, drinking games, harm reduction, students, youth.

and may result in overall mortality and morbidity com-

Introduction
Among young Australians, the health and social pro-
blems arising from alcohol use are largely the result of
acute intoxication [1 – 3]. Young people often consume
a high proportion of their total alcohol intake on
relatively few occasions, including drinking ‘binges’,
which involve the consumption of large quantities
of alcohol in a short time [4 – 6]. The resulting into-
xication poses an immediate risk to health and safety
parable with chronic alcohol dependence [3,7].
Moderating these drinking binges has been the focus
of health promotion and harm minimisation campaigns
targeted at this age group [7,8]. Understanding their
social and cultural context is central to these efforts.
Participation in drinking games has been noted in
several studies to be an important component of drinking
in this age group, and may be a significant determinant of
drinking binges [9,10]. Drinking games are social activities

Mark N. Polizzotto MB, BS, BMedSci1, Department of Medicine, St Vincent’s Hospital, Melbourne, Australia, Melanie M. Saw MB, BS,
BMedSc, Department of Medicine, Fremantle Hospital, Fremantle, Australia, Irene Tjhung MB, BS, Department of Medicine, Fremantle
Hospital, Fremantle, Australia, Eu Hua Chua MB, BS, Department of Medicine, St Vincent’s Hospital, Melbourne, Australia, Timothy R.
Stockwell PhD, Centre for Addictions Research of British Columbia, University of Victoria, British Columbia, Canada and Adjunct Professor,
National Drug Research Institute, Curtin University, Perth, Australia. Correspondence to Dr Mark N. Polizzotto, Department of Medicine,
St Vincent’s Hospital, Melbourne, Australia. Tel: 03 9076 2000. Fax: 03 9076 2222. E-mail: markpoliz@gmail.com
Received 20 July 2006; accepted for publication 24 January 2007.

ISSN 0959-5236 print/ISSN 1465-3362 online/07/050469–07 ª Australasian Professional Society on Alcohol and other Drugs
DOI: 10.1080/09595230701494374
470 M. N. Polizzotto et al.
in which standardised rules determine the amount of and
the manner in which alcohol is consumed. They use
success at a task or other signals to determine alcohol
consumption [9]. Studies internationally suggest that
participation in these games is widespread among young
people, particularly among college and university students,
and appears to increase both alcohol consumption and its
adverse consequences [10 – 13].
Drinking games may be an inherently undesirable
form of alcohol consumption, for a number of reasons
[11 – 15]. While playing, drinking becomes a function
not of the player’s own desires, but of external factors
and the actions of others [11]. Indeed, the rules of
many games are intended to ensure rapid consumption
of large amounts of alcohol [9,16]. This may lead, in
turn, to an impairment of judgement, leading players to
continue playing even when they have drunk exces-
sively, and loss of competence at the set task, which
further increases alcohol consumption (a phenomenon
some researchers have termed ‘reversal of competence’
[16]). The social pressures to continue playing—and
drinking—may also be considerable. Games are often
initiated by heavier drinkers, and so may also bring the
group’s average alcohol consumption up toward that of
its heaviest drinkers [12]. While players may intend to
drink heavily prior to entering the game, these factors
appear independently to increase alcohol consumption
beyond intentions [11].
Extensive evidence is available from both Europe and
the United States regarding the extent of drinking game
participation among young people, its contexts, moti-
vations and consequences, including its link with both
binge drinking and adverse health outcomes [11,15 –
19]. However, despite the acknowledged importance of
binge drinking in the drinking culture of young people
in Australia [5], the importance of drinking games and
their relationship with binge drinking in the Australian
context has not been explored. There is some anecdotal
evidence from media and other reports that drinking
games are widespread, but the extent of participation in
drinking games, their social context and their role in the
particular drinking patterns of Australian youth all
remain to be defined. Such information may both
deepen the existing understanding of these games and
inform local health intervention strategies.
We therefore undertook a qualitative and quantitative
analysis of drinking games in a population of Australian
students aged between 18 and 25 years. A combination
of structured interviews and questionnaires was used
for a descriptive, cross-sectional study of Western
Australian university students. We aimed to define the
prevalence of participation in drinking games; delineate
the types of games played; define the relation of
drinking games to drinking binges and their adverse
consequences; and explore the social contexts of the
games and participants’ motivations.
Methods
Qualitative methods
Interview design and implementation. A semi-structured
interview was conducted, using questions and talking
points developed initially by researchers from a review
of the existing literature, and expanded as the inter-
views progressed. Participants were asked in turn about
patterns of participation in drinking games; details of
games played; situations in which games were played;
factors contributing to participation; risks of participa-
tion; and adverse outcomes.
Each interviewer conducted approximately six to
eight interviews. Supervision was conducted once for
each interviewer, by review of a recorded trial interview.
Interviews were conducted individually with each
participant, with an emphasis on informal interaction;
this approach was found in trial interviews to improve
rapport with the subjects, and facilitate recall and
introspection when compared to a more structured
approach. Initial analysis was performed in parallel with
interviewing, at the completion of each day, such that
novel themes emerging from early interviews could be
used to inform later interviews.
Participant recruitment. Twenty-seven students in the
target age group from a variety of faculties at the University
of Western Australia were interviewed by four inter-
viewers. A convenience sample of students approached on
campus was used. Participants were recruited over 2
weeks, using a recruitment strategy intended to provide an
even mix of students of both genders from each of the
university’s faculties. The majority were recruited at
central public areas on campus, including the university
tavern, where all students congregate; in the later stages
additional participants were also recruited at common
areas of individual faculties, to ensure even representation
of students from the various faculties.
Interview analysis. All interviews were tape-recorded
and transcribed verbatim. Each transcript was reviewed
by at least two researchers working together, who
identified and coded emergent themes. These thematic
summaries were then reviewed by all researchers, with
reference to the original transcripts as needed (includ-
ing to review direct quotations). The major themes
presented thus emerged from this process of coding,
analysis and discussion among the researchers.
Quantitative methods
Questionnaire design. A questionnaire was developed
using the themes and information gathered from the
qualitative arm. Information collected included demo-
graphic data and ‘background’ patterns of consumption
of alcohol, including a table to provide details of alcohol
 Drinking games and alcohol consumption among Australian university students
consumption over the previous week. Students were
asked about their participation in drinking games,
details of the most recent game including alcohol
consumed, perceptions of games, and adverse out-
comes. The questionnaire was tested in a pilot study of
20 students in the target age group, who were not
included in the analysis; following this pilot, the
methods of recording alcohol consumption were
refined, incorporating a tabular record and a graphical
definition of ‘standard drink’.
Questionnaire administration. The questionnaire was
distributed to all students in seven second-year lectures
in the faculties of law, medicine, science, engineering,
arts and commerce. It was self-administered under
supervision. Questionnaires were distributed to 376
students; 357 were returned, for a response rate of 95%
(range 93 – 96% between faculties). Respondents out-
side the age criteria or for whom demographic data
were missing (32) and those who did not drink alcohol
(69) were excluded, leaving 256 for analysis.
Statistical analysis. Data analysis was carried out in the
Department of Public Health, University of Western
Australia, using SPSS version 8.0 and Microsoft Excel
software. w2 tests were used for analysis of categorical
data; t-tests for continuous data; and logistic regression
for multivariate analysis. Significance was defined as a
p-value of less than 0.05, or a 95% confidence interval
which did not include 1.0.
Definitions. Alcohol consumption was reported as the
number of ‘standard drinks’ (10 g of ethanol) based
on the respondent’s estimates following a graphical
explanation. Analysis of background alcohol consump-
tion used categories of risk of harm from the National
Health and Medical Research Council of Australia
(NHMRC) guidelines [20]. These define a ‘safe daily
limit’ for ‘low-risk’ drinking in men of four standard
drinks per day, and in women of two standard drinks
per day, with two alcohol-free days per week; ‘risky’
drinking is defined as five to six drinks in men and
three to four in women; and ‘high-risk’ drinking an
intake in excess of this. A drinking ‘binge’ was
defined, using a common international definition for
comparative purposes, as the consumption of five or
more standard drinks in one drinking session for
males and four or more standard drinks for females
[21].
Results
Qualitative results
Typology of drinking games. A typology of drinking
games was derived from the games described by
471
participants. These could be categorised according to
their characteristics in two dimensions: competitive vs.
non-competitive games, and games of skill vs. games of
chance.
Most games described were competitive games of
skill. One of the most popular, ‘Coins’, depends on the
player’s physical skill. Participants take it in turns to try
to bounce a coin into a glass—if successful, the player
nominates another to drink. If not, the player must
drink. Drinking was also introduced as a penalty into
established games of skill such as Monopoly and Trivial
Pursuit. Games of skill may promote a spiral of alcohol
consumption, as increasing intoxication leads to
decreasing skill and further drinking.
Several competitive games did not involve skill. In
these, the competition centred on consumption of
alcohol. Players, individually or in teams, race to see
who can drink the most alcohol in a set period, or a
fixed amount of alcohol in the shortest time. Games of
this type include ‘Centurion’, in which participants
drink one glass of beer or alcoholic soda per minute for
100 minutes with penalties for failure, and ‘Vodka
Shootout’, where players drink shots of vodka until the
last person left standing is deemed the winner. These
appear to be the most hazardous games, with their
emphasis on rapid consumption of large amounts of
alcohol; a variant of Centurion has been implicated in
the death from alcohol poisoning of one young Western
Australian man.
Several games involved neither competition nor skill,
being largely exercises in group bonding. Often these
involved external cues to drink, derived for example
from dice, cards or television shows. In one, ‘Star
Wars’, players each watch the eponymous movie for
their own cue to drink: one might drink when C3PO is
ignored, another when Chewbacca growls. In another,
‘Never Never’, each person names something they have
never done, and anyone who has performed that activity
must then drink.
Context and motivation. Interviewees stated that drink-
ing games most often arose spontaneously. Motiva-
tions for playing included boredom and a desire ‘to
get the evening started’. Games were usually initiated
by those perceived to be heavier drinkers, but
all members of the group felt pressure to play. Inter-
viewees said that the aim of participation was enjoy-
ment, not the competition per se. Drinking games also
provided a standardised form of interaction. Inter-
viewees said that the game ‘took the pressure off’ the
early, awkward stages of a gathering. They recalled
that this was particularly important when individuals
were less well acquainted. One also noted that the
games also had the effect of distributing attention
evenly across the group, with each person having a
defined role.
472 M. N. Polizzotto et al.
Occasionally, however, drinking games were planned
in advance. One interviewee described participating in
a drinking game tournament. This was billed as ‘the
anti-social event of the decade’ and an opportunity to
‘lose all respect for human dignity [and] end up face
down in a pile of your stomach contents’.
Alcohol consumption during games. Most interviewees
reported that drinking escalated once playing. Players
must either play by the rules and continue drinking, or
withdraw from the game and so from the social group.
In addition, the rate of consumption once playing was
such that they rapidly became drunk, and so were less
able to resist the pressure to continue drinking able or
judge when to stop: ‘Even though I started out just
being sociable, I ended up drinking so much that I
didn’t realise I should stop’; ‘I’ve never been so drunk
as when I’ve been playing a drinking games. You can’t
quit, and you just get drunker and drunker’. Reasons
given for stopping play included running out of alcohol,
losing consciousness or being too drunk to follow the
rules. Others reported stopping because the game had
become boring.
Awareness of risks of games. There was broad awareness
of the potential hazards of binge drinking, with
participants placing particular emphasis on the risks of
sustaining injury or becoming involved in arguments or
violence as a result of intoxication. However, this did
not appear to affect the decision to participate in
drinking games. Many of the participants were proud of
their extreme intoxication and regarded many negative
outcomes, such as losing consciousness or vomiting, as
‘badges of honour’.
Quantitative results
Population characteristics. The mean age of question-
naire respondents was 20 years; 58% were male. The
‘background’ rate of alcohol consumption by indivi-
duals was assessed. Men reported drinking significantly
more than woman over the previous week [mean 11
(range 0 – 58) vs. 6 (range 0 – 33), respectively; t ¼ 3.54,
p 5 0.01. However, when students were stratified by
NHMRC criteria for regular use, the proportion of
‘safe’, ‘risky’ and ‘high-risk’ drinkers was similar in men
and women (data not shown). The most popular
beverage was beer, followed by wine, then spirits, while
the predominant venue for alcohol consumption was
private homes (47%), followed by pubs (29%) and
other licensed venues (21%). Most alcohol was con-
sumed over the weekend (Friday night to Sunday), with
a mean of five standard drinks consumed. A mean of
three standard drinks were consumed over the remain-
der of the week, confirming the concentration of a high
proportion of alcohol into relatively few occasions.
Participation in drinking games. Respondents were given
a definition of a ‘drinking game’, and two examples of
common drinking games drawn from the qualitative
part of the study. A total of 74% of drinkers reported
having participated in a drinking game (‘game players’),
while 68% of drinkers had participated in the last 6
months. Game players reported playing an average of
four drinking games in the previous 6 months. A total
of 60% of game players reported pressure placed on
them by others to participate, while 50% reported that
they had placed some pressure on others to participate
(Table 1). Males were more likely to admit that they
had exerted ‘a lot’ or ‘a fair bit’ of pressure than females
(b ¼ 10.1, df ¼ 4, p ¼ 0.02).
Factors influencing participation. Multivariate analysis
was performed to assess the independent effect of
demographic variables on the probability of having ever
participated in a drinking game, and the frequency of
participation in the previous 6 months among game
players. Logistic regression was performed to analyse
the independent variables age, sex, university course
and background pattern of alcohol consumption
(categorised as ‘safe’, ‘hazardous’ or ‘harmful’ accord-
ing to the criteria above) with respect to the dependent
variable of ever having participated in a drinking game.
Only gender was found to have an independent effect,
with females less likely to have ever played a drinking
game (OR ¼ 0.34, 95% CI ¼ 0.12, 0.99, p 5 0.05).
Multiple regression was performed to analyse the same
independent variables on the dependent variable of
frequency of game playing in the last 6 months among
game players. Age, gender and background consump-
tion were each found to have an independent effect.
Younger students played more frequently than older
ones (b ¼ 70.25, p 5 0.01), males played more often
than females (b ¼ 70.16, p ¼ 0.02), and those with
heavier background alcohol consumption played more
often than lighter drinkers (b ¼ 0.25, p 5 0.01). No
interaction effects were observed.
Characteristics of drinking games. Specifics of the most
recent drinking game played were elicited. The most
common setting was a private home (65%), followed by
pubs (14%) and other licensed venues (10%). The
most common beverages were beer (77%) and spirits
(63%), followed by wine (35%). Competitive games of
skill were most common (played by 54%), followed by
group bonding games (31%) and competitive con-
sumption games (15%). Males drank an average of 13
standard drinks during the entire occasion (before,
during and after the game) and seven (range 1 – 20)
during the game itself; females an average of eight
standard drinks (t ¼ 5.1, p 5 0.01) during the occasion
and five (range 1 – 14) during the game (t ¼ 3.66,
p 5 0.01). Thus 97% of males and 95% of females
 Drinking games and alcohol consumption among Australian university students 473

Table 1. Perceived pressure to participate in drinking game{ Table 2. Adverse outcomes following drinking game participation{

Pressure from others Pressure placed on Percentage

to play others to play Adverse outcome Number (n ¼ 190)

% Males % Females % Males % Females Losing consciousness (‘passing out’) 61 32.1

(n ¼ 85) (n ¼ 101) (n ¼ 85) (n ¼ 101) Taking time off work or study 41 21.6
Sustaining an injury 31 16.3
A lot 5.9 9.9 9.4 8.9 Being asked to leave a pub or club 21 11.1
A fair bit 12.9 18.8 22.4 7.9 Being involved in a violent argument 17 8.9
A little 38.8 35.6 35.3 32.7 Being involved in a physical fight 15 7.9
None 42.4 35.6 32.9 50.5 Being involved in an accident 3 1.6
with more than $100 worth
{
of damage
Based on respondent recollection of most recent drinking Being taken to hospital 2 1.1
game played. Cell values are column percentages. Being charged with a crime 1 0.5
(including drink driving)
exceeded the recommended daily alcohol consumption
{
limit during the game alone, while 88% and 80%, Based on respondent recollection of adverse outcomes
respectively, met the study criteria for a drinking binge following any game played. More than one positive response
was allowed; 93 respondents (49%) reported no adverse
on that occasion. The drinking game itself lasted an outcome.
average of 1.5 hours (SD ¼ 1.3), while the longest time
was 10 hours. The crude estimated average drinking
rate during the game (based on the assumption of a Table 3. Perceived effect of drinking game participation on alcohol
constant rate of drinking over the course of the game) consumption{
was four drinks per hour (SD ¼ 2.5, range 1 – 15). There
was again a significant difference between males and Compared to the
amount intended to
females (5 vs. 3.5 drinks per hour; t ¼ 2.92, p 5 0.01). Compared to usual drink on that
consumption occasion
Effects and hazards of drinking games. There was general
acknowledgment of the hazards of drinking games. 91% % Males % Females % Males % Females
of game players described drinking games as potentially (n ¼ 85) (n ¼ 100) (n ¼ 85) (n ¼ 100)
hazardous. Just over half (51%) of game players
reported that they had experienced an adverse outcome Consumed 76.5 51.0 30.6 32.0
following participation in a drinking game (Table 2). more
The most common reported outcome was loss of Unchanged 20.0 38.0 14.1 11.0
Consumed less 0.0 2.0 55.3 57.0
consciousness due to alcohol consumption, which had
been experienced or witnessed by 89% of game players. {
Based on respondent recollection of most recent drinking
Of those, 63% reported that the person was put to bed, game played. Cell values are column percentages.
while 54% reported that the person was watched. The
unconscious person was left alone where they were in
19% of cases. tered questionnaire to explore the role of drinking
Game players reported an average of 16 binge games in the patterns of alcohol consumption of
drinking sessions (SD ¼ 15.2) in the previous 6 months; Australian university students. It provides the first
24% of these binges occurred in association with a analysis of the role played by drinking games in the
drinking game. Conversely, on average 71% of drinking alcohol consumption of young Australians.
games were played during a binge drinking session. Participation in drinking games was common and
Thus, while binges may occur when drinking games are regular among the study population. Three-quarters of
not being played, it appears that drinking games are drinkers surveyed had played a drinking game at some
associated closely with binges. Nearly two-thirds of point, and 70% of those had played at least once in the
students said that they drank more or much more previous 6 months. While these results should be
alcohol as a result of participating in the drinking game generalised with caution, given the limited nature of the
(Table 3). study sample, they suggest that participation in drinking
games is common among Australian university students
generally. The level of participation identified here is
Discussion
comparable to that found in several studies interna-
This study combines qualitative data from structured tionally in people of similar ages from a variety of
interviews and quantitative data from a self-adminis- backgrounds [10 – 12].
474 M. N. Polizzotto et al.
In this group, drinking games were associated with
both high levels and rates of alcohol consumption, and
with drinking binges. While the typology identifies
lower- and higher-risk games, the rules of each game
were clearly intended to facilitate alcohol consumption,
and even lower-risk games have the potential to
accelerate the rate of drinking. Significant amounts of
alcohol were consumed in the course of these games,
with average total consumption during the most recent
game of seven standard drinks for men and five
standard drinks for women, and a crude estimated
average rate of alcohol consumption during play of
more than four drinks per hour. A close relationship
also emerged between drinking games and drinking
binges: on average 70% of games played were
associated with a binge. Perhaps not surprisingly, given
this level of alcohol consumption, negative health and
social outcomes after game playing were also prevalent:
more than half the players reported having experienced
an adverse outcome following play.
Despite their hazards, drinking games were consid-
ered a socially acceptable and appealing activity by this
group. They appear to be an important part of a
broader culture among Australian university students
and young people in which binge drinking is considered
normal and enjoyable [4,5]. While interviewees re-
ported that games were often initiated by heavier
drinkers, participation was not confined to those who
drink the most: the games were played by a large
proportion of students, across age groups, genders and
faculties. Importantly, the pressure from the social
group to play and continue playing can be significant.
Nearly 60% of those surveyed here reported that they
felt pressure to participate, while 50% of females and
70% of males reported placing pressure on others.
This popularity, the high reported rates of participa-
tion and the level of alcohol consumption associated
with games each appear to be explained in part by the
social and developmental function that drinking games
fulfill for this group. Drinking games are perceived by
participants to develop camaraderie and community
spirit. They provide a formalised manner of interaction
during social occasions, and integrate individuals into
the group. Interviewees reported that these functions
were especially important in groups where few people
know each other, or where people are unsure of their
social role. As others have noted, games do more than
simply alter the pattern of alcohol consumption: the
whole rhythm and content of communication is
determined by the game while it is played [22,23].
This study supports and extends the previous literature
regarding drinking games in several respects. While the
drinking culture of young Australians differs in many
respects from that described in Europe and the United
States [4,5], it is notable that the qualitative analysis of
both the type and range of games played and participants’
descriptions of the social function of play show simila-
rities with previous studies internationally [16,20], while
the multivariate analysis provides a novel assessment of
the factors which influence participation. Interestingly,
however, while social pressures were a major theme here,
in contrast with some previous analyses sexually moti-
vated coercion did not emerge as significant [15].
Similarly, the quantitative analysis of total consumption
and consumption rates and the direct analysis of adverse
health outcomes following games extend previous
comparisons of drinking and rates of adverse outcomes
between players and non-players [11,24].
This analysis of drinking game contexts and high-risk
drinking behaviours has several implications for health
promotion and harm reduction strategies designed to
reduce the substantial number of deaths each year in
Australia caused by heavy sessional drinking, including
death due to alcohol poisoning and motor accidents
[25]. It would be relatively easy to incorporate specific
mention of the hazards of drinking games into existing
harm reduction messages [26 – 29]. In view of the
important social functions of drinking games and
alcohol consumption generally, prevention pro-
grammes could also attempt to develop alcohol-free
social contexts that meet some of the social roles that
are met currently by drinking games and drinking
binges. These findings also suggest that there is a need
to improve young people’s responses to outcomes such
as alcohol poisoning: while losing consciousness due to
excess alcohol consumption is common in this group,
fewer than 50% of respondents knew how to respond
appropriately [30].
Acknowledgements
The authors gratefully acknowledge Dr Judith Straton
and members of the Department of Public Health at the
University of Western Australia for their support of this
project.
References
[1] Holman CDJ. Quantification of morbidity and mortality
caused by alcohol, tobacco and illicit drugs in Western
Australia 1983 – 1988. Perth: Health Department of Wes-
tern Australia, 1995.
[2] Unwin E, Codde J, Swensen G, Saunders P. Alcohol-
caused deaths and hospitalisation in Western Australia, by
health services. Perth: Health Department of Western
Australia, 1997.
[3] Chikritzhs T, Jonas H, Heale P, Dietze P, Hanlin K,
Stockwell T. Alcohol-caused deaths and hospitalisations in
Australia, 1990 – 1997. Perth: National Drug Research
Institute, Curtin University, 1999.
[4] Blaze-Temple D, Fisher J, Cross D, Howat P. Alcohol and
young people; Australian baseline data for a WHO cross-
cultural study. Drug Educ J Aust 1987;1:215 – 23.
 Drinking games and alcohol consumption among Australian university students
[5] Nezlek JB, Pilkington CJ, Bilbro KG. Moderation in excess:
binge drinking and social interaction among students. J
Stud Alcohol 1994;55:342 – 51.
[6] Lang E, Stockwell T, Rydon P, Gamble C. Community
survey of patterns and places of drinking. Report on
patterns and places of drinking of 16 – 29 year olds in the
Perth Metropolitan Area. Perth: National Drug Research
Institute, Curtin University of Technology, 1991.
[7] Lang E, Stockwell T, Rydon P, Gamble C. Drinking
settings, alcohol related harm and support for prevention
policies. Perth: National Centre for Research into the
Prevention of Drug Abuse, Curtin University of
Technology, 1992.
[8] Moore L, Smith C, Catford J. Binge drinking:
prevalence, patterns and policy. Health Educ Res 1994;9:
497 – 505.
[9] Douglas P. Bizz-buzz, turtles, quarters, and one horse club:
the role of drinking games among high school and college
students. Alcohol Health Res World 1987;54 – 7.
[10] Pedersen W. Drinking games adolescents play. Br J Addict
1990;85:1483 – 90.
[11] Engs RC, Hanson DJ. Drinking games and problems
related to drinking among moderate and heavy drinkers.
Psychol Rep 1993;73:115 – 20.
[12] Wood MD, Johnson JT, Sher KJ. Characteristics of
frequent drinking game participants in college: an explora-
tory study. Alcohol Clin Exp Res 1992;16:417.
[13] Adams CE, Nagoshi CT. Changes over one semester in
drinking game playing and alcohol use and problems in a
college student sample. Subst Abuse 1999;20:97 – 106.
[14] Clapp JD, Lange J, Min JW, Shillington A, Johnson M,
Voas R. Two studies examining environmental predictors of
heavy drinking by college students. Prev Sci 2003;4:99 –
108.
[15] Borsari B. Drinking games in the college environment: a
review. J Alcohol Drug Educ 2004;48:29 – 51.
[16] Green TA, Grider SA. Reversal of competence in college
drinking games. Play Culture 1990;3:117 – 32.
[17] Johnson TJ. College students’ self-reported reasons
for why drinking games end. Addict Behav 2002;27:145 –
53.
475
[18] Newman IM, Crawford JK, Nellis MJ. The role and
function of drinking games in a university community. J
Am Coll Health 1991;39:171 – 5.
[19] Johnson TJ, Sheets VL. Measuring college students’
motives for playing drinking games. Psychol Addict Behav
2004;18:91 – 9.
[20] National Health and Medical Research Council. Australian
alcohol guidelines: health risks and benefits. Canberra:
Commonwealth of Australia Publishing Service, 2001.
[21] Wechsler H, Huo M. College students define binge
drinking and estimate its prevalence: results of a national
survey. J Am Coll Health 2000;49:57 – 64.
[22] Johnson TJ, Cohen EA. College students’ reasons for not
drinking and not playing drinking games. Subst Use Misuse
2004;39:1137 – 60.
[23] Johnson TJ, Wendel J, Hamilton S. Social anxiety, alcohol
expectancies, and drinking-game participation. Addict
Behav 1998;23:65 – 79.
[24] Johnson TJ, Cropsey KL. Sensation seeking and drinking
game participation in heavy-drinking college students.
Addict Behav 2000;25:109 – 16.
[25] Chikritzhs T, Catalano P, Stockwell T, et al. Australian
alcohol indicators, 1990 – 2001: patterns of alcohol use and
related harms for Australian states and territories. Perth:
National Drug Research Institute, Curtin University of
Technology, 2003.
[26] Borsari B, Bergen-Cico D, Carey KB. Self-reported
drinking-game participation of incoming college students.
J Am Coll Health 2003;51:149 – 54.
[27] Boots K, Midford R. Promoting safe parties: evaluation of
the 1993 Geraldton Partysafe campaign. Perth: National
Centre for Research into the Prevention of Drug Abuse,
Curtin University of Technology, 1995.
[28] O’Callaghan F, Jeffrey W, Callan VJ. Extending upon
student drinking patterns in an Australian population. Drug
Alcohol Rev 1990;9:239 – 44.
[29] Lockwood A, Saunders B. Preventing drug use problems:
the university as a site for local action. Drug Alcohol Rev
1991;10:29 – 35.
[30] Macdonald L, Verhoeven A, eds. Australian first aid, 2nd
edn. Canberra: St John Ambulance Australia, 1989.