Examination of Pregaming: Associations with Drinking Cognitions, Alcohol Use, and Negative Consequences at the Daily-Level among Adolescents and Young Adults




0000-0001-6572-4649 (Cross, Allison)

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Purpose: While research indicates that adolescents and young adults pregame (i.e., drink before going to an event or gathering), it is unclear how daily-level cognitions relate to pregaming behavior and how pregaming relates to alcohol consumption and consequences. We examined (1) occasion-level associations between drinking cognitions (i.e., willingness, attitudes, injunctive norms) and pregaming among adolescents and young adults, and (2) occasion-level associations between pregaming with quantity of alcohol consumed and negative consequences. We also explored potential moderating effects of age on the above associations as well as the moderating effects of the number of drinks on the association between pregaming and the number of negative consequences on drinking days. Methods: Participants from Texas (age 15-25) were enrolled in a longitudinal ecological momentary assessment (EMA) study employing a 3-week EMA burst format (8 surveys weekly, up to 2 times per day). These bursts were scheduled quarterly over a span of 12 months. Participants who reported any drinking days were included in the present analyses. The final analytic sample included 490 individuals ages 15-25 (53.6% Female, 45.2% White Non-Hispanic, Mean Age = 21.2 SD = 2.7). Data were analyzed with mixed effects multilevel models. Results: Multilevel models revealed that occasion-level drinking cognitions (i.e., occasions with higher willingness to drink and more positive attitudes toward pregaming than one’s usual) were associated with greater likelihood of pregaming (Willingness: odds ratio (OR=1.80) = X, p < 0.0001; attitudes: OR = 1.54, p = 0.0009), whereas injunctive norms were not significantly associated. Compared to drinking days when people did not pregame, pregaming days were associated with consuming more drinks (rate ratio (RR) = 1.79, p < 0.0001). For consequences, the positive association between alcohol use and number of consequences was reduced on pregaming days (p of the interaction term between number of drinks and pregame = 0.04). Age was not a significant moderator in any models tested. Conclusion: This study contributes to the literature by examining occasion-level associations between drinking cognitions with pregaming and the role of pregaming in experiencing negative consequences. These findings can be used to inform individual-level intervention approaches by incorporating risk information about willingness and attitudes and their association with pregaming.


Research Appreciation Day Award Winner - School of Public Health, 2024 Research Award - 2nd Place