title: Sex differences in college student adherence to NIAAA drinking guidelines.
abstract: BACKGROUND
  Exceeding nationally recommended drinking limits puts individuals at increased risk of experiencing harmful effects due to alcohol consumption. Both weekly and daily limits exist to prevent harm due to toxicity and intoxication, respectively. It remains unclear how well college students adhere to recommended limits, and whether their drinking is sensitive to the wider sex difference in weekly versus daily drinking limits.
  
  
  METHODS
  This study used a daily-level, academic-year-long, multisite sample to describe adherence to NIAAA daily (no more than 4 drinks per day for men, 3 drinks per day for women) and weekly (no more than 14 drinks per week for men, 7 drinks per week for women) drinking guidelines, and to test for sex differences and time effects. College students (n = 992; 58% female) reported daily drinking on a biweekly basis using web-based surveys throughout their first year of college.
  
  
  RESULTS
  Women exceeded weekly limits more frequently (15% of weeks [14 to 17%]) than men (12% [10 to 14%]). Women and men exceeded daily drinking limits similarly often (25 and 27%, respectively). In a generalized estimating equations analysis across all 18 biweekly assessments, adjusted for covariates and a linear trend over time, women were more likely to exceed weekly guidelines compared to men. Sex differences in exceeding daily limits were not significant. Over time, rates of exceeding limits declined for daily limits but only for men for weekly limits.
  
  
  CONCLUSIONS
  Female college students are more likely to exceed weekly alcohol intake limits than men. Furthermore, trends over time suggest that college students may be maturing out of heavy episodic drinking, but women may not mature out of harmful levels of weekly drinking. The observed disparity in risk for long-term health consequences may represent a missed opportunity for education and intervention.
authors.affiliation: Harvard Medical School, Center for Addiction Medicine , Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Bettina B
authors.initials: BB
authors.lastname: Hoeppner
authors.forename: Anna L
authors.initials: AL
authors.lastname: Paskausky
authors.forename: Kristina M
authors.initials: KM
authors.lastname: Jackson
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Barnett
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology / Q000639:trends; D015331:Cohort Studies; D005260:Female; D019983:Guideline Adherence / Q000592:standards* / Q000639:trends; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D054563:National Institute on Alcohol Abuse and Alcoholism (U.S.) / Q000592:standards*; D012727:Sex Characteristics; D013334:Students / Q000523:psychology; D014481:United States / Q000453:epidemiology; D014495:Universities; D055815:Young Adult
keywords: Alcohol; College Students; Drinking Guidelines; Sex Differences