title: Drinking games and contextual factors of 21st birthday drinking.
abstract: BACKGROUND
  21st birthday celebrations are among the highest risks for alcohol use throughout emerging adulthood and celebrants often experience a range of alcohol-related consequences.
  
  
  OBJECTIVE
  The present research considered what happens when drinking games are paired with an already high-risk event (i.e., 21st birthday celebrations) and how drinking games compare with other contextual factors on 21st birthdays.
  
  
  METHODS
  Approximately four days after turning 21, 1124 college students (55% women) completed an online survey assessing alcohol use and related consequences experienced during their birthday celebrations. Participants were also asked whether drinking games and other contextual factors were associated with their celebrations.
  
  
  RESULTS
  Overall, 18% of participants reported playing drinking games during their 21st birthday celebrations. These individuals reported consuming more alcohol, had higher estimated BACs, and experienced more negative consequences than those who did not play drinking games. The association between playing drinking games and alcohol use and negative consequences was stronger for men. The effect of drinking games on negative consequences was mediated through elevated BAC levels. Receiving bar specials, having drinks purchased, playing drinking games, and loud music were uniquely and significantly associated with all alcohol outcomes.
  
  
  CONCLUSIONS
  Together, these results suggest that drinking games are part of a larger context of risk contributing to extreme drinking on 21st birthdays. Furthermore, these results will help to facilitate interventions that are more individually tailored to target specific contextual risks, behaviors, and events.
authors.affiliation: Department of Psychology, University of Houston , Houston, TX , USA.
authors.forename: Clayton
authors.initials: C
authors.lastname: Neighbors
authors.forename: Lindsey M
authors.initials: LM
authors.lastname: Rodriguez
authors.forename: Dipali V
authors.initials: DV
authors.lastname: Rinker
authors.forename: Angelo M
authors.initials: AM
authors.lastname: DiBello
authors.forename: Chelsie M
authors.initials: CM
authors.lastname: Young
authors.forename: Chun-Han
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects / Q000097:blood / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010988:Play and Playthings; D012931:Social Environment; D013334:Students / Q000523:psychology*; D014495:Universities; D055815:Young Adult
keywords: 21st birthday; alcohol problems; alcohol use; context; drinking games