Harmful alcohol consumption is at the etiological core of a host of disease states and negative health outcomes in all demographics. While chronic alcohol use is often perceived as the most harmful pattern of consumption, the damaging effects of acute drinking episodes are frequently overlooked. Binge drinking is often moderated by numerous factors related to social facilitation, emotional regulation an even economics. While binge drinking may result in significantly fewer drinking days, the behavior carries confirmed physiological and psychological consequences as a result of the spikes in toxicity occurring during rapid alcohol consumption. Drinking games are frequently intended to expedite drinking in social groups, producing an obvious risk of increased intoxication. This meta-analysis investigates associations between drinking games and alcohol consequences.
The meta-analysis queried comprehensive databases of papers which met the following criteria: English-language based, empiric in method, observational, including at least one drinking game measure, including at least one alcohol-related outcome, and containing ample information for constructing correlations of drinking games and alcohol outcomes. Papers were screened and coded by the research team according to sample characteristics, resulting in a total of 31 papers being used in the meta-analysis after independent reconciliation. The analysis itself consisted of correlative testing for drinking game and alcohol-related measures, before converting the data into effect size measures. Effect size computations were completed using Fisher’s z-transformations, and differences were measured using mixed effects models. Publication bias was also investigated using regression tests.
Results of the meta-analysis found 30 of the 31 studies were based on adolescent and young adult data, which do compose the majority of drinking game participants. Effect sizes for drinking game participation and alcohol-related variables were found to be positive and medium in size across the entire analysis. This included the following variables being associated with drinking game participation: alcohol use frequency, alcohol use quantity, binge drinking, and consequences. Significance testing ruled out sampling error as the sole source of variation among effect sizes, implicating the possible influence of moderating variables. Gender was found to moderate the relationship between drinking games and alcohol-related variables. Samples with greater proportions of female participants had stronger relationships between drinking games and alcohol use quantity only.
Takeaway: this meta-analysis helps strengthen the notion that drinking games are associated with harmful alcohol-use outcomes. Dangers of drinking games should continue to be incorporated into treatment interventions and public health campaigns.