Native American/American Indian (NA/AI) and Multiracial people (those who claim multiple racial identities) report notably high alcohol use compared to other racial groups in the United States. Nearly half of the NA/AI population is also Multiracial, yet NA/AI and Multiracial college students report different motivations for drinking alcohol. Therefore, it remains unclear if NA/AI individuals who are also Multiracial are at different risk for alcohol use and negative alcohol-related consequences, and if there are distinct patterns of risk factors in these understudied populations. Because college-aged students are at risk for high levels of alcohol use, this exploratory study used the AlcoholEdu for College™ survey to compare the association between initial drinking age, college location (urban vs. rural), and alcohol use motivations and consequences between monoracial NA/AI (N = 2,363) and Multiracial NA/AI collegeaged students (N = 6,172). Monoracial NA/AI students reported higher incidences of alcohol use and alcohol-related problems such as blacking out and missing class, compared to Multiracial NA/AI students. Risk factors like earlier age of drinking onset were more strongly associated with negative consequences for monoracial NA/AI students compared to Multiracial NA/AI students. Despite similar levels of Internal Coping motivations for drinking (e.g., to feel more confident or sure of yourself), monoracial NA/AI students reported drinking more than Multiracial students and experienced more negative drinking-related outcomes. These results suggest Multiracial NA/AI students may draw on protective factors not accessible to monoracial NA/AI students, highlighting the need for interventions tailored to students at highest risk. Public Health SignificanceThis study suggests that monoracial and Multiracial Native American/American Indian college students differ in their motivations to drink alcohol and their experience of negative drinking-related outcomes. The relationship between established risk factors, such as age at alcohol use onset, and drinking outcomes varied, indicating that alcohol-related prevention and intervention efforts should be tailored to specific racial groups to be most effective.

Native American/American Indian (NA/AI) and Multiracial (those who claim more than one racial group) people report notably high alcohol use compared to other racial groups in the United States. However, NA/AI and Multiracial college students also report differences in their motivations for drinking alcohol. Therefore, it remains unclear if Multiracial NA/AI individuals are at different risk for alcohol use and negative alcohol-related consequences, and if there are distinct patterns of risk factors for alcohol consumption in these understudied populations. Given that college-aged students are at particularly high risk for alcohol use, we used the AlcoholEdu for CollegeTM survey in an exploratory study to compare the association between initial drinking age, college location (urban versus rural), and alcohol use motivations and consequences between monoracial NA/AI (N = 2,359) and Multiracial NA/AI college-aged students (N = 6,263). Overall, monoracial NA/AI students reported higher incidences of alcohol use and alcohol-related problems such as blacking out and missing class, compared to Multiracial NA/AI students. Risk factors, including earlier drinking age, impacted monoracial NA/AI students more than Multiracial NA/AI students, leading to higher rates of missing class and impaired driving. Despite similar levels of Internal Coping motivations for drinking (e.g., to feel more confident or sure of yourself), monoracial NA/AI students reported drinking more than Multiracial students and experiencing higher rates negative drinking-related outcomes. These results suggest that Multiracial NA/AI students may draw on protective factors not accessible to monoracial NA/AI students, highlighting the need for tailored interventions for students at highest risk.