The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use.

The use of the term binge drinking and the 5/4 measure have helped to advance the understanding of college alcohol use over the past 10 years. The present article discusses the importance, relevance, and utility of this measure.

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Athletes are a high-risk group for binge drinking and alcohol-related harms. Although special educational programs have targeted this group they have not sufficiently impacted the problem. Future prevention efforts targeted for athletes should address the unique social and environmental influences on athletes. Programs should also take advantage of motives of athletes for self-limiting alcohol intake. Colleges, athletic departments, coaches, and sports medicine professionals are urged to act to help reduce athletes risk of alcohol-related harms.

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