• Alcohol;
  • alcohol-related harm;
  • college;
  • drinking;
  • environment;
  • outlet density;
  • problems;
  • students;
  • university


Aims  To examine the geographic density of alcohol outlets and associations with drinking levels and related problems among university students.

Design  Cross-sectional survey study using geospatial data, with campus-level and individual-level analyses.

Participants  A total of 2550 students (mean age 20.2, 60% women) at six university campuses in New Zealand (63% response).

Measurements  Counts of alcohol outlets within 3 km of each campus were tested for their non-parametric correlation with aggregated campus drinking levels and related problems. Generalized estimating equations were used to model the relation between outlet counts within 1 km and 3 km of student residences and individual drinking levels/problems, with control for gender, age, ethnicity and high school binge drinking frequency, and adjustment for campus-level clustering.

Findings  Correlations for campus-level data were 0.77 (P = 0.07) for drinking and personal problems, and 0.31 (P = 0.54) for second-hand effects. There were consistent significant associations of both on- and off-licence outlet densities with all outcomes in student-level adjusted models. Effects were largest for 1 km densities and off-licence outlets.

Conclusions  There are positive associations between alcohol outlet density and individual drinking and related problems. Associations remain after controlling for demographic variables and pre-university drinking, i.e. the associations are unlikely to be due to self-selection effects. Increasing alcohol outlet density, and particularly off-licences, may increase alcohol-related harm among university students.