Daily-level analysis of drinking intensity and acute physical consequences

Objective: We examined associations of drinking intensity on a given drinking day with acute physical consequences in a sample of U.S. young adult drinkers. Methods: Participants were past 30-day drinkers at modal age 18 in the 2018 12th-grade Monitoring the Future study who were followed up as part of a daily study in 2019 (n = 911). Of these participants, n = 489 reported at least one drinking day. At age 19, they reported their alcohol use and consequences for 14 consecutive days (n = 1051 drinking days). Daily data were used to examine within- and between-person associations of drinking intensity (moderate [1-3 drinks for women, 1-4 drinks for men], binge [4-7/5-9], or high-intensity [8+/10+]) with four acute physical consequences: hangover, nausea, blackout, and passing out. Results: At least one acute physical consequence was reported on more than half (59.3%) of high-intensity drinking days compared to 40.7% of binge and 4.9% of moderate drinking days. Blackouts and passing out were reported on 17.1% and 9.2% of high-intensity drinking days, respectively. Compared to binge drinking days, high-intensity drinking days were associated with a greater likelihood of any physical consequences (adjusted odds ratio [aOR] = 4.64; 95% confidence interval [CI] = 2.00,10.75), a greater number of consequences (adjusted incident rate ratio [aIRR = 1.99; 95% CI = 1.16,3.42), and a greater likelihood of hangover (aOR = 3.72; 95% CI = 1.58,8.74). Acute physical consequences were also more likely on high-intensity and binge drinking days versus moderate drinking days. Conclusions: High-intensity drinking days were associated with a distinctly greater risk for acute physical consequences than binge or moderate drinking days.