Knowledge, attitudes and practices regarding alcohol use among undergraduate students at a South African university


public health
undergraduate health
alcohol use

How to Cite

Knowledge, attitudes and practices regarding alcohol use among undergraduate students at a South African university. (2024). Undergraduate Research in Health Journal, 2(1), e1650.


Background. Alcohol use among undergraduate students in academic institutions is a growing concern in South Africa (SA).
Objective. To determine the knowledge, attitudes and practices regarding alcohol use among undergraduate students at a SA university.
Methods. We conducted this cross-sectional study from August 2022 to April 2023. Undergraduate students ≥18 years were invited to complete a self-administered, anonymised, online questionnaire incorporating screening questions from the Alcohol Use Disorder Identification Tool (AUDIT). Univariable and bivariable analyses were then performed.
Results. Ultimately, we included 378 participants (65% female, median age 22 interquartile range 21 - 23 years). Overall, 78.9% (95% confidence interval (CI) 73.4 - 83.5) of participants had consumed alcohol previously, and among them, 14.4% (95% CI 10.6 - 19.3) consumed alcohol up to three times a week. Male students were more likely to engage in binge drinking than female students (18.2% v. 8.5%, p<0.001). Most students (68%) lacked awareness regarding the safe limit for alcohol consumption and underestimated the standard units of alcohol in a 330 mL can of beer (71.3%) or glass of wine (83.8%). Relationship stress and increased workload were the most cited triggers for consuming alcohol. Among those who underwent AUDIT screening, 11.7% (95% CI 8.3 - 16.2) had positive results for harmful or hazardous drinking, while 8.6% (95% CI 5.7 - 12.7) indicated likely alcohol dependence.
Conclusions. Our findings highlight a concerning alcohol burden among young people in academic institutions, particularly male students. A systemic evaluation of university drinking culture is recommended to support student wellness.



World Health Organization. Global Status Report on Alcohol and Health 2018. Geneva. WHO. 2018. https:// 6 October 2023).

World Health Organization. Global strategy to reduce the harmful use of alcohol. Geneva. WHO. 2010. https:// ?sequence=1 (accessed 6 October 2023.)

Shield KD, Parry C, Rehm J. Chronic diseases and conditions related to alcohol use. Alcohol Res 2014;35(2):155-

Morojele NK, Shenoi SV, Shuper PA, Braithwaite RS, Rehm J. Alcohol use and the risk of communicable

diseases. Nutrients 2021;13(10).

Ye Y, Shield K, Cherpitel CJ, Manthey J, Korcha R, Rehm J. Estimating alcohol-attributable fractions for

injuries based on data from emergency department and observational studies: A comparison of two methods.

Addiction 2018;114:462-470.

Chu KM, Marco JL, Owolabi EO, et al. Trauma trends during COVID-19 alcohol prohibition at a South

African regional hospital. Drug Alcohol Rev 2022;41:13-19.

Reuter H, Jenkins LS, De Jong M, Reid S, Vonk M. Prohibiting alcohol sales during the Coronavirus disease 2019 pandemic has positive effects on health services in South Africa. Afr J Prim Health Care Fam Med


Rochat TJ, Houle B, Stein A, Mitchell J, Bland RM. Maternal alcohol use and children’s emotional and cognitive outcomes in rural South Africa. S Afr Med J 2019;109(7):526–34. https://pubmed.ncbi.nlm.nih. gov/31266581/

Vellios NG, van Walbeek CP. Self-reported alcohol use and binge drinking in South Africa: Evidence from the national income dynamics study, 2014 - 2015. S Afr Med J 2018;108(1):33-39. https://pubmed.ncbi.nlm.

Hasking P, Shortell C, Machalek M. University students’ knowledge of alcoholic drinks and their perception of alcohol-related harm. J Drug Education 2005;35(2):95-109. 11. Karam E, Kypri K, Salamoun M. Alcohol use among college students: An international perspective. Curr Opin

Psychiatry 2007;20:213-221.

Kyei KA, Ramagoma M. Alcohol consumption in South African universities: Prevalence and factors at the

University of Venda. J Soc Sci 2013;36(1):77-86.

du Preez R, Pentz CD, Lategan BW. Why students drink: A study of South African university students’

drinking behaviour. S Afr J Higher Educ 2016;30(2).

Govender I, Nel K, Mogotsi MM. Experiences and opinions of first-year students at a previously disadvantaged medical university in South Africa about alcohol consumption. S Afr Fam Pract 2015;57(5):313-317. https://

Davoren MP, Cronin M, Perry IJ, O’connor K. Alcohol consumption among university students: a typology of consumption to aid the tailoring of effective public health policy. BMJ Open 2016;6:1-9. https://doi. org/10.1136/bmjopen-2016-011815

Kypri K, Cronin M, Wright CS. Do university students drink more hazardously than their non-student peers? Addiction 2005;100:713-714.

Slutske WS. Alcohol use disorders among US college students and their non-college-attending peers. Arch Gen Psychiatry 2005;62:321-327. 18. Blows S, Isaacs S. Prevalence and factors associated with substance use among university students in South

Africa: implications for prevention. BMC Psychol 2022;10(309). 19. Saunders JB, Aasland OG, Babor TF, De La Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on early detection of persons with harmful alcohol

consumption--II. Addiction 1993;88(6):791-804.

Alcohol Use Disorders Identification Test. Background. (accessed

July 2023).

Norman P, Cameron D, Epton T, et al. A randomised controlled trial of a brief online intervention to reduce

alcohol consumption in new university students: Combining self-affirmation, theory of planned behaviour messages, and implementation intentions. Br J Health Psychol 2018;23(1):108-127. bjhp.12277

Morojele NK, Lombard C, Harker Burnhams N, Petersen Williams P, Nel E, Parry CDH. Alcohol marketing and adolescent alcohol consumption: Results from the international alcohol control study (South Africa). S Afr Med J 2018;108(9):782-788.

Van Der Heever H, Thuli R, Mthabela H. Patterns of Alcohol Use amongst Undergraduate Students at a Health Sciences University. S Afr Article in J Drug Alcohol Res 2021;10(7). publication/356914643

Zamboanga BL, George AM, van Hedger K, Olthuis JV, Pilatti A, Dresler E. Participation in drinking games and predrinking among university students in Argentina, Australia, Canada, and New Zealand. Alcohol and Alcoholism 2021;56(6):683–8.

Singh S. South African male university students’ perspectives on gender norms concerning alcohol and related harmful behaviours towards female drinkers. Cult Health Sex 2023;25(5):554-566. 13691058.2022.2070671

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Copyright (c) 2024 B Mbuqa, R Ducasse, M Ferreira, L Danielkutty, B Radebe, N Jacob