Alcohol-related risk from pre-loading and heavy episodic drinking (HED) among a cohort of young Australian women: a cross-sectional analysis

Objective: To cross-sectionally examine heavy episodic drinking (HED) and pre-loading with alcohol among young Australian women in relation to the alcohol-induced adverse outcomes of memory loss, vomiting and injury. Methods: A total of 7,800 participants, aged 20-25 years, from the 1989-95 cohort of the Australian Longitudinal Study on Women's Health answered all questions on alcohol use, reported drinking alcohol in the previous year and were not pregnant at the third survey in 2015. Log-binomial models were used to estimate prevalence ratios for adverse outcomes associated with increased frequency of HED and pre-loading. Results: The majority of participants reported HED (83.4%) and/or pre-loading (65.6%), which had a moderate correlation (r=0.646). Just over half (55.2%) of participants experienced at least one adverse event, with vomiting being most common. As the frequency of HED or pre-loading increased, so did the risk of an adverse outcome. Conclusions: Both HED and pre-loading pose a risk to young Australian women, and that risk rises with increased frequency. Implications for public health: Although HED has been a target of public health policy and interventions, pre-loading has received limited attention. In addition to addressing HED, there is a need to consider the risk posed by pre-loading, a related, yet unique risky drinking behaviour.