Among Young People, Being Around Peers May Elicit Greater Drinking Cravings than the Presence of Alcohol

The presence of peers is a key prompt for alcohol cravings among young people, according to a new study in Alcohol: Clinical & Experimental Research. When certain settings, people, or items—a bar, a friend, a glass—are paired with alcohol, they can become conditioned cues, eliciting drinking cravings. These learned reactions are associated with alcohol use disorder (AUD), treatment outcomes, and relapse. Adolescents and emerging adults are particularly susceptible to peer influence. In real-world settings, studies have found that the presence of peers predicts young people’s intensifying drinking cravings at the moment. In laboratory studies, however, peer influence is largely absent, potentially limiting the usefulness of their findings. Better understanding peers as alcohol cues could inform more effective AUD prevention and treatment programs. For the current study, researchers from Brown University, RI, evaluated alcohol cravings among youth in the human laboratory, using drinking-related images with and without a social context, and in the real-world environment, using visual alcohol cues with and without the presence of peers.

Investigators drew from data collected for trials of medications aimed at reducing alcohol use among young people. The study involved 115 participants aged 14–24 (74% White, 20% Latine, 13% Black). They underwent a laboratory cue assessment, capturing to what extent images of alcohol and varying social contexts influenced their urge to drink. For the real-world assessment, participants were trained in assessing their alcohol cravings at intervals throughout the day using handheld devices. Every morning for an average of eight days, they reported whether they’d consumed alcohol the previous day. At random intervals each day, the devices nudged them to answer certain questions about their drinking (e.g., Is alcohol visible?). Researchers also collected demographical and clinical data on the participants, including AUD symptoms. They used statistical analysis to explore associations between visual cues and alcohol cravings in both environments.

The participants frequently experienced cravings after being exposed to alcohol-related cues. In the laboratory, drinking cravings were greatest when the images featured alcohol and a social context (e.g., two people drinking). Images without alcohol that implied a social drinking context (e.g., red solo cups in beer pong formation) and images featuring alcohol without that context (e.g., a beer bottle on a solid background) elicited higher cravings than neutral images. Participants’ laboratory reactions predicted their real-world cravings. Social and visual cues had a similar effect on their regular lives, even after accounting for other factors (age, sex, weekend, location, AUD symptoms, and more). In the lab, younger drinkers were more reactive than older youth to alcohol images conveying a social context. In the real-world settings, findings were consistent across the age range, suggesting that the link between cues and alcohol craving is not developmentally driven.

Interpersonal peer influences are central to the subjective experience of young people who use alcohol. The study findings reinforce the relevance of social context on young people’s cravings in response to alcohol cues, perhaps especially in real-world situations. They also underline the potential for a better understanding of cue reactivity in preventing, diagnosing, and treating dangerous drinking. Ongoing research that integrates contextual influences and study findings—combining laboratory and real-world assessments—is essential.

Peer elicited alcohol craving in adolescents and emerging adults: Bridging the laboratory and natural environment. S. Meisel, H. Treloar Padovano, M. Pielech, K. Goodyear, R. Miranda.

ACER-22-5508.R2