Policy implications of the widespread practice of 'pre-drinking' or 'pre-gaming' before going to public drinking establishments: are current prevention strategies backfiring?

AIM: To describe the research, policy and prevention implications of pre-drinking or pre-gaming; that is, planned heavy drinking prior to going to a public drinking establishment.
METHODS: The authors describe the phenomenon of pre-drinking, motivations for pre-drinking and its associated risks using available research literature, media and popular internet vehicles.
RESULTS: Heavy drinking prior to going out has emerged as a common and celebrated practice among young adults around the world. Apparent motivations are: (i) to avoid paying for high priced drinks at commercial drinking establishments; (ii) to achieve drunkenness and enhance and extend the night out; and (iii) to socialize with friends, reduce social anxiety or enhance male group bonding before going out. Limited existing research on pre-drinking suggests that it is associated with heavy drinking and harmful consequences. We argue that policies focused upon reducing drinking in licensed premises may have the unintended consequence of displacing drinking to pre-drinking environments, possibly resulting in greater harms.
CONCLUSIONS: Effective policy and prevention for drinking in licensed premises requires a comprehensive approach that takes into account the entire drinking occasion (not just drinking that occurs in the licensed environment), as well as the 'determined drunkenness' goal of some young people.