[Commentary] WHEN THE OBJECT IS TO GET DRUNK, PRE‐DRINKING MATTERS

We thank Room and Livingston 1 for their thoughtful commentary and are delighted to have the opportunity to respond. Room and Livingston's argument that we equate pre-drinking with off-premise consumption misses the point of our paper 2. Our goal was to describe the phenomenon of pre-drinking and discuss its implications for policy in relation to licensed premises. Pre-drinking is not simply a term that we are using to refer to off-premise drinking—‘pre-drinking’ and other similar terms such as ‘pre-gaming’, ‘pre-loading’, ‘front-loading’, ‘pre-bar’ and ‘pre-partying’ are used by young drinkers in various countries and cultures to refer to a certain style of drinking—namely, the rapid consumption of a large amount of alcohol before going out to whatever happens to be the ‘main event’, such as a party, bar or nightclub. For example, an online dictionary of new slang words defined by young people provides a typical definition of pre-drinking: ‘[The] act of drinking alcohol before you go out to the club to maximize your fun at the club while spending the least amount on extremely overpriced alcoholic beverages.’ (http://www.urbandictionary.com). Therefore, while we concur with Room and Livingston's suggestion that a substantial portion of youth drinking takes place off-premise and may sometimes represent the ‘main event’ of the evening, we are concerned with the common and widespread practice of planned, fast-paced, heavy drinking before going to a bar or nightclub and the policy implications for licensed premises of this pattern of behaviour. In assuming that the point is to compare on- and off-premise drinking, Room and Livingston cite Partanen's study 3 comparing home drinking to on-premise drinking among Helsinki respondents in the early 1970s as evidence that home drinking may be less likely to result in intoxication. However, home drinking occasions among all age drinkers in the 1970s cannot be equated with contemporary pre-drinking practices of young people. Moreover, while it is true that pre-drinking is often done at home (although it sometimes occurs in cheaper pubs before going to clubs 4), the critical aspect of pre-drinking is that it involves the rapid consumption of alcohol done with the intention of reaching a sufficient level of intoxication to carry one through the main event of the evening with minimal further spending on alcohol. This is clearly unlike home drinking described by Partanen, where, in comparison to on-premise drinking, ‘people do it in a more leisurely manner[italics added], which seems to lead to a lower degree of intoxication’3, p. 16]. Similarly, the issue is not whether drinking in a bar is more risky than drinking in other contexts, but rather whether heavy drinking before arriving at the bar produces more problems than would occur without pre-drinking. Of course, we recognize that bars and bar districts are high risk locations for aggression and other alcohol-related harm. However, among young people who go to bars, pre-drinking may increase their risk of extreme intoxication and alcohol-related harms. We are not suggesting that young people should drink in bars instead of at home, but that, for young people who go to bars, strategies might be developed to reduce the practice of loading up on alcohol before they go. One option to consider might be to encourage young bar-goers to do their early drinking at a bar where there is less reason for, and tolerance of, rapid consumption of alcohol in a short period of time than there might be in a private setting. This alternative might make drinking in the earlier part of the evening more leisurely, by fulfilling the social functions of pre-drinking (such as group bonding) while reducing the goal of ‘banking’ sufficient alcohol to last the evening. In the same vein, Room and Livingston misinterpret our paper as being concerned about whether policies favour on- or off-premise drinking when in fact our aim was to consider how current policies may have influenced the emergence of pre-drinking and suggest alternative approaches that might reduce this highly risky practice. If we all agree on the importance of recognizing and addressing the motivation among young people to get drunk, it is imperative that we understand the patterns of behaviour that emerge as a consequence of this underlying motivation. Pre-drinking, in particular, needs to be taken into account if we are to develop comprehensive policy, prevention and intervention programming that does not backfire or produce unanticipated consequences. The types of policies suggested by Room and Livingston may no longer be effective if young drinkers find ways to work around them by, for example, pre-drinking. As for the suggestion of increasing the availability of low-alcohol beverages; this approach is likely to be irrelevant among those motivated to get drunk. In sum, if we choose to ignore pre-drinking and assume that ‘policies that can reduce harm from on-premise consumption apply regardless of whether pre-drinking takes place’[1, p. 10] we may fall short in our goal of reducing alcohol-related harm among young people. None. This research was funded by the Canadian Institutes of Health Research (CIHR), Operating Grant (MOP 82872).