College Alcohol 101: How Big Is 1 Drink?

Many College Students -- and Probably Other Adults -- Don’t Know

Medically Reviewed by Brunilda Nazario, MD on April 15, 2005
From the WebMD Archives

College students tend not to know the standard size of a drink of alcohol, and their misunderstanding could be dangerous, says a new study.

In the study of 133 undergraduates, the students overpoured alcohol and underestimated their drinking, says Aaron M. White, PhD. White worked on the study, which appears in April's issue of Alcoholism: Clinical and Experimental Research.

The bigger the cup, the more alcohol the students poured.

"Most were really surprised. They did not realize they were drinking as much as they were," says White, an assistant professor of psychiatry at Duke University.

"They've been taught that four to five drinks were a dangerous level," White tells WebMD. "That's drilled into their heads. When you tell them that they're actually having six to eight drinks, a lot of those kids are really concerned."

"When we asked them to simply define how many ounces there should be in a single drink, they tended to give us numbers that were way too big. This tells us a few things. The first is that we have totally failed to teach students some of the most basic information about alcohol -- what a single serving is," writes White.

White says studies he's seen suggest that "adults really have no idea what a drink is, either." A 2005 survey by the American Medical Women's Association agrees.

The survey included 253 doctors, residents, and medical students. Eighty percent agreed that most adults who choose to drink do not know how the government defines a "standard drink" --12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits.

Not understanding serving size could have severe consequences.

For instance, a college woman who thinks she can have four drinks safely and has "four huge mixed drinks with five ounces of liquor in each drink, she literally could die," says White. "What if she defines one drink as a 22-ounce cup of wine from a box?"

Apart from the health risks, the findings may call into question research on f. college drinking. Let's say that college students report having three drinks per week one year, and only one weekly drink the next year.

On the surface, that looks like college drinking dropped. But if the trend in the second year was to use huge cups, the actual number of drinks could be off, says White. "It depends on what's in vogue, which I think makes it hard to track over time," he says.

Portion Distortion

Or, put it this way. "The best analogy in the nonalcoholic realm is if you ask people how many bagels they have each day," says White.

"Let's say it's one. But in reality, bagel size has gone through the roof. They say they're having one bagel, but they're really having four standard bagels," says White.

College students aren't the only ones who might overdo alcohol without knowing it. He and his colleagues note that a middle-aged woman might have a f. glass of wine for heart benefits but pour way more than what's recommended without knowing it.

People buy many alcoholic drinks in containers that hold multiple servings. For example, wine is typically sold in 25 ounce bottles that have five standard drinks.

College students often get a bad rap, says White. "That's really unfortunate," he tells WebMD.

"We as adults have failed the students. For all the money and hype and attention to the college drinking issue, we have failed to teach students what a drink is. I think it's pretty pathetic," he says.

"We need to back up a little bit and get on the same page about what a dose is," says White, pointing out that alcohol is a drug.

"How can you have a dialogue about safe vs. risky use if we don't all have a single concept of what a dose is?" He adds that teaching students about doses is "not to suggest in any way that they should be drinking." Most students in the study were under the legal drinking age and said they drank alcohol anyway.

"Underage drinkers have a tendency to drink more heavily and more quickly than of-age drinkers," says White.

Better Grasp About Beer

Study participants were better at gauging serving sizes of beer than wine or mixed drinks, says White. "Students who drink beer tend to be more accurate. Males are the ones who tend to drink beer; males tended to be more accurate because of that."

Women, who favored mixed drinks and shots, had "more of a discrepancy," says White. "In a way, this is a gender issue."

It wasn't that the students were totally clueless. Some asked if they should pour "regular drinks" or "college-student drinks," says White.

"They were surprised at their own behavior, not the issue in general."

Drink size and concentration of alcohol both matter, says White.

"It can't just be done by ounces," he says. "Who in their right mind is doing math in a bar all night? Alcohol and math do not go together. I drink; I'm not a neo-prohibitionist."

White favors putting serving-size information on alcoholic drinks. "It would be a piece of cake to put on the side of a wine bottle demarcations between servings," he says. "A source of frustration for me is to walk down aisle 10 [at the grocery store] and grape juice bottles have serving sizes. Walk down aisle 11, and wine does not have serving sizes."

Alcohol makers do include warning labels about safe, lawful, and responsible use of alcohol. But serving information is not required on packaging.

WebMD contacted the Distilled Spirits Council of the United States. In an emailed statement, Monica Gourovitch, the council's senior vice president of scientific affairs, tells WebMD that government agencies and public health organizations teach the public about the alcoholic content and standard sizes of drinks.

"Understanding alcohol equivalence is an important part of responsible drinking," says Gourovitch's statement. "There are many ways to convey this important scientific fact including the option of putting the information on product labels or the packaging. Current government regulations do not provide for a statement of the standard drink definition."

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SOURCES: White, A. Alcoholism: Clinical and Experimental Research, April 2005; vol 29. Aaron M. White, PhD, assistant professor of psychiatry, Duke University Medical Center. American Medical Women's Association, "Standard Drink Survey Key Findings Summary." Monica Gourovitch, senior vice president, scientific affairs, Distilled Spirits Council of the United States. News release, Alcoholism: Clinical and Experimental Research.

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