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Workbook for Changing College Student Drinking Habits

This workbook is based on research protocols tested in Project TrEAT (NIH#AA 08512).

Initial Visit


This workbook will guide the discussion between you and your health provider. It describes 6 steps to help you change your health behavior. While you will have the opportunity to talk about many health topics, the workbook focuses on alcohol use. Your physician or nurse will talk with you about each of the steps

Step 1: Summarizing Current Health Habits

How many days per week do you exercise? __________________

On a day when you exercise, how many minutes do you exercise? ________

Tobacco Use
Do you currently smoke cigarettes or use tobacco products? Yes No

If yes, how many cigarettes per day do you smoke? _______________

Alcohol Use
How many days per week do you drink alcohol? ___________________

How many days per week do you drink more than 4-5 drinks? ___________

How many drinks do you have in an average week? _______________

Have you had any problems related to your alcohol use, such as accidents, injuries, or falls? _______________________________________________

Have you currently felt like things are hopeless? Yes No

Do you currently feel sad and blue every day? Yes No

Step 2: Types of Drinkers

There are five different types of college drinkers. We define them by levels of alcohol consumption and problems related to drinking:

Abstainers image of red arrow Drink no alcohol or have less than 1 drink per month.
image of red arrow Alcohol use does not affect health or result in problems
Low-risk drinkers image of red arrow Fewer than 5 drinks per occasion for men and fewer than 14 drinks per week.
image of red arrow Fewer than 4 drinks per occasion for women and fewer than 7 drinks per week.
image of red arrow At times will consume NO alcohol, such as before driving, while operating machinery, or while pregnant.
High-risk drinkers image of red arrow Men who drink 14 or more drinks per week.
image of red arrow Women who drink 7 or more drinks per week.
image of red arrow Men who drink 5 or more drinks in a row, women who drink 4 or more drinks in a row.
image of red arrow Men and women who drink in high-risk situations.
Problem drinkers image of red arrow Students with one or more alcohol-related problems.
Alcohol-dependent image of red arrow Cannot stop drinking once started.
image of red arrow Drinking level has led to a physical need for alcohol.
image of red arrow Experiences problems related to alcohol use.

Where would you place yourself on this chart?

Pie chart diagramming different types of student drinkers [D]

Step 3: Reasons to Quit or Cut Down on Drinking

Think of reasons why you might want to quit or cut down on your drinking. Here are ideas other students have had. Mark any box that describes why you would want to change your drinking habits.

To do better in school
To decrease the chance of falls or other injuries
To reduce chances of dying in a car crash
To prevent blackouts
To decrease the chances of unwanted sexual experiences
To save money
To feel better
To have more energy
To be nicer to my friends
To reduce my weight
To reduce the number of headaches
To reduce stomach pain
To reduce my risk of developing an addiction to alcohol
To help me stop smoking
To decrease my chance of developing medical problems related to my drinking

Can you think of any other reasons why you might want to quit or cut down your drinking?

1. _________________________________________________
2. _________________________________________________
3. _________________________________________________

Step 4: How Much Should I Drink

This step will help you to decide on a drinking limit for yourself for a particular period of time. Talk with your primary care provider so you both agree on a reasonable goal.

As you develop this drinking limit agreement, or contract, answer the following questions:

  • How many standard drinks should I have?
  • How frequently should I drink?
  • When should I return for a follow-up visit?

As you talk about this drinking limit, keep in mind the amount of alcohol that counts as a standard drink. The picture below explains a standard drink.

12 oz. of beer or cooler 8-9 oz. of malt liquor
8.5 oz. shown in a 12-oz. glass that, if full, would hold about 1.5 standard drinks of malt liquor
5 oz. of table wine 1.5 oz. of brandy
(a single jigger)
1.5 oz. of spirits
(a single jigger of 80-proof gin, vodka, whiskey, etc.) Shown straight and in a highball glass with ice to show level before adding mixer
An image of a  12 oz. can of beer or wine cooler.
12 oz.
An image of an 8.5 oz. glass.
8.5 oz
An image of a 5 oz. glass.
5 oz.
An image of a 1.5 oz. brandy glass.
1.5 oz.
An image of 1.5 oz. highball glass.
1.5 oz.
Note:  People buy many of these drinks in containers that hold multiple standard drinks. For example, malt liquor is often sold in 16-, 22-, or 40 oz. containers that hold between two and five standard drinks, and table wine is typically sold in 25 oz (750 ml.) bottles that hold five standard drinks.

We will use two tools to help you change your drinking practices:

Drinking Limit Agreement

This agreement should clearly state your drinking limit and when to return for a follow-up visit with your primary care provider.

Fill out this Drinking Limit Agreement, or contract, with your primary care provider. A reasonable goal for some students is abstinence—not drinking any alcohol.

Drinking Agreement

Date _______________

I, ________________________________, agree to the following drinking goal:

Number of drinks and frequency:


Abstinence (zero drinks)

Period of time to cut down or quit:________________

Return visit in ________ week(s)

Student signature:  __________________________

Clinician signature: __________________________

Drinking Diary Cards

These cards are a way of keeping track of how much, and when, you drink. Use one card per week. Each day, record the number of drinks you consume. At the end of the week, add up the total number of drinks you consumed during the week. You and your health care provider will review these cards at your follow-up visit.

Keep a record of what you drink over the next 7 days

Beer/Ale Malt Liquor

Spirits Hard Liquor


Wine Cooler

Liqueur or Sherry

Weeks TOTAL: ___________

First Visit Summary

We've covered a great deal of information. Changing your lifestyle, especially your drinking patterns, can be a challenge.

Before your next visit, please do the following:

Make an appointment for your second visit next month BEFORE leaving.
Remember your drinking limit goal:
Use the diary cards to track your drinking.
Congratulate yourself every time you are tempted to drink heavily and are able to resist.
DON'T GIVE UP! Some people have days during which they drink too much.
Bring this workbook AND the diary cards with you to the next visit.
A clinic nurse will telephone you in two weeks to see how you're doing.

Remember that you are changing your behavior and it can be hard work. It becomes easier with time.

Image of a person in a liquor bottle

Second Visit

Thank you for coming today. Changing your lifestyle, including your drinking patterns, can be difficult. The purpose of this follow-up visit is to talk about the successes and difficulties you have had since your previous visit. We will cover the following topics:

  • Review of your alcohol use since the previous visit.
  • Step 5: Risky situations.
  • Step 6: Ways to cope with risky situations.
Image of two people in a wine glass

Let's begin . . .

Reviewing Your Alcohol Use and Drinking Goal

You and your health care provider will begin by talking about how you have been doing since your last visit. If you kept track of your alcohol use on the drinking diary cards, please review them together.

If you didn't complete the diary cards, please go back to page 7 and complete them now for the previous two weeks.

Drinking Limit Agreement

Your drinking limit goal at your last visit was:

From a review of your diary cards, were you able to meet this goal?

  • Yes
  • Somewhat
  • No

Whether you were able to stick to your drinking limit or not, it is likely that you encountered some difficult situations. The next steps focus on some of these situations.

Step 5: Identify Risky Situations

Your desire to drink may change according to your mood, the people you are with or if you are alone, and the availability of alcohol. Think about when and where you drink. Try to identify situations that make you want to drink.

The following list may help you remember situations or moods that make you want to drink. Please check the boxes that apply to you...


After classes or workSleeplessness
Certain placesSporting events
Social eventsTV or magazine ads
Family stressesUse of tobacco
FriendsWatching television
Other people drinkingWeekends
Summer time/semester breakExams

Anger, resentment
Anxiety, fear
Boredom, loneliness
Feelings of failure
Joy, happiness

Identify the three situations or moods when you are most likely to be tempted to drink. Write them below:

1. _________________________________________________
2. _________________________________________________
3. _________________________________________________

Step 6: How to Handle Risky Situations

In certain situations, especially if you are having a bad day, you will find that you are tempted to drink. It is important to figure out ahead of time how to make sure you will not drink when you are tempted. Here are some tips from other students about ways to cope without drinking when life gets you down.

Think of something pleasant you can do for yourself or for a friend.
Ask a friend to play cards or another game or talk about something totally different.
Telephone a sober friend or visit a sober neighbor.
Exercise: go for a walk, play a sport, or go to the gym.
Take a hot bath or shower.
Watch a movie or read a book or magazine.
Drink a soda or some other drink without alcohol.
Write your feelings down in a notebook.
Listen to music.
Surround yourself with positive people.

Some of the ideas may not work for you, but maybe you can think of other ideas that might work well. If so, write them down here.



Any lifestyle change is challenging. When you start to see progress, reward yourself. Rewards can help to balance the feeling that you're depriving yourself of something. In fact, what you're gaining is important to you, your family, your studies, and your friends.

Can you think of a way in which you can reward yourself for drinking less? Just DON'T use an alcoholic drink as a reward!

I'm going to reward myself by:


A great deal of information has been covered in this guide and during your visits.

  • Remind yourself that changing behavior can be difficult and that this is normal.
  • Remember to reward yourself for successes.
  • And when things don't work as well... Don't Give Up!
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Historical document
Last reviewed: 9/23/2005

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