Abstract
BACKGROUND: Despite guidelines recommending lower alcohol limits for individuals who flush, some still drink at unhealthy levels. This study investigates whether drinking motives are differentially associated with alcohol consumption based on self-reported flushing status among U.S. Asian young adults. Asian American youth report alcohol use at rates comparable to other high-risk groups, identifying the need to understand factors shaping these behaviors. METHODS: The current analysis drew participants from a longitudinal multi-cohort study examining the emotional and behavioral health of college students. Freshmen were recruited, all aged 18 years and older, to complete a baseline survey and follow up surveys over a four-year period. The analytic sample (Mean age = 19.4; 70.5% female) included 244 students who self-identified as Asian. Participants self-reported whether they experience facial flush when consuming alcohol and rated their endorsement of various drinking motives. Negative binomial regression models tested main effects and interaction effects between flushing status (flushers, non-flushers) and drinking motives (coping, enhancement, conformity, social). RESULTS: Facial flushing moderated enhancement, conformity, and social drinking motives, but not coping. Among flushers, enhancement and social motives were more strongly associated with greater alcohol consumption. Among non-flushers, conformity motives were stronger and associated with greater drinking, at a trend level. Overall, flushing or higher coping motives were associated with lower alcohol consumption. Peer drinking was associated with higher consumption in both flushing-status groups. CONCLUSIONS: The current study extends prior international research on drinking motives and flushing status to U.S. Asian young adults. Findings support the need for prevention strategies that address individual drinking motives and the modeling of alcohol use by peers. Reducing alcohol use among individuals who experience alcohol-induced flushing is a public health priority, given their heightened risk for alcohol-related cancers and other negative health outcomes.