Factors Associated with Pre-drinking Among Nightclub Patrons in the City of São Paulo

Aims: The aim of the study was to describe the phenomenon of pre-drinking (alcohol consumption before entering nightclubs or bars) and to identify factors associated with pre-drinking practices among patrons in the city of São Paulo, Brazil.

Methods: Individual-level data were collected by a portal survey of 2422 patrons at the entrance and at the exit of 31 nightclubs. The nightclubs were selected by two-stage sampling using a probability proportional to the establishments' capacity in the first stage and a systematic sample of patrons in the second stage. Breath alcohol concentration (BrAC) was measured. Face-to-face interview identified pre-drinking characteristics and past-year risk behaviors. Analysis used sample weights to compensate for nightclubs or patrons that were possibly over- or under-represented.

Results: Of the study participants, 41.3% (95% confidence interval (CI) = 33.7–49.3) engaged in pre-drinking on the night of the interview. Being male (odds ratio (OR) = 1.98, 95% CI = 1.45–2.71), past-year binge drinking (OR = 2.28, 95% CI = 1.70–3.07), previous episodes of severe effects from drunkenness (OR = 1.77, 95% CI = 1.40–2.22) and sexual risk behavior (OR = 1.67, 95% CI = 1.20–2.33) were associated with recent pre-drinking. Pre-drinking predicted higher BrACs at the nightclub exit.

Conclusion: Pre-drinking is prevalent among nightclub patrons and associated with risk behaviors, and is associated with alcohol intoxication at nightclub exits. Environmental prevention strategies must consider pre-drinking as a potential risk factor for alcohol intoxication in nightclubs.