Alcohol 'pre-loading': a review of the literature.

AIM To review the international literature concerning pre-loading (PL); this is drinking before going out to pubs and bars. METHOD A literature review conducted in May 2013 using the EBSCO database entering the following search terms 'pre-loading', 'front-loading', 'pre-partying' and 'pre-drinking'. Thereafter, the reference lists were checked for further relevant articles. The review consisted of 40 articles of which 11 were excluded because PL was not the primary unit of analysis or they did not fulfil a quality assurance criterion. RESULTS Despite being an internationally widespread development to date, most of the research on this has been from the USA and UK. The majority of US studies have been concerned with PL in a college and high school setting, while the research in the UK has mainly concentrated on the correlation/relationship between PL and what takes place when drinkers enter pubs and bars later in the evening. A consistent finding was that PL is associated with greater alcohol consumption, intoxication and alcohol-related risks. The price of alcohol and achieving intoxication were the main motivations for PL. However, other reasons included a chance to meet members of the opposite sex or own friends in surroundings that encouraged interaction rather than intoxication. CONCLUSION PL should be regarded as part of a wider drinking culture and understood within the context of what individuals require from a night out or staying in when drinking. There is little evidence to suggest that PL is a risk factor for admissions to accident and emergency services.