{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:38:49Z","timestamp":1792489129154,"version":"4.5.0"},"reference-count":60,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aim<\/jats:title>\n                    <jats:p>Stimulating the use of alcohol\u2010free beverages is portrayed as one strategy to reduce excessive alcohol use and alcohol\u2010related harm among students in higher education. This strategy relies on the assumption that students drink alcohol\u2010free to substitute alcohol (i.e. \u2018substitution effect\u2019), while other possibilities like drinking alcohol\u2010free in addition to alcohol (i.e. \u2018addition effect\u2019) or alcohol\u2010free acting as a step\u2010up to consume (more) alcohol (i.e. \u2018stepping\u2010stone\u2019 effect) have largely been neglected. Consequently, this pre\u2010registered study aimed to examine bi\u2010directional temporal associations between the quantity of alcohol and alcohol\u2010free use among university students (aim 1). Next, these bi\u2010directional temporal associations were examined in subgroups: females vs. males (aim 2) and members vs. non\u2010members of student associations (aim 3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational study, utilizing wave 2, wave 3 and wave 4 of Radboud University's Healthy Student Life study. Data were collected May\u2013July 2022, 2023 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>9951 university students, of which 6790 students had only cross\u2010sectional data, while 2383 and 778 students participated in 2 and 3 surveys, respectively. At wave 2, participants' mean age was 23 (standard deviation\u2009=\u20094.0). 70% were female, 17% were members of a student association, 13% were international students and 57% were enrolled in a bachelor programme.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>At all waves, participants self\u2010reported the frequency and quantity of alcohol and alcohol\u2010free beverage consumption, using two (adapted) items of the Alcohol Use Disorders Identification Test \u2013 Consumption (AUDIT\u2010C). Additionally, participants self\u2010reported on: gender, student association membership, living situation, relationship status and other substance use. Last, information on biological sex, age, educational programme and (inter)national status was received from the university administrative records. Random Intercept Cross\u2010Lagged Panel Models were used to study reciprocal effects between the quantity of alcohol and alcohol\u2010free use, by decomposing observed scores in between\u2010person differences and within\u2010person dynamics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      None of the analyses, in the total sample (aim 1;\n                      <jats:italic>b<\/jats:italic>\n                      between 0.02 and 0.03,\n                      <jats:italic>p<\/jats:italic>\n                      between 0.414 and 0.779) or in subgroups (aims 2\u20133;\n                      <jats:italic>b<\/jats:italic>\n                      between \u22120.001 and 0.12,\n                      <jats:italic>p<\/jats:italic>\n                      between 0.192 and 0.988), provided support for within\u2010person cross\u2010lagged effects between the quantity of alcohol and alcohol\u2010free use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Among Dutch university students, no evidence was found for substitution or stepping\u2010stone effects of alcohol\u2010free beverages, which (indirectly) suggests that students generally drink alcohol\u2010free as an additive to alcohol, rather than as a substitute or stepping\u2010stone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70667","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T08:40:55Z","timestamp":1792485655000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Substitution, addition or stepping\u2010stone? Exploring the temporal associations between the consumption of alcoholic and alcohol\u2010free beverages among Dutch university students"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9583-4184","authenticated-orcid":false,"given":"Kirsten J. M.","family":"van Hooijdonk","sequence":"first","affiliation":[{"name":"Behavioural Science Institute Radboud University  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9504-2147","authenticated-orcid":false,"given":"Lise J. J.","family":"Dams","sequence":"additional","affiliation":[{"name":"Behavioural Science Institute Radboud University  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4526-3854","authenticated-orcid":false,"given":"Tirza H. J.","family":"van Noorden","sequence":"additional","affiliation":[{"name":"Behavioural Science Institute Radboud University  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3910-3528","authenticated-orcid":false,"given":"Jacqueline M.","family":"Vink","sequence":"additional","affiliation":[{"name":"Behavioural Science Institute Radboud University  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2005.01116.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2010.71.742"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.2004.65.477"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-018-0962-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(22)00847-9"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.35946\/arcr.v35.2.11"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmaa170"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(09)60746-7"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15040910"},{"key":"e_1_2_10_11_1","unstructured":"Ministerie van Volksgezondheid Welzijn en Sport.Nationaal preventieakkoord [Internet].2018. 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