Profiles of transdermal alcohol concentration and their prediction of negative and positive alcohol-related consequences in young adults' natural settings.

Objective: Transdermal alcohol concentration (TAC) sensors provide a multidimensional characterization of drinking events that self-reports cannot. These profiles may differ in their associated day-level alcohol-related consequences, but no research has tested this. We address this using multilevel latent profile analysis.

Method: Two hundred twenty-two young adults who regularly engage in heavy drinking ( = 22.3, 64% female, 79% non-Hispanic White) responded to surveys and wore TAC sensors for 6 consecutive days. We tested whether four previously identified TAC profiles: (1) high-fast (8.5% of days), (2) moderate-fast (12.8%), (3) low-slow (20.4%), and (4) little-to-no-drinking days (58.2%) differed in numbers of negative and positive consequences and in the odds that both consequence types occurred on the same day.

Results: High-fast (incident rate ratio [IRR] = 6.18; IRR = 9.47) and moderate-fast (IRR = 3.71; IRR = 5.68) days contained more negative consequences compared to low-slow and little-to-no-drinking days. High-fast (IRR = 2.05), moderate-fast (IRR = 1.88), and low-slow (IRR = 1.43) days contained more positive consequences than little-to-no-drinking days. The odds of having only positive consequences were highest on low-slow, χ²(3) = 9.10, < .05, days but the odds of experiencing both consequence types increased on moderate-fast and high-fast days, χ²(3) = 39.63, < .001.

Conclusions: Compared to little-to-no-drinking days, TAC profiles indicative of drinking (high-fast, moderate-fast, and low-slow) contained more negative and positive consequences. However, the odds of experiencing positive consequences were highest among low-slow days and decreased on moderate-fast and high-fast days as the odds of negative consequences rose. These findings provide novel evidence reinforcing harm reduction approaches that seek to maximize positives and minimize negatives of alcohol consumption through emphasis on slow-paced, low-volume drinking. (PsycInfo Database Record (c) 2025 APA, all rights reserved).