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Background  A rank based social norms model predicts that drinkers’ judgements about their drinking will be based on the rank of their breath alcohol level amongst that of others in the immediate environment, rather than their actual breath alcohol level, with lower relative rank associated with greater feelings of safety. This study tested this hypothesis and examined how people judge their levels of drunkenness and the health consequences of their drinking whilst they are intoxicated in social drinking environments.    Methods  Breath alcohol testing of 1,862 people (mean age = 26.96 years; 61.86 % male) in drinking environments. A subset ( N  = 400) also answered four questions asking about their perceptions of their drunkenness and the health consequences of their drinking (plus background measures).    Results  Perceptions of drunkenness and the health consequences of drinking were regressed on: (a) breath alcohol level, (b) the rank of the breath alcohol level amongst that of others in the same environment, and (c) covariates. Only rank of breath alcohol level predicted perceptions: How drunk they felt ( b  3.78, 95 % CI 1.69 5.87), how extreme they regarded their drinking that night ( b  3.7, 95 % CI 1.3 6.20), how at risk their long-term health was due to their current level of drinking ( b  4.1, 95 % CI 0.2 8.0) and how likely they felt they would experience liver cirrhosis ( b  4.8. 95 % CI 0.7 8.8). People were more influenced by more sober others than by more drunk others.    Conclusion  Whilst intoxicated and in drinking environments, people base judgements regarding their drinking on how their level of intoxication ranks relative to that of others of the same gender around them, not on their actual levels of intoxication. Thus, when in the company of others who are intoxicated, drinkers were found to be more likely to underestimate their own level of drinking, drunkenness and associated risks. The implications of these results, for example that increasing the numbers of sober people in night time environments could improve subjective assessments of drunkenness, are discussed.

A rank based social norms model of how people judge their levels of drunkenness whilst intoxicated