Risk intentions following pill test scenarios are predicted by MDMA use history and sensation seeking: A quantitative field study at an Australian music festival

and Aims Most Australian Governments have resisted supporting formal pill testing (drug checking) at music festivals. With limited knowledge available regarding post‐pill test substance use behaviour, we aimed to understand risk behaviour within three pill test scenarios by determining the individual factors which predict subsequent risky or risk reduction intentions. Design and Methods Music festival attendees ( N  = 276) were presented with three hypothetical pill test scenarios and reported their risk intentions, MDMA use history and sensation seeking. The pill test scenarios described an inconclusive test (unknown substance), the detection of a high MDMA dose, or a harmful adulterant (PMA or PMMA). Results Findings revealed that access to pill test results would facilitate reduced risk behaviour rather than maintained or increased risk behaviour for people who have never used MDMA. However, people who have used MDMA were not necessarily more likely to engage in risk reduction following a pill test. Furthermore, and using predictive analyses, harm‐reducing behaviours are less likely when a person has a history of MDMA use and for those high in sensation seeking, particularly if a test result indicates a high MDMA dose. Discussion and Conclusions Pill testing alone may not prevent adverse outcomes in some festival attendees. While some individuals are more likely to reduce their risk than maintain or increase their risk, other features of a pill test scenario (e.g. referral to support services, drug education) are likely to be important facilitators of harm reduction intentions.