AIMS: To explore differences in alcohol consumption and negative nightlife experiences between young people who drink prior to attending city nightlife venues and those who do not drink until reaching bars and nightclubs.

DESIGN, SETTING AND PARTICIPANTS: A cross-sectional survey of 380 young people (aged 18-35 years) in bars and nightclubs in a large city centre in the North-west of England.

MEASUREMENTS: An anonymous questionnaire explored participants' basic demographics; frequency of utilizing nightlife; quantities of alcohol consumed prior to and during a typical night out in the city; and negative experiences in the city's nightlife in the previous year [fighting, being verbally abused, being sexually molested (e.g. groped) and being too drunk to walk].

FINDINGS: Participants who reported drinking prior to attending nightlife (e.g. at their own or a friend's home) reported significantly higher total alcohol consumption over a night out than those not drinking until reaching bars and nightclubs. Over a quarter (26.5%) of female and 15.4% of male alcohol consumption over a night out occurred prior to attending nightlife. Individuals who drink before going out were over four times more likely to report drinking >20 units on a usual night out and 2.5 times more likely to have been involved in a fight in the city's nightlife during the previous 12 months.

CONCLUSIONS: Measures to tackle drunkenness and alcohol-related violence in nightlife should expand beyond those targeted solely at nightlife environments. Continued disparities in pricing and policing of alcohol between on- and off-licensed premises may increase at-home drinking prior to nights out and alcohol-related problems in residential areas.