This study investigated the role of sensation seeking, peer group drinking and self-efficacy in refusing to drink alcohol in influencing alcohol consumption of a sample of 588 Italian university students. Results confirmed that heavy drinkers are typically males living in university residences. Alcohol use is more frequent among students with higher sensation seeking. Moreover, students whose friends drink alcohol and who report lower self-efficacy in refusing to drink alcohol tend to drink themselves to a higher rate and to be involved in drunkenness episodes. The impact of sensation seeking on drinking behaviors appears to be partly influenced by perceived group drinking and perceived self-efficacy. Results emphasize the importance of preventative interventions targeted to group norms and enhancing students' refusal skills. (Published Abstract)