A latent class analysis of underage problem drinking: evidence from a community sample of 16-20 year olds

The aim of this paper is to shed light on the nature of underage problem drinking by using an empirically based method to characterize the variation in patterns of drinking in a community sample of underage drinkers. A total of 4056 16-20-year-old current drinkers from 212 communities in the US were surveyed by telephone as part of the National Evaluation of the Enforcing Underage Drinking Laws (EUDL) Program. Latent class models were used to create homogenous groups of drinkers with similar drinking patterns defined by multiple indicators of drinking behaviors and alcohol-related problems. Two types of underage problem drinkers were identified; risky drinkers (30%) and regular drinkers (27%). The most prominent behaviors among both types of underage problem drinkers were binge drinking and getting drunk. Being male, other drug use, early onset drinking and beliefs about friends drinking and getting drunk were all associated with an increased risk of being a problem drinker after adjustment for other factors. Beliefs that most friends drink and current marijuana use were the strongest predictors of both risky problem drinking (OR=4.0; 95% CI=3.1, 5.1 and OR=4.0; 95% CI=2.8, 5.6, respectively) and regular problem drinking (OR=10.8; 95% CI=7.0, 16.7 and OR=10.2; 95% CI=6.9, 15.2). Young adulthood (ages 18-20) was significantly associated with regular problem drinking but not risky problem drinking. The belief that most friends get drunk weekly was the strongest discriminator of risky and regular problem drinking patterns (OR=5.3; 95% CI=3.9, 7.1). These findings suggest that underage problem drinking is most strongly characterized by heavy drinking behaviors which can emerge in late adolescence and underscores its association with perceptions regarding friends drinking behaviors and illicit drug use.