Risk factors for frequent high alcohol consumption among Swedish secondary-school students

The aim of this study was to analyze the impact and possible causal interrelationships of psychological, psychosocial and socioeconomic factors on frequent high consumption of alcoholic beverages in a Swedish secondary-school student population.

A cross-sectional study via questionnaire was administered to 1,384 high school students in Trelleborg, Sweden, from 1999 to 2001 (658 boys, 726 girls; response rates, 84.6% in 1999, 89.3% in 2000 and 91.7% in 2001). Logistic regression analyzed the relationship between various risk factors and frequent high alcohol consumption.

Interest in trying drugs was the strongest indicator for frequent high alcohol consumption, after adjusting for age, socioeconomic status and psychosocial risk factors (boys: odds ratio (OR) = 3.9, 95% confidence interval (CI): 2.5-6.0; girls: OR = 2.7, 95% CI: 1.8-3.9). This variable also had the highest population-attributable fraction (PAF; boys = 39%, girls = 29%). High purchasing power increased the risk of frequent high alcohol consumption (boys: OR = 2.1, 95% CI: 1.4-3.0; PAF = 25%; girls: OR = 1.6, 95% CI: 1.1-2.3; PAF = 16%). The association between high alcohol consumption and psychosocial factors differed by gender. Participation in organized team sports was associated with increased risk among boys (OR = 3.0, 95% CI: 2.0-4.7; PAF = 32%), but not girls (OR = 1.0, 95% CI: 0.7-1.5; PAF = 0%). Parental acceptance of alcohol consumption was more important for the latter (girls: OR =1.7, 95% CI: 1.2-2.3; PAF = 27%; boys: OR = 1.5, 95% CI: 1.0-2.1; PAF = 21%).

Psychological, psychosocial and socioeconomic elements were independent risk factors for frequent high alcohol consumption. Discrepancies in risk factor patterns between boys and girls suggest alternate approaches be considered in interventiods.