RESEARCH ARTICLE
Iden i ying P edic o s and P e alence o
Alcohol Consump ion among Uni e si y
S uden s: Nine Yea s o Follow-Up
Lucı
´a Mou e-Rod ı
´guez
1
*, Ma ı
´a Piñei o
1
, Mon se a Co al Va ela
2
, Soco o Rod ı
´guez-
Holguı
´n
2
, Fe nando Cada ei a
2
, F ancisco Caamaño-Iso na
1
1CIBER de Epidemiologı
´a y Salud Pu
´blica (CIBERESP), Depa men o P e en i e Medicine, Uni e sidade
de San iago de Compos ela, San iago de Compos ela, Spain, 2Depa men o Clinical Psychology and
Psychobiology, Uni e sidade de San iago de Compos ela, San iago de Compos ela, Spain
*[email p o ec ed]
Abs ac
Aim
To e alua e he p e alence o alcohol consump ion among uni e si y s uden s du ing la e
adolescence and young adul hood and o iden i y he associa ed ac o s.
Ma e ial and Me hods
Coho s udy among uni e si y s uden s in Spain (n = 1382). Hea y Episodic D inking
(HED) and Risky Consump ion (RC) we e measu ed wi h he Alcohol Use Diso de s Iden i-
ica ion Tes (AUDIT) a ages 18, 20, 22, 24 and 27 yea s. Da a on po en ial ac o s associ-
a ed wi h alcohol use we e ob ained wi h an addi ional ques ionnai e. Mul ile el logis ic
eg ession o epea ed measu es was used o ob ain adjus ed OR (Odds Ra ios).
Resul s
The a es o p e alence o RC we e lowe , bu no s a is ically signi ican , in women. The
age- ela ed changes in hese a es we e simila in bo h gende s, and he p e alence o RC
peaked a 20 yea s. By con as , he p e alence o HED was signi ican ly lowe in women
and peaked a 18 yea s in women and a 22 yea s in men. Mul i a ia e models showed ha
ea ly age o onse o alcohol use (OR = 10.6 and OR = 6.9 o women; OR = 8.3 and
OR = 8.2 o men) and posi i e expec a ions abou alcohol (OR = 7.8 and OR = 4.5 o
women; OR = 3.6 and OR = 3.3 o men) we e he mos impo an isk ac o s o RC and
HED. Li ing away om he amily home was also a isk ac o o bo h consump ion pa e ns
among women (OR = 3.16 and OR = 2.34), while a high ma e nal educa ion le el was a isk
ac o o RC among bo h gende s (OR = 1.62 o women; OR = 2.49 o men).
Conclusions
Alcohol consump ion dec eases signi ican ly a he end o you h, wi h highe a es o p e a-
lence and a la e peak among men. P e en ion s a egies should ocus on belie s and
PLOS ONE | DOI:10.1371/jou nal.pone.0165514 No embe 3, 2016 1 / 15
a11111
OPEN ACCESS
Ci a ion: Mou e-Rod ı
´guez L, Piñei o M, Co al
Va ela M, Rod ı
´guez-Holguı
´n S, Cada ei a F,
Caamaño-Iso na F (2016) Iden i ying P edic o s
and P e alence o Alcohol Consump ion among
Uni e si y S uden s: Nine Yea s o Follow-Up.
PLoS ONE 11(11): e0165514. doi:10.1371/jou nal.
pone.0165514
Edi o : Hajo Zeeb, Leibniz Ins i u e o P en ion
Resea ch and Epidemiology BIPS, GERMANY
Recei ed: May 30, 2016
Accep ed: Oc obe 13, 2016
Published: No embe 3, 2016
Copy igh : ©2016 Mou e-Rod ı
´guez e al. This is
an open access a icle dis ibu ed unde he e ms
o he C ea i e Commons A ibu ion License,
which pe mi s un es ic ed use, dis ibu ion, and
ep oduc ion in any medium, p o ided he o iginal
au ho and sou ce a e c edi ed.
Da a A ailabili y S a emen : All ele an da a a e
wi hin he pape . Ou s udy was app o ed by he
Bioe hics Commi ee o he Uni e sidade de
San iago de Compos ela. Subjec s we e in o med
e bally and in w i en o ma , as pa o he
ques ionnai e, ha pa icipa ion was olun a y,
anonymous, and he possibili y o op -ou was
a ailable a any ime. Subjec s also we e in o med
abou he e-mail when hey should w i e in o de o
op -ou . Finally, membe s o he esea ch eam
explained o he s uden s in he class oom ha he
expec a ions abou alcohol and on delaying he age o onse . Women a e a pa icula isk
o hese consump ion pa e ns i hey li e away om hei pa en s. Belonging o a high-
income amily is a s ong isk ac o o RC.
In oduc ion
Alcohol consump ion cons i u es a public heal h p oblem wo ldwide, and Eu ope has he high-
es a e o consump ion pe capi a [1]. In Spain, alcohol consump ion is deeply oo ed in social
cus oms and un il ecen ly was adi ionallyassocia ed wi h amily and sociale en s, wi h
mainly men pa aking[2]. Howe e , in he las decade,hea y episodicd inking(HED), cha ac-
e izedby he in ake o la ge amoun s o alcohol ina sho pe iodo ime(p oducingblood
alcohol le els o a leas 0.8 g/l), has eplaced he adi ional pa e n o consump ion among
young people [2].
Al hough in he gene al popula ion alcohol consump ion is mo e p e alen in men han in
women, his dis inc ionis becomingblu ed in young adul s, pa icula ly ega ding HED, he
p e alence o which is simila in bo h sexes [3]. To da e, he age- ela ed dis ibu iono p e a-
lence a es has ollowed a bell-shaped cu e,peakinga a ound 21 yea s in he US [4] and a
be ween19 and 24 yea s dependingon hecoun yand gende in Eu opean s udies, usually
wi h ea lie peaks in emales [3,5]. One o he la es and mos widely ci ed e iews on he opic
[6] has mainly ci ed he ollowing a iables o HED in uni e si y s uden s: gende , age, e hnic-
i y, eligion,expec a ionsabou alcohol, age o onse o alcoholconsump ion, consump ion o
o he d ugs,heal h and s ess, pe sonali y, physical ac i i y, socioeconomicle el, li ing ci cum-
s ances,and any amily his o y o alcoholism.P e alence a es o HED ound in heses udies
can be explained by he impo anceo di e en isk ac o s in di e en Eu opean coun ies.
The b ains o adolescen s and young adul s a e pa icula lysuscep ible o he neu o oxic
e ec so HED [7–10]. Coho s udies ha e shown an associa ion be ween his pa e n o alco-
hol consump ion and cogni i e[7], s uc u al[8] and neu o unc ionale ec s[9]. Mo eo e , in
he uni e si y en i onmen , HED has been associa edwi h poo e academicpe o mance[11],
g ea e consump ion o medicines[12], highe incidenceo inju ies [13] and a highe incidence
o isky sexual beha io [10], ela i e o con ol subjec s.Finally, i is impo an o ake in o
accoun ha codeso beha io acqui ed du ingadolescence end o be main ained in adul -
hood[14].
The objec i eo his s udy was o e alua e he p e alenceo alcohol consump ion among
uni e si y s uden s du ingadolescenceand young adul hoodand o iden i y he associa ed
ac o s.
Ma e ials and Me hods
Design, Popula ion and Sample
We ca iedou a coho s udy among uni e si y s uden s (Compos ela Coho ,Spain), be ween
No embe 2005 and Feb ua y2015. We usedclus e sampling o selec he pa icipan s.Thus,
a leas one o he i s -yea classes was andomly selec ed om each o he 33 uni e si y acul-
ies/schools(a o al o 53 classes). The numbe o classes selec edin each uni e si y acul y o
schoolwas p opo ional o he numbe o s uden s. All s uden s p esen in he class on he day
o he su eywe e in i ed o pa icipa e in he s udy (n = 1382). Abs inen s uden s we e
excluded om he associa ion analysis, al hough he numbe s a e included in he sample
P edic o s and P e alence o Alcohol Use among Uni e si y S uden s
PLOS ONE | DOI:10.1371/jou nal.pone.0165514 No embe 3, 2016 2 / 15
da a would be gua ded ca e ully by he esea ch
eam. The e o e, o hese las wo easons we
conside ha we do no upload he da ase o a
s able, public eposi o y. Howe e , he au ho s
ag ee o make eely a ailable any ma e ials and
da a desc ibed in he publica ion upon easonable
eques o he Co esponding Au ho .
Funding: Funding o his s udy was p o ided by
he Spanish Na ional Plan on D ugs (PND, SPI/
3462/2010). PND played no u he ole in his
s udy.
Compe ing In e es s: The au ho s ha e decla ed
ha no compe ing in e es s exis .
desc ip ion.This s udy was app o ed by he Bioe hicsCommi eeo he Uni e sidade de San i-
ago de Compos ela.Subjec s we e in o medbo h e bally and in w i en o ma , as pa o he
ques ionnai e, ha pa icipa ionwas olun a y, anonymous, and he possibili y o op -ou was
a ailable a any ime.Subjec s we e in o med ha hey we e ee o illo e use o ill he ques-
ionnai e. This p ocedu e was app o ed by he Bioe hicsCommi ee.
Da a Collec ion P ocedu e
Two eam esea che s isi ed each i s -yea class oom in No embe 2005 and in i ed all s u-
den s p esen in he class o pa icipa e in he s udy. Pa icipan s we e e alua ed ia a sel -
adminis e edques ionnai e in he same class oom (1s ques ionnai e).In No embe 2007, he
same eam o esea che s isi ed he hi d-yea class oom in o de o ollow-up wi h he s u-
den s. Pa icipan s we e e-e alua ed ia a sel -adminis e edques ionnai e (2nd ques ion-
nai e). The ques ionnai es we e linked using bi h da e, sex, school,and class. S uden s who
p o ided a phone numbe in he i s o secondques ionnai e we e u he e alua ed by phone
a 4.5-, 6.5-, and 9.0- yea ollow-ups (3 d, 4 d and 5 d ques ionnai e).On all i e occasions,
alcoholuse was measu edwi h he Galician alida ed e sion o he AUDIT [15,16]. In addi-
ion o he AUDIT, we used ano he ques ionnai e ha asked abou he po en ial ac o s asso-
cia ed wi h alcohol use (educa ionalle el and alcohol use o pa en s, alcohol- ela ed p oblems
and age o onse o use). One o he i ems in hesecondques ionnai especi ically e e ed o
expec a ionsabou alcohol use. In his ques ion he s uden s we e equi ed o ank 7 posi i e
and 7 nega i e expec a ionsabou he e ec so alcohol. This ques ion was gene a ed using
i ems om a ques ionnai e p e iously used wi h young Spanish adul s [17]. Mo e de ails abou
da a collec iona e a ailable in he ollowing e e ences [11,12,18].
De ini ion o a iables
Independen a iables. Se e alsocio-demog aphic a iables we e conside ed: gende ,
place o esidence (pa en al home/away om he pa en al home), and ma e nal educa ional
le el (p ima y school/highschool/uni e si y).
Alcohol use in he amily was included as mo he ’s alcohol use (doesn’ consume/con-
sumes).Fou ca ego ieswe e de ined o age o onse o use (a e 16 yea s old, a 16, a 15,
be o e he age o 15).
Cannabis consump ion a he beginningo he s udy was measu edwi h he ques ion “Do
you consume cannabis when you go ou ? Ne e ; Some imes;Mos o he imes; Always”. The
ca ego ieswe e eca ego izedin o No ("ne e ")and Yes ("some imes"o “mos o he ime” o
“always”). Tobacco consump ion a he beginningo he s udy was also measu ed as a dicho o-
mous a iable, wi hou any empo al e e ence: No/Yes.
Finally, aking he numbe o posi i e and nega i e expec a ionsin o accoun , a sco e ang-
ing om 0 o 14 was gene a ed (0 being he maximum o nega i e expec anciesand 14 he
maximum o posi i e expec ancies).The sco es we e di idedin o e iles.
Dependen a iables.
1. Risky consump ion (RC). Dicho omous a iable gene a ed om AUDIT sco e. A di e en
cu -o alue was es ablished acco ding o gende := >5 o women; and = >6 o men.
These cu -o s a e ecommendedin he Galician alida ed e sion o he AUDIT.
2. Hea y episodicd inking(HED). This is a dicho omous a iable gene a ed om he hi d
AUDIT ques ion “How o en do you ha e 6 o mo e alcoholic d inks pe occasion?”, which
was codedas ollows: ne e = 0, less han once a mon h = 0, once a mon h = 1, once a
week= 1, daily o almos daily = 1. The sensi i i y and speci ici yo his ques ion wi h his
P edic o s and P e alence o Alcohol Use among Uni e si y S uden s
PLOS ONE | DOI:10.1371/jou nal.pone.0165514 No embe 3, 2016 3 / 15
cu -o alue a e espec i ely0.72 and 0.73, and he a ea unde he cu eis 0.767 (95% CI:
0.718–0.816)[19].
S a is ical analysis
We used mul ile ellogis ic eg ession o epea ed measu es o ob ain adjus ed Odds Ra ios
(OR) o independen a iables om he inal RC and HED models. Con idencein e als o
95% (95% CI) we e calcula ed. These models a e mo e lexible han adi ional models and
he e o e allow us o wo k wi h co ela ed da a. As his is he case, he e is a dependencys uc-
u e. The same subjec was measu edse e al imes, and he esponses we e s ongly co ela ed.
The uni e si y acul y/schooland class oom we e conside ed o be andom a iables. The ol-
low-up ime was included as an o se e m.
Maximal models we e gene a ed, including all heo e icalindependen a iables. F om
hese maximal models, inal models we e gene a ed. Final models included all signi ican a i-
ables o non-signi ican a iables when hei exclusion changed he OR o o he a iables by
mo e han 10%. Da a we e analyzed using Gene alizedLinea Mixed Models in R s a is ical
so wa e.
Resul s
The cha ac e is icso he sample o women and men a e summa isedin Tables 1and 2 espec-
i ely. The e we e no signi ican di e encesbe ween he sexes in ela ion o any o hese
a iables.
The a es o p e alence o RC we e always lowe in women, al hough he di e enceswe e
no s a is icallysigni ican .The age- ela ed changes in hese a es we e simila in men and
women, and he p e alenceo RC peakeda 20 yea s. By con as , he p e alence o HED was
signi ican lylowe in women o all ages and peakeda 18 yea s in women and a 22 yea s in
men. The a es o p e alenceo RC and HED in each age g oup o women and men a e shown
in Tables 3and 4 espec i ely. Figs 1and 2p esen he ends o p e alenceso RC and HED,
o bo h sexes.
In ela ion o he ac o s associa ed wi h RC and HED, he mul i a ia e model e ealed he
ollowingas isk ac o s in bo h sexes:ea ly onse o alcohol consump ion (OR = 10.7 and
OR = 6.90 in women compa ed wi h OR = 8.30 and OR = 2.23 in men) and posi i e expec a-
ionsabou alcohol (OR = 7.80 and OR = 4.54 in women compa ed wi h OR = 3.59 and
OR = 3.26 in men). These da a a e p esen ed in Tables 5and 6.
Olde age o pa icipan s cons i u ed a p o ec i e ac o (OR = 0.06 and OR = 0.13 in
women compa ed wi h OR = 0.11 and OR = 0.34 in men), and he e ec was g ea e in women
han in men o bo h pa e ns o consump ion. Finally, in ela ion o he sociodemog aphic
cha ac e is ics o he amily, high ma e nal educa ional le el ac ed as a isk ac o only o RC
(OR = 1.62 in women compa ed wi h OR = 2.49 in men), while he place o esidence was sig-
ni ican only in women o bo hRC and HED (OR = 3.16 and OR = 2.34). These da a a e p e-
sen ed in Tables 5and 6.
Discussion
The indingsindica e high a es o p e alenceo bo h RC and HED in he popula ion o uni-
e si y s uden s unde s udy. Mo eo e , mul i a ia e models showed ha ea ly age o onse o
d inkingand posi i e expec a ionsabou alcohol we e he mos impo an isk ac o s o RC
and HED espec i ely. Finally, li ing away om he amily home also cons i u ed a isk ac o
P edic o s and P e alence o Alcohol Use among Uni e si y S uden s
PLOS ONE | DOI:10.1371/jou nal.pone.0165514 No embe 3, 2016 4 / 15
o bo hpa e ns consump ion among women, whilea high ma e nal educa ional le elwas
ound o be a isk ac o o RC in bo h women and men.
The dis ibu iono changes in p e alence o HED ollowed a bell-shaped cu e,simila o
ha desc ibedin p e ious s udies [4], al hough wi h an ea lie peakin women han in men.
Al hough he HED pa e n is gene allyconside ed o peak du ing he i al li e s age be ween
adolescenceand young adul hood[20,21], which has beenexplained as a consequenceo he
acquisi ion o new social oles and esponsibili ies a his s age [22], his was only con i medin
Table 1. Cha ac e is ics o emale ini ial sample and ollow-up samples.
Pe cen age o mean (95%CI)
Ini ial (18–19
yea s old)
n = 992
2-yea ollow-up (20–
21 yea s old) n = 669
4-yea ollow-up (22–
23 yea s old) n = 461
6-yea ollow-up (24–
25 yea s old) n = 266
9-yea ollow-up (27–
28 yea s old) n = 325
p- alue
Ma e nal educa ional
le el
P ima y school 41.8 (38.4–45.3) 44.2 (40.1–48.4) 43.1 (38.3–48.3) 47.3 (41.3–54.1) 45.7 (40.1–51.8)
High school 33.6 (30.2–37.1) 30.5 (26.4–34.7) 30.6 (25.8–35.8) 26.5 (20.4–33.3) 28.1 (22.5–34.2)
Uni e si y 24.6 (21.2–28.1) 25.3 (21.3–29.6) 26.3 (21.4–31.4) 26.1 (20.1–32.9) 26.2 (20.7–32.4) 0.642
Residence
In pa en al home 24.7 (22.1–27.5) 22.9 (19.7–26.1) 22.2 (18.5–26.0) 22.1 (18.1–26.1) 20.9 (16.5–25.1)
Away om he pa en al
home
75.3 (72.6–78.0) 77.1 (74.0–80.3) 77.8 (74.1–81.6) 77.9 (73.9–81.9) 79.1 (74.9–83.5) 0.720
Uni e si y en ance
g ade
a
9–10 poin s 45.6 (42.3–49.1) 43.2 (39.3–47.5) 43.2 (38.4–48.3) 43.3 (38–3–48.8) 47.1 (41.3–52.9)
7 - <9 poin s 48.8 (45.5–52.3) 50.3 (46.4–54.6) 50.6 (45.8–55.6) 50.1 (45.1–55.6) 47.1 (41.3–52.9)
5 - <7 poin s 5.6 (2.2–9.0) 6.5 (2.5–10.7) 6.2 (1.4–11.2) 6.6 (1.6–12.1) 5.8 (0–11.6) 0.977
Posi i e expec a ions
abou alcohol
Low 37.1 (33.4–40.9) 37.5 (33.2–42.1) 36.5 (31.4–42.0) 36.5 (30.9–42.3) 37.9 (31.7–44.3)
Medium 34.0 (30.3–37.8) 32.6 (28.3–37.3) 34.6 (29.4–40.1) 35.4 (29.8–41.1) 34.8 (28.6–41.2)
High 28.9 (25.2–32.7) 29.9 (25.5–34.5) 28.9(23.7–34.4) 28.1 (22.5–33.8) 27.2 (21.0–33.6) 0.999
Age o onse o use o
alcohol
A e 16 yea s old 19.0 (16.5–21.8) 17.9 (14.9–21.3) 16.5 (13.0–20.5) 16.7 (12.1–22.5) 14.5 (10.5–19.2)
A 16 yea s old 38.9 (35.6–42.2) 38.1 (34.1–42.2) 36.8 (32.0–41.7) 40.1(33.6–46.8) 36.6 (30.9–42.6)
A 15 yea s old 25.6 (22.7–28.7) 25.9 (22.3–29.6) 26.5 (22.2–31.1) 26.4 (20.8–32.7) 28.3 (23.0–34.0)
Be o e age o 15 yea s 16.5 (14.0–19.7) 18.1 (15.0–21.5) 20.3 (16.4–24.5) 16.7 (12.1–22.5) 20.7 (16.0–25.9) 0.438
Hea y episodic
d inking
b
Ne e 61.2 (58.2–64.3) 61.3 (57.7–65.1) 59.0 (54.7–63.7) 59.4 (53.8–65.5) 60.0 (54.8–65.4)
Less han once a mon h 20.9 (17.8–23.9) 20.9 (17.3–24.7) 23.4 (19.1–28.1) 22.2 (16.5–28.3) 22.5 (17.2–27.9)
Mon hly 9.8 (6.7–12.8) 9.1 (5.5–12.9) 9.1 (4.8–13.8) 9.8 (4.1–15.9) 9.8 (4.6–15.3)
Mo e equen ly 8.2 (5.1–11.2) 8.7 (5.1–12.5) 8.5 (4.1–13.2) 8.6 (3.0–14.8) 7.7 (2.5–13.1) 0.999
AUDIT: To al (mean) 5.4 (5.2–5.7) 5.6 (5.1–5.8) 5.6 (5.2–6.0) 5.6 (5.0–6.1) 5.3 (4.9–5.8) 0.884
Cannabis
consump ion
18.6 (16.2–21.1) 19.0 (15.9–22.0) 20.6 (16.8–24.4) 18.0 (13.2–22.9) 18.8 (14.4–23.2) 0.942
Tobacco consump ion 31.0 (28.1–34.0) 31.5 (27.9–35.1) 34.3 (29.8–38.7) 31.2 (25.4–37.0) 32.9 (27.7–38.2) 0.786
a
Va iable wi h a scale o 1 o 10
b
Ques ion 3 o he AUDIT.
doi:10.1371/jou nal.pone.0165514. 001
P edic o s and P e alence o Alcohol Use among Uni e si y S uden s
PLOS ONE | DOI:10.1371/jou nal.pone.0165514 No embe 3, 2016 5 / 15
women in he p esen s udy. We ound ha one in i emen o age 27 yea s con inued o ollow
his pa e n o alcohol consump ion. These indingsshould be conside ed in he cu en social
and economicsi ua ion in Spain, which is unde goingan economicc isis ha is pa icula ly
a ec ingyoung adul s and g ea ly limi ing hei access o he job ma ke [23]. This may cause
delay in he acquisi ion o new oles and esponsibili ies ha a e unde s ood o be pa o his
new li e s age o passage in o adul hood[20]. Finally, in ela ion o di e encesbe ween he
sexes, HED was no as p e alen in emales as in males. Howe e , i is possible ha he
Table 2. Cha ac e is ics o male ini ial sample and ollow-up samples.
Pe cen age o mean (95%CI)
Ini ial (18–19
yea s old) n = 371
2-yea ollow-up (20–
21 yea s old) n = 206
4-yea ollow-up (22–
23 yea s old) n = 139
6-yea ollow-up (24–
25 yea s old) n = 81
9-yea ollow-up (27–
28 yea s old) n = 90
p- alue
Ma e nal educa ional
le el
P ima y school 32.0 (26.5–37.8) 35.8 (28.4–43.3) 41.6 (32.8–50.8) 43.0 (31.6–54.8) 41.6 (31.5–53.5)
High school 27.6 (22.1–33.3) 27.4 (19.9–34.9) 25.5 (16.8–34.7) 24.1 (12.7–35.8) 27.0 (16.8–38.9)
Uni e si y 40.3 (34.8–46.0) 36.8 (29.3–44.3) 32.8 (24.1–42.0) 32.9 (21.5–44.7) 31.5 (21.3–43.4) 0.449
Residence
In he pa en al home 29.7(25.1–34.5) 27.8 (21.9–34.1) 28.8 (21.6–36.4) 31.6 (23.9–40.6) 28.9 (20.0–38.3)
Away om he pa en al
home
70.3 (65.7–75.1) 72.2 (66.3–78.5) 71.2 (64.0–78.9) 68.4 (60.7–77.4) 71.7 (62.2–80.5) 0.949
Uni e si y en ance
g ade
a
9–10 poin s 50.7 (45.3–56.2) 47.5 (40.6–55.0) 50.0 (42.0–59.2) 50.0 (41.4–60.1) 51.7 (41.6–62.7)
7 - <9 poin s 42.7 (37.3–48.2) 43.6 (36.6–51.0) 43.5 (35.5–52.7) 42.2 (33.6–52.3) 42.7 (32.6–53.7)
5 - <7 poin s 6.6 (1.1–12.1) 8.9 (2.0–16.4) 6.5 (0–15.7) 7.8 (0–17.8) 5.6 (0–16.6) 0.996
Posi i e expec a ions
abou alcohol
Low 29.7 (23.7–36.0) 33.0 (25.1–41.0) 34.2 (25.0–44.3) 35.4 (25.3–46.4) 31.6 (20.3–43.7)
Medium 38.0 (32.0–44.4) 30.7 (22.9–38.8) 31.7 (22.5–41.8) 32.3 (22.2–43.4) 30.4 (19.0–42.5)
High 32.3 (26.3–38.7) 36.3 (28.5–44.4) 34.2 (25.0–44.3) 32.3 (22.2–43.4) 38.0 (26.6–50.0) 0.705
Age o onse o
alcohol use
A e 16 yea s old 18.1 (12.5–24.1) 16.8 (9.2–24.7) 15.5 (6.9–25.5) 16.4 (6.0–29.7) 18.2 (7.8–30.3)
A 16 yea s old 36.9 (31.2–42.8) 41.0 (33.5–49.0) 44.0 (35.3–54.0) 50.7 (40.3–64.0) 48.1 (37.7–60.1)
A 15 yea s old 21.6 (15.9–27.5) 20.2 (12.7–28.2) 21.6 (12.9–1.6) 23.9 (13.4–37.2) 20.8 (10.4–32.8)
Be o e age o 15 yea s 23.4 (17.8–29.4) 22.0 (14.4–30.0) 19.0 (10.3–9.0) 9.0 (0.0–22.3) 13.0 (2.6–25.1) 0.381
Hea y episodic
d inking
b
Ne e 39.1 (34.0–44.7) 43.2 (36.4–50.6) 42.4 (34.5–51.7) 46.9 (37.0–58.9) 45.6 (35.6–56.5)
Less han once a mon h 25.3 (20.2–31.0) 20.4 (13.6–27.8) 21.6 (13.7–30.8) 21.0 (11.1–33.0) 21.1 (11.1–32.1)
Mon hly 12.7 (7.5–18.3) 14.6 (7.8–22.0) 13.7 (5.7–22.9) 17.3 (7.4–29.3) 15.6 (5.6–26.5)
Mo e equen ly 22.9 (17.8–28.6) 21.8 (15.0–29.2) 22.3 (14.4–31.6) 14.8 (4.9–26.8) 17.8 (7.8–28.8) 0.905
AUDIT: To al (mean) 7.8 (7.2–8.4) 7.4 (6.6–8.2) 7.3 (6.4–8.2) 6.5 (5.4–7.6) 7.1 (6.0–8.2) 0.784
Cannabis
consump ion
27.0 (22.3–31.6) 27.7 (21.3–34.0) 25.9 (18.3–33.5) 23.5 (13.6–33.3) 24.4 (15.0–33.9) 0.885
Tobacco consump ion 27.5 (22.8–32.2) 21.8 (16.0–27.7) 23.0 (15.7–30.4) 23.5 (13.6–33.3) 24.4 (15.0–33.9) 0.636
a
Va iable wi h a scale o 1 o 10
b
Ques ion 3 o he AUDIT.
doi:10.1371/jou nal.pone.0165514. 002
P edic o s and P e alence o Alcohol Use among Uni e si y S uden s
PLOS ONE | DOI:10.1371/jou nal.pone.0165514 No embe 3, 2016 6 / 15
p e alence o HED in women may ha e beenunde es ima ed, as he 3 d ques ion o he
AUDIT conside s consump ion o 6 o mo e d inks.
This same hypo hesis o new oles and esponsibili iescan be one explana ion o he
impo an dec easeobse eda age o 24 yea s o bo h consump ion pa e ns, i espec i eo
g oup o gende . A e collegeyea s, when high p e alences o consump ion a e obse ed,
young people becomeconce nedabou hei u u es, and y o en e he job ma ke and
acqui e new esponsibili ies. In ac , du ing his ages, s uden s who en e ed college wi h be e
g ades,decla ed no HED o RC p ac ices a all. Mo eo e , he sligh inc ease a age 27 may be
due o new adul alcohol consump ion.
Rega ding he ac o s associa ed wi h RC and HED, ea ly onse o alcohol consump ion was
ound o be he main isk ac o o bo hpa e ns o d inking.This is consis en wi h he ind-
ings o p e ious s udies,in whichea ly onse o d inkinghas beenassocia edwi h highe con-
sump ion and nega i e consequences du ing adolescenceand wi h p oblems ela ed o alcohol
Table 3. Main cha ac e is ics o he emale subjec s and alcohol consump ion a age 18, 20, 22, 24 and 27 yea s.
Pe cen age o Risky Consump ion Pe cen age o Hea y Episodic D inking
Age in yea s Age in yea s
18–19 20–21 22–23 24–25 27–28 18–19 20–21 22–23 24–25 27–28
Ma e nal educa ional le el
P ima y school 47.2 46.1 39.1 12.0 18.9^ 17.1 12.6 11.2 5.6 4.7^
High school 53.5 55.9 42.9 11.4 16.5^ 18.5 19.3 20.0 4.3 4.4^
Uni e si y 57.3*58.9*51.7 13.0 29.4^ 18.7 21.4*18.3 1.4 5.9^
Residence
In pa en al home 42.2*40.1*36.3 9.5 14.7^ 13.9 11.2*12.7 3.2 0*^
Away om he pa en al home 54.9 56.1 45.4 12.9 22.6^ 19.4 18.5 16.5 4.5 6.2^
Uni e si y en ance g ade
a
9–10 poin s 40.4 41.5 29.6 0 22.2^ 5.8 12.2 22.2 0 5.6
7 - <9 poin s 50.8 49.5 37.6 11.7 18.5^ 16.2 16.9 12.2 3.1 2.1^
5 - <7 poin s 53.6 57.3 51.3*12.1 22.6^ 20.8*17.9 19.6 3.7 6.8^
Posi i e expec a ions abou alcohol
Low 27.5 33.3 25.0 5.4 10.9^ 7.1 6.9 7.4 2.2 3.6
Medium 64.3 60.6 49.3 18.8 18.8^ 19.4 17.6 18.6 6.2 3.0^
High 71.0*64.5*59.8*12.1*32.9*^ 27.4*26.7*19.7*3.0 6.3^
Age o onse o alcohol use
A e 16 yea s old 30.5 42.3 28.8 7.9 2.5^ 7.9 8.7 10.6 7.9 0
A 16 yea s old 57.3 57.0 44.2 14.3 22.8^ 13.4 18.1 17.7 5.5 3.0^
A 15 yea s old 69.2 70.0 61.3 11.7 28.2^ 28.5 22.7 20.8 0 7.7^
Be o e age 15 yea s 78.9*63.8*56.8*23.7 33.3*^ 38.7*26.7*21.0 7.9 10.5^
Cannabis consump ion a 18 yea s old
No 42.9 45.8 37.2 9.6 14.8^ 13.3 12.0 12.6 3.7 2.7^
Yes 89.2*79.5*66.3*22.9*47.5*^ 38.4*37.0*27.4*6.2 14.8*^
Tobacco consump ion a 18 yea s old
No 37.7 42.4 34.0 9.8 16.1^ 10.5 12.2 12.9 3.8 3.7^
Yes 82.1*73.5*60.8*16.9 30.8*^ 34.4*26.5*20.9*4.8 7.5^
To al 51.5 52.2 43.2 12.2 20.9^ 17.9 16.7 15.7 4.1 4.9^
a
Va iable wi h a scale o 1 o 10.
*Signi ican di e ences in ela ion o ca ego y, p<0.05.
^ Signi ican di e ences in ela ion o age g oup, p<0.05.
doi:10.1371/jou nal.pone.0165514. 003
P edic o s and P e alence o Alcohol Use among Uni e si y S uden s
PLOS ONE | DOI:10.1371/jou nal.pone.0165514 No embe 3, 2016 7 / 15
abuse and dependencyin adul s [24]. Fo example, C an o d [25] showed ha he isk o HED
in uni e si y s uden s was up o ou imes highe in s uden s whohad begund inkinga ea -
lie s ages (OR = 4.15), es ablishing his a iable as an impo an p edic o o HED indepen-
den ly o ace o gende . G ea e pa en al pe missi enesshas been indica ed as an explana o y
ac o o his associa ion.P e ious s udies ha e shown ha alcohol consump ion in adoles-
cen s is a ec edby he pe cep ion ha he young people ha e o hei pa en s’ a i ude o
d inking[26,27]. Child eno mo e pe missi e pa en s begin o d ink a ea lie ages and unde -
ake isky d inkingbeha io du ing adolescenceand ea ly adul hood.
In he p esen s udy, posi i e expec a ionsabou alcohol ac ed as a isk ac o o RC and
HED in bo h sexes. This is consis en wi h p e iously epo ed indings, in ela ion o bo h he
RC pa e n [28,29] and he HED pa e n [30,31]. We also ound di e ences be ween he sexes
in ela ion o expec a ionsabou alcohol, as p e iously epo ed[32,33], wi h his ac o ha ing
a g ea e in luencein emales.
Table 4. Main cha ac e is ics o he male subjec s and alcohol consump ion a ages 18, 20, 22, 24 and 27 yea s.
Pe cen age o Risky Consump ion Pe cen age o Hea y Episodic D inking
Age in yea s Age in yea s
18–19 20–21 22–23 24–25 27–28 18–19 20–21 22–23 24–25 27–28
Ma e nal educa ional le el
P ima y school 47.4 59.7 45.6 14,7 24.3^ 29.3 36.1 31.6 8.8 18.9^
High school 60.0 58.2 65.7 10.5 29.2^ 38.0 41.8 51.4 10.5 25.0^
Uni e si y 65.8*70.3 57.8 38.5*42.9^ 39.0 40.5 48.9 30.8 17.9
Residence
In pa en al home 51.4 56.1 47.5 18.5 19.2^ 34.9 41.9 30.0*14.8 7.7^
Away om he pa en al home 60.5 64.9 58.6 24.1 35.9^ 35.7 31.6 48.5 18.5 25.0^
Uni e si y en ance g ade
a
9–10 poin s 47.8 61.1 44.4 20.0 0 21.7 22.2 33.3 0 0
7 - <9 poin s 51.3 55.7 55.0 26.5 36.8^ 31.3 34.1 36.7 20.6 28.9
5 - <7 poin s 64.6*69.8 56.5 19.0 28.3^ 41.0 45.8 50.7 16.7 13.0^
Posi i e expec a ions abou alcohol
Low 33.7 42.4 39.0 10.3 32.0^ 20.2 25.4 19.5 3.4 20.0
Medium 64.0 70.9 55.3 36.8 41.7^ 37.7 41.8 42.1 31.6 29.2
High 73.2*75.4*68.3*26.1 23.3^ 46.4*46.2*65.9*17.4*16.7^
Age o onse o alcohol use
A e 16 yea s old 32.8 62.1 61.1 18.2 28.6^ 17.2 37.9 38.9 9.1 21.4
A 16 yea s old 60.2 71.8 66.7 38.2 32.4^ 31.4 40.8 47.1 32.4 21.6
A 15 yea s old 73.9 68.6 56.0 12.5 31.2^ 46.4 40.0 52.0 12.5 18.8^
Be o e age o 15 yea s 89.3*86.8 68.2 0 50.0^ 66.7*65.8*59.1 0 20.0^
Cannabis consump ion a 18 yea s old
No 45.4 57.3 47.6 17.7 26.5^ 22.1 27.5 35.0 11.3 14.7^
Yes 92.0*86.0*77.8*36.8 45.5^ 72.0*68.4*66.7*36.8*36.4*^
Tobacco consump ion a 18 yea s old
No 47.6 56.5 51.4 17.7 30.9^ 25.7 34.2 36.4 11.3 20.6^
Yes 85.3*84.4*68.8 36.8 31.8^ 61.8*55.6*65.6*36.8*18.2^
To al 58.0 62.6 55.4 22.2 31.1^ 35.6 38.8 43.2 17.3 20.0^
a
Va iable wi h a scale o 1 o 10.
*Signi ican di e ences in ela ion o ca ego y, p<0.05.
^ Signi ican di e ences in ela ion o age g oup, p <0.05.
doi:10.1371/jou nal.pone.0165514. 004
P edic o s and P e alence o Alcohol Use among Uni e si y S uden s
PLOS ONE | DOI:10.1371/jou nal.pone.0165514 No embe 3, 2016 8 / 15
Fig 1. P e alences o isky consump ion among emale and male Spanish uni e si y s uden s om 18–19 yea s old o 27–28 yea s old.
doi:10.1371/jou nal.pone.0165514.g001
P edic o s and P e alence o Alcohol Use among Uni e si y S uden s
PLOS ONE | DOI:10.1371/jou nal.pone.0165514 No embe 3, 2016 9 / 15
