Identifying patterns of alcohol use among secondary school students in Canada: A multilevel latent class analysis

Introduction: Harm from alcohol use depend not only on the volume of consumption but also on drinking patterns. This study identifies patterns of alcohol consumption in youth and investigates how these patterns vary across schools and whether individual- and school-level factors are associated with engagement in patterns of alcohol consumption.

Methods: The sample consists of 45,298 grade 9 to 12 students attending 89 secondary schools across Ontario and Alberta (Canada), who participated in the COMPASS study during the school year 2013-14. The frequency of drinking, the frequency of binge drinking, and age of alcohol-use initiation were used to characterize alcohol use patterns.

Results: The multilevel latent class analysis identified 4 student-level latent groups and 2 school-level latent groups. Student-level groups of youth were characterized as non-drinkers (44.2%), light drinkers (41.8%), regular drinkers (11.1%), and heavy drinkers (2.9%). Two groups of schools were characterized as either low-use (44.9%) or high-use (55.1%) schools, with significantly different probability of membership in each student-level group. Male students (OR 1.30) and upper grades (OR 1.93) were significantly associated with membership in higher use groups of individuals. The median household income and the number of off-premise alcohol outlets had no significant association with patterns of alcohol consumption within schools.

Conclusions: A large proportion of students reported a level of drinking, suggesting that, in addition to delaying the onset of alcohol use, interventions need to encourage drinker students to quit drinking or lower their consumption. Schools may need to select and/or alter external interventions according to the dominant patterns of alcohol use among their students.