Inequalities in young adult frequency and quantity of alcohol use in a longitudinal Swedish sample

Background Alcohol-related mortality is more prevalent in disadvantaged socioeconomic groups. Yet the relationship between socioeconomic position and alcohol use in young adulthood, when alcohol is often consumed in high quantities, is not well understood and findings are inconclusive. In this study, our aim was to examine whether two often-conflated dimensions of alcohol use (i.e., frequency and quantity) in young adulthood associate with parental educational attainment. We also explored whether parental alcohol use (same two dimensions) or young adult educational attainment may help explain this association. Methods Data was collected from two waves (2000 & 2010) of the Swedish Level of Living Survey, with parents surveyed ten years before the young adults. Young adults’ (N = 803) risk of daily/weekly and monthly drinking, relative to less frequent drinking, was analysed by multinomial logistic regression and estimated as relative risk ratios (RR); episodic heavy drinking was assessed through binary logistic regression and estimated as odds ratios (OR). Results Young adults whose parents held a compulsory (versus tertiary) degree were less likely to drink daily/weekly (RR = 0.18, 95% CI [0.07, 0.47]) but more likely to drink heavily (OR = 2.67, 95% CI [1.17, 6.06]). The same dimensions of alcohol use were associated across generations but did not explain inequalities by parental educational attainment. Accounting for young adult educational attainment left an independent effect of parental compulsory education (RR = 0.27, 95% CI [0.10, 0.73]) on young adult daily/weekly drinking. Conclusions Parental educational attainment can be viewed as an early-life structural factor that confers differential risk for young adult alcohol use, depending on the dimension of use: high educational attainment is a risk factor for frequent drinking while low educational attainment is a risk factor for episodic heavy drinking.