The results of this study show that the pattern of risky alcohol consumption in university students is significantly associated with severe dysfunctional family structures, although no significant association is observed between risky alcohol consumption, binge drinking pattern and the presence of a family history of alcohol consumption mentioned by these students, when it is adjusted by sociodemographic and occupational factors.
Differences were observed when analyzing risky alcohol consumption stratified by sex: male students between 17 and 24 years of age who studied and worked or were looking for a job and who had a moderate or severe dysfunctional family structure had higher risky alcohol consumption. Female students between 17 and 20 years old who studied and looked for work and who had a moderate or severe dysfunctional family structure presented a higher risky alcohol consumption. Greater use of the binge drinking pattern was identified in male students who were also looking for work and in female students between 17 and 20 years old, who studied and worked or were in search of employment. Although there is no information available related to the pattern of alcohol consumption in private universities, our results could be extrapolable to Spanish private universities since the sociodemographic and occupational factors defined in our sample are similar to the results obtained in Spanish private universities (higher percentage of students between 21–24 years old, female, enrolled in careers in Social and Legal Sciences, followed by students who are pursuing careers in Health Sciences) [22].
There are multiple factors that influence college students’ alcohol consumption: demographic factors, personality type, personal drinking history, expectations when drinking, reasons for drinking alcohol, type of activity, academic participation, and family and social influence [23, 24]. In this article we focus primarily on the study of family influence and social support, personal history of alcohol, demographic factors and the type of activity performed by students.
In general, an environment in which alcohol consumption is encouraged and perceived as positive and normal tends to have more drinkers than peer groups where excessive alcohol consumption is not encouraged [7]. The relationship between family and alcohol consumption is not limited to the already established causality; there is another aspect, no less important that refers to the importance of this pathology in family interactions, and to the dysfunctional relationship dynamics that are created due to this problem [7]. Unstable and incoherent family and living environment factors (for example, transitional living conditions, inconsistent care, violence) resulting from substance use that caregivers have linked to the incidence of psychological and emotional development problems among their children [7].
There is a correlation between family functioning and the presence of addiction, such as alcohol consumption, showing the need for family support [25]. Similarly, Sánchez Queija et al., [26] point out that affective family relationships play a significant role in the prevention of substance use, like alcohol or tobacco, in adolescence and young adults. Thus, individuals who have received care and support during childhood, and enjoy a more cohesive family environment during adolescence and adulthood, showed less substance use. Individuals who start using in those years do not reach the level of substance use observed among those who have grown up in less favorable family contexts.
Severe family dysfunction is related to an increase in standard drinking units of alcohol / week, an increase in smoking, and in the use of illegal drugs [27]. Like the literature, our results show that there is a significant association between students' risky alcohol consumption pattern and dysfunctional family structure, with no such significance observed in the binge drinking pattern.
There is mixed scientific evidence on the association of family history of alcohol consumption with alcohol consumption, among which is intensive consumption [28,29,30]. and alcohol dependence [31]. A meta-analysis carried out in university students reveals that family history appears to have significant small to medium effects on the consequences of alcohol, symptoms of alcohol use disorder, and the participation of other drugs in samples of higher education students [32]. In contrast, small effects (many not significant) were found for consumption alone.
This suggests that college students with a family history may not drink more overall, but those who use alcohol or drugs may be more susceptible to problematic use.
The current study has some limitations: the questionnaire used has not yet been validated. However, this questionnaire consists of validated questions and scales from previously validated national questionnaires, like the Spanish National Health Survey [16] or the EDADES [3] survey, among others. The participation rate is around 3–5% depending on the university, taking into account that the project is a dynamic cohort that involves not only a baseline survey but also a follow-up over time and that participation is entirely voluntary, with no financial or other compensation for the collaboration. Another limitation of our study is its design. Although cross-sectional studies can determine prevalence, they cannot establish causality between alcohol consumption patterns and the other variables considered, especially family support. However, based on biological plausibility and the results of previous longitudinal studies, the observed trend, at least in the case of family support, could be correct.