Risky relationships: Secondhand harms and health indicators associated with college students' relationships with heavy drinkers

Abstract

Background

Heavy drinking is pervasive on college campuses, yet little is known about how heavy drinkers affect college students around them. People with versus without heavy drinkers in their lives often differ systematically, complicating such analyses. This study tested whether relationships with heavy drinkers were associated with alcohol-related harms to others (AHTOs) and related health indicators among college students after using propensity score weighting to account for demographic and behavioral differences between those with and without heavy drinkers in their lives.

Method

Data were from a probability-based survey of 1901 US college students, recruited in November–December 2021 (16% response rate), 271 of whom had a heavy drinker in their life. There were two sets of outcomes: (1) AHTOs (i.e., harassment, physical, sexual) and (2) health indicators (i.e., frequent mental distress and service use because of someone else's drinking). Secondary models were stratified by the heavy drinker's relationship to the participant (i.e., intimate peer, other peer, and family member). To correct for multiple testing, p-values < 0.002 were considered significant.

Results

In double-robust propensity score-weighted regressions, relationships with a heavy drinker (vs. not) were associated with harassment (aOR = 3.89 [2.05, 7.38]) and sexual AHTOs (aOR = 2.98 [1.29, 6.88]). Students with a heavy drinker in their life (vs. not) had greater odds of frequent mental distress (aOR = 2.05 [1.28, 3.29]) and service use because of someone else's drinking (aOR = 7.39 [3.32, 16.47]). All relationship types were associated with harassment and service use because of someone else's drinking. Relationships with heavy drinking other peers and family members were associated with frequent mental distress.

Conclusions

Relationships with a heavy drinker are associated with college AHTOs and health indicators.