The Association between the School Environment and Adolescent Alcohol Drinking Behavior in Six Cities in China

Drinking alcohol during adolescence has short-term and long-term effects on physical and mental health. At this stage, teenagers are greatly influenced by their schoolmates and friends. We conducted a multicenter cross-sectional study to investigate the association between school environment factors and adolescents' drinking behavior in China. Using multistage stratified cluster sampling, the study investigated 27,762 middle school students from six cities in China. The logistic regression model was used to explore the association between the school environment and adolescent alcohol drinking behaviors after adjusting for confounders, including gender, age, city, location, and smoking status. Compared with students with none of their close friends drinking, students with more than half of their close friends drinking were more likely to drink in a year (OR = 20.148, 95% CI: 17.722-22.905, p < 0.001) and in a month (OR = 13.433, 95% CI: 11.779-15.319, p < 0.001). In addition, classmates' drinking behaviors, friends' persuasion, and attending parties were risk factors for adolescents' drinking behavior, while the propaganda and regulations of banning drinking in school were protective factors. The school environment, especially friends drinking, is associated with students' drinking behavior. It is necessary to mobilize the strength of schools and peers to strengthen the prevention and control of adolescent drinking.

Automated summary

Drinking alcohol during adolescence has both short-term and long-term effects on physical and mental health. A multicenter cross-sectional study in China found that the school environment, especially friends' drinking behaviors, significantly influenced adolescent drinking behavior. Students with more friends who drank were more likely to drink themselves, and factors such as classmates' drinking behaviors, friends' persuasion, and attending parties were also associated with increased risk of adolescent drinking. On the other hand, school policies and regulations banning drinking were protective factors.