Cigarette smoking, risky alcohol consumption, and marijuana smoking among university students in Germany: identification of potential sociodemographic and study-related risk groups and predictors of consumption
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Abstract
Abstract: (1) Background: Cigarette smoking, risky alcohol consumption, and marijuana smoking are
the most common behaviors of legal and illicit drug use worldwide, including among university
students. To plan effective evidence-based programs to prevent the risky consumption of these
substances among university students, the present study aimed to identify potential sociodemographic
and study-related risk groups and predictors of consumption. (2) Methods: A cross-sectional online
health survey with approximately 270 health-related items was conducted among students at the
University of Mainz, Germany. Cigarette smoking, risky alcohol consumption (AUDIT-C score: female
≥4, male ≥5), and marijuana smoking were chosen as dependent variables. Fifty-six of the 270 health-
related items were chosen as independent variables and put together in five groups (sociodemographic,
psychological, study-related psychosocial, general psychosocial and health behavior). The prevalence
of cigarette smoking, risky alcohol consumption, and marijuana smoking was assessed using
established and validated instruments. Pearson’s chi-square test was used to analyze the differences in
prevalence between the sociodemographic and study-related groups, and binary logistic regression was
used for analyses with stepwise inclusion of the five variable groups. (3) Results: Of the 3991 university
students who entered analyses, 14.9% reported smoking cigarettes, 38.6% risky alcohol consumption,
and 10.9% smoking marijuana. The prevalence of these differed between genders, fields of study, and
aspired degrees, among other factors. Binary logistic regression analyses revealed nine significant
predictors (p ≤ .05) of cigarette smoking (Nagelkerke R² = 0.314), 18 of risky alcohol consumption
(Nagelkerke R² = 0.270), and 16 of marijuana smoking (Nagelkerke R² = 0.239). (4) Conclusions: This
study showed cigarette smoking, risky alcohol consumption, and marijuana smoking among university
students in Germany to be associated with multiple factors, especially health behaviors. Furthermore,
each of the substances was highly associated with each of the two other substances we examined. Other
variable groups, such as psychological or psychosocial variables, seemed to play a rather minor role.
Therefore, our recommendation for future prevention programs is that substance use among university
students should be addressed as a whole, not just in terms of specific substances.