School performance and alcohol use problems in early adulthood: a longitudinal study.

There is inconsistent evidence about the association between school performance and subsequent use of alcohol and alcohol problems in adolescents and young adults. This study examines whether school performance at 14 years is associated with drinking problems in early adulthood; and whether this association is explained by family and individual factors in childhood and adolescence. Data were from a 21-year follow-up of 3,478 Australian young adults from birth to the age of 21 years when data on use of alcohol were collected. Child school performance (CSP) was assessed at 14 years via self- and maternal report. Alcohol consumption at 21 years was measured via self-report, and alcohol abuse and dependence were assessed by the computerized version of Composite International Diagnostic Interview (CIDI-Auto). Potential confounding factors were prospectively measured between the child's birth and age of 14 years. School performance at 14 years predicted young adults' alcohol consumption and alcohol use disorders (AUDs). After controlling for confounding, children who had lower school performance had increased risk of drinking more than two glasses of alcohol per day in early adulthood (odds ratio=1.7; 95% confidence interval: 1.1-2.6). There was a similar pattern of association between CSP and young adults' alcohol abuse and dependence (AUD) measured by CIDI-Auto. Level of academic performance in high school children predicts their drinking problems as young adults, independently of a selected group of individual and family confounders. Exploration of the pathway linking school performance and alcohol problems in young people may help identify opportunities for preventive interventions.