Substance Use Related Harms in College Students: Latent Class Analysis of Personal Consequences and Secondhand Effects

Background and Purpose: The use of substances by college students carries with it the increased probability of experiencing personal consequences (i.e., driving under the influence, personal injury, unprotected sexual activity, and physical illness) as well as harm associated with exposure to others using substances. Secondhand effects can impact students through strains (i.e., having study or sleep interrupted, caring for an intoxicated peer, and having living space messed up) and threats (i.e., unwanted sexual advance, being insulted or humiliated, feeling unsafe, and being pushed, hit, assaulted) (Thompson, et al., 2017). Many students experience both personal consequences and secondhand effects concurrently. Yet, most research has examined the experience of harms as aggregate counts of separate constructs (e.g., Rickwood, George, Parker & Mikhailovich, 2011). Our study identified latent classes representing distinct subgroups of response pattern harms associated with personal substance use and the substance use of others.

Methods: The student body (n=1,352) at a small rural northeastern college were invited by email to participate in the study. Data were collected in a cross-sectional design using the CORE survey. Respondents (n=412) were 55.1% women, 92.2% white/non-Hispanic, and had a median age of 20 (range:17-52). Participants were queried on their experience of nineteen consequences related to their substance use in the past year. Respondents also indicated from a list of six items if the drinking of other students interfered with their life on campus. The Proc LCA procedure of SAS-9.4 was used to identify latent classes and model their association with demographic and substance use correlates.   

Results: Model fit indicators (i.e., AIC, CAIC) showed that of the series of 1 through 5 class models, the 5-class model provided the better fit to the data. These classes represented response patterns as: No Harms- consisting of 25.1% of the sample; Secondhand Only Harms – 13.3% of the sample; Common Harms – 33.5% of the sample; Combined Harms- consisting of 6.3%; and, Greater Harms – having 21.8% of respondents. Class memberships are orthogonal to one another with each class representing a specific pattern of experienced harms. Omnibus log-likelihood test results showed that women, early onset risk, past 30-day substance use, and binge drinking in the past 2-weeks were strong correlates of class membership. Specific odds ratios showed the degree to which each covariate influenced membership in each of the five classes.  

Conclusions and Implications: Modeling the response patterns of experienced harms provides a framework for policymakers, researchers, and student life personnel when designing prevention strategies, action plans, and future research on substance misuse among college students. College students are a segment of the better educated in the population. A social welfare advocate might question; if a significant proportion of students are exposed, not only to the physiological stresses of psychoactive substances, but also to the stresses and strains of undesirable consequences, then to what degree will they be able to flourish while facing a demanding physical environment and an increasingly complex global society?