Alcohol use among 10th-graders: Distinguishing between high-intensity drinking and other levels of use

Introduction: Drinking at levels beyond standard binge drinking thresholds poses particularly high risks to youth. Few studies have examined high-intensity drinking (HID; 10+ drinks in a row) in high school students and none have tested whether peer drunkenness and parental knowledge (e.g., about youth's whereabouts) distinguish between binge and high-intensity drinkers. Methods: We used data from the Monitoring the Future study collected from nationally-representative samples of U.S. 10th graders (modal age 16 years old) in 2016–2018 (n = 14,824; 48.3% girls, 46.8% boys). We conducted multinomial logistic regression to examine odds of drinking at one of four mutually-exclusive levels: HID in the past 2 weeks, binge (5+) drinking in the past 2 weeks, any alcohol use in the past year, and no alcohol use in the past year. Results: Low parental knowledge and peer drunkenness were both associated with higher odds of each drinking level, including HID vs. binge, binge vs. alcohol use, and alcohol use vs. no alcohol use. Boys had higher odds than girls of HID compared to binge drinking and of no alcohol use compared to alcohol use. Conclusions: Parent and peer risk factors differentiate HID from other levels of drinking.