Effect of multiple risk behaviours in adolescence on educational attainment at age 16 years: a UK birth cohort study

Objectives To explore the association between adolescent multiple risk behaviours (MRBs) and educational attainment. Design Prospective population-based UK birth cohort study. Setting Avon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort of children born in 1991-1992. Participants Data on some or all MRB measures were available for 5401 ALSPAC participants who attended a clinic at age 15 years and/or completed a detailed questionnaire at age 16 years. Multiple imputation was used to account for missing data. Primary outcome measures Capped General Certificate of Secondary Education (GCSE) score and odds of attaining five or more GCSE examinations at grades A*-C. Both outcome measures come from the National Pupil Database and were linked to the ALSPAC data. Results Engagement in MRB was strongly associated with poorer educational attainment. Each additional risk equated to -6.31 (95% CI -7.03 to -5.58, p<0.001) in capped GCSE score, equivalent to a one grade reduction or reduced odds of attaining five or more A*-C grades of 23% (OR 0.77, 95%CI 0.74 to 0.81, p<0.001). The average cohort member engaged in 3.24 MRB and therefore have an associated reduction in GCSE score equivalent to three and a half grades in one examination, or reduced odds of attaining five or more A*-C grades of 75%. Conclusion Engagement in adolescent MRB is strongly associated with poorer educational attainment at 16 years. Preventing MRB could improve educational attainment and thereby directly and indirectly improve longer-term health.