Concurrent Tobacco Use and Binge Drinking Among University Students in 30 Countries in Africa, Asia, Latin America, and the Caribbean

The aim of this study was to investigate concurrent tobacco use and binge drinking and the co-occurrence risks of each substance among university students in Africa, Asia, Latin America, and the Caribbean. A cross-sectional survey of 24,753 university students, 58.6% women and 41.4% men, mean age of 20.8 years (SD = 2.6) from 30 countries, was conducted in 2013–2015. Five percent of the university students had engaged in concurrent tobacco use and binge drinking, 17.7% in binge drinking only, and 8.0% in current tobacco use only. Overall, among past month tobacco users, 32.1% were frequent binge drinkers, and among binge drinkers, 45.6% were frequent tobacco users. Compared to students who neither smoked nor were binge drinkers, concurrent tobacco users and binge drinkers were more likely to be men (OR = 3.09, CI = 2.55, 3.74), were older (OR = 2.00, CI = 1.56, 2.36), had a wealthier family background (OR = 1.60, CI = 1.30, 1.96), were living in an upper middle or high-income country (OR = 0.27, CI = 0.10, 0.72), used illicit drugs (OR = 3.16, CI = 2.64, 3.83), were gambling (OR = 2.41, CI = 1.91, 3.04), had been in a physical fight (OR = 2.08, CI = 1.67, 2.59), had sustained an injury (OR = 1.25, CI = 1.03, 1.50), and lacked involvement in organized religious activity (OR = 0.40, CI = 0.32, 0.52). Prevention and treatment strategies should better incorporate the comorbidity of tobacco and alcohol use in their intervention programs.