An Epidemiological Latent Class Analysis of Alcohol Use Behavior Among Adult Drinkers

Introduction: The NIAAA has established several guidelines for engaging in low-risk or moderate drinking, however many drinkers exceed these limits. Limited research has identified latent classes of alcohol users based on their typical drinking behavior. Using this approach to examine the typology of drinking patterns in US adult drinkers and factors associated with riskier patterns may inform future prevention efforts. The purpose of the current study was to (1) identify and interpret subgroups of adult drinkers characterized by their drinking behavior patterns, and (2) examine demographic differences in the prevalence of these subgroups. Method: The current study used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) III. Adults ages 18 to 64 who reported any past-year alcohol use were included in the analytic sample. These adults (N=22,776) were mostly Caucasian (55.76%) and women (53.57%). Information on participants’ past-year typical daily drinking quantity, frequency, heavy episodic drinking (HED; 4+/5+ drinks for women/men), extreme drinking (8+/10+ drinks for women/men), and frequency of intoxication were used as indicators of alcohol use. Results: Latent class analysis was used to select the optimum number of classes based on alcohol use indicators. A 5-class solution was selected. Class 1 (32%) consisted of infrequent, light drinkers with no reported past-year intoxication. Class 2 (22%) consisted of frequent, light drinkers. Class 3 (14%) was comprised of moderate, frequent drinkers with occasional HED. Class 4 (16%) was comprised of frequent, non-extreme HED drinkers. Class 5 (16%) consisted of heavy, frequent drinkers who engaged in extreme HED and exhibited frequent intoxication. Class prevalences were modeled as a function of sex, ethnicity (defined as White and non-White), and age (18 to 24, 25 to 44, and 45 to 64 years). Among women, the most common class was Class 1 (46%). For men, the most common class was Class 5 (31%). Among both non-White and White adults, the most common class was Class 1 (39% and 44%). Regarding age, the most common class for young adults was Class 5 (37%); the most common class for middle and older adults was Class 1 (28% and 45%). Discussion: While the largest classes consisted of infrequent and frequent low-risk drinkers, many adults exceeded daily drinking guidelines and engaged in occasional or frequent HED. Importantly, 16% of drinking adults reported not only frequent HED but also extreme drinking. Given the potential risk for harms and alcohol use disorder and that young adults represent the largest group within this class, a greater focus on prevention efforts is needed for this at-risk group.