title: Alcohol Drinking in University Students Matters for Their Self-Rated Health Status: A Cross-sectional Study in Three European Countries.
abstract: BACKGROUND
  Alcohol drinking was linked to self-rated health in different populations, but the observed association was inconsistent. We studied the association among university students across three European countries with different patterns of drinking.
  
  
  METHODS
  We analyzed data from three universities, one from each country: Germany (beer dominant), Bulgaria (wine dominant), and Poland (unclassified among youths, spirits dominant in adults) (N= 2103). Frequency of drinking and problem drinking (≥2 positive responses on CAGE-scale), on the one side, and self-rated health, caring for one's own health, and worsening of health since the last year, on the other side, were assessed by means of self-administered questionnaire. The association between alcohol- (independent) and health-related (dependent) variables was evaluated by means of logistic regression, adjusting for country and sex.
  
  
  RESULTS
  Poor self-rated health and worsened health since previous year were associated with problem drinking {odds ratio 1.82 [95% confidence interval (CI) 1.21-2.73] and 1.61 (95% CI 1.17-2.21), respectively}, but not with a higher frequency of drinking. In contrast, not caring for one's own health was associated with frequent drinking [1.40 (95% CI 1.10-1.78)], but not with problem drinking [1.25 (95% CI 0.95-1.63)]. The results were consistent across the studied countries and for both sexes.
  
  
  CONCLUSIONS
  The health status of university students was associated with problem drinking. A high frequency of drinking was associated with the lack of care of own health, but it was not associated with current health status. These associations were independent of the predominant pattern of drinking across the studied countries.
authors.affiliation: Department of Epidemiology of Infectious Diseases, Hannover Medical School, Hannover, Germany; Department of Epidemiology, Helmholtz-Centre for Infection Research, Braunschweig, Germany.
authors.forename: Rafael T
authors.initials: RT
authors.lastname: Mikolajczyk
authors.affiliation: Department of Psychology, Faculty of Arts, PJ Šafárik University , Košice , Slovakia.
authors.forename: Rene
authors.initials: R
authors.lastname: Sebena
authors.affiliation: Department of Public Health Medicine, School of Public Health, Bielefeld University , Bielefeld , Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Warich
authors.affiliation: Faculty of Philosophy, Sofia University , Sofia , Bulgaria.
authors.forename: Vihra
authors.initials: V
authors.lastname: Naydenova
authors.affiliation: Institute of Family Sciences, Catholic University of Lublin , Lublin , Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Dudziak
authors.affiliation: Department of Psychology, Faculty of Arts, PJ Šafárik University , Košice , Slovakia.
authors.forename: Olga
authors.initials: O
authors.lastname: Orosova
keywords: CNSHS; cross-country comparison; emerging adulthood; problem drinking; self-rated health