Purpose: We aimed to evaluate changes in the frequency of drinking, alcohol dependence and alcohol-related harm in freshman college students from 2005, 2012 and 2016, and identify risk-associated factors. Method: A cross-sectional study involving 5009 freshman students was carried out in Spain in 2005, 2012 and 2016. The Dimensions of Alcohol Use Disorders Identification Test (frequency of drinking, symptoms of dependence and alcohol-related harm) was analysed. Adjusted relative risks (RRs) and their 95% confidence intervals were estimated using negative binomial regression. Results: Place of residence, positive expectancies and early onset of alcohol consumption continue to be crucial conditions for developing patterns of risky consumption, alcohol dependence and harm. Women and men were more vulnerable to alcohol harm and dependence when living away from home, having higher economic status and positive alcohol expectancies. Cohorts from 2012 and 2016 were at lower risk of risky alcohol consumption. Men belonging to the 2012 and 2016 cohorts were at lower risk of alcohol negative consequences compared with the 2005 cohort. However, women remained vulnerable over time to alcohol dependence and harm. Starting drinking after 16 protects them both from alcohol dependence and harm. Conclusions: Women are more vulnerable to alcohol dependence and harm in recent cohorts of freshmen. Limiting access to alcohol at a younger age and working on false positive expectancies could benefit freshmen by avoiding alcohol damage and alcohol dependence.
Keywords: alcohol dependence; alcohol-related harm; audit domains; cohorts; freshmen.