Not in education, employment, or training (NEET) and risk of alcohol use disorder: a nationwide register-linkage study with 485 839 Swedish youths

OBJECTIVE: To investigate to what extent being outside education, employment or training after completed secondary education in Sweden might affect the risk of subsequent alcohol use disorders (AUDs), with sociodemographic indicators, such as sex, domicile and origin, taken into account. DESIGN: Population register-based cohort study with 485 839 Swedish youths. SETTING: Sweden. PARTICIPANTS: All youths who were born between 1982 and 1991 and were aged between 19 and 24 years when they completed secondary education in Sweden, between 2005 and 2009. PRIMARY OUTCOME MEASURE: Cox regression models were used to estimate the HR of first record of entry into alcohol-related medical care with a diagnosis of an AUD, by level of labour market attachment, from 1 January 2009 to 31 December 2016. RESULTS: About 4% of the youth population were outside education, employment or training and 25% were in insecure workforce after they completed secondary education. The risk of AUD was higher among youths in insecure workforce, HR 1.40 (95% CI 1.30 to 1.50), and among those outside education, employment or training, HR 1.30 (95% CI 1.11 to 1.51), compared with youths within the core workforce, also after adjusting for age, domicile, sex and origin. Being in education was associated with lower HR of AUD, HR=0.84 (95% CI 0.78 to 0.90). CONCLUSION: Youths who are in insecure workforce and outside education, employment or training are at higher risk of AUD. Targeted policy actions are needed to support a successful school-work transition to secure equal opportunities for young people.