Substance use and academic performance among university students: systematic review and meta-analysis

Abstract Background Substance use is a widespread concern among young adults and is particularly significant among college students. Substance use in this population is associated with several academic, physical, mental, and social difficulties. This systematic review and metanalysis explores whethe...

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Main Authors: Giampiera Bulfone, Fabio Ingravalle, Francesco Scerbo, Rocco Mazzotta, Ilaria Simonelli, Alessandra Pancaldi, Stefano Ungaro, Michela Cocco, Ercole Vellone, Rosaria Alvaro, Antonio Vinci, Massimo Maurici
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Medical Education
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Online Access:https://doi.org/10.1186/s12909-025-07530-y
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author Giampiera Bulfone
Fabio Ingravalle
Francesco Scerbo
Rocco Mazzotta
Ilaria Simonelli
Alessandra Pancaldi
Stefano Ungaro
Michela Cocco
Ercole Vellone
Rosaria Alvaro
Antonio Vinci
Massimo Maurici
author_facet Giampiera Bulfone
Fabio Ingravalle
Francesco Scerbo
Rocco Mazzotta
Ilaria Simonelli
Alessandra Pancaldi
Stefano Ungaro
Michela Cocco
Ercole Vellone
Rosaria Alvaro
Antonio Vinci
Massimo Maurici
author_sort Giampiera Bulfone
collection DOAJ
description Abstract Background Substance use is a widespread concern among young adults and is particularly significant among college students. Substance use in this population is associated with several academic, physical, mental, and social difficulties. This systematic review and metanalysis explores whether there is an effect of the legal and illegal substance and alcohol consumption behaviors on academic achievement among university students. Methods The databases searched were MEDLINE, CINHAL, Scopus, ERIC, and PROSPERO, updated in January 2025. The risk of bias was assessed using the Edwards score. We used a random-effects model. The protocol of this review was registered in the Open Science Framework. Results The systematic review included 21 studies, while the meta-analysis included four studies. In a sample of 1,219 subjects in the control group and 350 legal and illegal substances consumers, there is a negative and significant association of substances consumption on academic achievement [SMD = − 0.61 (95% CI − 0.84 to − 0.38; p = 0.008). In a subgroup analysis, a sample of 2,479 subjects in the control group and 7,134 alcohol consumers, there is a non-statistically significative association of alcohol consumption on academic achievement [SMD = − 0.24 (95% CI -0.51 to 0.04; p = 0.073). Conclusions Despite the limitations of this study, this systematic review provides quantitative evidence on the relationship between legal and illegal use of substances among university students and academic achievement. Specifically, we found a significant medium association of substance use in general and a small effect for alcohol consumption on academic achievement. Clinical trial number Not applicable.
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spelling doaj-art-831356e8ea1442de9709792b04e54ebc2025-08-20T03:45:32ZengBMCBMC Medical Education1472-69202025-07-0125111210.1186/s12909-025-07530-ySubstance use and academic performance among university students: systematic review and meta-analysisGiampiera Bulfone0Fabio Ingravalle1Francesco Scerbo2Rocco Mazzotta3Ilaria Simonelli4Alessandra Pancaldi5Stefano Ungaro6Michela Cocco7Ercole Vellone8Rosaria Alvaro9Antonio Vinci10Massimo Maurici11Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia” (DGFI), University of CataniaDoctoral Degree in Nursing Sciences and Public Health, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Doctoral Degree in Nursing Sciences and Public Health, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Doctoral Degree in Nursing Sciences and Public Health, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Doctoral Degree in Nursing Sciences and Public Health, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Department of Biomedicine and Prevention, University of Rome “Tor Vergata”Abstract Background Substance use is a widespread concern among young adults and is particularly significant among college students. Substance use in this population is associated with several academic, physical, mental, and social difficulties. This systematic review and metanalysis explores whether there is an effect of the legal and illegal substance and alcohol consumption behaviors on academic achievement among university students. Methods The databases searched were MEDLINE, CINHAL, Scopus, ERIC, and PROSPERO, updated in January 2025. The risk of bias was assessed using the Edwards score. We used a random-effects model. The protocol of this review was registered in the Open Science Framework. Results The systematic review included 21 studies, while the meta-analysis included four studies. In a sample of 1,219 subjects in the control group and 350 legal and illegal substances consumers, there is a negative and significant association of substances consumption on academic achievement [SMD = − 0.61 (95% CI − 0.84 to − 0.38; p = 0.008). In a subgroup analysis, a sample of 2,479 subjects in the control group and 7,134 alcohol consumers, there is a non-statistically significative association of alcohol consumption on academic achievement [SMD = − 0.24 (95% CI -0.51 to 0.04; p = 0.073). Conclusions Despite the limitations of this study, this systematic review provides quantitative evidence on the relationship between legal and illegal use of substances among university students and academic achievement. Specifically, we found a significant medium association of substance use in general and a small effect for alcohol consumption on academic achievement. Clinical trial number Not applicable.https://doi.org/10.1186/s12909-025-07530-yAlcohol drinkingSubstances use disordersUniversity studentAcademic achievement
spellingShingle Giampiera Bulfone
Fabio Ingravalle
Francesco Scerbo
Rocco Mazzotta
Ilaria Simonelli
Alessandra Pancaldi
Stefano Ungaro
Michela Cocco
Ercole Vellone
Rosaria Alvaro
Antonio Vinci
Massimo Maurici
Substance use and academic performance among university students: systematic review and meta-analysis
BMC Medical Education
Alcohol drinking
Substances use disorders
University student
Academic achievement
title Substance use and academic performance among university students: systematic review and meta-analysis
title_full Substance use and academic performance among university students: systematic review and meta-analysis
title_fullStr Substance use and academic performance among university students: systematic review and meta-analysis
title_full_unstemmed Substance use and academic performance among university students: systematic review and meta-analysis
title_short Substance use and academic performance among university students: systematic review and meta-analysis
title_sort substance use and academic performance among university students systematic review and meta analysis
topic Alcohol drinking
Substances use disorders
University student
Academic achievement
url https://doi.org/10.1186/s12909-025-07530-y
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