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

• Published in: BMC medical education Vol. 25; no. 1; pp. 959 - 12
• Main Authors: Bulfone, Giampiera, Ingravalle, Fabio, Scerbo, Francesco, Mazzotta, Rocco, Simonelli, Ilaria, Pancaldi, Alessandra, Ungaro, Stefano, Cocco, Michela, Vellone, Ercole, Alvaro, Rosaria, Vinci, Antonio, Maurici, Massimo
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 01.07.2025; BioMed Central; BMC
• Subjects: Academic achievement; Academic failure; Academic Performance - statistics & numerical data; Adaptation; Alcohol Abuse; Alcohol drinking; Alcohol Drinking - epidemiology; Alcohol Education; Alcohol use; Cognition & reasoning; Cognitive Development; College students; Comorbidity; Cultural capital; Drinking; Drug use; Economic development; Educational aspects; Educational research; Failure; Females; Humans; Information Seeking; Information Sources; Literature Reviews; Marijuana; Medical Subject Headings-MeSH; Mental disorders; Meta Analysis; Psychological aspects; Public health; Search Strategies; Short Term Memory; Social aspects; Social Capital; Students - psychology; Students - statistics & numerical data; Substance abuse; Substance use disorder; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Substances use disorders; Surveys; Systematic review; Theses; Tobacco; Universities; University student; University students; Young Adult; Young adults; Italy; Egypt; Finland; Spain; Academic achievement; Alcohol drinking; Substances use disorders; University student
• ISSN: 1472-6920; 1472-6920
• DOI: 10.1186/s12909-025-07530-y

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. 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. 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). 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. Not applicable.