Combining family history and alcohol screening measures to identify emerging adults at risk of not being in education, employment, or training (NEET).

Purpose: Being outside of the labor and education system during young adulthood, a status termed not in education, employment, or training (NEET), is a risk factor for later social and health outcomes. This study examined whether parental substance use (PSU) moderates the relationship between personal alcohol consumption and NEET. Such information may inform screening practices.

Methods: Participants included 2,940 respondents (15-25-year-olds) to a 2014 Danish national survey. In this historical cohort study, survey data were linked with register data on respondents' parents and follow-up register data on respondents' educational/employment status (2015-2018). The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) identified respondents with hazardous drinking. PSU was measured using survey and register data. Our outcome identified those who were NEET during 1 + years follow-up. Analyses included gender stratified multivariable logistic regressions.

Results: Survey-based PSU was associated with higher odds of NEET (OR = 1.67, p <.001). An AUDIT-C + by survey PSU interaction was statistically significant for females (OR = 2.70, p =.007): AUDIT-C + females with survey PSU had higher odds of NEET than AUDIT-C + females without survey PSU. Results were similar using register PSU. For both genders, other parental factors (unemployment and psychiatric problems) were also associated with higher odds of NEET.

Conclusion: Using family history (including unemployment, psychiatric problems, and substance use) may enhance screening to identify emerging adults at risk of adverse social outcomes. Survey- and register-based PSU were similarly associated with NEET, suggesting that asking emerging adults about their parents' substance use may be as informative as more objective measures of family risk.