Background: The prevalence and predictors of alcohol use and abuse among school students were investigated with the aim of gaining insight to guide prevention interventions.

Method: A cross-sectional, self-administered survey pertaining to a one-month period was conducted among students in grades 11 and 12 in purposively selected schools with mixed-race groups. Frequencies and χ² analyses were conducted and forward stepwise, conditional entry logistic regression models were fitted to determine the significant demographic predictors and influence of peers and parents on students' alcohol use and binge drinking.

Results: About 54% of students had used alcohol before, while 14.5% had had their first drink before the age of 13. In the relevant month, 41% used alcohol and 32% engaged in binge drinking. Students who were more likely to have used alcohol in the preceding month were older [odds ratio (OR) = 1.44, P = 0.006], male (OR = 2.1, P < 0.001), white (OR = 5.1, P < 0.001), had often seen their fathers drunk (OR = 1.9, P < 0.001) and had friends who frequently use alcohol (OR = 3.5, P < 0.001). Students who were more likely to report binge drinking in the preceding month were older (OR = 1.6, P < 0.001), male (OR = 2.4, P < 0.001), white (OR = 1.6, P = 0.048), had often seen their fathers (OR = 1.5, P = 0.001) and mothers (OR = 1.4, P = 0.05) drunk and had friends who frequently use alcohol (OR = 3.6, P < 0.001).

Conclusion: The long-term consequences of hazardous drinking patterns initiated during adolescence may have negative effects on achievement in life, health and general well-being, and therefore these patterns are in need of urgent address. While older, white male students are at particular risk, the significant influence of peer and parental alcohol use is highlighted and should be considered when developing prevention interventions in schools.