A Multilevel Analysis of College Student Alcohol Consumption: Integrating Genetic, Psychological, Social, and Cultural FactorsBarry

College student alcohol consumption is a critical public health issue influenced by multilevel factors. While previous studies have often examined genetic, psychological, social, or cultural determinants in isolation, few have integrated these dimensions within a unified temporal framework. This study employs Markov chain modeling to analyze dynamic behavioral transitions in alcohol use among university students over a 12-week academic semester. Through ecological momentary assessment (EMA), data were collected from 299 undergraduates stratified by academic discipline (Portuguese Language and Mathematics) and gender. Results reveal significant variations in drinking patterns across weekends, weekdays, and exam periods, with male students and those in certain disciplinary cultures showing higher behavioral volatility. Key findings include the mediating role of impulsivity in genetic risk expression, the contextual influence of romantic relationships, and culturally moderated drinking motivations. The study underscores the need for multi-target interventions that combine genetic screening, psychological support, academic integration, and culturally adapted environmental strategies. Our integrative model contributes to the literature by bridging biological and sociocultural perspectives and introducing a temporal dimension to risk assessment, offering new insights for tailored prevention programs in higher education settings.