Health risk behaviours such as tobacco smoking, alcohol consumption and physical inactivity are prevalent during adolescence and have also been shown to co-occur during this period. A growing body of evidence suggests that these behaviours are strongly associated with adverse health outcomes in later life, including chronic health conditions, morbidity and premature mortality.

Successful completion of compulsory education is important to an individual’s well-being and lifelong opportunities. Those with lower educational attainment are more likely to smoke, be overweight and have poor physical and mental health outcomes. They also experience reduced employment opportunities and earning potential, while successful completion of compulsory education is strongly associated with increased aspirations and life satisfaction and those with college degrees or higher are the most likely to engage in healthy behaviours.

Single health risk behaviours are negatively associated with educational outcomes, but very little is known about the relationship between multiple risk behaviours (MRB) and educational attainment.

Using linked data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population based birth cohort study of children born in England and data from the national pupil database (NPD), we are exploring this association.