Doctors are less likely to warn college students about the health risks of drinking, smoking or drug use than young adults not enrolled in college, according to a new survey.

College students are more likely to report they engage in binge drinking or driving under the influence than their peers who are not in college, the researchers report in JAMA Pediatrics.

Lead author Dr. Ralph Hingson of the National Institute on Alcohol Abuse and Alcoholism told Reuters he was surprised by the results. He noted there is strong evidence that brief screening and intervention by doctors reduces alcohol problems in young people. “(But) they don’t always happen because providers, physicians, nurses and social workers don’t routinely ask every young person about their drinking, drug use or smoking,” he said.

The survey included more than 2,000 students, who were followed starting in 10th grade. They were questioned again when they were a year past high school graduation. The survey found 42 percent were enrolled in a four-year college, 25 percent were enrolled in a two-year college, and 33 percent were not enrolled in any college.

Three-quarters of college students said they had seen a doctor in the previous year, compared with 65 percent of those who were not students. More than 70 percent of young people in every group were asked about drinking, drug use or smoking. However, less than half of college students were told about the risks of substance use, compared with 53 to 57 percent of those who were not students.

Among young people who drank, smoked or used drugs at least six times a month, those who were not students were more likely than college students to be told to reduce or stop these activities. Overall, only about 20 percent of young people were told to reduce or stop their substance use.