Age at first drink and the first incidence of adult-onset DSM-IV alcohol use disorders.
Level 3 - non-randomized controlled study
Prospective longitudinal cohort study evaluating incidence over a 3-year follow-up
PubMed 18828796 · doi:10.1111/j.1530-0277.2008.00806.x
What was done
This longitudinal cohort study evaluated 22,316 U.S. drinkers aged 18 years and older over a 3-year follow-up. Investigators assessed associations between age at first drink (AFD categories: <15 years, 15–17 years, vs. 18+ years) and the first incidence of adult-onset DSM-IV alcohol abuse, dependence, and specific diagnostic criteria. Models adjusted for duration of exposure to risk, family history, childhood risk factors, baseline covariates, and drinking volume, with subgroup analyses conducted in a low-risk subsample free of baseline psychiatric and familial risk factors.
What was found
After adjusting for risk factors, incident alcohol dependence was elevated in individuals with AFD <15 years (odds ratio [OR] = 1.38) and in women with AFD 15–17 years (OR = 1.54). Incident alcohol abuse was elevated for AFD <15 years (OR = 1.52) and AFD 15–17 years (OR = 1.30). Among specific abuse criteria, only hazardous drinking and continued drinking despite interpersonal problems were significantly associated with AFD. When additionally controlling for alcohol consumption volume, all primary associations became non-significant. However, in a low-risk subgroup without baseline risk factors, early AFD (<18 years) remained strongly associated with incident dependence (OR = 3.79) and continued drinking despite physical/psychological problems (OR = 2.71), but not with alcohol abuse.
Why it matters
The study demonstrates that the link between early drinking onset and adult alcohol use disorders persists even after controlling for exposure duration and background risk factors, though much of this association operates through overall drinking volume.
Limits
Age at first drink and childhood risk factors were assessed retrospectively and are subject to recall bias. Follow-up was restricted to a 3-year window, which captures only short-term adult incidence rather than lifetime trajectories. The abstract does not provide exact confidence intervals or p-values for the reported odds ratios.
Cited by
- supports The age at which someone has their first alcoholic drink is one of the strongest determinants of whether they will develop alcoholism.