Having more alcohol-specific household rules reduced risk of early-onset of heavy alcohol use. Having more substance-using peers increased the risk of early-onset heavy alcohol use. Early-onset heavy alcohol use increased the odds of developing an alcohol use disorder in early adulthood.
Early initiation and heavy alcohol use throughout adolescence are associated with increased risk of alcohol-related harm. Parenting factors and peer influences in early adolescence are crucial to reduce risk of later alcohol-related harm.

Author

Wing See Yuen, Gary Chan, Raimondo Bruno, Philip Clare, Richard Mattick, Alexandra Aiken, Veronica Boland, Nyanda McBride, Jim McCambridge, Tim Slade, Kypros Kypri, John Horwood, Delyse Hutchinson, Jake Najman, Clara De Torres and Amy Peacock

Citation

Yuen, W., Chan, G., Bruno, R., Clare, P., Mattick, R., Aiken, A., Boland, V., McBride, N., McCambridge, J., Slade, T., Kypri, K., Horwood, J., Hutchinson, D., Najman, J., De Torres, C. and Peacock, A., 2020. Adolescent Alcohol Use Trajectories: Risk Factors and Adult Outcomes. Pediatrics, 146(4), p.e20200440.


Source
Pediatrics
Release date
01/10/2020

Adolescent Alcohol Use Trajectories: Risk Factors and Adult Outcomes

Abstract

Objectives

Adolescents often display heterogenous trajectories of alcohol use. Initiation and escalation of alcohol use may be important predictors of later harms, including alcohol use disorder (AUD). Previous conceptualizations of these trajectories lacked adjustment for known confounders of adolescent alcohol use, which we aimed to address by modeling dynamic changes in alcohol use throughout adolescence while adjusting for covariates.

Method

Survey data from a longitudinal cohort of Australian adolescents (n = 1813) were used to model latent class alcohol use trajectories over 5 annual follow-ups (mean age = 13.9 until 17.8 years). Regression models were used to determine whether child, parent, and peer factors at baseline (mean age = 12.9 years) predicted trajectory membership and whether trajectories predicted self-reported symptoms of AUD at the final follow-up (mean age = 18.8 years).

Results

The researchers identified 4 classes: abstaining (n = 352); late-onset moderate alcohol use (n = 503); early-onset moderate alcohol use (n = 663); and early-onset heavy alcohol use (n = 295). Having more alcohol-specific household rules reduced risk of early-onset heavy alcohol use compared with late-onset moderate alcohol use (relative risk ratio: 0.31; 99.5% confidence interval [CI]: 0.11–0.83), whereas having more substance-using peers increased this risk (relative risk ratio: 3.43; 99.5% CI: 2.10–5.62). Early-onset heavy alcohol use increased odds of meeting criteria for AUD in early adulthood (odds ratio: 7.68; 99.5% CI: 2.41–24.47).

Conclusion

This study provides evidence that parenting factors and peer influences in early adolescence should be considered to reduce risk of later alcohol-related harm. Early initiation and heavy alcohol use throughout adolescence are associated with increased risk of alcohol-related harm compared with recommended maximum levels of consumption.


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