Age at first alcohol use: a risk factor for the development of alcohol disorders.
OBJECTIVE
This study aimed to describe the natural course of DSM-III-R alcohol disorders as a function of age at first alcohol use and to investigate the influence of early use as a risk factor for progression to the development of alcohol disorders, exclusive of the effect of confounding influences.


METHODS
Data were obtained from a community sample (N=5,856) of lifetime drinkers participating in the 1990-1991 Mental Health Supplement of the Ontario Health Survey.


RESULTS
Survival analyses revealed a rapid progression to alcohol-related harm among those who reported having their first drink at ages 11-14. After 10 years, 13.5% of the subjects who began to drink at ages 11 and 12 met the criteria for a diagnosis of alcohol abuse, and 15.9% had a diagnosis of dependence. Rates for subjects who began to drink at ages 13 and 14 were 13.7% and 9.0%, respectively. In contrast, rates for those who started drinking at ages 19 and older were 2.0% and 1.0%. Unexpectedly, a delay in progression to harm was observed for the youngest drinkers (ages 10 and under). Hazard regression analyses revealed a nonlinear effect of age at first alcohol use, marked by an elevated risk of developing disorders among subjects first using alcohol at ages 11-14.


CONCLUSIONS
First use of alcohol at ages 11-14 greatly heightens the risk of progression to the development of alcohol disorders and therefore is a reasonable target for intervention strategies that seek to delay first use as a means of averting problems later in life.
DeWit
D J
DJ
Social, Prevention and Health Policy Research Department, Centre for Addiction and Mental Health, London, Ontario, Canada. ddewitt@julian.uwo.ca
Adlaf
E M
EM
Offord
D R
DR
Ogborne
A C
AC
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D002648:Child; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D011314:Preventive Health Services; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012307:Risk Factors; D012494:Sampling Studies; D016019:Survival Analysis