title: Age of drinking onset and injuries, motor vehicle crashes, and physical fights after drinking and when not drinking.
abstract: BACKGROUND
  Earlier age of drinking onset has been associated with greater odds of involvement in motor vehicle crashes, unintentional injuries, and physical fights after drinking. This study explores whether early drinkers take more risks even when sober by comparing potential associations between age of drinking onset and these outcomes after drinking relative to when respondents have not been drinking.
  
  
  METHODS
  From a national sample, 4,021 ever-drinkers ages 18 to 39 were asked age of drinking onset, not counting tastes or sips. They were also asked if they were ever in motor vehicle crashes, unintentionally injured, or in physical fights after drinking and when not drinking. GEE logistic regression models for repeated measures dichotomous outcomes compared whether odds ratios between age of onset and these adverse outcomes significantly differed when they occurred after drinking versus when not drinking, controlling for respondents' demographic characteristics, cigarette and marijuana use, family history of alcoholism, ever experiencing alcohol dependence, and frequency of binge drinking.
  
  
  RESULTS
  Compared with persons who started drinking at age 21+, those who started at ages <14, 14 to 15, 16 to 17, and 18 to 20 had, after drinking, respectively greater odds: 6.3 (2.6, 15.3), 5.2 (2.2, 12.3), 3.3 (1.5, 7.3), and 2.2 (0.9, 5.1) of having been in a motor vehicle crash; 6.0 (3.4, 10.5), 4.9 (3.0, 8.6), 3.7 (2.4, 5.6), and 1.9 (1.2, 2.9) of ever being in a fight; and 4.6 (2.4, 8.7), 4.7 (2.6, 8.6), 3.2 (1.9, 5.6), and 2.3 (1.3, 4.0) of ever being accidentally injured. The odds of experiencing motor vehicle accidents or injuries when not drinking were not significantly elevated among early onset drinkers. The odds of earlier onset drinkers being in fights were also significantly greater when respondents had been drinking than not drinking.
  
  
  CONCLUSIONS
  Starting to drink at an earlier age is associated with greater odds of experiencing motor vehicle crash involvement, unintentional injuries, and physical fights when respondents were drinking, but less so when respondents had not been drinking. These findings reinforce the need for programs and policies to delay drinking onset.
authors.affiliation: Division of Epidemiology and Prevention Research, National Institute on Alcohol Abuse and Alcoholism, 5635 Fishers Lane, Bethesda, MD 20892, USA. rhingson@mail.nih.gov
authors.forename: Ralph W
authors.initials: RW
authors.lastname: Hingson
authors.forename: Erika M
authors.initials: EM
authors.lastname: Edwards
authors.forename: Timothy
authors.initials: T
authors.lastname: Heeren
authors.forename: David
authors.initials: D
authors.lastname: Rosenbloom
mesh_terms: D000058:Accidental Falls; D000063:Accidents, Traffic / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000374:Aggression / Q000523:psychology; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology* / Q000523:psychology; D000435:Alcoholic Intoxication / Q000453:epidemiology / Q000523:psychology; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055815:Young Adult