Does Age At First Drink Predict Problem Behaviors when Age At First Drunkenness is Taken Into Account?

Objective: Many studies have reported that the earlier the age at first drink (AFDrink) the higher the later drinking levels and related problems. However, unless adolescents do not proceed into drunkenness, it is unclear why consuming small quantities at early age should lead to later problems. The present study investigates the link between AFDrink and problem behaviors (smoking, cannabis use, injuries, fights, and low academic performance) among 15-year olds who did and did not proceed into drunkenness. Among the former, we tested whether the age at first drunkenness (AFDrunk) and the time elapsed from AFDrink and AFDrunk predicted problem behaviors. Method: Multilevel structural equation models were estimated based on a sample of 44,801 alcohol-initiated students from 38 North American and European countries and regions of the Health Behavior in School-aged Children (HBSC) survey. Results: Overall, there was a significant association between AFDrink and all five problem behaviors. However, this was only the case among those with drunkenness experiences but not among those never been drunk. Among the former, AFDrunk was a strong predictor for all five problem behaviors but not the time elapsed from AFDrink to AFDrunk. Conclusions: Not an early AFDrink but an early progression into drunkenness is a risk factor for various problem behaviors in adolescence. Prevention of (early) drunkenness appears to be more important for public health than delaying the AFDrink.