• J W Toumbourou, I R Williams, V M White, P C Snow, G D Munro, and P E Schofield.
• Centre for Adolescent Health, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Melbourne, Australia. jwt@unimelb.edu.au
• Addiction. 2004 Apr 1; 99 (4): 498-508.

AimsTo establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies.ParticipantsOne thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993.DesignLongitudinal follow-up across five waves of data collection.SettingPost high school in Victoria, Australia.MeasurementsSelf-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour.FindingsDrinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours.Findingsrevealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21.ConclusionsFuture research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.

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