• Yong Yi Lee, Tim Slade, Mary Lou Chatterton, Long Khanh-Dao Le, Joahna K Perez, Jan Faller, Cath Chapman, Nicola C Newton, Matthew Sunderland, Maree Teesson, and Cathrine Mihalopoulos.
• Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; School of Public Health, The University of Queensland, Brisbane, Australia; Queensland Centre for Mental Health Research, Brisbane, Australia. Electronic address: yongyi.lee@monash.edu.
• Prev Med. 2024 Apr 1; 181: 107898107898.

BackgroundPublic health guidelines recommend delaying the initiation age for alcohol. However, the causal link between age-at-first-drink (AFD) and future alcohol use in young adulthood is uncertain. This study examined the association between AFD and alcohol-related outcomes at age 20 years using an Australian sample.MethodsData were obtained from Waves 1-19 (years 2001-2019) of the Household, Income and Labour Dynamics in Australia Survey on 20-year-olds with responses across ≥3 consecutive waves (n = 2278). The AFD for each respondent (between 15 and 20 years) was analysed relative to Australian legal drinking age (18 years). Inverse probability treatment weighting was used to evaluate associations between AFD and four outcomes at age 20 years: risk of current alcohol use; quantity of weekly alcohol consumption; risk of binge drinking; and frequency of binge drinking. Adjustments were made for confounders (e.g., heavy drinking by parents). Robustness of study findings was evaluated using several diagnostic tests/sensitivity analyses.ResultsAmong 20-year-olds, those with an AFD of 15-16 years consumed significantly more alcohol per week compared to an AFD of 18 years. Additionally, 20-year-old drinkers with an AFD of 16 years were significantly more likely to binge drink (though this association was likely confounded). An inverse dose-response relationship was observed between AFD and weekly alcohol consumption at 20 years, where a higher AFD led to lower alcohol consumption.ConclusionStudy findings indicate an association between a higher AFD and consuming less alcohol in young adulthood, which could potentially support the scale-up of prevention programs to delay AFD among Australian adolescents.Copyright © 2023. Published by Elsevier Inc.

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