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Patterns of alcohol use in adolescents: early predictors and adulthood outcomes

Wing See Yuen

Alcohol is one of the leading risk factors for death and disability in young people 1. Although people usually first start drinking alcohol at around 15-16 years of age 2, this can vary, and adolescents often follow different patterns or “trajectories” of drinking. The age at which an adolescent first consumes alcohol and how quickly they escalate their alcohol use may be important predictors of alcohol-related problems in early adulthood.

Our study identifies different patterns of alcohol use throughout adolescence in a cohort of young Australians. We found that certain parenting and peer factors in early adolescence were linked to trying alcohol for the first time at a younger age and drinking at levels that exceed current Australian guidelines. We also found that these adolescent drinking patterns can predict symptoms of alcohol use disorder in early adulthood.

Who participated in this study?

For this study, we used data from the Australian Parental Supply of Alcohol Longitudinal Study (APSALS) cohort, which comprised 1927 families recruited from grade 7 in Australian schools in 2010 and followed up for seven years.

What were the aims?

We wanted to discover whether a range of child, parent, and peer factors in the first year (Grade 7, age 12.9 years on average) were associated with different patterns of drinking across five years (Grade 8 to 12) and whether these patterns of drinking were associated with symptoms of alcohol-use disorder at the seventh year (age 18.8 years on average).

What patterns of alcohol use did we find?

We identified four different patterns of drinking:

  • Abstaining, consisting of 19% (352) of participants, of whom over 90 per cent did not consume any alcohol in any of the five years, and of the few who did drink, the vast majority only had a sip.
  • Late-onset moderate drinking, consisting of 28% (503) of participants, of whom the majority had their first sip of alcohol at around 17 years of age but did not have their first full drink until around 18 years of age.
  • Early-onset moderate drinking, consisting of 37% (663) of participants, of whom the majority had their first sip of alcohol by around 15 years of age and at age 18 drank between 1 to 10 full drinks at most fortnightly.
  • Early-onset heavy drinking, consisting of 16% (295) of participants, of whom the majority had their first sip of alcohol by around 14 years of age and at age 18 drank between 5 to 11+ full drinks fortnightly or more often.

Of particular interest was comparing the group reporting late-onset moderate drinking, which roughly follows current Australian guidelines for alcohol use, and the group reporting early-onset heavy drinking, which reflects a potentially high-risk pattern of drinking.

What predicted patterns of alcohol use?

We found three factors in early adolescence that were linked to lower risk of early onset heavy drinking compared to late-onset moderate drinking. These were:

  • Stricter parental monitoring, such as keeping track of your child’s after-school activities.
  • More alcohol-specific rules, such as maintaining clear rules with your child that they are not allowed to drink at home/outside with friends/at a party/etc.
  • Having fewer peers who use alcohol and/or tobacco.

What did the different patterns of alcohol use predict?

Compared to late-onset moderate drinking, early-onset heavy drinking was linked to increased odds of meeting diagnostic criteria for alcohol dependence, alcohol abuse, and alcohol use disorder. However, it is important to keep in mind that these are based on self-reported symptoms and do not reflect a formal clinical diagnosis. Nevertheless, these results suggest that there may be early signs indicative of clinical problems related to certain patterns of alcohol use.

What is the main takeaway message for this study?

In summary, parents of children entering adolescence should consider parenting factors, such as parental monitoring and alcohol-specific rules, and also peer influences in order to reduce risk of early-onset heavy drinking, and in turn, reduce the risk of developing alcohol-related problems later in life. Our findings broadly support Australian government recommendations for adolescents to delay their first drink until they’re at least 18 years of age and for those who are over 18, to consume no more than four standard drinks on a single occasion in order to minimise harm.

Where can I find more information about this study?

If you’d like to read the full paper or have any questions about this study, please contact Wing See Yuen at w.yuen@unsw.edu.au

You can read the full study here.



  1. Mokdad, A. H., Forouzanfar, M. H., Daoud, F., Mokdad, A. A., El Bcheraoui, C., Moradi-Lakeh, M., Kyu, H. H., Barber, R. M., Wagner, J., Cercy, K., Kravitz, H., Coggeshall, M., Chew, A., O’Rourke, K. F., Steiner, C., Tuffaha, M., Charara, R., Al-Ghamdi, E. A., Adi, Y., … Murray, C. J. L. (2016). Global burden of diseases, injuries, and risk factors for young people’s health during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, 387(10036), 2383–2401. https://doi.org/10.1016/s0140-6736(16)00648-6
  2. Australian Institute of Health and Welfare 2020. National Drug Strategy Household Survey 2019. Drug Statistics series no. 32. PHE 270. Canberra AIHW. https://doi.org/10.25816/e42p-a447