Age at first drink, experiences of drunkenness, and alcohol-related problems in Canadian youth: Is early onset bad if you are a moderate drinker?

Objective: This article examines early age at first drink (AFD) (14 years and younger) and alcohol-related problems, with a focus on experiences of drunkenness. It challenges the assumption that all early AFD is harmful by investigating whether early drinkers who typically consume alcohol in moderation experience minimal problems or harms. Method: Participants were drawn from the 2012 Student Drug Use Survey in Canada’s Atlantic Provinces of New Brunswick, Nova Scotia, and Newfoundland and Labrador, an anonymous cross-sectional survey of high school students (ages 15–19 years). Negative binomial regression techniques were used to assess alcohol problems and harms (12-item scale) in association with early-onset drinking. Results: Among ever-drinking high school students (n = 4,752), 65% had their first drink before age 15, 73% reported having ever been drunk, and 55% indicated at least one alcohol-related problem in the past 12 months, with a mean of 1.39 problems. Analyses revealed that experiencing an alcohol-related problem was more strongly associated with ever being drunk than with early AFD. Modeled together, individuals who reported early AFD and who had never been drunk reported significantly fewer problems relative to individuals who reported early AFD and late AFD but had been drunk. Conclusions: Early AFD is commonly linked to alcohol-related problems in youth and is predictive of future alcohol-related harms in adulthood. However, considerable heterogeneity in the likelihood of suffering alcohol-related problems exists, contextualized by individual drinking patterns. Given the high prevalence of early AFD, harm minimization efforts could achieve greater success by directing youth to consume alcohol in moderation, rather than focusing solely on abstinence.