Heavy alcohol consumption and marital status: disentangling the relationship in a national study of young adults.

AIMS

To investigate why alcohol consumption varies by marital status, assessing (i) differences in heavy consumption prior to changes in marital status (indicating selection) and increases or decreases in heavy consumption associated with changes in marital status (indicating causation), (ii) whether such increases or decreases are transient, and (iii) the possible mediating effect of parental status.

DESIGN

Longitudinal cohort.

SETTING

Great Britain.

PARTICIPANTS

Data from the 23- and 33-year surveys of the 1958 British birth cohort (all born in England, Wales and Scotland, 3-9 March 1958).

MEASUREMENTS

Heavy drinking, defined as more than 35 (men) and 20 (women) units/week; changes between ages 23 and 33 in consumption and marital status.

FINDINGS

The divorced had the highest consumption levels at both ages, the married had the lowest. Selection effects were minimal in both sexes. Overall, heavy drinking declined between ages 23 and 33 (21.4-13.0% in men, 6.4-3.4% in women), but increased among individuals who divorced, compared to the continuously married (adjusted OR = 2.05, 95% CI = 1.49, 2.83 for men; OR = 2.61, 95% CI = 1.67, 4.09 for women), most strikingly for recent divorces (adjusted OR = 4.97, 95% CI = 2.86, 8.57 and OR = 5.25, 95% CI = 2.60, 10.65). High rates of heavy drinking persisted for never married men (19.1%) and women (5.2%).

CONCLUSIONS

The heavy drinking level of divorced young adults was not due to selection. Marital separation was accompanied by increases in heavy drinking, with pronounced short-term effects. Adverse alcohol-related health consequences may occur in the immediate period around divorce. Individuals who never marry appear to have a chronic heavy consumption pattern that may contribute to their increased mortality.