Department of Psychological Medicine, University of Otago, 23 Mein Street, Wellington, New Zealand.
Health Promotion Agency, 101 The Terrace, Wellington, 6011, New Zealand.
Drug Alcohol Depend. 2019 Jan 1;194:238-243. doi: 10.1016/j.drugalcdep.2018.10.012. Epub 2018 Nov 6.
International public policy on age of first alcoholic drink (AFD) has emphasised the long-term benefits of delaying AFD. This study aimed to compare AFD to age of first intoxication (AFI) as predictors of substance use disorder and mental disorder outcomes in adulthood.
Data were obtained from a longitudinal birth cohort in Christchurch, New Zealand. Participants were born in 1977. Analysis samples ranged from n = 1025 (age 18) to n = 962 (age 35). Measures of AFD and AFI were generated using parental- and self-report data collected from age 11. Outcomes at age 18-35 were alcohol quantity consumed, DSM-IV alcohol use disorder (AUD) and AUD symptoms, major depression, anxiety disorder, and nicotine, cannabis, and other illicit drug dependence. Covariate factors measured during childhood included family socioeconomic status, family functioning, parental alcohol-related attitudes/behaviours, and individual factors.
There was a significant unadjusted association between AFD and symptoms of AUD (p < .001) and nicotine dependence (p < .05) but not other outcomes. AFI was significantly (p < .05) associated with all outcomes. After adjustment for covariates, the association between AFD and outcomes was not statistically significant. Conversely, in adjusted models, statistically significant (p < .05) associations remained between AFI and all AUD and substance use disorder outcomes but not alcohol consumption or mental disorder outcomes.
AFI was a more robust predictor of adult substance use disorder outcomes than AFD. Public health and policy interventions aimed at prevention of long term harms from alcohol should therefore focus on AFI rather than AFD.
国际上针对首次饮酒年龄（AFD）的公共政策强调了延迟 AFD 的长期益处。本研究旨在比较 AFD 和首次醉酒年龄（AFI）作为成年后物质使用障碍和精神障碍结果的预测指标。
数据来自新西兰克赖斯特彻奇的一项纵向出生队列研究。参与者于 1977 年出生。分析样本范围从 n=1025（18 岁）到 n=962（35 岁）。AFD 和 AFI 的测量值是通过从 11 岁开始收集的父母和自我报告数据生成的。18-35 岁的结果包括饮酒量、DSM-IV 酒精使用障碍（AUD）和 AUD 症状、重度抑郁症、焦虑症以及尼古丁、大麻和其他非法药物依赖。儿童期测量的协变量因素包括家庭社会经济地位、家庭功能、父母与酒精相关的态度/行为以及个体因素。
在未调整的情况下，AFD 与 AUD 症状（p<0.001）和尼古丁依赖（p<0.05）之间存在显著关联，但与其他结果无关。AFI 与所有结果均显著相关（p<0.05）。在调整协变量后，AFD 与结果之间的关联不再具有统计学意义。相反，在调整模型中，AFI 与所有 AUD 和物质使用障碍结果之间仍然存在统计学上显著的关联（p<0.05），但与饮酒或精神障碍结果无关。
AFI 是成年物质使用障碍结果的更有力预测指标，而 AFD 则不然。因此，预防酒精长期危害的公共卫生和政策干预措施应侧重于 AFI，而不是 AFD。
