Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Addiction. 2023 Sep;118(9):1739-1750. doi: 10.1111/add.16216. Epub 2023 May 16.
Analyzing long-term trajectories of alcohol use has the potential to strengthen policy and intervention priorities and timing. We identified and described trajectories of alcohol use and binge drinking frequency from mid-adolescence to early adulthood and measured the association of the role of early drinking initiation with trajectory membership.
DESIGN, SETTING, PARTICIPANTS: This was a longitudinal cohort study conducted in the United States. The National Longitudinal Survey of Youth 1997 is a nationally representative cohort of youth aged 12-16 years at baseline. The analytic sample included individuals who participated in two or more annual interviews between ages 15 and 30 years (n = 8809).
Participants self-reported the number of days in the past 30 days they: (1) drank alcohol and (2) binge drank (five or more drinks on one occasion). We used group-based trajectory modeling to identify distinct trajectories from ages 15-30 years of past 30-day drinking and past 30-day binge drinking. Using multinomial logistic regression, we evaluated associations between early drinking initiation (≤ 14 years) and key demographics with trajectory membership.
We identified five past 30-day drinking groups: late-escalating (16.0%), moderate frequency (19.0%), high frequency (11.2%), low frequency (35.4%) and no/infrequent (18.4%). Early drinking initiation (versus later) was associated with higher odds of membership in the moderate [adjusted multinomial odds ratio (aMOR) = 4.88; 95% confidence interval (CI) = 4.00, 5.94] and high-frequency groups (aMOR = 4.68; 95% CI = 3.74, 5.86) than in the no/infrequent comparator trajectory. We identified five groups with distinct binge drinking frequency patterns: later escalating (9.9%), high frequency (3.9%), low frequency (28.7%), earlier onset (9.5%) and no/infrequent (48.0%). Early initiation was associated with increased odds of membership in earlier-onset and high-frequency groups compared with the no/infrequent group. For both outcomes, additional differences in probability of group membership were identified by gender, racial identity, parental factors (religiosity, high school completion) and household characteristics (household size, income, and region of residence).
Youth in the United States appear to follow heterogeneous drinking and binge drinking trajectories from adolescence into adulthood. These may include higher-use trajectories as well as trajectories with different escalation timing (e.g. earlier versus later). Early initiation of drinking may increase risk of membership in higher- and earlier-use trajectory groups.
分析酒精使用的长期轨迹具有增强政策和干预措施重点和时机的潜力。我们从青少年中期到成年早期确定并描述了酒精使用和狂欢饮酒频率的轨迹，并衡量了早期饮酒开始与轨迹成员资格的关系。
设计、地点、参与者：这是在美国进行的一项纵向队列研究。1997 年全国青少年纵向调查是一项具有全国代表性的青少年队列研究，基线时年龄为 12-16 岁。分析样本包括在 15 至 30 岁之间参加过两次或两次以上年度访谈的个体（n=8809）。
参与者自我报告过去 30 天内：（1）饮酒和（2）狂欢饮酒（一次五杯或更多）的天数。我们使用基于群组的轨迹建模来确定从 15 岁到 30 岁期间过去 30 天的饮酒和过去 30 天的狂欢饮酒的不同轨迹。使用多项逻辑回归，我们评估了早期饮酒开始（≤14 岁）与关键人口统计学因素与轨迹成员之间的关联。
我们确定了五个过去 30 天的饮酒组：晚期递增组（16.0%）、中度频率组（19.0%）、高频组（11.2%）、低频组（35.4%）和无/低频率组（18.4%）。与无/低频率的比较轨迹相比，早期饮酒开始（而不是以后）与较高的中等频率组（调整后的多项优势比[aMOR]=4.88；95%置信区间[CI]=4.00，5.94）和高频组（aMOR=4.68；95%CI=3.74，5.86）成员资格的可能性更高。我们确定了五个具有不同狂欢饮酒频率模式的组：后期递增组（9.9%）、高频组（3.9%）、低频组（28.7%）、早期起始组（9.5%）和无/低频率组（48.0%）。与无/低频率组相比，早期开始与早期开始和高频组成员资格的可能性增加有关。对于这两个结果，通过性别、种族身份、父母因素（宗教信仰、高中毕业）和家庭特征（家庭规模、收入和居住地区）确定了群体成员资格概率的其他差异。
美国的年轻人似乎从青少年期到成年期遵循不同的饮酒和狂欢饮酒轨迹。这些可能包括更高使用率的轨迹以及不同的上升时间轨迹（例如早期与晚期）。早期饮酒开始可能会增加加入更高和更早使用轨迹组的风险。
