Assessing alcohol guidelines in teenagers: results from a 10-year prospective study

To assess the value of drinking guidelines applied in adolescence for predicting alcohol-related outcomes in young adulthood.

We conducted an eight-wave, population-based cohort study of 696 males and 824 females in Victoria between 1992 and 2003. Adolescent drinking was assessed at five survey waves, in six month intervals, from mean age 15.4-17.4 years. We created three measures of adolescent alcohol use using categories from NHMRC drinking guidelines: risky/high-risk drinking in the short and long term (2001), and high-risk drinking (2007). Each measure was defined according to the number of waves at which drinking was reported at or above the designated level during adolescence: non-drinkers, zero waves (low-risk drinkers), one wave, and 2+ waves. Alcohol use disorders and alcohol-related sexual behaviours were assessed at mean age 24.1 years.

Fourteen per cent of males and 17% of females were non-drinkers during adolescence. Using each NHMRC drinking guideline, the prevalence of each outcome for men increased with the number of waves at which drinking was reported above the low-risk level (p-values <0.007). The association was less clear for women. The prevalence of each outcome was lower among the nondrinkers compared to the low-risk drinkers for both men and women.

These findings support the emphasis in the NHMRC guidelines on abstaining from alcohol during the adolescent years. Any drinking, even at the low-risk level, may not be appropriate in adolescence. However, refinements that could better capture the risk of adolescent drinking in women would be useful.