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The Association Between Early Drinking and Dependence Varies by Drinking Context.

Karina Conde1, Raquel I Peltzer1, Paula V Gimenez1

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Early drinking (ED) is controversially linked to later alcohol dependence. This study found the association between early drinking and alcohol dependence varies significantly across different global drinking contexts and country clusters.

Keywords:
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Area of Science:

  • Global health
  • Epidemiology
  • Substance abuse research

Background:

  • The relationship between early drinking (ED) and later alcohol dependence remains debated, with hypotheses suggesting causality or ED as a marker for vulnerability.
  • Most evidence stems from high-income countries, limiting understanding of global associations and contextual influences.
  • Discerning the ED-dependence link is crucial for public health interventions aimed at delaying youth alcohol consumption.

Purpose of the Study:

  • To investigate if the association between early drinking (ED) and alcohol dependence varies across countries grouped by shared drinking characteristics.
  • To explore potential biological versus psychosocial mechanisms underlying the ED-dependence association by examining its variability across different cultural drinking contexts.

Main Methods:

  • Utilized data from 169 countries via the WHO Global Information System on Alcohol and Health.
  • Employed multiple correspondence analysis (MCA) and hierarchic classification to cluster countries based on heavy episodic drinking (HED), prevalence of actual drinkers, and alcohol policies.
  • Conducted beta regressions, adjusted for income and gender, to estimate the association between ED and alcohol dependence within country clusters.

Main Results:

  • Identified four country clusters: primarily abstainers, low drinking, high drinking, and very high drinking countries.
  • Found a significant positive association between early drinking (ED) and alcohol dependence globally and in low-drinking country clusters (primarily abstainers and low drinking).
  • Observed no significant association between ED and alcohol dependence in high and very high drinking country clusters, with gender-specific differences noted in adjusted analyses.

Conclusions:

  • The association between early drinking (ED) and alcohol dependence is not uniform globally and is moderated by country-specific drinking contexts.
  • Findings suggest the ED-dependence link may be influenced by individual/environmental vulnerabilities or psychosocial factors that interact with cultural drinking norms.
  • The variability underscores the need for context-specific public health strategies regarding youth alcohol consumption and dependence prevention.