Evidence map›Paper›PMID 41082637›Full record

ArticleAddiction (Abingdon, England)2026

Does alcohol use and related harm differ based on the age of initiation to alcohol? Results from a prospective cohort study.

Philip J Clare, Wing See Yuen, Alexandra Henderson, Kypros Kypri, Raimondo Bruno, Tim Slade, Delyse Hutchinson, Nyanda McBride, Monika Wodalowski, Jim McCambridge and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Addiction (Abingdon, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. The Brain Age Gap as a Predictor of Alcohol Initiation in Adolescence.bioRxiv : the preprint server for biology · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Philip J ClarePrevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-2009-7386
Wing See YuenNational Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.ORCID 0000-0002-2791-6858
Alexandra HendersonNational Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.
Kypros KypriSchool of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.ORCID 0000-0002-9657-9904
Raimondo BrunoNational Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.
Tim SladeThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-1725-9188
Delyse HutchinsonNational Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.ORCID 0000-0003-3221-7143
Nyanda McBrideNational Drug Research Institute, Curtin University, Bentley, Western Australia, Australia.ORCID 0000-0003-1714-6631
Monika WodalowskiResearch and Innovation Portfolio, The University of Sydney, Sydney, New South Wales, Australia.
Jim McCambridgeUCL School of Pharmacy, University College London, London, UK.
Louisa DegenhardtNational Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.ORCID 0000-0002-8513-2218
Veronica C BolandNational Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.ORCID 0000-0002-6872-7770
Richard P MattickNational Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.
Amy PeacockNational Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.ORCID 0000-0002-5705-2026

Funding

Australian Research Council 1096668Australian Rotary HealthFoundation for Alcohol Research and EducationNational Health and Medical Research Council 1135991National Health and Medical Research Council 2016825National Health and Medical Research Council APP1041867National Health and Medical Research Council APP1045318National Health and Medical Research Council APP1109366National Health and Medical Research Council APP1146634National Health and Medical Research Council APP1174630National Health and Medical Research Council APP1197488National Health and Medical Research Council GNT0188568National Health and Medical Research Council GNT1009381National Health and Medical Research Council GNT1064893
6 · The paper itself

Abstract

BACKGROUND AND

aimsThere is evidence to suggest that earlier initiation to alcohol increases the rate and severity of alcohol consumption. However, this often overlooks the fact that earlier initiation also means a longer drinking history. This paper estimated differences in patterns of alcohol use and harm across adolescence and early adulthood, allowing for the fact that the patterns over time may differ depending on the age at which initiation occurred.

designProspective cohort study.

settingAustralia.

participantsThe Australian Parental Supply of Alcohol Longitudinal Study (APSALS), a cohort of n = 1906 adolescents recruited in adolescence (mean age 12.9) from 107 Australian schools and followed up until adulthood (11 annual waves total, 2010-2021). MEASUREMENTS: We defined age of initiation as the age at which alcohol consumption was first reported in the study. Our outcomes were amount of alcohol consumed, monthly heavy episodic drinking, alcohol-related harm and self-reported symptoms of alcohol use disorder in the years following initiation.

findingsThose who initiated at age 12 had a lower risk of consumption [risk ratio (RR) 0.01; 95% confidence interval (CI) = 0.01-0.02] in the year following initiation (age 13), compared with those who initiated at age 18. Similarly, those who initiated at age 15 had a lower risk of alcohol use disorder in the year after initiation (RR 0.66; 95% CI = 0.52-0.83), compared with those who initiated at age 18. However, at age 20, those who initiated at age 12 showed higher consumption (RR 1.57; 95% CI = 1.18-2.09), monthly heavy episodic drinking (RR 1.24; 95% CI = 1.02-1.51) and alcohol-related harms [incidence-rate ratio (IRR) 1.73; 95% CI = 1.21-2.46] than those who initiated at age 18. Similar results were seen for symptoms consistent with DSM-IV alcohol dependence (RR 1.20; 95% CI = 1.05-1.38), DSM-IV alcohol abuse (RR 1.54; 95% CI = 1.04-2.29) and DSM-5 alcohol use disorder (RR 1.36; 95% CI = 1.12-1.65). However, there was evidence of ageing out, with risk of heavy episodic drinking and alcohol-related harm peaking around age 20 and then declining, regardless of when initiation occurred.

conclusionsLater initiation to alcohol appears to be associated with more rapid escalation in drinking and related harm, but lower 'peak' harm than earlier initiation. The findings support the current guidelines recommending adolescents avoid alcohol until adulthood, and reinforce the need for public health intervention targeting both children and parents.

Indexed as

Alcohol DrinkingAlcohol-Related DisordersBinge DrinkingUnderage DrinkingAdolescentAdultAge FactorsAustraliaChildFemaleHumansLongitudinal StudiesMaleProspective StudiesYoung Adultadolescencealcoholalcohol‐related harminitiationprospective cohortrisky drinking

Identifiers

PMID41082637
PMCPMC12710686

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.