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Back To Vidyya Early Drinking Onset Increases Lifetime Injury Risk

Those Who Start Drinking Before Age 14 Are 12 Times More Likely To Be Injured Than Those Who Begin Drinking At Or After Age 21

Ralph Hingson, Sc.D., and other researchers at the Boston University School of Public Health reported in the September 27 issue of the Journal of the American Medical Association that the younger people are when they begin drinking the more likely they are to be injured later in life when under the influence of alcohol. Those who start drinking before age 14 are 12 times more likely to be injured than those who begin drinking at or after age 21. After adjusting for history of alcoholism, family history of alcoholism, and other characteristics associated with early onset drinking, the researchers found that people who begin drinking before age 14 are about three times more likely than those who begin drinking at or after age 21 to be injured while drinking.

"This analysis shows that for each year under age 21 that drinking onset is delayed, risk for later life injury diminishes," said Enoch Gordis, M.D., Director, National Institute on Alcohol Abuse and Alcoholism. The NIAAA reported in 1998 that early drinking onset is associated with increased lifetime risk for the clinical disorders alcohol dependence (alcoholism) and alcohol abuse.

Finding the reasons for these associations is a focus of continuing NIAAA research. "What is clear now--and grows clearer with each new scientific report — is that young people and their parents need to be aware of both short- and long-term risks of adolescent drinking," said Dr. Gordis.

The source of the data for both the alcohol disorder and the injury-risk analyses was the National Longitudinal Alcohol Epidemiologic Survey (NLAES), conducted in 1992 for NIAAA by the U.S. Bureau of the Census to assess drinking practices and effects among adult Americans. The most comprehensive survey of alcohol use ever conducted, NLAES involved 42,862 face-to-face interviews of Americans 18 years of age and older. Reports from the NLAES data (published in 1998 as Drinking in the United States*) continue to provide the epidemiologic basis that guides research and informs public policy formulation.

Dr. Hingson’s analysis for the injury risk study was supported by the National Highway Traffic Safety Administration and used NLAES data. The NLAES will be repeated in 2002 as the National Epidemiologic Survey of Alcohol-Related Conditions.

About 66 percent of the 1992 NLAES sample reported having ever consumed alcohol, 49 percent had their first drink before age 21, and 3 percent had their first drink (defined as the first full drink of alcohol excluding tastes or small sips) before age 14. About 15 percent of the 27,081 NLAES respondents who had ever consumed alcohol reported having been at some time in their lives in a drinking situation that increased the risk of injury; 3 percent had been in such a situation in the past year. Of the respondents who had ever consumed alcohol, about 8 percent had been injured after or while drinking and about 3 percent had been injured during the past year.

Unintentional injury (including motor vehicle crashes, falls, drownings, burns, and unintended gunshot wounds) claimed 94,331 lives in 1998 and is the leading cause of death for persons aged 1-34 years. Approximately one-third of unintentional injuries are estimated to be alcohol-related.

"Our report shows that younger age of drinking onset is associated with frequent heavy drinking later in life--not only for persons who are alcohol dependent but also for other drinkers. This is part — but not all — of the reason that early drinking heightens the injury risk for persons both above and below the legal drinking age," said Dr. Hingson.

"These findings provide important information for physicians and other health care providers to share with their adolescent patients."

For reprints of the article, please telephone 617/638-5160 or email at For additional information about Youth drinking visit For additional alcohol research information, please visit

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Editor: Susan K. Boyer, RN
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