College students who first became drunk at a young age have elevated odds of attributing episodes of unplanned or unprotected intercourse to drinking, according to findings from a survey conducted at more than 100 U.S. colleges and universities in 1999.1 The odds of saying that drinking had led to unplanned intercourse during the current school year were twice as high among students who had first gotten drunk at age 12 or younger as among their peers who had first been intoxicated at age 19 or older; the odds of reporting that unprotected intercourse had resulted from drinking also were doubled among those who had had an episode of drunkenness by age 12. These results take into account a number of variables related to early drunkenness and change little when students' frequency of binge drinking and alcohol dependence are included as controls.
The analyses are based on data gathered from students at 119 four-year colleges in 40 states; the schools were public and private institutions of varying sizes, representing a cross-section of four-year colleges nationwide. More than 14,000 students completed the mail-in survey, which included questions about respondents' drinking habits and items that relate to criteria for diagnosing alcohol abuse or dependence. The researchers restricted the analyses to the 11,739 students who were aged 19 or older (the oldest age category in which respondents reported first having gotten drunk).
Asked how old they had been when they first got drunk, 3% of respondents said they had been no older than 12, 71% answered 13-18 years of age and 16% said 19 or older; 11% said they had never been intoxicated. Among 8,657 students who had consumed alcohol in the past year and had at some point drunk to intoxication, results of chi-square analyses revealed that the likelihood of having gotten drunk at a young age was elevated among younger students, males, whites, never-married respondents, those who had smoked cigarettes or marijuana at a young age, students whose parents did not disapprove of alcohol and those with at least one parent who had a drinking problem. These factors were used as controls in logistic regression analyses examining the independent effects of the age at which students first got drunk on various outcomes during college.
Nine percent of students in the sample met standard criteria for alcohol dependence, and 54% had binged (defined as having had five drinks in a row for men and four in a row for women) during the two weeks preceding the survey. The proportions who were alcohol-dependent and who had recently binged fell sharply as the age at which students had first gotten drunk increased; findings from the multivariate analyses confirmed that the odds of alcohol dependence and bingeing were highest among those who had first gotten drunk during the preadolescent or early teenage years and declined steadily thereafter.
Substantial proportions of students said that drinking had "caused them" to engage in risky sexual behavior during the current school year. Twenty percent said that they had had unplanned intercourse as a result of drinking; the proportion was 31% among respondents who had first gotten drunk at ages 12-15, fell to 13% among those who had first been drunk at age 19 or later, and was only 1% among those who had never been intoxicated. Similarly, whereas 10% overall reported that alcohol consumption had led to unprotected intercourse, the proportion declined from 18% of those whose first experience of drunkenness occurred at age 12 to 6% among those who had first been drunk at age 19 or older; it was less than 1% among students who had never gotten drunk.
In the multivariate analyses, students who had first gotten intoxicated before age 19 had elevated odds of having had unplanned sex because of drinking during the current school year. The odds ratio was 1.3 for those who had been 18 the first time they got drunk, climbed steadily to 2.4 for those who had been 13-15 years old and was 2.0 for those who had been 12 or younger. When frequency of binge drinking and alcohol dependence were added as controls, the odds ratios were reduced somewhat (1.1-1.7) but still indicated an increased risk of unplanned intercourse for respondents who had first been drunk at age 18 or younger
The regression analysis showed that the likelihood of having had unprotected sex increased steadily as the age at which students first got drunk decreased from 17 (odds ratio, 1.8) to 12 or younger (2.2). Again, when controls included frequency of bingeing and alcohol dependence, the effect was diminished, but the odds remained significantly elevated (1.4-1.7).
As the researchers note, their findings do not explain why early drunkenness is associated with risky sexual behavior later in adolescence. Among the possible reasons they suggest are that individuals who begin drinking at a young age tend to be risk takers in general, do not fully appreciate the potential consequences of risky behaviors and are predisposed to attributing their risky behavior to their alcohol consumption. In any case, the analysts conclude, the findings "underscore the need for physicians and other health care providers to query their patients about the age at which they began drinking and were first drunk, and to counsel them about the numerous risks to health that [are] associated with early onset of drinking."--D. Hollander
REFERENCE
1. Hingson R et al., Early age of first drunkenness as a factor in college students' unplanned and unprotected sex attributable to drinking, Pediatrics, 2003, 111(1):34-41.