Age of Alcohol Use Initiation: A Prospective Risk Factor for Suicide Attempts among Youth but not Young Adults

Objective: To examine an early age of alcohol use initiation (prior to age 13) as a predictor of future suicide attempt in a nationally representative cohort of youth. Methods: Analyses were based on data from the National Longitudinal Study of Adolescent Health and restricted to adolescents age 13 years and older who also participated in all three data waves (Wave 1:1995; Wave 2:1996; and Wave 3:2008) (N=10,417). Logistic regression models were computed to determine the associations between early alcohol use initiation (prior to age 13) and associations with suicidal ideation and attempts in Wave 1, Wave 2 and Wave 3 while controlling for potential confounders (i.e., binge drinking, delinquent behaviors, depressive symptoms, low self esteem, and receiving psychiatric treatment). Results: Early alcohol use initiation was associated with suicidal ideation and attempt across all three data waves in unadjusted logistic regression analyses. In multivariate analyses, early alcohol use initiation was associated with suicidal ideation and attempt in Wave 1 (Adj.OR = 2.40; 95% CI: 1.15, 5.00) and Wave 2 (Adj.OR = 3.13; 95% CI: 1.67, 5.87) but not in Wave 3 (Adj.OR = 1.71; 95% CI: 0.54, 5.43) relative to nondrinkers. Conclusions: An early age of alcohol use initiation was associated with increased risk for suicidal ideation and attempt during adolescence, but not in young adulthood. Additional research is needed to determine the factors that may reduce the adverse consequences of early alcohol use initiation as well as to determine strategies for reducing and delaying alcohol use among youth.