Substance Use
Family dynamics and environmental factors influencing progression from alcohol experimentation to initiation in youth: Evidence from the Adolescent Brain Cognitive Development (ABCD) Study Maya I. Harwood* Huiru Dong Maya I. Harwood Daniel F. Otero-Leon Mohammad S. Jalali
Early alcohol initiation is linked to the later development of problem drinking and other negative health outcomes. While previous research has identified predictors of alcohol use, few studies have distinguished between the phases of experimentation and initiation – key stages in youth drinking patterns. This study evaluated the influence of sociodemographic, familial, and environmental factors on the time from alcohol experimentation to initiation among preadolescent youth, using data from the Adolescent Brain Cognitive Development (ABCD) Study (2016-2022). For each study participant (N=11,694), alcohol consumption was assessed bi-annually. Experimentation was defined as the first instance of alcohol sipping, while initiation was defined as consuming at least one full drink during the study period. An extended Cox model was used to examine the effects of sociodemographic characteristics, family dynamics, parental alcohol use, alcohol expectancies, and environmental factors on the likelihood of alcohol initiation following experimentation. Among 1,225 youths who reported sipping alcohol during the study, 87 (7.1%) went on to have at least one full drink. Significant factors associated with a higher likelihood of alcohol initiation included older age (hazard ratio [HR] = 1.85, 95% confidence interval [CI]: 1.46-2.35, p < 0.001), household rules allowing alcohol consumption (HR = 2.78, 95% CI: 1.58-4.92, p < 0.001), family conflict (HR = 1.18, 95% CI: 1.07-1.30, p < 0.001), and positive expectancies about alcohol use (HR = 1.13, 95% CI: 1.04-1.23, p = 0.004). No significant differences were observed based on sex, race, ethnicity, family income, parental alcohol use, and neighborhood safety. Family and household dynamics emerged as robust influencing factors of early alcohol initiation following experimentation. These findings suggest that environmental interventions should be considered for prevention of alcohol use progression among preadolescent youth.