Substance Use
Alcohol use from adolescence into adulthood: the role of state-level alcohol policy and contextual factors on alcohol use trajectories Lynsie Ranker* Lynsie Ranker Ranker Boston University School of Public Health
While we know familial and environmental forces influence adolescent alcohol initiation and use, the literature is limited regarding the role of such factors experienced in adolescence on drinking patterns into adulthood. We examined associations between several contextual factors and past 30-day drinking frequency trajectories from age 12-35 years within the National Longitudinal Survey of Youth (1997) cohort. Specifically, we assessed the role of: a) the stringency of the state policy environment (measured via Alcohol Policy Scale, APS), b) parenting style, c) youth mental health, and d) recent stressful life events (e.g., parental divorce, crime victimization, homelessness, and family member hospitalization, incarceration, or death). Five drinking trajectories were identified within the cohort (N=8,984) using latent class growth curve modeling: high frequency (12.0%), moderate use surrounding age 21 (17.5%), late escalating (19.4%), no/infrequent (21.4%), and consistent low frequency (29.6%). In multinomial models with low frequency as the comparison trajectory, a 10-unit higher APS score was associated with reduced odds of moderate drinking membership (adjusted OR [aOR]=0.82, 95%CI 0.72, 0.93) after adjustment for covariates. Associations between APS score and other trajectory memberships were null. Similar effect magnitudes were seen for the influence of parenting style and youth mental health on trajectory membership. Experiencing stressful events in early adolescence had the largest effect magnitudes for high frequency drinking (aOR 1.20, 95%CI 1.04, 1.39) and moderate drinking (aOR 1.17, 1.02, 1.35) memberships. Results demonstrate the distinct roles of stringent state alcohol policy, parenting practices, and positive youth mental health in reducing risk of normative drinking (e.g., limiting escalation prior to age 21). However, stress and upheaval increase the risk of drinking trajectories characterized by early initiation and high frequency.