University of Oulu

Jonna Levola, Richard J Rose, Antti Mustonen, Marian Sarala, Jouko Miettunen, Jari Koskela, Anni-Emilia Niemelä, Solja Niemelä, Association of age at first drink and first alcohol intoxication as predictors of mortality: a birth cohort study, European Journal of Public Health, Volume 30, Issue 6, December 2020, Pages 1189–1193,

Association of age at first drink and first alcohol intoxication as predictors of mortality : a birth cohort study

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Author: Levola, Jonna1; Rose, Richard J.2; Mustonen, Antti3;
Organizations: 1Department of Psychiatry, Hospital District of Helsinki and Uusimaa, Hyvinkää Area, Järvenpää, Finland
2Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
3Center for Life Course Health Research, University of Oulu, Oulu, Finland
4Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
5Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
6Department of Psychiatry, University of Turku, Turku, Finland
7Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Oxford University Press, 2020
Publish Date: 2021-12-14


Background: More information on the health-related repercussions of age at onset of adolescent drinking is needed. The aim of this study was to examine the associations between self-reported age at first drink and age at first alcohol intoxication with the risk of death by age 30.

Methods: The sample (n = 6564; 49.1% males) included all participants of the Northern Finland Birth Cohort Study 1986 (NFBC1986) for whom the two measures of adolescent drinking were available. Self-reported age at onset of first drink and first alcohol intoxication were analyzed along with background variables and data regarding subsequent psychiatric diagnoses. Adolescents were dichotomized into those reporting age at first drink and age at first intoxication before or after age 14. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence interval (95% CI) for death by age 30.

Results: By the age of 30, 0.7% (n = 47) of all 6564 participants were deceased. In the multivariable models, male gender and a history of illicit substance use in adolescence were associated with both all-cause mortality and mortality due to accidents or suicide. After controlling for confounding variables, age at first alcohol intoxication was associated with all-cause mortality (HR 2.33; 95% CI 1.04–5.20) as well as death due to accidents or suicide (HR 2.99; 95% CI 1.11–8.05).

Conclusions: Earlier age at first intoxication carries long-term repercussions with respect to premature loss of life. Efforts should be made targeting the prolongation of initiating binge drinking in adolescence to diminish this mortality risk.

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Series: European journal of public health
ISSN: 1101-1262
ISSN-E: 1464-360X
ISSN-L: 1101-1262
Volume: 30
Issue: 6
Pages: 1189 - 1193
DOI: 10.1093/eurpub/ckaa134
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
3141 Health care science
Funding: This research was funded by the Juho Vainio foundation and Päivikki and Sakari Sohlberg foundation.
Copyright information: © The Author(s) 2020. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (