University of Oulu

Jonna Levola, Marian Sarala, Antti Mustonen, Richard J. Rose, Jouko Miettunen, Anni-Emilia Niemelä, Solja Niemelä, Frequent Alcohol Intoxication and High Alcohol Tolerance During Adolescence as Predictors of Mortality: A Birth Cohort Study, Journal of Adolescent Health, Volume 67, Issue 5, 2020, Pages 692-699, ISSN 1054-139X,

Frequent alcohol intoxication and high alcohol tolerance during adolescence as predictors of mortality : a birth cohort study

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Author: Levola, Jonna1; Sarala, Marian2; Mustonen, Antti3;
Organizations: 1Psychiatry Division, Hyvinkää Area, Hospital District of Helsinki and Uusimaa and Helsinki University Hospital, Hyvinkää, Finland
2Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
3Center for Life Course Health Research, University of Oulu, Oulu, Finland
4Department of Psychological & Brain Sciences, Indiana University, Bloomington, Indiana
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, 0.4 MB)
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Language: English
Published: Elsevier, 2020
Publish Date: 2021-12-14


Purpose: Long-term prospective studies evaluating the health burden that is consequent to adolescent drinking are needed. The aim of this study was to examine the predictive associations between self-reported alcohol tolerance and frequent intoxication at age 15–16 years and the risk of death by age 33 years.

Methods: A sample (n = 6,615; 49.3% males) of the Northern Finland Birth Cohort Study 1986 was studied. Self-reported alcohol tolerance (drinks needed to feel intoxicated) and frequency of alcohol intoxication at age 15–16 years were analyzed along with background variables and data regarding subsequent psychiatric diagnoses. Categories were formed for both predictive variables from self-reported tolerance and frequency of intoxication in mid-adolescence. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence interval (95% CI) for death by age 30 years.

Results: By the age of 33 years, of all 6,615 participants, 53 (.8%) were deceased. The HR for death by age 33 years was 3.08 (95% CI 1.17–8.07) among adolescents with high alcohol tolerance compared with adolescents without alcohol use or intoxication. The frequency of alcohol intoxication was also associated with mortality; HR 2.05 (95% CI 1.01–4.16) for those who had been intoxicated one to two times and HR 3.02 (95% CI 1.21–7.54) for those who had been intoxicated three or more times in the past 30 days compared with adolescents without intoxication.

Conclusions: High self-reported alcohol tolerance and frequent alcohol intoxication during mid-adolescence significantly predicted death by age 33 years. These behaviors carry long-term repercussions with respect to premature loss of life. Substantial efforts should be made to diminish this mortality risk.

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Series: Journal of adolescent health
ISSN: 1054-139X
ISSN-E: 1879-1972
ISSN-L: 1054-139X
Volume: 67
Issue: 5
Pages: 692 - 699
DOI: 10.1016/j.jadohealth.2020.07.034
Type of Publication: A1 Journal article – refereed
Field of Science: 3141 Health care science
3124 Neurology and psychiatry
Funding: This research was funded by the Juho Vainio Foundation, Sohlberg Foundation, and State Research Funding (the expert responsibility area [ERVA] of the Oulu University Hospital and Lapland Hospital District).
Copyright information: © 2020 Society for Adolescent Health and Medicine. This manuscript version is made available under the CC-BY-NC-ND 4.0 license