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Alcohol use initiation as a prospective risk factor for suicide attempts across adolescence and young adulthood
  1. M H Swahn*,
  2. R M Bossarte,
  3. F McCarty
  1. Correspondence College of Health and Human Sciences, Georgia State University, P.O. Box 3995, Atlanta, GA 30302, USA


The current study examines early alcohol use initiation as a predictor of suicide attempt in a large cohort of youth. Analyses were based on the National Longitudinal Study of Adolescent Health, a cohort of adolescents followed to young adulthood. Analyses were restricted to adolescents age 13 years and older who participated in all three data waves (Wave 1:1995; Wave 2:1996 and Wave 3:2002) (N=10 417). Logistic regression models were computed to determine the associations between early alcohol use initiation (prior to age 13) and suicide attempt in Wave 1–Wave 3 while controlling for potential confounders (ie, binge drinking, delinquent behaviours, depression, low self esteem and psychiatric treatment). In this study, 13.8% of adolescents initiated alcohol use prior to age 13. 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 to 5.00) and Wave 2 (Adj.OR 3.13; 95% CI 1.67 to 5.87) but not in Wave 3 (Adj.OR 1.71; 95% CI 0.54 to 5.43) relative to non-drinkers. Early alcohol use is 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.

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