Published online August 1, 2008
PEDIATRICS Vol. 122 No. 2 August 2008, pp. e298-e304 (doi:10.1542/peds.2007-3412)
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ARTICLE

Adverse Childhood Experiences Predict Earlier Age of Drinking Onset: Results From a Representative US Sample of Current or Former Drinkers

Emily F. Rothman, ScDa, Erika M. Edwards, MPHb, Timothy Heeren, PhDc and Ralph W. Hingson, ScD, MPHd

Departments of a Social and Behavioral Sciences
b Epidemiology
c Biostatistics, Boston University School of Public Health, Boston, Massachusetts
d National Institute on Alcohol Abuse and Alcoholism, Division of Epidemiology and Prevention Research, Bethesda, MD

OBJECTIVE. Our goal was to determine whether adverse childhood experiences predicted the age at which drinking was initiated and drinking motives in a representative sample of current or former drinkers in the United States.

METHODS. In 2006, a probability sample of 3592 US current or former drinkers aged 18 to 39 were surveyed. Multinomial logistic regression examined whether each of 10 adverse childhood experiences was associated with earlier ages of drinking onset, controlling for demographics, parental alcohol use, parental attitudes toward drinking, and peers' drinking in adolescence. We also examined whether there was a graded relationship between the number of adverse childhood experiences and age of drinking onset and whether adverse childhood experiences were related to self-reported motives for drinking during the first year that respondents drank.

RESULTS. Sixty-six percent of respondents reported ≥1 adverse childhood experiences, and 19% reported experiencing ≥4. The most commonly reported adverse childhood experiences were parental separation/divorce (41.3%), living with a household member who was a problem drinker (28.7%), mental illness of a household member (24.8%), and sexual abuse (19.1%). Of the 10 specific adverse childhood experiences assessed, 5 were significantly associated with initiating drinking at ≤14 years of age (compared with at ≥21 years of age) after adjustment for confounders, including physical abuse, sexual abuse, having a mentally ill household member, substance abuse in the home, and parental discord or divorce. Compared with those without adverse childhood experiences, respondents with adverse childhood experiences were substantially more likely to report that they drank to cope during the first year that they used alcohol.

CONCLUSIONS. Results suggest that children with particular adverse childhood experiences may initiate drinking earlier than their peers and that they may be more likely to drink to cope with problems (rather than for pleasure or to be social).

Key Words: age of drinking onset • drinking initiation • adverse childhood experiences

Abbreviations: ACE—adverse childhood experience • NESARC—National Epidemiologic Survey on Alcohol and Related Conditions • CI—confidence interval • OR—odds ratio • aOR—adjusted odds ratio

Accepted Apr 8, 2008.