Survey of Marine Corps military recruits reveals risk factors for alcohol disorders in young adults

Young men age 18 to 20 are significantly more likely to be risky drinkers if they start drinking alcohol at a young age, according to a large survey of male Marine Corps recruits, the results of which are published in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. Other risk factors for drinking problems include tobacco use, having a small or rural hometown and growing up in a household with alcohol abuse.

In 2004, about 2.3 percent of all 12-year-olds and 69.8 percent of all 21-year-olds reported that they currently drank alcohol, according to background information in the article. Approximately 4.4 million Americans used alcohol for the first time in 2004; 86.9 percent of them were younger than 21. A previous study found that male Marines age 18 to 25 drink heavily at twice the rate of civilians in the same age group (38.6 percent vs. 17.8 percent).

Sylvia Y. N. Young, M.D., M.P.H., of the Naval Health Research Center, San Diego, Calif., and colleagues studied the association between childhood experiences and risky underage drinking in 41,482 male Marine recruits age 18 to 20. All the men completed the Recruit Assessment Program questionnaire between June 2002 and April 2006, on which they provided demographic and other personal information and answered three questions designed to detect risky drinking. The questionnaire also included items to gauge a variety of adverse childhood experiences, including physical neglect, emotional and sexual abuse or domestic violence.

A total of 6,128 recruits (14.8 percent) were identified as risky drinkers, 18,693 (45.1 percent) as non-risky drinkers and 16,661 (40.2 percent) as non-drinkers. Among drinkers, age at first drink was most strongly associated with risky drinking—those who began drinking at age 13 or younger were 5.5 times as likely to be identified as risky drinkers. Risky drinkers were more likely than either non-risky drinkers or non-drinkers to be smokers, from a rural or small hometown, have experienced childhood sexual or emotional abuse, and to have a household member who had a drinking problem or mental illness. They also were more likely to report education beyond a high-school level, having more close family members or friends for personal support, and being motivated to join the military for travel, adventure or to leave problems at home.

"Factors inversely associated with risky drinking were being married, attending religious services weekly or more often, neither parent having completed high school, not knowing parental educational achievement and motivation to join the military ‘to serve my country,' for education and new job skills, or for a 20-year military career. A history of emotional neglect was also inversely associated," the authors write.

"Our findings underscore the need for programs and policies to reduce underage drinking, such as the minimum legal drinking age of 21 years," they conclude. "Our study results also reinforce the need for public health efforts to prevent tobacco use and child abuse. After early age at first alcohol use, the factor most strongly associated with risky drinking was tobacco use. Whether reducing smoking will reduce risky drinking among youth is an important but unexplored question."

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(Arch Pediatr Adolesc Med. 2006;160:1207-1214. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: This study was supported by the Department of Defense. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org.


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