Age of First Use, Age of Habitual Use, and Problematic Alcohol Use: a Cross-cultural Examination Among Young Adults in Seven Countries

Earlier age of alcohol use initiation has been consistently associated with later problematic alcohol use. However, it is unclear what aspect of early initiation is key for risk assessment and whether there are cultural differences. The present study examined relationships between Age of First Use (AFU) and Age of Habitual Use (AHU) on alcohol use behaviors across seven countries (USA, England, Argentina, Uruguay, Spain, Canada, South Africa). Participants were 5336 college students reporting past month alcohol consumption. Participants provided information, via online survey, on AFU, AHU, and current drinking behaviors. Results demonstrated significant direct associations between age variables and all outcomes, except for AHU to drinking frequency. Furthermore, AFU demonstrated stronger associations with drinking frequency, while AHU was more strongly associated with AUDIT scores and negative consequences. A moderation effect of country was discovered among several regression paths. These findings suggest AHU should receive greater focus in alcohol research.