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This study examined associations between patterns of alcohol use initiation and progression from age 12 to 14 years and recent cigarette and marijuana use, and violent and delinquent behavior at age 14. The study sample (n = 2,193) was predominantly African American or Hispanic (43% and 37%, respectively) and low-income (68% receiving free, or reduced price, lunch). They completed classroom-based surveys when in 6th-8th grades. Multilevel latent class analyses were used to identify the heterogeneous alcohol use trajectories. Linear and logistic mixed-effects regression was then used to examine the association between these patterns and high-risk behaviors in 8th grade. Five alcohol use trajectories were identified: (1) No Use (63.3%), (2) Onset of Consistently Infrequent Use at Age &lt;12 (13.3%), (3) Onset of Monthly Use at Age 14 (9.9%), (4) Onset of Monthly Use at Age 13 to Heavy Use at Age 14 (6.6%), and (5) Onset of Consistently Heavy Use at Age 12 (6.9%). Relative to non-users, membership in any of the alcohol use trajectory classes was significantly associated with greater past month cigarette and marijuana use, as well as violent behaviors in 8th grade. Higher levels of delinquent behaviors were significantly associated with membership in all but one of the alcohol use trajectory classes relative to the "no use" class. Results suggest that any use of alcohol in early adolescence is associated with other high-risk behaviors and support the critical need for efforts to prevent early initiation and progression of alcohol use among youth as a key component to prevent future high-risk behaviors.

Effects of Alcohol Use Initiation Patterns on High-Risk Behaviors among Urban, Low-Income, Young Adolescents