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Transition probabilities for four states of alcohol use in adolescence and young adulthood: what factors matter when?
Author(s) -
Probst Charlotte,
Moyo Daniel,
Purshouse Robin,
Rehm Jürgen
Publication year - 2015
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12985
Subject(s) - abstinence , hazard ratio , demography , poison control , medicine , injury prevention , occupational safety and health , young adult , suicide prevention , population , cohort study , binge drinking , cohort , confidence interval , psychology , gerontology , environmental health , psychiatry , pathology , sociology
Background and Aims Risky single‐occasion drinking (RSOD) is a health threat, particularly at younger ages. The study aimed to quantify transition probabilities (TPs) between abstinence, use of alcohol, RSOD and frequent RSOD, and to understand how TPs are associated with key demographic factors. Design Cohort study (baseline, two follow‐ups). A Markov model was fitted to estimate annual TPs and hazard ratios (HRs) for age, sex and socio‐economic status (SES). Setting Adolescent and young adult general population of Munich (Germany) and surrounding areas. Participants A total of 3021 people aged 14–25 years at baseline in 1995 followed‐up in 1998/1999 ( n = 2548) and 2003–2005 ( n = 2210). Measurements Alcohol use, RSOD status, age, sex and SES (subjective financial situation) were assessed in a standardized interview. Findings The highest TPs (> 65%) were found for staying in the same drinking state. Higher age [hazard ratio (HR) for 1‐year increase = 0.87, 95% confidence interval (CI) = 0.84–0.91], being female (HR = 0.30, 95% CI = 0.21–0.42), and a high SES (HR = 0.64, 95% CI = 0.43–0.97) were associated with a lower hazard to progress from use to RSOD. While age was associated predominantly with transitions between abstinence and alcohol use, sex was more relevant for transitions associated with RSOD and frequent RSOD. Conclusions German adolescents and young adults tend to be stable in the drinking states of abstinence, use of alcohol, risky single‐occasion drinking and frequent risky single‐occasion drinking. Females are less likely to transition to riskier states and more likely to transition back from frequent risky single‐occasion drinking, higher age is associated with lower hazard of transitioning and participants of higher socio‐economic status are less likely to transition from ‘use of alcohol’ to ‘risky single‐occasion drinking’.