Risky Alcohol Use, Age at Onset of Drinking, and Adverse Childhood Experiences in Young Men Entering the US Marine Corps

OBJECTIVE: To examine how childhood experiences relate to risky underage drinking. DESIGN: A survey study of men starting military training between June 11, 2002, and April 5, 2006. Multivariate logistic regression models compared risky drinkers with "all others" or with nonrisky drinkers; excluding nondrinkers. SETTING: Marine Corps Recruit Depot, San Diego, Calif. PARTICIPANTS: Forty-one thousand four hundred eighty-two men aged 18 to 20 years. Main Exposures Age at drinking onset; childhood emotional, physical, and sexual abuse; childhood emotional and physical neglect; and household alcohol abuse, mental illness, domestic violence, or divorce. MAIN OUTCOME MEASURES: Risky drinking identified by scoring responses to 3 questions about alcohol consumption. RESULTS: Of 41,482 young men, 6128 (14.8%) were identified as risky drinkers, 18,693 (45.1%) as nonrisky drinkers, and 16 661 (40.2%) as nondrinkers. Among drinkers, early initiation of alcohol use was strongly associated with risky drinking, with a 5.5-fold risk if age at onset of drinking was 13 years or younger. Other associated factors included tobacco use, rural or small hometown, higher education, motivation to join the military for travel or adventure or to leave problems at home, numerous close friends and relatives, household alcohol abuse or mental illness, and childhood sexual or emotional abuse. When the comparison group included nondrinkers, additional associated factors included childhood physical abuse and domestic violence. CONCLUSIONS: These analyses confirm previous findings on risks for alcohol misuse in young adults and quantify these risks in new, large, multivariable models, adding unique perspective from a population of young Marines. Public health efforts to decrease alcohol misuse may be effectively targeted by prevention of underage alcohol use, tobacco use, and childhood abuse.