The overall effect of parental supply of alcohol across adolescence on alcohol-related harms in early adulthood-a prospective cohort study
Clare, PJ and Dobbins, T and Bruno, R and Peacock, A and Boland, V and Yuen, WS and Aiken, A and Degenhardt, L and Kypri, K and Slade, T and Hutchinson, D and Najman, JM and McBride, N and Horwood, J and McCambridge, J and Mattick, RP, The overall effect of parental supply of alcohol across adolescence on alcohol-related harms in early adulthood-a prospective cohort study, Addiction, 115, (10) pp. 1833-1843. ISSN 0965-2140 (2020) [Refereed Article]
Background and Aims Recent research suggests that parental supply of alcohol is associated with more risky drinking
and alcohol-related harm among adolescents. However, the overall effect of parental supply throughout adolescence remains
unclear, because parental supply of alcohol varies during adolescence. Due to the complexity of longitudinal data,
standard analytical methods can be biased. This study examined the effect of parental supply of alcohol on alcohol-related
outcomes in early adulthood using robust methods to minimize risk of bias. Design Prospective longitudinal cohort
study. Setting Australia Participants A cohort of school students (n = 1906) recruited in the first year of secondary
school (average age 12.9 years) from Australian schools in 2010–11, interviewed annually for 7 years.
Measurements The exposure variable was self-reported parental supply of alcohol (including sips/whole drinks) during
5 years of adolescence (waves 1–5). Outcome variables were self-reported binge drinking, alcohol-related harm and symptoms
of alcohol use disorder, measured in the two waves after the exposure period (waves 6–7). To reduce risk of bias, we
used targeted maximum likelihood estimation to assess the (counterfactual) effect of parental supply of alcohol in all five
waves versus no supply on alcohol-related outcomes. Findings Parental supply of alcohol throughout adolescence saw
greater risk of binge drinking [risk ratios (RR) = 1.53; 95% confidence interval (CI) = 1.27–1.84] and alcohol-related
harms (RR = 1.44; 95% CI = 1.22–1.69) in the year following the exposure period compared with no supply in adolescence.
Earlier initiation of parental supply also increased risk of binge drinking (RR = 1.10; 95% CI = 1.05–1.14), and
any alcohol-related harm (RR = 1.09; 95% CI = 1.05–1.13) for each year earlier parental supply began compared with
later (or no) initiation. Conclusions Adolescents whose parents supply them with alcohol appear to have an increased
risk of alcohol-related harm compared with adolescents whose parents do not supply them with alcohol. The risk appears
to increase with earlier initiation of supply.
parental supply of alcohol, Adolescence, alcohol, cohort studies, confounding, epidemiology, targeted maximum likelihood