BACKGROUND: Alcohol use, alcohol intoxication, tobacco, cannabis
and other drug use are frequent among young Swiss men. The
association between age at first alcohol intoxication and other substance
use is of interest from both clinical and public health perspectives.
METHODS: A census of Swiss francophone 19 year-old men consecutively
reporting for processing at the army recruitment in Lausanne,
Switzerland were assessed via a self-report survey that included:
number of drinks (i.e., 10 g ethanol each) and number of drinking
occasions with six or more drinks over the past 12 months; age at first
alcohol intoxication; current tobacco and cannabis use; and lifetime use
of other (illegal) substances, including prescription drug abuse. Weekly
risky drinking was defined as >21 drinks per week and risky single
occasion drinking (RSOD) as 6 or more drinks per occasion. Associations
between age at first intoxication and current weekly risky
drinking, RSOD, current tobacco and cannabis use, and lifetime use
of other drugs were determined through logistic regression models.
Poisson regressions that allowed for over-dispersion were used to model
number of standard drinks per week and RSOD episodes per month at
age 19, based on age at first intoxication.
RESULTS: Of the 12,133 young men presenting for the mandatory
army recruitment procedures, 9,686 (80%) completed the survey. Of
these, 8,687 (90%) reported at least one episode of alcohol intoxication,
with a median age (Interquartile range [IQR]) at first intoxication of
15 years (14, 16), 6 (1, 16) drinks/week, and 2 (0, 4) RSOD episodes of
binge drinking/month. Prevalence of current tobacco and cannabis use
was 50.2% and 44.6% respectively. Lifetime use of other drugs was
17.2%. Odds ratio (95% CI) for subjects with a first alcohol intoxication
before the age of 15 showed they were more likely than subjects with a
first intoxication at age 15 or older to present weekly risky drinking [3.2
(2.8, 3.6)], RSOD [2.3 (2.1, 2.6)], current tobacco [2.6 (2.4, 2.8)],
cannabis use [2.7 (2.5, 3.0)], and lifetime use of other drugs [3.5 (3.1,
3.9)]. For each age from 13 to 19 years, the occurrence of first
intoxication was associated with a 15.6% (95% CI 14.6, 16.6) increase
in the number of drinks per week and a 14.7% (13.7, 15.6) increase in
the number of RSOD episodes per month.
CONCLUSION: Among 19 year-old Swiss men, the prevalence of alcohol
intoxication is elevated, with the age at first intoxication for half of them
being less than 15 years. Since early alcohol intoxication is associated
not only with heavier alcohol use at age 19 but also with increased risk
of tobacco, cannabis and other drug use, physicians should consider
age at first intoxication both as a potential target for counseling and as
a potential indicator of later alcohol and other substance use.