Adolescent alcohol-use trajectories in the transition from high school JOHN WINSTON TOUMBOUROU 1 , IAN R. WILLIAMS 1 , PAM C. SNOW 2 & VICTORIA M. WHITE 3 1 Centre for Adolescent Health, Murdoch Childrens Research Institute and Department of Paediatrics, University of Melbourne, 2 Deakin University and Centre for Youth Drug Studies, Australian Drug Foundation and 3 Centre for Behavioural Research into Cancer, Victorian Anti-Cancer Council, Australia Abstract A cohort of 3300 students from high schools across Victoria, Australia, were surveyed regarding their patterns of alcohol consumption from mid-1993 to 1995. The first wave of data was collected halfway through the students’ final year of school (year 12). Students were then resurveyed 3 months following school completion and on two subsequent occasions, each separated by 6- month intervals. Analysis of the four waves of data indicated that five longitudinal patterns (trajectories) characterized temporal trends in male and female alcohol use through the transition from high school. Stable non-use trajectories were evident for 17% of males and 16% of females. Trajectories of less than weekly use characterized 45% of females and 46% of males, and showed little tendency to escalate toward harmful use. Among those using alcohol on a weekly or more frequent basis in high school, with few exceptions, use continued with at least the same frequency, but the quantity of alcohol consumed tended to escalate over time toward harmful levels. Overall, findings indicate that patterns of alcohol use tend to be stable over time, and more frequent alcohol use during the final year of high school tends to precede potentially harmful alcohol use following high school. Encouraging those high school students who consume alcohol once per week or more often to use alcohol on a less than weekly basis may be a valuable yet neglected harm minimization strategy. [Toumbourou JW, Williams IR, Snow PC, White VM. Adolescent alcohol-use trajectories in the transition from high school. Drug Alcohol Rev 2003;22:111 – 116] Key words: adolescence, alcohol abuse, alcohol drinking patterns, developmental stages students. Introduction Alcohol is second only to smoking in its contribution to preventable health and social costs [1], with patterns of potentially harmful alcohol use particularly common among young Australians [2]. Australian public health policies aimed at reducing the costs of alcohol misuse typically emphasize harm minimization strategies [2]. One such strategy has involved publishing alcohol consumption guidelines aimed at encouraging alcohol use within levels assessed to hold a low risk of harm [3]. In attempting to modify such patterns of alcohol use it is important to understand the initiation and establish- ment of this behaviour in adolescence and young adulthood [4]. Binge drinking, involving high amounts of alcohol consumption on a few days each week, is particularly prevalent among young Australians [5]. With almost 95% of 15-year-old Victorians participating in school in 2001, and retention rates to year 12 of nearly 80% for that same year [6], the school setting provides an important means of reaching large numbers of adoles- cents. High levels of academic attainment within these populations may make them particularly amenable to well-designed public health messages. In order to design and implement successful public health strate- gies for this target group, their patterns of alcohol consumption need to be understood more clearly. Longitudinal community studies provide an impor- tant method of identifying subgroups who differ across time in their adherence to recommended levels for alcohol use. Longitudinal continuities in the develop- ment of behaviour have been referred to variously as developmental pathways or trajectories [7]. The present study was concerned with investigating trajectories into potentially harmful alcohol use during the transition Received 18 July 2002; accepted for publication 21 January 2003. J. W. Toumbourou BA (Hons), MA, PhD, Centre for Adolescent Health, Murdoch Childrens Research Institute and Department of Paediatrics, University of Melbourne, Australia; I. R. Williams BEd, BSc (Hons), Centre for Adolescent Health, Murdoch Childrens Research Institute and Department of Paediatrics, University of Melbourne, Australia; P. C. Snow BApplSci, Grad Dip, PhD, Deakin University and Centre for Youth Drug Studies, Australian Drug Foundation, Victoria, Australia; V. M. White PhD, Centre for Behavioural Research into Cancer, Victorial anti- Cancer Council, Australia. Correspondence to Dr J. W. Toumbourou, Centre for Adolescent Health, 2 Gatehouse Street, Parkville, Vic 3052, Australia; E-mail: toumbouj@cryptic.rch.unimelb.edu.au Drug and Alcohol Review (June 2003), 22, 111 – 116 ISSN 0959-5236 print/ISSN 1465-3362 online/03/020111–06 # Australian Professional Society on Alcohol and Other Drugs DOI: 10.1080/09595230100100534