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Research Summary

Adolescent Health Behaviors Predict Adult Behaviors and Consequences

Two cohort studies in Finland examined how adolescent tobacco and alcohol use influence both adult use of these substances and related consequences.

In one study of 903 students followed from age 15 through 28, adolescent drinking predicted adult drinking. Further, both early alcohol and tobacco use predicted later smoking. The prevalence of smoking at age 28 among those who had not smoked at age 15 was significantly greater for those who had drunk, compared with those who had not drunk, during adolescence (27% versus 18%).

The other study included a population-based sample of 10,943 people whose data from a questionnaire on substance use was gathered at age 14 and then linked to national crime and hospital registries covering the subsequent 17–18 years. Analyses were adjusted for social class, family type (two-parent or single-parent), school performance, and other substance use.

  • Men who had been occasionally or often intoxicated at age 14, compared with those who had never been intoxicated, were significantly more likely as adults to have a drinking-while-intoxicated (DWI) offense (odds ratios, ORs, 1.7 and 2.9, respectively) and to be treated in a hospital for addiction (ORs 2.5 and 7.5, respectively).
  • Early smoking was also significantly associated with later DWI and hospital addiction treatment among men (OR 1.5 for experimental and 4.3 for daily use and DWI; OR 4.5 for daily use and hospitalization).
  • Women who had been often intoxicated at age 14 were more likely to have a later DWI offense (OR 7.4, P=0.09). All other findings for women were non-significant.


These studies suggest that adolescent risk behaviors continue into adulthood, and that one risk behavior can lead to other risk behaviors and to serious consequences later in life. These findings highlight the importance of preventing alcohol and tobacco use in adolescence to avoid serious problems—including tobacco dependence, driving while intoxicated, and addiction—in adulthood.

Richard Saitz, MD, MPH


Paavola M, Vartiainen E, Haukkala A. Smoking, alcohol use, and physical activity: a 13-year longitudinal study ranging from adolescence into adulthood. J Adol Health. 2004;35(3):238–244.
(view abstract)

Riala K, Hakko H, Isohanni, M, et al. Teenage smoking and substance use as predictors of severe alcohol problems in late adolescence and in young adulthood. J Adol Health. 2004;35(3):245–254.
(view abstract)