Prospective correlates of drinking cessation: variation across the life-course

Aims: To assess age variation in correlates of drinking cessation.

Design: Prospective study of a US general population sample.

Setting: Face-to-face household interviews.

Participants: Past-year ≥ monthly drinkers interviewed at baseline and 3-year follow-up (n = 14 885).

Measurements: Baseline values and selected changes over follow-up in alcohol consumption, alcohol use disorder (AUD), socio-demographic and health characteristics, other substance use and psychiatric comorbidity were used to predict drinking cessation in three age groups.

Findings: Correlates of drinking cessation varied over the life-course, with pregnancy/presence of an infant, nicotine or drug use disorder, incident AUD, cluster A personality disorder, liver disease and incident retirement being important at younger ages and high-school graduation, family income ≥ $70 000, volume of ethanol intake, Asian race/ethnicity, mood disorder and incident cardiovascular disease being significant at older ages. Age-invariant correlates included smoking cessation over follow-up, odds ratio (OR) = 2.82 [95% confidence interval (CI): 1.62-4.92] to 3.45 (2.20-5.39); college education, OR = 0.42 (0.27-0.65) to 0.54 (0.36-0.83); black and Hispanic race/ethnicity, OR = 1.74 (1.18-2.29) to 1.88 (1.21-2.93) and 1.58 (1.11-1.25) to 1.73 (0.83-3.63), respectively, and months since last drink, OR = 1.24 (1.13-1.36) to 1.29 (1.19-1.39).

Conclusions: Factors associated with ceasing alcohol use in US adults appear to differ over the life-course, reflecting age variation in both their prevalence and impact and supporting the importance of role transitions and health problems (the 'sick quitter' effect). The most consistent correlates of drinking cessation included factors reflecting ability/inability to give up potentially addictive substances and factors associated with perceived acceptability of drinking and subgroup-specific drinking contexts that might facilitate/impede continued drinking.