Drinking firsts at home and with parental knowledge: Racial/ethnic differences in associations with later alcohol outcomes among underage youth

Background Prior research has shown that early alcohol experiences, such as age of initiation and speed of progression between drinking milestones, vary across racial/ethnic groups. To inform culturally tailored prevention efforts, this longitudinal study examined racial/ethnic differences in the associations of drinking firsts at home and with parental knowledge with alcohol use outcomes among underage youth. Methods The study included baseline and five follow‐up surveys, collected every 6 months, from California adolescents (ages 12–16 years at baseline). The analytic sample was composed of the 689 adolescents who reported lifetime alcohol use at baseline or a follow‐up survey (5% Black, 37% Latinx, 46% White, and 12% other/mixed racial/ethnic group; 54% female). Participants who reported consumption of a full drink, intoxication, or heavy episodic drinking (HED) were asked ages and contexts of these drinking firsts, including whether the initiation was at their own home and whether their parents/guardians knew about this drinking event. Outcomes included past‐6‐month alcohol frequency, alcohol quantity, and number of alcohol‐related problems. Multilevel negative binomial regression analyses were conducted, controlling for demographics and age of initiation by type of drinking behavior. Moderation analyses examined racial/ethnic differences. Results For consumption of the first full drink, both drinking at home and parental knowledge were negatively associated with all outcomes; associations did not vary by race/ethnicity. First intoxication at own home was negatively associated with the number of drinks for Latinx youth and with the number of problems for Black youth. For first HED, drinking at own home was positively associated with drinking frequency across groups, and for Black youth specifically, parental knowledge of their first HED experience was significantly associated with greater later alcohol frequency and quantity. Conclusions Results suggest that the association of family contexts of drinking first with later alcohol outcomes among underage youth varied by stage of alcohol use and race/ethnicity. Results add to the limited body of work about how family contexts of drinking firsts are associated with later adverse alcohol outcomes. Results showed that the associations between family contexts of drinking firsts and later alcohol outcomes among underage youth varied by alcohol use milestones (first whole drink, first intoxication, and first HE