Heavy alcohol consumption and marital status: disentangling the relationship in a national study of young adults

Aims. To investigate why alcohol consumption varies by marital status, asse ssing (i) differences in heavy consumption prior to changes in marital stat us (indicating selection) and increases or decreases in heavy consumption a ssociated with changes in marital status (indicating causation), (ii) wheth er such increases or decreases are transient, and (iii) the possible mediat ing effect of parental status. Design. Longitudinal cohort. Setting. Great Britain. Participants. Data from the 23- and 33-year surveys of the 1958 Br itish birth cohort (all born in England, Wales and Scotland, 3-9 March 1958 ). Measurements. Heavy drinking, defined as more than 35 (men) and 20 (wome n) units/week; changes between ages 23 and 33 in consumption and marital st atus. Findings. The divorced had the highest consumption levels at both age s, the married had the lowest. Selection effects were minimal in both sexes . Overall, heavy drinking declined between ages 23 and 33 (21.4-13.0% in me n, 6.4-3.4% in women), but increased among individuals who divorced, compar ed to the continuously married (adjusted OR= 2.05, 95% CI = 1.49,2.83 for m en; OR = 2.61, 95% CI = 1.67,4.09 for women), most strikingly for recent di vorces (adjusted OR = 4.97, 95% CI = 2.86,8.57 and OR = 5.25, 95% CI = 2.60 ,10.65). High rates of heavy drinking persisted for never married men (19.1 %) and women (5.2%). Conclusions. The heavy drinking level of divorced youn g adults was not due to selection. Marital separation teas accompanied by i ncreases in heavy drinking, with pronounced short-term effects. Adverse alc ohol-related health consequences may occur in the immediate period around d ivorce. Individuals who never marry appear to have a chronic heavy consumpt ion pattern that may contribute to their increased mortality.