Early Life Health, Trauma and Social Determinants of Lifetime Abstention from Alcohol.

Aims: Factors influencing lifetime abstention from alcohol may be relevant to the validity of analyses of alcohol's impact on health outcomes. We evaluate relationships between early life experiences, social factors, and demographic characteristics on lifetime abstainer status in models disaggregating by gender and, among women, race/ethnicity.

Methods: Analyses use the landline sample (N = 5382) of the 2010 U.S. National Alcohol Survey. Surveyed participants who reported never drinking alcohol were defined as lifetime abstainers. Additional variables assessed included demographics, dispositions to risk taking and impulsivity, and indicators of early life stress like economic difficulty, childhood trauma and early onset of health conditions. Logistic regression models predicting lifetime abstention were estimated.

Results: Lifetime abstainers are more likely to be women and, among women, to be non-White and Latina. Those reporting that their religion discouraged drinking and that religion was very important to them were more likely to be lifetime abstainers. Higher education levels were associated with reduced rates of lifetime abstention among women. Also among women, family problem drinking was associated with lower rates of lifetime abstention. However, childhood economic difficulty significantly predicted lower abstention only for White women, and childhood sexual abuse was significantly related to lower lifetime abstention only for Black women.

Conclusions: Understanding the characteristics and determinants of individuals who never drink alcohol is relevant to any analysis of alcohol-related health outcomes. Results point to specific factors related to lifetime abstention with potential to bias such analyses if not included as control measures.

Short Summary: Analyses evaluating relationships between early life experiences, social factors, and demographics with lifetime abstainer status identified characteristics associated with both poor health and with better health. These included lower risk taking and impulsivity scores and lower rates of family problem drinking, childhood economic difficulties and childhood sexual abuse.