Possible link between early alcohol use, alcohol dependence, dailynicotine use, and fewer years of

Grant, research assistant professor of psychiatry at WashingtonUniversity School of Medicine as well as corresponding author forthe study. "In addition," said Matt McGue, a professor in the department ofpsychology at the University of Minnesota, "what is missing is anexplanation for the basis of the association. We might consider twopossibilities. One, adolescent substance use results in diminishededucational achievement because substance use is neurotoxic to thedeveloping adolescent brain, or because adolescents who usesubstances have experiences that reduce the likelihood they willpursue higher education." Another possibility, he added, is that "individuals who usesubstances in adolescence differ from those who do not on a rangeof risk factors prior to substance use exposure, which not onlylead to their use of substances but also reduce the likelihood theyachieve a college education.

This possibility means that adolescentsubstance use is merely an indicator of the risk factors thatdiminish the likelihood of college attainment." "Because our participants were in their late 30s when theireducational attainment was assessed, we were better able to addresslifetime educational attainment than most previous studies, whichhave focused on high school dropouts or educational attainment in18-25 year-olds," said Grant. "We also examined educationalattainment in a veteran cohort that had access to education viabenefits of the G.I. bill, thereby alleviating some of the economicbarriers to higher education that might otherwise be confoundedwith alcohol and drug outcomes." Grant and her colleagues examined data collected from two points intime: a 1987 questionnaire, and a 1992 telephone diagnosticinterview of 6,242 male twins (n=3,121 pairs with a mean age of41.9 years in 1992) who had served in the U.S. military during theVietnam-era and were therefore eligible for educational benefitsafter military service.

Specific factors addressed were reducededucational attainment - defined as less than 16 years - as well asearly alcohol and cannabis use, daily nicotine use, lifetimecannabis use, and alcohol, nicotine, cannabis, and any illicit drugdependence. "Although all substance use measures were associated with lowereducational attainment in preliminary analyses," said Grant, "onlyearly alcohol use, alcohol dependence, and daily nicotine useremained significantly associated with reduced educationalattainment in twin pairs discordant for substance use. In contrast,the associations between cannabis/other illicit drugs andeducational attainment were not significant, suggesting that thisassociation may be attributable to familial influences shared bythe two measures." "In this study, they conclude that within twin pairs discordant foradolescent substance use, the unexposed twin was more likely tocomplete college than his/her exposed cotwin," said McGue. "Thisprovides much stronger support for a causal influence than astandard epidemiological study because of the control afforded bycomparing the discordant twins.

However, it is important torecognize that it does not prove causality." "It is possible that early alcohol use and alcohol dependenceimpede later educational attainment," noted Grant. "Possiblemechanisms for this include cognitive and motivational changesstemming from early alcohol use/dependence that hinder academicsuccess. Although daily nicotine use is not likely to impaircognitive functioning, it may lead to motivational changes thataffect academic performance. It is also possible that theassociation between these substances and lower educationalattainment remains because both are attributable to a factor thatwe did not control for in our present analyses, such as personalitycharacteristics and cognitive ability prior to substance use." Grant said these findings underscore the complicated relationshipbetween substance use and educational attainment. "By controlling for all familial influences that contribute to bothsubstance use and educational attainment, through our discordanttwin design, we have a much stronger indicator of the directassociation between substance use and educational attainment," shesaid.

"However, because we were studying higher levels of education- 16+ years - in high school graduates, we may have understated thetrue effect of alcohol on education. It may be that these effectsare more pronounced at even lower levels of education. Nonetheless,our findings lend credence to ongoing public health efforts toreduce adolescent smoking and drinking, which in turn may havebeneficial effects on school dropout and lifelong educationalattainment." Additional References Citations.

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