College of Public Health

Manik Ahuja and Manul Awasthi Publish on Alcohol Initiation

Dr. Manik Ahuja, Assistant Professor in the East Tennessee State University College of Public Health’s Department of Health Services Management and Policy, has published an article in Substance Use & Misuse.  The article, “Early Age of Alcohol Initiation and Its Association with Suicidal Behaviors,” tests the association of early alcohol initiation versus later initiation with suicidal ideation and attempt in an ethnically diverse sample.

Manul Awasthi, doctoral student in the same department, is a co-author.   Additional co-authors include members of the University of Northern Colorado and Saint Barnabas Medical Center.

According to the World Health Organization, there is one death every 40 seconds due to suicide amounting to almost 800,000 deaths annually. Suicide is a global public health concern and was the 10th leading cause of death in the United States in 2017. It was the second leading cause of death among individuals between the ages of 10 and 34, and the fourth leading cause of death among individuals between the ages of 35 and 54.

“Rates of suicide have continued to rise over the last twenty years in the U.S., which is a major public health problem.  Rates for suicide were only further exacerbated during the COVID-19 pandemic, said Dr. Ahuja.  “We must continue to identify factors that contribute to suicidal behaviors, such as alcohol, where intervention is possible.”  

The Substance Abuse and Mental Health Services Administration (SAMHSA) revealed that alcohol misuse or dependence increases suicide risk tenfold.  Studies have also found that alcohol use increases the risk of suicide irrespective of other associated risk factors including preexisting psychiatric disorders.    Although the purchase or drinking of alcohol is illegal by individuals under the age of 21 in the United States, 11% of all the alcohol consumption in the country was by people aged 12 to 20 years.  

“As alcohol is widely available, and has become normative in our culture, it is critical to consider its risks, particularly for youth initiation it’s use at an early age,” continued Dr. Ahuja. “Parents, caregivers, educations, and others in the community must continue to further understand the risks of early alcohol use, particularly for adolescents age 14 or earlier where there is an elevated risk.”

A total of 13,867 participants were selected for this study which included 56.9% females and 43.1% males. Race and ethnicity were reported as 28.8% non-Hispanic White, 39.1% Black, 20.3% Latino, and 11.9% Asian. Early alcohol initiation was associated with higher odds of suicide ideation as compared with those who initiated drinking at an older age.  Early age at initiation was also associated with higher odds of lifetime suicide attempt versus later age initiation.  

“Over recent years there has been a high level of marketing for alcohol in both internet and television as, for example, the association of beer advertisements with sporting events,” said Dr. Ahuja.  “Despite its social acceptability and its ease of access, alcohol is extremely dangerous for youth, particularly at a young age.   We must continue to work towards prevention efforts that will reduce or eliminate consumption among youth, particularly age 14 or earlier, where the risk of suicide ideation and attempts is much higher.”

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