News Release

Adults who misused alcohol as teens report dissatisfaction and poor health in midlife, study finds

A Virginia Commonwealth University- and Rutgers-led study of more than 2,700 pairs of twins showed the consequences of drinking in adolescence for health can last decades

Peer-Reviewed Publication

Virginia Commonwealth University

RICHMOND, Va. (Sept. 27, 2022) — Teen alcohol misuse is a catalyst of poor life satisfaction and health outcomes later in life, a new Virginia Commonwealth University and Rutgers University-led study found.

The researchers, whose study “Exploring the Relationships Between Adolescent Alcohol Misuse and Later Life Health Outcomes,” published in Alcoholism: Clinical & Experimental Research this month, found:

  • Higher rates of adolescent alcohol misuse were correlated with higher rates of young adult alcohol problems.
  • Drinking problems in participants’ 20s were associated with alcohol struggles in their 30s.
  • These drinking behaviors were connected to poorer physical health and lower life satisfaction.

The findings, researchers say, indicate teen drinking’s indirect influence on midlife physical health and life outcomes and highlight the need for prevention strategies for better long-term health.

“Understanding these long-term effects will further our understanding of early targeted interventions in adolescence that may prevent or mitigate long-term negative health consequences and improve quality of life across the lifespan,” said Angela Pascale, first author of the study and a student in the Ph.D. in Health Psychology program at VCU’s College of Humanities and Sciences.

Unlike other studies of its kind that found adolescent alcohol misuse directly influences later life substance use and mental-health related outcomes, Pascale, her co-corresponding author Jessica Salvatore, Ph.D., an associate professor at Rutgers University who previously worked at VCU, and their coauthors found that adolescent drinking may indirectly influence long-term physical health and life satisfaction, rather than influencing it directly.

“Even though we observed these effects, they were somewhat modest, suggesting adolescent alcohol misuse is not the only driver of later poor physical health and life dissatisfaction,” said Pascale, who suggested that continued alcohol-related problems might play a role as well.

In addition, where previous studies of adolescent alcohol misuse often looked at health outcomes in the years shortly after teens are surveyed in young adulthood, Pascale said, this study looks at health across multiple decades into early midlife.

“This study is unique in that it seeks to understand whether poor physical health consequences continue beyond your 20s,” Pascale said. “Our findings imply that drinking in adolescence and the consequences that follow are seen two decades later across multiple developmental stages.”

Researchers defined adolescent alcohol misuse based on responses about frequency of drunkenness, frequency of alcohol use and alcohol problems at ages 16, 17, and 18.5. The early midlife outcomes they measured included life satisfaction, physical symptoms and self-rated health at age 34.

Using data from questionnaires of 2,733 pairs of twins born in Finland in the late 1970s, the study controls for variables of nature and nurture — shared genetics and a shared rearing environment, respectively.

“The longitudinal twin design is especially helpful for clarifying whether there are confounding family factors that predispose someone to both misuse alcohol in adolescence and experience poorer physical health and well-being later on in early midlife,” Salvatore said. “This is because the twin design allows us to compare exposures and outcomes over time within the same family.”

“The findings — and in particular the findings that effects remained consistent even after controlling for genetic and environmental factors that twin siblings share — underscore the importance of preventative interventions targeting adolescents with alcohol misuse and in turn mitigating health consequences later into adulthood,” Pascale said.

The study’s authors include Pascale, Salvatore and their coauthors: Mallory Stephenson in the Department of Psychology at VCU; Peter Barr, Ph.D., of SUNY Downstate Health Sciences University; Richard Viken, Ph.D., and Richard J. Rose, Ph.D., of Indiana University; Antti Latvala, Ph.D., Sari Aaltonen, Ph.D., Maarit Piirtola, Ph.D., Jaakko Kaprio, M.D., Ph.D., of the University of Helsinki, which led the Finnish Twin Cohort Study; Hermine Maes, Ph.D., of the Virginia Institute for Psychiatric and Behavioral Genetics at VCU; and Danielle M. Dick, Ph.D., of Rutgers University, also formerly of VCU.


This study was supported by grants from the National Institute on Alcohol Abuse and Alcoholism, part of the National Institutes of Health, and the Academy of Finland.


About VCU and VCU Health

Virginia Commonwealth University is a major, urban public research university with national and international rankings in sponsored research. Located in downtown Richmond, VCU enrolls nearly 29,000 students in 238 degree and certificate programs in the arts, sciences and humanities. Twenty-three of the programs are unique in Virginia, many of them crossing the disciplines of VCU’s 11 schools and three colleges. The VCU Health brand represents the VCU health sciences academic programs, the VCU Massey Cancer Center and the VCU Health System, which comprises VCU Medical Center (the only academic medical center in the region), Community Memorial Hospital, Tappahannock Hospital, Children’s Hospital of Richmond at VCU, and MCV Physicians. The clinical enterprise includes a collaboration with Sheltering Arms Institute for physical rehabilitation services. For more, please visit and


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