The proportion of men who start to drink alcohol in their teens has surged more than threefold over the past few decades in India, suggests research published online in the Journal of Epidemiology & Community Health.
Those living in urban areas and poorer households are more likely to start drinking at an early age, the findings show.
Studies from high-income countries have shown that starting drinking early in life is a consistent predictor of alcohol-related harm across the life course. But whether this association also exists in low and middle-income countries, such as India, is not clear.
The researchers therefore questioned just under 2000 randomly selected 20-49 year old men from rural and urban areas in Northern Goa about the age at which they first started to drink alcohol, how much they drank, and whether they had sustained any injuries as a result of their drinking.
Levels of psychological distress were also assessed using a validated questionnaire (GHQ).
The responses showed that the proportion of men who started drinking in their teens rose from 20% for those born between 1956 and 1960 to 74% for those born between1981-85 - a more than threefold rise.
Consistent with studies from high-income countries, this study found that starting to drink alcohol during the teenage years was associated with a greater likelihood of developing lifetime alcohol dependence, hazardous or harmful drinking, alcohol related injuries, and psychological distress in adulthood.
Teen drinkers were more than twice as likely to be distressed and alcohol dependent as those who did not start drinking early in life. And they were three times as likely to have sustained injuries as a result of their drinking.
In India, alcohol consumption and its harmful effects are emerging as a major public health problem, say the researchers, who suggest that the trend is "alarming."
And they conclude that their findings highlight the importance of generating public awareness about the hazards of starting to drink early in life, and of enforcing regulations designed to limit underage drinking.
[Adolescent drinking onset and its adult consequences among men: population based study from India Online First doi 10.1136/jech-2014-204058]