Alcohol and cigarette use from ages 23 to 55: Links with health and well-being in the long-term national child development study

Objective: Using longitudinal data from the National Child Development Study, an ongoing study of a nationally representative British cohort born in 1958 (n = 9,137; 51% female), we examined how patterns of alcohol and cigarette use from young adulthood (age 23) to midlife (age 55) are associated with health and well-being. Method: We first used a nonparametric multilevel latent class specification to identify eight unique paths of alcohol and cigarette use from ages 23 to 55, and then assessed how these long-term latent paths related to overall health, heart problems, chronic illness, and quality of life at midlife. Results: Results show that adults who consistently drank within current U.K. low-risk guidelines (i.e., not exceeding 14 units of alcohol per week) and abstained from smoking from young adulthood to midlife reported the best overall health and well-being compared with latent paths involving steady, light to moderate drinking and both current and prior smoking, increasing drinking and smoking, and infrequent drinking/abstention. Conclusions: British adults who consistently drank within new lower risk guidelines and abstained from smoking from young adulthood to midlife reported the best overall health and well-being across numerous indicators. However, apparent observed health benefits of stable low-dose alcohol use (vs. abstention) are weakened by the fact that by age 55 almost all alcohol “abstainers” in the National Child Development Study sample were former drinkers, and that respondents who followed infrequent drinking/abstention paths were the mostly likely to report poor health, psychological distress, and low educational qualifications in early adulthood.