We note the importance of age of first drink in the AUC analyses. Early exposure to alcohol may have causal effects on later addictive behaviors. Adolescent exposure to alcohol preferentially increases alcohol drinking during adulthood in rat models (60), along with brain changes in important neurotransmitter systems and brain areas for appetitive behavior (61,62). Similar mechanisms in humans are a plausible hypothesis (63,64). Prevention strategies to delay exposure to alcohol might receive additional attention in public health efforts at harm reduction.
