However, it is critical to note that most possible causal mechanisms linking early AFD and increased risk of AUD entail the assumption that early drinking leads to heavy drinking during adolescence, with heavy exposure to ethanol during a period of physical and neurological maturation constituting the primary direct risk factor and/or marker of risk. Clearly, not all early drinkers engage in heavy adolescent drinking, and the link between the two behaviors may be particularly tenuous in cultures where early drinking is the norm. Consequently, the lack of data on volume and pattern of consumption and drinking context during adolescence constitutes a serious limitation of this analysis, both for understanding the etiology and assessing the policy implications of the association between early drinking and subsequent risk for AUD (Rossow, 2006).
