Among the studies that were included, larger and arguably more important effects on the risk of adult alcohol problems were observed in relation to feeling drunk during the first episode and the initiation of regular drinking than AFD itself.19 20 These variables representing more significant involvement in alcohol use, or lying a little further along a putative causal pathway, and showing more noteworthy effects, are important to consider carefully. AFD may represent an important event in the acquisition of this new behaviour, whose effects are much more likely to be felt on proximal rather than distal outcomes.16 32 33 The characteristics of the first event, such as were studied by Warner and White, and other early drinking episodes should be fruitful to explore.34
