Australian Research Council, Australian Rotary Health, Foundation for Alcohol Research and Education, National Drug and Alcohol Research Centre.

The Australian Parental Supply of Alcohol Longitudinal Study (APSALS) was established in 2010 to investigate the short- and long-term associations between exposure to early parental alcohol provision, early adolescent alcohol initiation, subsequent alcohol use and alcohol-related harms, controlling for a wide range of parental, child, familial, peer and contextual covariates. The cohort commenced with 1927 parent-child dyads comprising Australian Grade 7 school students (mean age = 12.9 years, range = 10.8-15.7 years), and a parent/guardian. Baseline, 1- and 2-year follow-up data have been collected, with > 90% retention, and a 3-year follow-up is under way. The data collected include child, familial, parental and peer factors addressing demographics, alcohol use and supply, parenting practices, other substance use, adolescent behaviours and peer influences. The cohort is ideal for prospectively examining predictors of initiation and progression of alcohol use, which increases markedly through adolescence.

Initiating alcohol use earlier in adolescence is associated with an increased risk of binge drinking and higher quantity of consumption in late secondary school, supporting an argument for delaying alcohol initiation for as long as possible to reduce the risk for problematic use in later adolescence and the alcohol-related harms that may accompany this use.

Whether parental supply of alcohol affects the likelihood of later adolescent risky drinking remains unclear. We conducted a systematic review and meta-analysis to synthesize findings from longitudinal studies investigating this association. We searched eight electronic databases up to 10 September 2016 for relevant terms and included only original English language peer-reviewed journal articles with a prospective design. Two reviewers independently screened articles, extracted data and assessed risk of bias. Seven articles met inclusion criteria, six of which used analytic methods allowing for meta-analysis. In all seven studies, the follow-up period was ≥12 months and attrition ranged from 3% to 15%. Parental supply of alcohol was associated with subsequent risky drinking (odds ratio = 2.00, 95% confidence interval = 1.72, 2.32); however, there was substantial risk of confounding bias and publication bias. In all studies, measurement of exposure was problematic given the lack of distinction between parental supply of sips of alcohol versus whole drinks. In conclusion, parental supply of alcohol in childhood is associated with an increased likelihood of risky drinking later in adolescence. However, methodological limitations preclude a causal inference. More robust longitudinal studies are needed, with particular attention to distinguishing sips from whole drinks, measurement of likely confounders, and multivariable adjustment.

Parents' restrictiveness of their children's drinking was associated with lower risky drinking, but the risk of bias in the existing literature precludes strong inferences about the association. Further longitudinal studies with prospective measurement of parent behaviour, low attrition, and control for likely confounders, are needed.

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Parental supply of alcohol to adolescents was associated with increased risk of drinking, but not bingeing. These parentally-supplied children also consumed fewer drinks on a typical drinking occasion. Adolescents supplied alcohol from non-parental sources had greater odds of drinking and bingeing. Further follow-up is necessary to determine whether these patterns continue, and to examine alcohol-related harm trajectories. Parents should be advised that supply of alcohol may increase children's drinking.

Sipping alcohol has different associations with known predictors of adolescent alcohol use than drinking whole beverages, and sipping may be a distinct or separable behavior. Future research should better define quantities of early consumption and assess the relationship between early sipping and drinking on long-term outcomes separately.