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Objectives The unemployed are assumed to adopt unhealthy behaviours, including harmful use of alcohol. This study sought to elucidate the relations between unemployment before age 21years and consumption of alcohol from 21 to 42years. The design was based on the conception of youth as a sensitive period for obtaining drinking scars' that are visible up to middle age.

Setting The Northern Swedish Cohort Study has followed up a population sample from 1981 to 2007 with five surveys.

Participants All pupils (n=1083) attending the last year of compulsory school in Lulea participated in the baseline survey in classrooms, and 1010 of them (522 men and 488 women) participated in the last follow-up survey that was conducted at classmate reunions or by post or by phone.

Outcome measure The trajectory of alcohol consumption from 21 to 43years, obtained with latent class growth analyses, was scaled.

Results Men were assigned to five and women to three consumption trajectories. The trajectory membership was regressed on accumulation of unemployment from 16 to 21years, with multinomial logistic regression analyses. The trajectory of moderate consumption was preceded by lowest exposure to unemployment in men and in women. With reference to this, the relative risk ratios for high-level trajectory groups were 3.49 (1.25 to 9.79) in men and 1.41 (0.74 to 2.72) in women, but also the trajectories of low-level consumption were more probable (relative risk ratio 3.18 (1.12 to 9.02) in men and 2.41 (1.24 to 4.67) in women).

Conclusions High-level alcohol consumption throughout adulthood is, particularly among men, partly due to scars' from youth unemployment, particularly in men, but there are also groups of men and women where unemployment in the teens predicts a trajectory of low consumption.