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BACKGROUND Men's age at first birth may negatively or positively affect alcohol-related morbidity and mortality, although little evidence is available. METHODS We used register data of over 22,000 brothers to analyze the associations between age at first birth and alcohol-related morbidity and mortality from the age of 35 until the age of 60 or 72. We employed conventional Cox models and inter-sibling models, which allowed adjustment for unobserved social and genetic characteristics shared by brothers. RESULTS The findings show that men's