Skip to main content

User account menu

  • Log in

Languages

  • English

Main navigation

  • About ISSUP

    • ISSUP Rationale
    • Membership
      • Membership Criteria
      • Code of Ethics
      • Who is ISSUP for?
    • News
    • International Partners
    • Governance
    • ISSUP Scientific Council
    • Friends of ISSUP (USA)
    • ISSUP Workshops
      • Bali 2025
      • Thessaloniki 2024
      • Buenos Aires 2023
      • Manila 2022
      • Abu Dhabi 2022
      • International Conference 2021 (Virtual)
      • Africa 2020 (Virtual)
      • Vienna 2019
      • Nairobi 2018
      • Cancún 2017
      • Campinas 2016
      • Bangkok 2015
    • ISSUP Awards
      • Evidence-Based Award
      • Local Initiative Award
      • Services Award
      • Excellence in Training Provision
      • Outstanding Contribution to ISSUP Award
    • In Memoriam
    • Acknowledgements
    • ISSUP Website Guides
    • Contact ISSUP
    • FAQs - Frequently Asked Questions
  • Professional Development

    • Online Learning Hub
      • How to Register
      • UTC Self Led Courses
    • Universal Curricula (UC)
      • Universal Prevention Curriculum
      • Universal Treatment Curriculum
      • Universal Recovery Curriculum
      • Access UPC & UTC
      • Training Providers
      • Becoming a Training Provider
      • Global Training Program
    • Resources
      • Glossary
      • ISSUP Webinars
      • ICAP certification
      • INEP Plus
      • Prevention Insights Video Series
      • Prevention Lists
      • HealthEKnowledge
      • WiRED International
      • Quality in Treatment
      • SPR-ISSUP Prevention Workbook
    • Job Board
  • Knowledge Share

    • Search in the Knowledge Share
    • ADDICTOLOGY Journal
      • Latest Issue
  • National Chapters

    • Africa
      • ISSUP Botswana
      • ISSUP Côte d’Ivoire
      • ISSUP Egypt
      • ISSUP The Gambia
      • ISSUP Kenya
      • ISSUP Namibia
      • ISSUP Nigeria
      • ISSUP South Africa
      • ISSUP Tanzania
      • ISSUP Togo
      • ISSUP Uganda
    • The Americas
      • ISSUP Argentina
      • ISSUP The Bahamas
      • ISSUP Brazil
      • ISSUP Canada
      • ISSUP Chile
      • ISSUP Colombia
      • ISSUP Ecuador
      • ISSUP El Salvador
      • ISSUP Guatemala
      • ISSUP Mexico
      • ISSUP Panama
      • ISSUP Paraguay
      • ISSUP Peru
      • ISSUP United States
    • Asia
      • ISSUP Afghanistan
      • ISSUP India
      • ISSUP Indonesia
      • ISSUP Kazakhstan
      • ISSUP Lebanon
      • ISSUP Malaysia
      • ISSUP in Pakistan
      • ISSUP Philippines
      • ISSUP Qatar
      • ISSUP Sri Lanka
      • ISSUP Thailand
      • ISSUP Türkiye
      • ISSUP United Arab Emirates
      • ISSUP Uzbekistan
      • ISSUP Vietnam
    • Europe
      • ISSUP Czech Republic
      • ISSUP Greece
      • ISSUP Italy
      • ISSUP Spain
      • ISSUP Ukraine
      • ISSUP United Kingdom
    • How to Become a National Chapter
    • ISSUP National Chapters' Advisory Committee
  • Events

    • Search through all events
  • Networks

    • A–Z
  • My ISSUP

    • Member Directory
    • Apply for membership

Epi

data, info
Back to Epi main page
Jose Luis Vazquez Martinez

Historical trends in the grade of onset and sequence of cigarette, alcohol, and marijuana use among adolescents from 1976–2016: Implications for “Gateway” patterns in adolescence

Jose Luis Vazquez Martinez - 22 August 2019

Source: Keyes, K. M., Rutherford, C., & Miech, R. (2019). Historical trends in the grade of onset and sequence of cigarette, alcohol, and marijuana use among adolescents from 1976–2016: Implications for “Gateway” patterns in adolescence. Drug and alcohol dependence, 194, 51-58.(link is external)

 

Highlights

 

  • Grade of first use of alcohol/cigarettes increasing, onset of marijuana(link is external) use stable.

  • Majority of adolescent use marijuana in a grade prior to or same as cigarettes.

  • Marijuana displaces alcohol/cigarettes as 1 st substance among users of >1 substance.

 

Abstract

Introduction: In the past decade, marijuana use prevalence among adolescents has remained relatively steady while cigarette and alcohol prevalence has declined. We examined historical trends in: average grade of onset of marijuana, alcohol, and cigarette use by 12th grade; proportion who try alcohol/cigarettes before first marijuana use, among those who use by 12th grade; and conditional probability of marijuana use by 12th grade after trying alcohol/cigarettes.

 

Methods: Data were drawn from 40 yearly, cross-sectional surveys of 12thgrade US adolescents. A subset of students (N = 246,050) were asked when they first used each substance. We reconstructed cohorts of substance use from grade-of-onset to determine sequence of drug use, as well as probability of marijuana use in the same or later grade.

 

Results: Average grade of first alcohol and cigarette use by 12th grade increased across time; e.g., first cigarette increased from grade 7.9 in 1986 to 9.0 by 2016 (, SE = 0.001, p < 0.01). The proportion of 12thgrade adolescents who smoke cigarettes before marijuana fell below 50% in 2006. Each one-year increase was associated with 1.11 times increased odds of first cigarette in a grade after first marijuana (95% C.I. 1.11–1.12). Among those who initiate alcohol/cigarettes prior to marijuana by 12thgrade, the probability of subsequent marijuana use is increasing.

 

Conclusion: Marijuana is increasingly the first substance in the sequence of adolescent drug use. Reducing adolescent smoking has been a remarkable achievement of the past 20 years; those who continue to smoke are at higher risk for progression to marijuana use.

link to full text(link is external)
0 comments
Contact Us

Stay Connected

Newsletter

ISSUP is funded by the U.S. Department of State via the Bureau of International Narcotics and Law Enforcement Affairs (INL). INL works to keep Americans safe by countering crime, illegal drugs, and instability abroad.

Copyright © International Society of Substance Use Prevention and Treatment Professionals Privacy Policy (link is external)