The Relationship Between Early Age of Onset of Initial Substance Use and Engaging in Multiple Health Risk Behaviors Among Young Adolescents

Abstract

Background: Previous research based on problembehavior theory has found that early age of onset of substance use is associated with engaging in multiple health risk behaviors among high school students. It is unknown whether these relationships begin during early adolescence.Objective: To examine the relationships between early age of onset of cigarette, alcohol, marijuana, and cocaine use and engaging in multiple risk behaviors among middle school students.Methods: A modified version of the Centers for Disease Control and Prevention Youth Risk Behavior Survey was administered to 2227 sixth through eighth grade students attending 53 randomly selected middle schools in North Carolina. A Health Risk Behavior Scale was constructed from 16 behaviors, including indicators of violence and weapon carrying; current substance use; nonuse of helmets when biking, in-line skating or skateboarding; not wearing a seat belt; riding with a driver who had been drinking; and suicide plans. Among this sample of middle school students, the scale had a mean (SD) of 4.1 (2.7) (range=0-15), and had a high internal reliability coefficient (␣=0.74). The independent variables included first time use of cigarettes, alcohol, marijuana, and cocaine at age 11 years or earlier; actual age of onset of each substance; race and ethnicity; family composition; sex; school grade; academic ranking; and older age for school grade. These data were analyzed with analysis of variance, Spearman r, and multiple linear regression.Results: All the independent variables were found to be associated (PϽ.005) with the Health Risk Behavior Scale during the bivariate analyses. When each of these significant variables were entered into a multiple regression model, having smoked at age 11 years or younger accounted for 21.9% of the variation in the Health Risk Behavior Scale. Male sex, early marijuana or cocaine use, older age, lower academic rank, white race, and living in a 1parent family explained an additional 19.1% of variation in the model (adjusted R 2 =0.41, PϽ.001). When the actual ages of onset of the use of substances were analyzed, in order of magnitude; age of onset of smoking; male sex; age of onset of alcohol and marijuana use; age; lower academic ranking; age of onset of cocaine use; white race; and lower academic rating accounted for 52.8% (PϽ.001) of the variation in the Health Risk Behavior Scale.Editor's Note: I guess we can now say that early, early age of onset of substance abuse is associated with engaging in multiple health risk behaviors.

Multiple health behavior change research: An introduction and overview

“…Conversely, tobacco use increases the likelihood of experimentation with illicit drug use (Lai, et al, 2000). Also, tobacco and other substance use are highly predictive of youth engagement in multiple risk behaviors including bicycling without a helmet, violence and weapon carrying, not using a seatbelt, and suicidal ideation (DuRant, et al, 1999). In Driskell and colleagues' (2008, this issue) analysis of behavioral risk clustering among students in grades 4 through 12, the likelihood of having multiple risks increased with age.…”

Understanding why children die in high-income countries

“…57,58 There is an association between early alcohol use and multiple risk behaviours. 59 In the UK, nearly half of adolescents have engaged in binge drinking by 15 years of age, and a third in hazardous drinking by 16 years, with no clear difference in gender predisposition. In contrast, the pattern of other individual risk behaviours varies between males and females, with antisocial and criminal behaviour, cannabis-use and vehicle-related problems more prevalent amongst adolescent males, and teenage smoking, self-harm and physical inactivity more common in adolescent females.…”

Anabolic steroid abuse among teenage girls: An illusory problem?

“…All of these studies used anonymous or confidential questionnaires; none, to our knowledge, provided an explicit definition of AAS, and none cautioned respondents that AAS should not be confused with corticosteroids or sports supplements. Several additional studies (Coker et al, 2000;Durant et al, ,1999Grunbaum et al, 1998;Middleman et al, 1995;Miller et al, 2005;Zullig et al, 2001), utilized CDC data from individual regions; these studies by definition have the same flaws as the national CDC studies already discussed, and hence are omitted from Table 3. Overall, therefore, it would follow that most estimates of AAS use among high-school girls should be greatly inflated by false-positives.…”