Adolescence to Young Adulthood: When Socioeconomic Disparities in Substance Use Emerge

Abstract

We examined trends in cigarette, alcohol, and marijuana use by eventual educational attainment in 1,902 participants from Project EAT, a 10-year longitudinal study following participants from early adolescence through young adulthood. Generally, for cigarettes and marijuana, disparities were evident by early adolescence with prevalence of use highest among those who had no secondary education. With alcohol, use diverged during young adulthood when the college group reported the most weekly alcohol use while those without postsecondary education reported greatest daily use. When disparities in substance use behaviors first emerge and later escalate can guide how to craft and target interventions.

RÉSUMÉ

Desde la adolescencia hasta la adultez temprana: Cuándo las desigualdades socioeconómicas surgen en el consumo de sustancias

Examinamos las tendencias en el consumo de cigarrillos, alcohol y marihuana en base al nivel de estudios logrado en 1902 participantes del Proyecto EAT, un estudio longitudinal de 10 años en donde se investigó a los participantes desde su adolescencia hasta su adultez temprana. En términos generales, en los casos de cigarrillos y marihuana, las diferencias se hicieron evidentes durante los primeros años de la adolescencia; el consumo más frecuente se registró entre quienes no tuvieron una educación secundaria. En el caso del alcohol, el consumo se divergió durante la adultez temprana cuando el grupo universitario reportó un consumo semanal de alcohol más frecuente, mientras que los participantes sin una educación superior reportaron un mayor consumo diario. Saber en qué momento las diferencias en el comportamiento relacionado al consumo de sustancias surgen y, posteriormente, se intensifican puede ayudar a diseñar y focalizar intervenciones.

RESUMEN

De l'adolescence au début de l’âge adulte: l’émergence des disparités socio-économiques en matière de toxicomanie

Nous avons étudié les tendances en matière de consommation de cigarettes, d'alcool et de cannabis par rapport au niveau d’études atteint sur un total de 1902 participants au Projet EAT, une étude longitudinale sur 10 ans qui suit les participants du seuil de l'adolescence au début de l’âge adulte. En règle générale, les disparités en matière de consommation de cigarettes et de cannabis étaient manifestes dès les premières années de l'adolescence, avec une prédominance de la consommation la plus élevée parmi ceux qui n'avaient pas fait d’études secondaires. Concernant l'usage de l'alcool, les divergences émergeaient durant les premières années de l’âge adulte, avec une consommation d'alcool hebdomadaire la plus élevée chez le groupe « études universitaires » et la consommation quotidienne la plus élevée chez les groupes n'ayant pas fait d’études post-secondaires. Le moment où les disparités en matière de toxicomanie émergent, puis vont en augmentant, peut contribuer à une meilleure élaboration et un meilleur ciblage des interventions.

Keywords :

• smoking
• alcohol
• marijuana
• young adulthood
• adolescence
• socioeconomic status

THE AUTHORS

Rachel Widome, PhD, MHS, is an Assistant Professor in the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN. She is a social epidemiologist with research interests in how social factors influence health-related behaviors such as tobacco use, physical activity, and diet. She is particularly interested in the young adult age group, health disparities, and how policy can be used to promote health.

Melanie M. Wall, PhD, is a Professor of biostatistics and the Director of the Division of Biostatistics at the Department of Psychiatry in Columbia University, New York. Her expertise is in latent variable modeling and spatial and longitudinal data analysis with extensive experience working with epidemiological observational data related to behavioral psychosocial public and mental health.

Melissa N. Laska, PhD, RD, is an Associate Professor in the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN. Dr. Laska's primary research interests are in environmental, social and behavioral determinants of obesity among young people. Her current work focuses primarily on excess weight gain among adolescents as they transition into young adulthood, as well as on neighborhood access to healthy foods, particularly in underserved communities.

Marla E. Eisenberg, ScD, MPH, is an Associate Professor of pediatrics in the Division of Adolescent Health and Medicine, University of Minnesota, Minneapolis, MN. Dr. Eisenberg's research focuses on multilevel influences on high-risk health behaviors among adolescents and young adults.

Dianne Neumark-Sztainer, PhD, MPH, RD, is a Professor in the Division of Epidemiology and Community Health, School of Public Health, and an Adjunct Professor at the Department of Pediatrics, both at the University of Minnesota, Minneapolis, MN. Her research focuses on adolescent nutrition and the prevention of weight-related problems, including eating disorders, unhealthy weight control behaviors, body dissatisfaction, and obesity.

Notes

1 The figures show trends in substance use by educational group, pooled across gender. In all figures, percentages that do not share a letter are significantly different (p < .05) from each other at that particular developmental stage. For instance, for monthly cigarette use among early adolescents (Figure 1), the prevalence estimate for the no postsecondary group (15.9%) was significantly different from both the 2-year college (2.9%) and 4-year college (4.3%) groups. The 2-year and the 4-year groups are not significantly different. The 2-year and no postsecondary education groups are not statistically different from each other and thus share the letter “a” after their estimates on the figure.