Forecasting Disparities With Early Substance-Use Milestones

ABSTRACT

Substance use contributes to health disparities across race/ethnicity, gender, and socioeconomic status (SES). Although adolescent research indicates group-based differences in regular use, few studies have examined patterns when initiation is just beginning. Using a sample of 917 Rhode Island middle schools students (54% female, 26% non-Hispanic White), we collected demographic information at baseline (M age 12.2); we then examined ever-puff (cigarettes), ever-sip (alcohol), and ever-use (marijuana) behaviors three years later. For cigarette use, we found differences based on SES and race/ethnicity (prevalence was particularly high among Native American youths). Marijuana use was associated with lower SES, and alcohol use was higher among females than males. Overall, findings indicate racial/ethnic-, gender- and SES-based differences in early substance-use milestones. From a prevention standpoint, it is important to evaluate differences not only in heavy substance use, but in early milestones, as they may set the course for health disparities across the life span.

KEYWORDS:

• alcohol
• gender
• health disparities
• marijuana
• race and ethnicity
• SES
• tobacco

Funding

This study was supported by National Institute on Alcohol Abuse and Alcoholism Grant K02 AA021761 (Jackson) and National Institute on Drug Abuse Grant T32 DA016184 (Roberts).

Notes

1. Coding was intended to distinguish single versus mixed cultural background. Adolescents who reported Hispanic, no race (N = 53) and adolescents who reported Black Hispanic or White Hispanic (N = 44) were coded as Hispanic; adolescents who reported Hispanic and another race (e.g., Asian) and adolescents who reported two or more races were coded as multiethnic/multiracial.

2. Participants also reported age-at-first-full-cigarette and age-at-first-full-drink, which allowed us to run Cox proportional hazards models (survival analyses) with age as the time scale. These analyses revealed the following: The hazard of low-SES youths for full-cigarette initiation was 2.6 times that of high-SES youths (see Table 1 for information on dichotomizing SES); the hazard of low-SES youths for full-drink initiation was 1.4 times that of high-SES youths; and the hazard of females for full-drink initiation was 1.6 times that of males.