Young adults' recreational social environment as a predictor of ecstasy use initiation: findings of a population-based prospective study
Version of Record online: 4 JUN 2013
© 2013 Society for the Study of Addiction
Volume 108, Issue 10, pages 1809–1817, October 2013
How to Cite
Smirnov, A., Najman, J. M., Hayatbakhsh, R., Wells, H., Legosz, M. and Kemp, R. (2013), Young adults' recreational social environment as a predictor of ecstasy use initiation: findings of a population-based prospective study. Addiction, 108: 1809–1817. doi: 10.1111/add.12239
- Issue online: 13 SEP 2013
- Version of Record online: 4 JUN 2013
- Accepted manuscript online: 14 MAY 2013 06:06AM EST
- Manuscript Accepted: 25 APR 2013
- Manuscript Revised: 6 DEC 2012
- Manuscript Received: 3 SEP 2012
- Australian Research Council's Linkage Projects. Grant Number: LP0776879
- Drug offers;
- drug use initiation;
- ecstasy (MDMA);
- social contacts;
- social environment
To examine prospectively the contribution of the recreational social environment to ecstasy initiation.
Population-based retrospective/prospective cohort study.
Data from screening an Australian young adult population to obtain samples of users and non-users of ecstasy.
A sample of 204 ecstasy-naive participants aged 19–23 years was obtained, and a 6-month follow-up identified those who initiated ecstasy use.
We assessed a range of predictors of ecstasy initiation, including elements of participants' social environment, such as ecstasy-using social contacts and involvement in recreational settings.
More than 40% of ecstasy-naive young adults reported ever receiving ecstasy offers. Ecstasy initiation after 6 months was predicted independently by having, at recruitment, many ecstasy-using social contacts [adjusted relative risk (ARR) 3.15, 95% confidence interval (CI): 1.57, 6.34], attending electronic/dance music events (ARR 6.97, 95% CI: 1.99, 24.37), receiving an ecstasy offer (ARR 4.02, 95% CI: 1.23, 13.10), early cannabis use (ARR 4.04, 95% CI: 1.78, 9.17) and psychological distress (ARR 5.34, 95% CI: 2.31, 12.33). Adjusted population-attributable fractions were highest for ecstasy-using social contacts (17.7%) and event attendance (15.1%).
In Australia, ecstasy initiation in early adulthood is associated predominantly with social environmental factors, including ecstasy-using social contacts and attendance at dance music events, and is associated less commonly with psychological distress and early cannabis use, respectively. A combination of universal and targeted education programmes may be appropriate for reducing rates of ecstasy initiation and associated harms.