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Young adults' recreational social environment as a predictor of ecstasy use initiation: findings of a population-based prospective study

Authors

  • Andrew Smirnov,

    Corresponding author
    1. Drug Harm Reduction Branch, Health Protection Directorate, Division of the Chief Health Officer, Queensland Health, Herston, Queensland, Australia
    • School of Population Health, Queensland Alcohol and Drug Research and Education Centre, The University of Queensland, Herston, Queensland, Australia
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  • Jake M. Najman,

    1. School of Population Health, Queensland Alcohol and Drug Research and Education Centre, The University of Queensland, Herston, Queensland, Australia
    2. School of Social Science, The University of Queensland, Brisbane, Queensland, Australia
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  • Reza Hayatbakhsh,

    1. School of Population Health, Queensland Alcohol and Drug Research and Education Centre, The University of Queensland, Herston, Queensland, Australia
    2. Mount Isa Hospital, Mount Isa, Queensland, Australia
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  • Helene Wells,

    1. Crime and Misconduct Commission, Brisbane, Queensland, Australia
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  • Margot Legosz,

    1. Crime and Misconduct Commission, Brisbane, Queensland, Australia
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  • Robert Kemp

    1. Drug Harm Reduction Branch, Health Protection Directorate, Division of the Chief Health Officer, Queensland Health, Herston, Queensland, Australia
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Correspondence to: Andrew Smirnov, QADREC, School of Population Health, The University of Queensland, Herston Road, Herston, QLD 4006, Australia. E-mail: a.smirnov@uq.edu.au

Abstract

Aims

To examine prospectively the contribution of the recreational social environment to ecstasy initiation.

Design

Population-based retrospective/prospective cohort study.

Setting

Data from screening an Australian young adult population to obtain samples of users and non-users of ecstasy.

Participants

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.

Measurements

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.

Findings

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%).

Conclusions

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.

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