• Adolescence;
  • alcohol use;
  • cannabis use;
  • DSM-IV cannabis use disorder;
  • tobacco use



To examine whether early onset of tobacco or alcohol use, and continued use of tobacco or alcohol in early adolescence, are related to a higher likelihood of developing a cannabis use disorder during adolescence.

Design and setting

Data were used from four consecutive assessment waves of the TRacking Adolescents' Individual Lives Survey (TRAILS), a general Dutch population study. TRAILS is an ongoing longitudinal study that will follow the same group of adolescents from the ages of 10 to 24 years.


The sample consisted of 1108 (58% female) adolescents (mean ages at the four assessment waves are 11.09, 13.56, 16.27 and 19.05 years, respectively)


Cannabis use disorders were assessed using the Composite International Diagnostic Interview 3.0 (CIDI). Adolescent tobacco and alcohol use were assessed using self-report questionnaires.


Early-onset tobacco use [odds ratio (OR) = 1.82, confidence interval (CI) = 1.05–3.14, P < 0.05], but not early-onset alcohol use (OR = 1.33, CI = 0.84–2.12, P > 0.05), was associated with a higher likelihood of developing a cannabis use disorder. Similarly, adolescents who reported continued use of tobacco (OR = 2.47, CI = 1.02–5.98, P < 0.05), but not continued use of alcohol (OR = 1.71, CI = 0.87–3.38, P > 0.05), were more likely to develop a cannabis use disorder.


Early-onset and continued tobacco use appear to predict the development of a cannabis use disorder in adolescence, whereas early onset and continued alcohol use do not.