Revisiting drug progression: long-range effects of early tobacco use
Article first published online: 22 JUN 2005
Volume 100, Issue 9, pages 1358–1369, September 2005
How to Cite
Vega, W. A. and Gil, A. G. (2005), Revisiting drug progression: long-range effects of early tobacco use. Addiction, 100: 1358–1369. doi: 10.1111/j.1360-0443.2005.01141.x
- Issue published online: 28 JUN 2005
- Article first published online: 22 JUN 2005
- Submitted 13 September 2004; initial review completed 27 December 2004; final version accepted 3 March 2005
- Drug abuse and dependence;
- drug use progression;
- ethnic differences;
- tobacco use
Aims Drug progression models have been a cornerstone of scientific and public policy discussions for decades. These models have been criticized for their lack of causal mechanisms leading to drug dependence. Future research should focus on identification of pathways and covariates. This study re-examines tobacco use onset and progression to drug dependence in a multi-ethnic sample followed longitudinally from early to late adolescence (1990 to 1998–2000).
Methods Data were collected in schools (n = 1208) during early adolescence (mean age 11.07), and subsequently face-to-face interviews were conducted at late adolescence (mean age 20.01).
Findings Results indicated ethnic differences in rates and progression of tobacco use, with African Americans and foreign-born Latinos having larger proportions of abstainers and lower rates of persistent use. Most early adolescent smokers progressed to regular use. The odds of progression to marijuana abuse or dependence by later adolescence were highest (O.R. = 4.9) among persistent smokers, but not significant for foreign-born Latinos. The odds of progression to drug abuse or dependence were also highest (O.R. = 6.4) for persistent smokers, but not significant for African Americans.
Conclusions Implications for research on pathways and mechanisms of progression are discussed. Prevention programs may interrupt drug progression if they delay onset of tobacco use until mid-adolescence. Preventing targeted marketing efforts by the tobacco industry, regulating and enforcing tobacco control laws and pricing cigarettes at cost levels that adolescents find prohibitive are effective supplements to traditional behavior change interventions.