Social gradient in initiation and transition to daily use of tobacco and cannabis during adolescence: a retrospective cohort study
Article first published online: 1 JUN 2011
© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction
Volume 106, Issue 8, pages 1520–1531, August 2011
How to Cite
Legleye, S., Janssen, E., Beck, F., Chau, N. and Khlat, M. (2011), Social gradient in initiation and transition to daily use of tobacco and cannabis during adolescence: a retrospective cohort study. Addiction, 106: 1520–1531. doi: 10.1111/j.1360-0443.2011.03447.x
- Issue published online: 12 JUL 2011
- Article first published online: 1 JUN 2011
- Accepted manuscript online: 29 MAR 2011 05:34AM EST
- Submitted 6 September 2010; initial review completed 3 November 2010; final version accepted 18 March 2011
- retrospective cohort;
- social gradient;
- time-discrete analysis;
Aims This study explores whether the family socio-economic status (F-SES) and school situation could have an impact on tobacco and cannabis initiation and transition to daily use during adolescence.
Design and setting A French cross-sectional nation-wide survey conducted in 2005 containing retrospective data.
Participants French teenagers aged 17 (n = 29 393).
Measurement The F-SES was defined by the highest occupational category of either parent, with seven categories ranging from unemployed/inactive to managers/professionals. Ages at repeat school years, at leaving school, at the first episode of drunkenness and at initiation of illicit drug use were used to model tobacco and cannabis initiation and transition to daily use with time-discrete logistic regressions.
Findings The risk for tobacco initiation was almost equally distributed across F-SES groups, but the risk of a progression to daily use was higher in every F-SES category compared to managers/professionals [odds ratio (OR) from 1.17 to 1.90]. Compared to managers/professionals, risk of cannabis initiation was lower in all F-SES categories (OR from 0.63 to 0.87), but all categories except farmers were at increased risk of transition to daily use: the OR range between 1.29 (intermediate) and 1.98 (unemployed/inactive). Repeating school years and leaving school predicted daily use of tobacco (OR = 2.00 and 2.37) and cannabis (4.58 and 2.07).
Conclusions Adolescents from the highest family socio-economic status categories are at risk for tobacco and cannabis experimentation but are less prone to engage in daily use. Psychological and social mechanisms that inhibit transition to daily use should be investigated, including school attainment and performance.