title: High-risk behaviors associated with early smoking: results from a 5-year follow-up.
abstract: OBJECTIVE
  To compare grade 7 nonsmokers, experimenters, and smokers on the basis of prevalence of other problem behaviors at both grade 7 and grade 12.
  
  
  METHODS
  Based on longitudinal self-report data from 4327 California and Oregon students, we used logistic regression to develop weighted estimates of the prevalence of academic difficulties, substance use, and delinquent behavior within the three smoking status groups at grades 7 and 12. Huber variance estimates, which adjust for weighting and clustering of observations, were used to assess the statistical significance of differences across groups.
  
  
  RESULTS
  Compared with nonsmokers, early smokers were at least 3 times more likely by grade 12 to regularly use tobacco and marijuana, use hard drugs, sell drugs, have multiple drug problems, drop out of school, and experience early pregnancy and parenthood. These adolescents were also at higher risk for low academic achievement and behavioral problems at school, stealing and other delinquent behaviors, and use of predatory and relational violence. Early experimenters were at significantly greater risk for these problems as well, although to a lesser extent than smokers. Importantly, the higher risk among experimenters and smokers of experiencing many of these problems was evident as early as grade 7.
  
  
  CONCLUSIONS
  Early experimenters and smokers are more likely than nonsmokers to experience various problem behaviors by grade 12, with many of these problems evident as early as grade 7. Results suggest that substance use programs that target multiple problems in addition to smoking may be most effective for these high-risk adolescents.
authors.affiliation: RAND, Santa Monica, California 90407-2138, USA
authors.forename: P L
authors.initials: PL
authors.lastname: Ellickson
authors.forename: J S
authors.initials: JS
authors.lastname: Tucker
authors.forename: D J
authors.initials: DJ
authors.lastname: Klein
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000145:classification / Q000523:psychology*; D000367:Age Factors; D000704:Analysis of Variance; D002140:California / Q000453:epidemiology; D002648:Child; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007604:Juvenile Delinquency; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology; D009922:Oregon / Q000453:epidemiology; D015995:Prevalence; D011336:Probability; D012309:Risk-Taking; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D012920:Social Behavior Disorders / Q000453:epidemiology*; D013332:Student Dropouts; D019966:Substance-Related Disorders / Q000453:epidemiology