title: Does elementary school alcohol, tobacco, and marijuana use increase middle school risk?
abstract: OBJECTIVE
  To assess whether alcohol, tobacco, and other drug (ATOD) use in elementary school may have serious implications for continued ATOD use in middle school and beyond.
  
  
  METHODS
  Longitudinal analyses were conducted on questionnaire data from 331 middle school students who had previously provided ATOD-use data during elementary school. Non-school personnel administered questionnaires in three participating school districts in three different states. The sample of students was ethnically and geographically diverse, including students from a range of low socioeconomic status backgrounds living in rural, urban or inner-city environments.
  
  
  RESULTS
  Middle school alcohol use was almost three times as likely to occur if alcohol use had occurred in elementary school (OR = 2.94, p <.001). Elementary school use of tobacco and marijuana also greatly increased the likelihood of middle school use (OR = 5.35, p <.001 and OR = 4.25, p <.05, respectively).
  
  
  CONCLUSIONS
  Early use of ATOD is associated with greatly increased odds of later use, which has important implications for the timing of drug prevention programs. Preventive interventions designed for use in pediatric practice settings should commence no later than elementary school, during the middle childhood years.
authors.affiliation: Developmental Studies Center, Oakland, California, USA. Nance_Wilson@yahoo.com
authors.forename: Nance
authors.initials: N
authors.lastname: Wilson
authors.forename: Victor
authors.initials: V
authors.lastname: Battistich
authors.forename: S Leonard
authors.initials: SL
authors.lastname: Syme
authors.forename: W Thomas
authors.initials: WT
authors.lastname: Boyce
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000428:Alcohol Drinking / Q000453:epidemiology*; D002648:Child; D002652:Child Behavior; D006801:Humans; D008137:Longitudinal Studies; D008385:Marijuana Smoking / Q000453:epidemiology*; D011336:Probability; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology