title: Association between early onset of cigarette, alcohol and cannabis use and later drug use patterns: an analysis of a survey in European metropolises.
abstract: OBJECTIVE
  The study presents data about age of onset of alcohol, cigarette and cannabis use and investigates the association between age of onset and later drug use patterns.
  
  
  METHODS
  Using a sample from a cross-sectional multi-site study, personal interviews were conducted with 3,503 individuals aged 12-49 years. Last-month prevalence, age of onset and associations with subsequent use patterns were investigated.
  
  
  RESULTS
  Having started with cannabis before the age of 16 years was associated with an odds ratio of 1.6 for heavy cannabis use. For males, the odds ratio of heavy cannabis use was 1.7, when cannabis was already initiated by the age of 16. Heavy use of ecstasy, amphetamines, hallucinogens and cocaine is associated with use of cigarettes before 13 (OR = 1.9). For males, the odds ratio was 2.2 and for women 1.9.
  
  
  CONCLUSIONS
  Early use of alcohol, according to this data, does not seem to be related to subsequent heavy drug use. Early onset cannabis users show increasing probabilities of heavy use patterns. Preventive intervention programs have to start earlier than school-based programs normally do and specific developmental pathways need to be addressed.
authors.affiliation: Institute of Epidemiology and Social Medicine, University of Greifswald, Walther-Rathenau-Strasse 48, DE-17487 Greifswald, Germany. sebastian.baumeister@uni-greifswald.de
authors.forename: S E
authors.initials: SE
authors.lastname: Baumeister
authors.forename: P
authors.initials: P
authors.lastname: Tossmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000437:Alcoholism / Q000453:epidemiology*; D002648:Child; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology*