title: Early initiation of substance use and subsequent risk factors related to suicide among urban high school students.
abstract: OBJECTIVE
  To examine the association between onset of substance use and risk factors related to suicide.
  
  
  METHODS
  1252 adolescents in two urban school districts completed surveys as part of a large, randomized controlled prevention effectiveness trial. Risk factors measured included depressive symptoms, suicide ideation, suicide ideation specifically with alcohol and/or drug use, endorsement of suicide as a personal option, and suicide attempt.
  
  
  RESULTS
  In our final multivariate models that controlled for current substance use and demographic characteristics, we found that earlier onset of hard drug use among boys was associated with all five suicide risk factors. In comparison, among girls, earlier onset of regular cigarette smoking, getting drunk, and hard drug use was associated with some of suicide risk factors.
  
  
  CONCLUSIONS
  The findings confirm the importance of screening for substance use in early adolescence. The association between early substance use and suicide risk factors differed by gender; both research and intervention efforts need to incorporate gender differences.
authors.affiliation: The Pacific Institute for Research and Evaluation, 1516 E. Franklin St. Suite 200, Chapel Hill, NC 27514, United States. cho@pire.org
authors.forename: Hyunsan
authors.initials: H
authors.lastname: Cho
authors.forename: Denise Dion
authors.initials: DD
authors.lastname: Hallfors
authors.forename: Bonita J
authors.initials: BJ
authors.lastname: Iritani
mesh_terms: D017668:Age of Onset; D002648:Child; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D013334:Students / Q000523:psychology* / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control*; D013405:Suicide / Q000706:statistics & numerical data*; D013997:Time Factors; D014505:Urban Population / Q000706:statistics & numerical data*