title: Concurrent alcohol and tobacco use during early adolescence characterizes a group at risk.
abstract: OBJECTIVE
  To investigate whether concurrent alcohol and tobacco use during early adolescence characterizes a subgroup that differs from users of one substance only regarding several risk factors for later substance use problems.
  
  
  METHODS
  Participants were from a prospective longitudinal cohort study of 384 children at risk for later psychopathology, with the majority being born with obstetric complications and psychosocial adversities. Assessments of adolescent drug consumption and related intrapersonal characteristics were obtained at age 15.
  
  
  RESULTS
  Compared to consumers of alcohol only, 15-year-olds drinking and smoking during the same time period (past 4 weeks) had significantly higher levels of consumption and more excessive use of alcohol, started drinking at an earlier age, had higher scores on the Fagerström Test for Nicotine Dependence, and more cannabis use. This group could be distinguished from users of alcohol only by higher novelty seeking and more positive alcohol effect expectancies. Compared to consumers of tobacco only, concurrent users reported higher nicotine dependence and more cannabis use. No significant differences were observed regarding frequency and age at initiation of tobacco use, tobacco-related sensitivity, self-efficacy and instrumentality as well as novelty seeking.
  
  
  CONCLUSIONS
  Concurrent alcohol and tobacco use during early adolescence is associated with characteristics that are well known as risk factors for later alcohol use problems and dependence and that should be targeted by prevention programs.
authors.affiliation: Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, P.O. Box 122120, D-68072 Mannheim, Germany.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Schmid
authors.forename: Erika
authors.initials: E
authors.lastname: Hohm
authors.forename: Dorothea
authors.initials: D
authors.lastname: Blomeyer
authors.forename: Ulrich S
authors.initials: US
authors.lastname: Zimmermann
authors.forename: Martin H
authors.initials: MH
authors.lastname: Schmidt
authors.forename: Günter
authors.initials: G
authors.lastname: Esser
authors.forename: Manfred
authors.initials: M
authors.lastname: Laucht
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D000428:Alcohol Drinking / Q000453:epidemiology*; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D014029:Tobacco Use Disorder / Q000453:epidemiology*