title: Effects of prenatal cocaine/polydrug exposure on substance use by age 15.
abstract: OBJECTIVE
  Examined effects of prenatal cocaine exposure (PCE) on tobacco, alcohol, marijuana and cocaine use by age 15.
  
  
  METHODS
  Adolescent (n=358; 183 PCE, 175 non-prenatally cocaine exposed; NCE) drug use was assessed using urine, hair, and/or blood spot samples and self-report (Youth Risk Behavior Surveillance System; YRBSS) at ages 12 and 15. Logistic regression assessed effects of PCE on drug use controlling for other drug exposures, environment and blood lead levels (BLL).
  
  
  RESULTS
  Adjusted percentages of drug use (PCE vs. NCE) were: tobacco 35% vs. 26% (p<.04), marijuana 33% vs. 23% (p<.04), alcohol 40% vs. 35% (p<.01), and any drugs 59% vs. 50% (p<.005). PCE adolescents were twice as likely to use tobacco (OR=2.02, 95% CI=1.05-3.90, p<.04), 2.2 times more likely to use alcohol (OR=2.16, 95% CI=1.21-3.87, p<.01) and 1.8 times more likely to use marijuana (OR=1.81, 95% CI=1.02-3.22, p<.04) than NCE adolescents. A race-by-cocaine-exposure interaction (p<.01) indicated PCE non-African American adolescents had greater probability of tobacco use (65%) than NCE non-African American youth (21%). PCE was associated with any drug use (OR=2.16, CI=1.26-3.69, p<.005), while higher BLL predicted alcohol use (p<.001). Violence exposure was a predictor of tobacco (p<.002), marijuana (p<.0007) and any drug (p<.04).
  
  
  CONCLUSIONS
  PCE and exposure to violence increased the likelihood of tobacco, marijuana or any drug use by age 15, while PCE and higher early BLL predicted alcohol use. Prevention efforts should target high risk groups prior to substance use initiation.
authors.affiliation: Case Western Reserve University Jack, Joseph and Morton Mandel School of Applied Social Sciences, United States. Electronic address: sonia.minnes@case.edu.
authors.forename: Sonia
authors.initials: S
authors.lastname: Minnes
authors.affiliation: Case Western Reserve University School of Medicine, Departments of Pediatrics, Psychiatry and Environmental Health Sciences, United States.
authors.forename: Lynn
authors.initials: L
authors.lastname: Singer
authors.affiliation: Case Western Reserve University Jack, Joseph and Morton Mandel School of Applied Social Sciences, United States.
authors.forename: Meeyoung O
authors.initials: MO
authors.lastname: Min
authors.affiliation: Case Western Reserve University Jack, Joseph and Morton Mandel School of Applied Social Sciences, United States.
authors.forename: Miaoping
authors.initials: M
authors.lastname: Wu
authors.affiliation: Case Western Reserve University Jack, Joseph and Morton Mandel School of Applied Social Sciences, United States.
authors.forename: Adelaide
authors.initials: A
authors.lastname: Lang
authors.affiliation: Case Western Reserve University Jack, Joseph and Morton Mandel School of Applied Social Sciences, United States.
authors.forename: Susan
authors.initials: S
authors.lastname: Yoon
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002675:Child, Preschool; D019970:Cocaine-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult
keywords: Adolescent substance use; Lead; Prenatal cocaine exposure; Violence