title: Early adolescent patterns of alcohol, cigarettes, and marijuana polysubstance use and young adult substance use outcomes in a nationally representative sample.
abstract: BACKGROUND
  Alcohol, tobacco and marijuana are the most commonly used drugs by adolescents in the U.S. However, little is known about the patterning of early adolescent substance use, and its implications for problematic involvement with substances in young adulthood. We examined patterns of substance use prior to age 16, and their associations with young adult substance use behaviors and substance use disorders in a nationally representative sample of U.S. adolescents.
  
  
  METHODS
  Using data from Wave 4 of the Add Health Survey (n=4245), we estimated the prevalence of various patterns of early adolescent use of alcohol, cigarettes, and marijuana use individually and in combination. Then we examined the effects of patterns of early use of these substances on subsequent young adult substance use behaviors and DSM-IV substance use disorders.
  
  
  RESULTS
  While 34.4% of individuals reported no substance use prior to age 16, 34.1% reported either early use of both alcohol and marijuana or alcohol, marijuana and cigarettes, indicating the relatively high prevalence of this type of polysubstance use behavior among U.S. adolescents. Early adolescent use of all three substances was most strongly associated with a spectrum of young adult substance use problems, as well as DSM-IV substance use disorder diagnoses.
  
  
  CONCLUSIONS
  This research confirms the elevated prevalence and importance of polysubstance use behavior among adolescents prior to age 16, and puts early onset of alcohol, marijuana and cigarette use into the context of use patterns rather than single drug exposures.
authors.affiliation: National Institute on Alcohol Abuse and Alcoholism, United States. Electronic address: psych.hmossmd@gmail.com.
authors.forename: Howard Barry
authors.initials: HB
authors.lastname: Moss
authors.affiliation: Alcohol Epidemiologic Data System, CSR, Incorporated, United States.
authors.forename: Chiung M
authors.initials: CM
authors.lastname: Chen
authors.affiliation: Alcohol Epidemiologic Data System, CSR, Incorporated, United States.
authors.forename: Hsiao-Ye
authors.initials: HY
authors.lastname: Yi
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005006:Ethnicity; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology* / Q000523:psychology*; D015995:Prevalence; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Adolescent; Alcohol; Cigarettes; Marijuana; Polysubstance use; Substance use disorders