title: Polydrug use among urban adolescent cigarette smokers.
abstract: Adolescent smokers are at increased risk for polydrug use, which is associated with more consequences than use of a single drug. Here we classified subgroups of polydrug use among urban adolescent cigarette-smokers; described the sociodemographic, smoking, and depression correlates; and identified three-year outcomes associated with subgroup membership.
  
  
  
  Adolescent cigarette smokers (N=176; Mage=16.1; 35% male; 27% white) completed surveys assessing drug use, smoking characteristics, demographics, and depressive symptoms at baseline and 12, 24, and 36months follow-up.
  
  
  
  Almost all participants (96%) reported using, on average, two (SD=0.97) substances (including other tobacco products) in addition to cigarettes. Latent class analysis revealed two distinct classes of polydrug users. "Limited Range Use" (84%) class members reported current use of other tobacco, alcohol, and marijuana, as did "Extended Range Use" class members (16%) who also reported current use of "harder drugs" (i.e., cocaine/crack, hallucinogens, ecstasy, and misused prescriptions). The classes did not differ on demographics or baseline likelihood of marijuana (χ2=0.25; p<0.62) or alcohol use (χ2=3.3; p<0.07). At baseline, a larger proportion of Extended Range Use class members reported both smoking the entire cigarette and symptoms of clinical depression. Extended Range Use class membership at baseline predicted higher mean depression scores at 24 and 36months.
  
  
  
  Adolescent cigarette-smokers who reported extended range use (18%) also reported symptoms of clinical depression at baseline and follow-up. These findings indicate a need for early monitoring of depression symptoms and prevention and cessation interventions targeting this high-risk group.
authors.affiliation: Center for Tobacco Control Research and Education, University of California, San Francisco, 530 Parnassus Avenue, Suite 366, San Francisco, CA 94143, USA. Electronic address: Karma.McKelvey@ucsf.edu.
authors.forename: Karma L
authors.initials: KL
authors.lastname: McKelvey
authors.affiliation: Center for Tobacco Control Research and Education, University of California, San Francisco, 530 Parnassus Avenue, Suite 366, San Francisco, CA 94143, USA; Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, Box TRC 0984, San Francisco, CA 94143, USA.
authors.forename: Danielle E
authors.initials: DE
authors.lastname: Ramo
authors.affiliation: Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, Box TRC 0984, San Francisco, CA 94143, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Delucchi
authors.affiliation: Department of Pediatrics, 3333 California Street, Suite 245, San Francisco, CA 94118, USA.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Rubinstein
mesh_terms: D000293:Adolescent; D000073865:Cigarette Smoking; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012495:San Francisco / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control; D014504:Urban Health
chemical_list: D004338:Drug Combinations
keywords: Adolescent; Polydrug use; Smoking; Substance use; Tobacco