Alcohol, marijuana, and tobacco use patterns among youth in Canada

Division of Preventive Oncology, Cancer Care Ontario, 620 University Avenue, Toronto, ON, Canada M5G 2L7.
Cancer Causes and Control (Impact Factor: 2.74). 06/2008; 19(4):361-9. DOI: 10.1007/s10552-007-9095-4
Source: PubMed


The authors characterized changes in the prevalence of alcohol, tobacco, and marijuana use over time, and examined age of onset, co-morbid use and sociodemographic factors associated with ever using alcohol, tobacco, or marijuana in a nationally representative sample of Canadian youth. Data were collected from students in grades 7-9 as part of the Canadian Youth Smoking Survey (n = 19,018 in 2002; n = 29,243 in 2004). Descriptive analyses examined age of onset, co-morbid substance use and changes over time. Logistic regression models were used to examine factors associated with ever trying alcohol, tobacco, or marijuana with the 2004 data. Alcohol was the most prevalent substance used by youth and it was also the only substance which exhibited increased rates of use between 2002 and 2004. Co-morbid substance use was common, and it was rare to find youth who had used marijuana or tobacco without also having tried alcohol. As expected, youth who had poorer school performance were more likely to drink and smoke marijuana or tobacco, as were youth with more disposable income. Such timely and relevant data are important for guiding future policy, programming, and surveillance activities.

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Available from: Rashid Ahmed, May 21, 2014
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    • "In other words, marijuana use may account for some of the elevated health/functional impairments associated with ARPG in adolescents, specifically in relation to mild-to-moderate substance-use behaviors and low-average grades. Our results are consistent with previous studies in which adolescent marijuana use has been linked to functional impairments including increased alcohol and tobacco use, lower grade-point average, and high school dropout (Bray et al., 2000; Brook et al., 2008; Leatherdale et al., 2008; Reboussin et al., 2007) and the notion that marijuana use may link to experimentation with a wide range of substances (i.e., as a “gateway” drug). The current findings suggest that some of these “gateway” behaviors may also link to problematic gambling. "
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    ABSTRACT: Background and aims: Gambling is common in adolescents and at-risk and problem/pathological gambling (ARPG) is associated with adverse measures of health and functioning in this population. Although ARPG commonly co-occurs with marijuana use, little is known how marijuana use influences the relationship between problem-gambling severity and health- and gambling-related measures. Methods: Survey data from 2,252 Connecticut high school students were analyzed using chi-square and logistic regression analyses. Results: ARPG was found more frequently in adolescents with lifetime marijuana use than in adolescents denying marijuana use. Marijuana use was associated with more severe and a higher frequency of gambling-related behaviors and different motivations for gambling. Multiple health/functioning impairments were differentially associated with problem-gambling severity amongst adolescents with and without marijuana use. Significant marijuana-use-by-problem-gambling-severity-group interactions were observed for low-average grades (OR = 0.39, 95% CI = [0.20, 0.77]), cigarette smoking (OR = 0.38, 95% CI = [0.17, 0.83]), current alcohol use (OR = 0.36, 95% CI = [0.14, 0.91]), and gambling with friends (OR = 0.47, 95% CI = [0.28, 0.77]). In all cases, weaker associations between problem-gambling severity and health/functioning correlates were observed in the marijuana-use group as compared to the marijuana-non-use group. Conclusions: Some academic, substance use, and social factors related to problem-gambling severity may be partially accounted for by a relationship with marijuana use. Identifying specific factors that underlie the relationships between specific attitudes and behaviors with gambling problems and marijuana use may help improve intervention strategies.
    Full-text · Article · Jun 2014 · Journal of Behavioural Addictions
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    • "In 2009, 34.6% of smokers aged 18 to 25 reported past-month cannabis use compared with 8.9% of young adult nonsmokers [1]. Depending on definitions of use, tobacco use increases the risk of cannabis use from 2 (e.g., past 30-day tobacco use is associated with past 30-day marijuana use [2]) to 52 times (e.g., having ever tried tobacco is associated with having ever tried marijuana [3]) in adolescents, and 3 to 6.4 times in adults [4-6]. "
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    ABSTRACT: There is elevated prevalence of marijuana use among young adults who use tobacco, but little is known about the extent of co-use generated from surveys conducted online. The purpose of the present study was to examine past-month marijuana use and the co-use of marijuana and tobacco in a convenience sample of young adult smokers with national US coverage. Young adults age 18 to 25 who had smoked at least one cigarette in the past 30 days were recruited online between 4/1/09 and 12/31/10 to participate in an online survey on tobacco use. We examined past 30 day marijuana use, frequency of marijuana use, and proportion of days co-using tobacco and marijuana by demographic characteristics and daily smoking status. Of 3512 eligible and valid survey responses, 1808 (51.5%) smokers completed the survey. More than half (53%, n = 960) of the sample reported past-month marijuana use and reported a median use of 18 out of the past 30 days (interquartile range [IR] = 4, 30). Co-use of tobacco and marijuana occurred on nearly half (median = 45.5%; IR = 13.1, 90.3) of the days on which either substance was used and was more frequent among Caucasians, respondents living in the Northeast or in rural areas, in nonstudents versus students, and in daily versus nondaily smokers. Residence in a state with legalized medical marijuana was unrelated to co-use or even the prevalence of marijuana use in this sample. Age and household income also were unrelated to co-use of tobacco and marijuana. These results indicate a higher prevalence of marijuana use and co-use of tobacco in young adult smokers than is reported in nationally representative surveys. Cessation treatments for young adult smokers should consider broadening intervention targets to include marijuana.
    Full-text · Article · Apr 2012 · Addiction science & clinical practice
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    • "Among those who use TOB, the risk for MJ use is two to 52 times higher for adolescents (e.g., Abdel-Ghany & Wang, 2003; Everett, Malarcher, Sharp, Husten, & Giovino, 2000; Leatherdale, Hammond, & Ahmed, 2008) and 3 to 6.4 times greater for young adults (Agrawal & Lynskey, 2009; Clough, 2005; Leatherdale, Hammond, Kaiserman, & Ahmed, 2007), depending on the exact definitions of TOB and MJ used. For example, in the 2004 Canadian Youth Smoking Survey of 7 th to 9 th graders, having ever tried TOB was associated with 52 times greater likelihood of having ever used MJ compared to never trying TOB (Leatherdale et al., 2008), while in the 1997 Youth Risk Behavior Survey for high school students in the U.S., past 30 day use of multiple TOB substances was associated with 31 times greater odds of past 30 day MJ use compared to no TOB use (Everett et al., 2000). "
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    ABSTRACT: Tobacco (TOB) and marijuana (MJ) are the most widely used drugs among adolescents and young adults. The literature on their co-use, however, has not been systematically reviewed. We identified 163 English language articles published from 1999 to 2009 examining TOB and MJ co-use, correlates or consequences of co-use, or interventions for prevention or cessation of co-use with participants aging 13-25 years. Most studies (n=114, 70%) examined TOB and MJ co-use, and 85% of relationships studied indicated a significant association. Fifty-nine studies (36%) examined correlates or consequences of co-use. Factors consistently associated with increased likelihood of co-use, defined as significant associations in at least four studies, were African-American ethnicity, mental and physical health characteristics (e.g., high-intensity pleasure temperament), and school characteristics (e.g., good grades). The only consistent consequence of co-use was exacerbation of mental health symptoms. Few studies examined prevention (n=3) or cessation (n=2) interventions for TOB and MJ co-use, and the findings were stronger for prevention efforts. A sufficient literature base has documented that TOB and MJ use are strongly related in young people, yet few consistent correlates and consequences of co-use have been identified to inform intervention targets.
    Full-text · Article · Mar 2012 · Clinical psychology review
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