Good Practices
Early use of substances (I)
People involved in substance abuse prevention pay quite a bit of attention to the age that young people begin to first use alcohol and tobacco. This is because early use of these substances has been linked with later substance use problems. For example, a recent large US study found that the age of first use is a powerful predictor of later alcohol abuse and dependence. The study found that 40 per cent of those who began drinking alcohol at 14 years of age or younger experienced alcoholism at some point in their lives, in contrast to roughly 10 per cent of those who began drinking at age 20 or older.
This has led some people to conclude that early use actually causes alcoholism. Two studies in this month's (August 2001) edition of the journal, Alcoholism: Clinical and Experimental Research, suggest that this isn't quite the case. The study found that early drinking was linked with a number of other problems in adulthood in addition to alcoholism (e.g., poorer mental health, poorer educational performance). But the findings also suggested that the early age of first drinking was not the cause of the later problems -- rather the authors concluded that early use was itself a symptom of earlier problems in the child's development (with self-esteem, family relations, etc).
The age in which young people begin to use tobacco, alcohol and other substances varies greatly around the world. In Canada, for example, most people begin smoking tobacco in the 11-15 age range (only 14 per cent begin after 20 years of age). The risks associated with starting to smoke at an early age are clear. The earlier young people begin smoking daily -- an indication of dependency -- the more cigarettes they are likely to smoke, the less likely they are to quit and the more likely they are to be heavy smokers as adults.
In Canada again, the average age of first use of alcohol is 12 or 13 years. First use of cannabis occurs for a significant number of Canadian youth at ages 14 and 15. First use of other substances typically occurs in the following years. An exception to this pattern is the use of inhalants, which appears to occur in the years before adolescence among those that use these substances.
What information do network members have on the ages of first use of different substances? Is the age of first use important information to be collecting?
References:
Grant, B.F., Dawson, D.A. Age of Onset of Alcohol Use and its Association with DSM-IV Alcohol Abuse and Dependence: Results from the National Longitudinal Alcohol Epidemiological Survey. Journal of Substance Abuse, Vol. 9, 1997.
Chen, J., Millar, W. Age of smoking initiation: implications for quitting, National Population Health Survey, Statistics Canada, Health Reports, Spring, Vol. 9, No. 4, 1998.
McGue, M, et al. Origins and consequences of age at first drink. I. Familial risk and heritability; II. Association with substance use disorders, disinhibitory behaviours and psychopathology and P3 amplitude. Alcoholism: Clinical and Experimental Research. Research Society on Alcoholism. Baltimore, MD, August 2001.