Cigarette Smoking as a Predictor of Alcohol and Other Drug Use by Children and Adolescents: Evidence of the “Gateway Drug Effect”

Abstract

Data from a statewide survey, conducted by the Indiana Prevention Resource Center, of 20,629 Indiana students in grades 5-12 were analyzed to determine the extent to which cigarette smoking predicted use of alcohol and other drugs and acted as a so-called "gateway drug." A three-stage purposive/quota cluster sampling strategy yielded a representative sample of Indiana students, stratified by grade. Cross-tabulated data revealed a strong, dose-dependent relationship between smoking behavior and binge drinking, as well as use of alcohol and illicit drugs. Daily pack-a-day smokers were three times more likely to drink alcohol, seven times more likely to use smokeless tobacco, and 10-30 times more likely to use illicit drugs than nonsmokers. A stepwise multiple regression analyzed the role that the student's perceptions of the risk of using drugs and of peer approval/disapproval of the student's drug use, gender, grade in school, and ethnic background played in predicting alcohol and other drug use.

Alcohol and tobacco use disorders in a general population: short-term and long-term associations from the St. Louis Epidemiological Catchment Area Study

“…In addition, our finding that TD may lead to an AUD, and an AUD may lead to TD, is consistent with work showing a prospective association between alcohol and tobacco consumption (Fleming et al, 1989;Jackson et al, 2002;Rohde et al, 1995;Simon et al, 1995;Torabi et al, 1993). It is not unlikely, then, that desistence of use of one substance might lead to reduced use of the other substance, which has implications for prevention of substance use.…”

“…Bien and Burge, 1990;Istvan and Matarazzo, 1984), most work has been limited to cross-sectional analyses and/or use of consumption measures, particularly among adolescents (e.g. Fleming et al, 1989;Jackson et al, 2002;Rohde et al, 1995;Simon et al, 1995;Torabi et al, 1993). Although these studies are informative with regard to identifying risk factors for substance use onset, they fail to inform us about the etiology of a substance use disorder.…”

Perceived academic performance and alcohol, tobacco and marijuana use: Longitudinal relationships in young community adolescents

“…Apparent inconsistencies between our findings and others (in which cigarette use predicted later alcohol use, and change in alcohol use predicted development of cigarette use, Duncan, Duncan, and Hops (1998)), may arise from sample differences; our larger sample was not restricted to non-users at mean age 13, and our analysis controls for antisocial behaviour. Prevalence rates in our sample, in which approximately 80% have used alcohol, 33% tobacco and 35% marijuana by age 15, are similar to Australian (Drug Info Clearinghouse, 2002) and slightly higher than US reports (Torabi, Bailey, & Majd-Jabbari, 1993).…”

Parent–child connectedness and communication in relation to alcohol, tobacco and drug use in adolescence: An integrative review of the literature

“…Although it is understandable that substances are examined separately, given their differing legal frameworks and social acceptability of use, we argue that it is crucial to examine alcohol, tobacco and drug use together in one review. Adolescents tend to use more than one substance at a time (Fraga, Sousa, Ramos, Dias, & Barros, 2011;Torabi, Bailey, & Majd-Jabbari, 1993) so focussing on one substance, such as alcohol, does not necessarily reflect the reality of their use. Also, given that the legal status of each substance is different, parents may have different views on smoking and alcohol compared to drugs.…”