Predictors of Early-Onset Cannabis Use in Adolescence and Risks for Substance Use Disorder Symptoms in Young Adulthood

Abstract

Early detection of risks for substance use disorders is essential to lifelong health and well-being for some youth. Very early-onset use is proposed as an indicator of risk for substance use disorders, but risk and protective factors related to early-onset use have not been identified. The current study compared risk and protective factors that distinguish early- and late-onset cannabis users from abstainers using data collected from a large community sample. The study also examined onset-group differences in participants’ reports of substance use disorder symptoms a decade later. Heavy episodic drinking (early-onset: OR = 7.29 CI = [1.60, 33.19]) and engagement with peers involved in deviant behaviors (early-onset: OR = 2.50 CI = [1.50, 4.13]) are risk factors for early-onset cannabis use. Protective factors, including parent monitoring (early-onset: OR = 0.73 CI = [0.58, 0.93]), engagement with peers involved in positive behaviors (early-onset: OR = 0.54 CI = [0.39, 0.76]), school engagement (early-onset: OR = 0.83 CI = [0.72, 0.96]), and academic grades (early-onset: OR = 0.37 CI = [0.21, 0.65]) also predicted early versus later onset-group differences. Early age of onset may be distinctly related to risk and protective factors previously associated with risks for substance use in all adolescents.

Factors associated with cannabis use in early adolescence

“…In contrast to reports that parental lifetime and past-year cannabis use was associated with use by adolescents aged 12 to 17 years, [44][45][46] we did not detect an association in the current study. We also found no association between parental smoking, drinking or binge drinking and early cannabis use.…”

Parent-child Relations, Religiousness, and Adolescent Substance Use Disorders

“…The treatment effects literature recommends that selection models include a substantial set of covariates to ensure that prediction is maximized. The covariates comprised many found in previous studies of adolescent SUDs (Chassin et al, 2014;Gray & Squeglia, 2018;Merrin, Leadbeater, Sturgess, Ames, & Thompson, 2022;Rajapaksha et al, 2022) and in research on parent-child relations and adolescent religiousness (Pearce, Uecker & Denton, 2019;Smetana & Rote, 2019;Smith, 2003;Smith & Adamczyk, 2021). The following demographic variables were included: gender (female or male); age (12-17); family income; family structure (e.g., two parent, single mother); living above or below the poverty level; residing in a metro or non-metro area; and race/ethnicity (white, African American, Latinx, Asian, Indigenous, other).…”

Can High and Consistent School‐Related Protective Factors Prevent Cannabis Use Among American Indian Middle School Students?

“…In the context of adolescent cannabis use, risk factors are variables that increase likelihood of cannabis use, while protective factors (also commonly referred to as health‐promoting, or promotive factors) decrease likelihood of cannabis use. Moreover, as described by Leadbetter and colleagues, 9,10 the various protective elements within an adolescent's social environment can significantly influence them, providing a robust counter to the potential use of cannabis. These elements can shape belief systems or establish social connections that conflict with early substance use, providing the required resources and environments to foster self‐confidence and personal growth.…”

“…In an Australian sample of secondary school students (approximately age 14), students who felt connected to school (defined by commitment to school, positive relationships with teachers and peers, opportunities to participate in school, and sense of belonging in school) had a lower odds of substance use (including cannabis use) 16 . In a longitudinal study of Canadian adolescents, school engagement (a 4‐item scale that measured relationships with teachers and satisfaction in school) and academic grades in school were associated with a lower odds of early onset cannabis use 9 . In a longitudinal sample of urban adolescents in New York, an early warning index of school problems based on official school records (including standardized test scores, poor attendance, failing one or more core subjects, school suspension and grade retention), was associated with problem substance use (a measure which included cannabis and other illicit drugs) during adolescence, the transition to adulthood, and into adulthood 17 .…”