The role of first use of inhalants within sequencing pattern of first use of drugs among Brazilian university students.

Abstract

The present study investigated the role of first use of inhalants within a first drug sequencing pattern. In a representative sample of university students from 27 Brazilian capitals (n=12,711), we analyzed the patterns of transition from/to first use of inhalants to/from the first use of alcohol, tobacco, cannabis, cocaine, hallucinogens, ecstasy, amphetamines, prescription opioids, and tranquilizers. Cox proportional hazards models were used to analyze data. Drugs that were not specified as the pair of drugs tested in each model were included as time-varying covariates in all models. In this sample, first use of inhalants was preceded only by the first use of alcohol and tobacco. However, first use of inhalants preceded first use of cannabis, amphetamines, cocaine, and tranquilizers. First use of inhalants preceded the first use of prescription opioids, and vice versa. This study highlights the need to intervene early with youths who are at risk of or just beginning to use inhalants, since this class of drugs seems to be the first illegal drug in Brazil to be experimented by respondents in our sample. There is also a call for attention to individuals who have already first used inhalants because of their higher chance to experiment with other drugs such as cannabis, cocaine, and prescription drugs. All these findings show an in-transition culture of drug use, which should be tracked through the time, since some classical models (i.e., gateway model) might be outdated and might also not fit within different settings.

In‐transition culture of experimentation with cannabis in Latin American college students: A new role within a potential drug use sequencing pattern

“…In Brazil, our group recently conducted some studies using the same sample of the present study . We found that cannabis use does not seem to precede the use of inhalants and amphetamines , despite having prevalence of cannabis use (19.8%) higher than these other drugs (16.6% and 8.4%, respectively).…”

The Gateway Hypothesis, Common Liability to Addictions or the Route of Administration Model? A Modelling Process Linking the Three Theories

“…However, subjects who initiated inhalants and who did not start the sequence with tobacco were more at risk to initiate OID first or after tobacco or cannabis. Inhalant use is rare in France [42] but some research conducted in Brazil, where these substances are used widely, showed that first use of inhalants followed tobacco initiation but preceded the first use of some illicit substances, suggesting that inhalants should be included in the second step of the gateway model in association with cannabis [43,44] .…”

Effect of Adolescent Cigarette Smoking on Adulthood Substance Use and Abuse: The Mediating Role of Educational Attainment

“…One of the signaling behaviors that researchers and policy makers are interested in for intervention is early cigarette smoking (Castaldelli-Maia, Nicastri, Garcia de Oliveira, Guerra de Andrade, & Martins, 2014; Mathers, Toumbourou, Catalano, Williams, & Patton, 2006). …”

“…In the review by Mathers et al (2006)—based on longitudinal studies from 1980 to 2005 that looked at the association between tobacco use under 18 years of age and outcomes at 18 years of age or older—early tobacco smoking was a risk marker for later alcohol initiation and alcohol-related problems, such as alcohol abuse, dependence, and binge drinking (Brook et al, 2002; Ellickson et al, 2001; Lewinsohn, Rohde, & Brown, 1999). A retrospective study that used a non-U.S. sample evaluated the transitions of drug use involving inhalants, and also found a transition from tobacco to inhalants (Castaldelli-Maia et al, 2014). In longitudinal studies that examined the association between adolescent smoking and substance abuse, age at follow-up ranged from 18 to 32 years; the majority of follow-up times were under age 30 (Mathers et al, 2006).…”