Cited by 61Substance Abuse Treatment and OutcomesYouth, Drugs, and ViolenceSmoking Behavior and Cessation

Predictors of initiation of nicotine, alcohol, cannabis, and cocaine use: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

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Blanco, Carlos, Flórez‐Salamanca, Ludwing, Secades‐Villa, Roberto, Wang, Shuai, Hasin, Deborah S.·2018·The American Journal on Addictions

Abstract

Background and Objectives: There may be substantial overlap in the risk factors for substance use and substance use disorders (SUD). Identifying risk factors for substance use initiation is essential for understanding the etiology and natural history of SUD and to develop empirically‐based preventive interventions to reduce initiation. Methods: Analyses were done on Wave 1 participants of the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) (n = 43,093). Estimates of the cumulative probability of substance use initiation were obtained separately for nicotine, alcohol, cannabis, and cocaine. Survival analyses with time‐varying covariates were implemented to identify risk factors for substance initiation. Results: The lifetime cumulative probabilities of substance initiation were 45.5% for nicotine, 82% for alcohol, 19.6% for cannabis, and 6.4% for cocaine. Among respondents with lifetime nicotine use, 50% had used it by age 15.3, whereas for alcohol, cannabis, and cocaine the respective ages were 17.8, 16.6, and 19.8. Previous use of another substance, being male, having a cluster B personality disorder, family history of SUD, and being separated, divorced, or widowed increased the risk of use of all the substances assessed, whereas social anxiety disorder and some personality disorders were associated with specific substances. Discussion and Conclusions: Although the age of substance use initiation varies by substance, in more than 50% of cases initiation of use occurs in the first two decades of life. Although most risk factors for substance use initiation are common across substances, some are substance‐specific. Scientific Significance: This information may help in the development of empirically‐based preventive interventions. (Am J Addict 2018;27:477–484)

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Crossref · 10.1111/ajad.12764

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Authors
Blanco, C., Flórez‐Salamanca, L., Secades‐Villa, R., Wang, S., & Hasin, D. S.
Affiliations
  • National Institute on Drug Abuse (US)
  • New York State Psychiatric Institute (US)
  • Universidad de Oviedo (ES)
Corresponding author
Flórez‐Salamanca, Ludwing
Venue
The American Journal on Addictions
Publisher
Wiley
Published
2018-08-07
Volume
27
Issue
6
Pages
477-484
ISSN
  • 1055-0496 (ISSN-L)
  • 1521-0391
OpenAlex
W2887263992
Cited by
61
References
42
Citations by year
2026: 2 · 2025: 14 · 2024: 4 · 2023: 10 · 2022: 9 · 2021: 11 · 2020: 5 · 2019: 6
FWCI
4.29
Type
journal article
Language
en
Open access
Locations
  • American Journal on Addictions (publishedVersion)
  • PubMed (publishedVersion)
  • Consultation of the Doctoral Thesis Database (TESEO) (Ministerio de Educación, Cultura y Deporte) (submittedVersion, cc-by-nc-nd)
Funders
NIH Clinical Center (AA014223, AA018111, CA133050, DA019606, DA020783, DA023200, DA023973)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Demography › Youth, Drugs, and Violence
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Keywords
substance use initiation, nicotine use, alcohol consumption, cannabis use, cocaine use, risk factors, age of initiation, personality disorders, social anxiety disorder, family history of substance use disorder, marital status, substance use prevention
MeSH terms
Adolescent, Adult, Marijuana Abuse, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Risk Factors, Tobacco Use Disorder, United States, Age of Onset, Cocaine-Related Disorders, Alcohol-Related Disorders

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