Stages of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory.
Abstract
Sequential stages of involvement in alcohol and/or cigarettes, marijuana, other illicit drugs and medically prescribed psychoactive drugs from adolescence to adulthood are investigated in a longitudinal cohort that has been followed from ages 15 to 35. Alternative models of progression are tested for their goodness of fit. Four stages are identified: that of legal drugs, alcohol or cigarettes; marijuana; illicit drugs other than marijuana; and medically prescribed drugs. Whereas progression to illicit drugs among men is dependent upon prior use of alcohol, among women either cigarettes or alcohol is a sufficient condition for progression to marijuana. Age of onset and frequency of use at a lower stage of drug use are strong predictors of further progression.
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Epidemiological data suggest that tobacco acts as a 'gateway' to subsequent substance abuse.
“Although epidemiological data suggest that tobacco acts as a ‘gateway’ to subsequent substance abuse (Kandel et al. 1992; Lai et al. 2000; Degenhardt et al. 2010), it is not clear from human studies whether this reflects social influences or a drug effect (Lindsay & Rainey, 1997; Anthony, 2012).”
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“The initiation of tobacco use during adolescence is of great concern, because it can result in long-term consequences including an increased risk of progression to use of other illegal drugs (Kandel et al. 1992), and a decreased probability of smoking cessation (Chen and Millar 1998).”
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- Authors
- Kandel, D. B., Yamaguchi, K., & Chen, K.
- Affiliations
- Columbia University (US)
- Venue
- Journal of Studies on Alcohol
- Publisher
- Alcohol Research Documentation, Inc.
- Published
- 1992-09
- Volume
- 53
- Issue
- 5
- Pages
- 447-457
- ISSN
- 0096-882X (ISSN-L)
- 1934-2683
- OpenAlex
- W2161886949
- Cited by
- 1,039
- References
- 1
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 6 · 2023: 11 · 2022: 13 · 2021: 18 · 2020: 25 · 2019: 25 · 2018: 26 · 2017: 30 · 2016: 24 · 2015: 51 · 2014: 38 · 2013: 38 · 2012: 34
- FWCI
- 13.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Studies on Alcohol (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (2r01da003196-05, 5r01da002867-06)
- National Institute on Drug Abuse (DA03196, DA 01097, DA02867)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Demography › Youth, Drugs, and Violence
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- gateway theory, adolescent drug use, alcohol consumption, cigarette smoking, cannabis use, illicit drug use, prescription drug use, sex differences, age of onset, longitudinal cohort
- MeSH terms
- Adolescent, Adult, Pharmaceutical Preparations, Female, Humans, Male, Illicit Drugs, Cohort Studies, Substance-Related Disorders
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