Early and Late Adolescent Factors that Predict Co-use of Cannabis with Alcohol and Tobacco in Young Adulthood

• DOI: 10.1007/s11121-020-01086-7
• Publication Date: 2020-01-20T19:02:38Z
• Authors: Elizabeth J. D’Amico; Anthony Rodriguez; Joan S. Tucker; Michael S. Dunbar; Eric R. Pedersen; Regina A. Shih; Jordan P. Davis; Rachana Seelam
• Keywords: Adult; Male; Adolescent; Alcohol Drinking; 150; 610; Marijuana Smoking; Underage Drinking; Adolescents; Risk Assessment; California; Clinical and health psychology; Substance Misuse; Alcohol Use and Health; Co-use; Tobacco Use; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Clinical Research; Risk Factors; Surveys and Questionnaires; Behavioral and Social Science; Psychology; Humans; Minority Health; Functioning; Cannabis; Pediatric; Public health; Cannabinoid Research; Clinical and Health Psychology; Prevention; Substance Abuse; Marijuana; 3. Good health; Health Disparities; Alcoholism; Good Health and Well Being; Cross-Sectional Studies; Adolescent Behavior; Public Health and Health Services; Women's Health; Mental health; Female; Alcohol; Young adults

The changing legal landscape of cannabis in the USA has coincided with changes in how cannabis is used, including its co-use with other substances. This study analyzed 10 years of data from a diverse cohort of youth (N = 2429; 54% Hispanic, 16% Asian, 16% white, 3% black, 10% multiracial) to examine predictors in early and late adolescence of co-use of alcohol with cannabis (AC) and tobacco with cannabis (TC) at age 21. Two forms of co-use were examined: concurrent (use of both substances in past month) and sequential (use of one substance right after the other). Analyses focused on four predictor domains: individual (e.g., resistance self-efficacy), peer (e.g., time spent around peers who use), family (e.g., sibling use), and neighborhood (i.e., perceived alcohol and drug problems in neighborhood). For each co-use combination (AC or TC), we estimated parallel process piecewise latent growth models in a structural equation modeling framework using Mplus v8. The final AC and TC co-use models included all predictor variables from the four domains. Increases in positive expectancies and time spent around peers who use AC, as well as steeper decreases in resistance self-efficacy, were all related to a greater likelihood of AC co-use in young adulthood. Increases in sibling TC use and time spent around peers who use TC, as well as steeper decreases in resistance self-efficacy, were all related to a greater likelihood of TC co-use in young adulthood. Overall, findings highlight the importance of addressing peer influence in prevention programming during both early and late adolescence.