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

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Abstract

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.

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Acknowledgements

The authors wish to thank the districts and schools who participated and supported this project. We would also like to thank Kirsten Becker and Jennifer Parker for overseeing the school survey administrations and the web-based surveys.

Funding

Work on this article was supported by funds from the Tobacco-Related Disease Research Program of the University of California, Grant Number 26IR-0011 to Joan Tucker, and three grants from the National Institute of Alcohol Abuse and Alcoholism (R01AA016577; R01AA020883; R01AA025848) to Elizabeth D’Amico.

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D’Amico, E.J., Rodriguez, A., Tucker, J.S. et al. Early and Late Adolescent Factors that Predict Co-use of Cannabis with Alcohol and Tobacco in Young Adulthood. Prev Sci 21, 530–544 (2020). https://doi.org/10.1007/s11121-020-01086-7

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  • DOI: https://doi.org/10.1007/s11121-020-01086-7

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