Longitudinal associations between youth tobacco and substance use in waves 1 and 2 of the Population Assessment of Tobacco and Health (PATH) Study

Introduction:
This text discusses a longitudinal study examining the bidirectional associations between tobacco use and substance use among U.S. youth. The study aims to identify the strength and direction of these associations across a range of tobacco products and substances.

Key Points:

* The study uses data from the Population Assessment of Tobacco and Health (PATH) Study, an ongoing longitudinal study of U.S. adults and youth.
* The analysis includes 11,996 youth aged 12-17 years, with data from Waves 1 and 2.
* The study examines the associations between ever tobacco use and subsequent substance use, and ever substance use and subsequent tobacco use.
* Controlling for demographic characteristics, sensation seeking, past-year mental health problems, and prior and concurrent use of other tobacco products and substances.
* Across tobacco products, associations were consistent with marijuana (except pipes, smokeless tobacco, and snus pouches) and other drugs (except smokeless tobacco).
* Ever alcohol and non-prescribed Ritalin/Adderall use consistently predicted subsequent tobacco use across all products assessed.
* Ever marijuana use predicted subsequent tobacco use across all products except smokeless tobacco.
* Bidirectional associations between e-cigarette use and any drug use (including and excluding alcohol) not only extend cross-sectional findings among U.S. high school seniors but may also suggest common factors underlying the use of e-cigarettes, cigarettes, and any drugs.

Main Message:
The study found bidirectional associations between tobacco use and substance use among U.S. youth, indicating that ever tobacco use predicted subsequent alcohol or any drug use, and ever alcohol or any drug use predicted subsequent tobacco use. These associations were robust to numerous potential confounders, including demographic characteristics, sensation seeking, past-year mental health problems, and prior and concurrent use of other tobacco products and substances. The findings suggest that preventive and intervention efforts may benefit from a comprehensive screening of tobacco, alcohol, and drug use among youth. Additionally, future research should identify risk factor(s) shared across substances that, when mitigated most effectively, prevent the onset of substance use in youth.

Silveira, Marushka L., Kevin P. Conway, Victoria R. Green, Karin A. Kasza, James D. Sargent, Nicolette Borek, Cassandra A. Stanton, et al. “Longitudinal Associations between Youth Tobacco and Substance Use in Waves 1 and 2 of the Population Assessment of Tobacco and Health (PATH) Study.” Drug and Alcohol Dependence 191 (October 2018): 25–36. https://doi.org/10.1016/j.drugalcdep.2018.06.018.