The relationship of early-onset regular smoking to alcohol use, depression, illicit drug use, and other risky behaviors during early adolescence: Results from the youth supplement to the Third National Health and Nutrition Examination Survey

Purpose: Recently we found that the early onset of regular tobacco use is a s predictive of lifetime drug use and depressive disorders as it is of alco hol use disorders [Alcohol.: Clin. Exp. Res. 23 (1999) 513.]. This finding, which paralleled findings regarding early onset of alcohol use [J. Subst. Abuse 10 (1998) 59.], suggested that early regular use of any drug might si mply be an indicator of risk for a constellation of problem behaviors. The purpose of the present study is to test this hypothesis as well as to study the strength and patterns of associations among these problem behaviors al ready present among youth. The results will permit description of more prec ise profiles to identify groups of children at risk. Methods: Using data fo r respondents aged 12-16 from the Third National Health and Nutrition Exami nation Survey (NHANES III), descriptive statistics were calculated and logi stic regression models were estimated. Results: Descriptive analyses indica ted that in comparison with those who never smoked, or who simply experimen ted, early-onset regular smokers, both those who began at age 13 or younger and those who did so between 14 and 16, were those most likely to use alco hol and other drugs as well as have school problems and early sexual experi ences culminating in pregnancy. Multivariate logistic regression analyses w ere conducted to assess the associations among these high-risk behaviors. I mplications: These results support the hypothesis that early onset of smoki ng is but an indicator of a syndrome of problem behaviors already in place during childhood. They also suggest that the significance of an age onset v ariable may differ depending on the age of the sample used. As follow-up da ta are collected, we expect to learn much about the natural course of the d istinct risk groups identified in the analyses by studying longitudinally t his nationally representative group of early adolescents. (C) 2001 Elsevier Science Inc. All rights reserved.