Which factors predict substance use initiation in kids?

Sociodemographic factors appear to be the strongest predictors of substance use initiation during early adolescence, according to a study. The addition of resource-intensive measures, such as hormones, neurocognitive assessment, and structural neuroimaging, does not lead to better prediction.

Substance use initiation was defined as trying any nonprescribed substance, such as alcohol, tobacco, and cannabis, among others, by age 12.

The authors followed 6,829 substance-naïve youths from the Adolescent Brain Cognitive Development Study (ages 9‑10 years) for 3 years. They examined a total of 420 variables as predictors of substance use initiation using a penalized logistic regression with elastic net.

The variables assessed included demographic characteristics, self and peer involvement with substance use, parenting behaviors, mental and physical health, culture and environment, hormones, neurocognitive functioning, and structural neuroimaging.

Of the children, 982 (14.4 percent) reported initiating substance use by the age of 12, with alcohol being the most common. Models with only self-report predictors showed a prediction performance similar to those that included hormones, neurocognitive factors, and neuroimaging predictors (AUC_test, 0.66).

The most robust predictor of substance use initiation was sociodemographic factors. This was followed by cultural and environmental factors, physical health factors, and parenting behaviours.

Specifically, the strongest predictor was a religious preference of Mormon (coefficient, ‑0.87), followed by a religious preference for Jewish (coefficient, 0.32), and by Black youths (coefficient, ‑0.32).

“The application of these large-scale findings in clinical settings could help to streamline and tailor prevention and early intervention efforts,” the authors said.