TY - JOUR
T1 - In-transition culture of experimentation with cannabis in Latin American college students
T2 - A new role within a potential drug use sequencing pattern
AU - Castaldelli-Maia, João Mauricio
AU - Nicastri, Sérgio
AU - Cerda, Magdalena
AU - Kim, June H.
AU - de Oliveira, Lúcio Garcia
AU - de Andrade, Arthur Guerra
AU - Martins, Silvia S.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Introduction and Aims: Given a scenario of intense discussion about the legal situation of cannabis users worldwide, this paper aims to investigate the role of cannabis within a drug use sequencing pattern. Design and Methods: Data came from a representative sample of college students from 27 Brazilian capitals (n = 12 711). We analysed the patterns of transition from/to the first use of cannabis to/from the first use of alcohol, tobacco and seven other illegal drugs. Survival analysis methods were used to analyse age of onset data on all potential drug pairs. Drugs that were not specified as the target drug pair tested in each survival model were included as time-varying covariates in all models. Results: We found significant transitions from alcohol [adjusted hazard ratio (aHR) = 1.41, 95% confidence interval (CI) 1.15–1.73, P < 0.001] and inhalants (aHR = 1.56, 95% CI 1.26–1.93, P < 0.001) to cannabis. Moreover, we found significant transitions from cannabis to alcohol (aHR = 2.40, 95% CI 1.47–3.91, P < 0.001), cocaine (aHR = 7.47, 95% CI = 4.26–13.09, P < 0.001), prescription opioids (aHR = 2.16, 95% CI 1.29–3.63, P < 0.01) and tranquilisers (aHR = 1.51, 95% CI 1.11–2.06, P < 0.01). Discussion and Conclusions: Overall, our findings point to a strategic role of cannabis within drug first use sequence pattern. We had an important and unexpected finding—the bi-directional relationship between alcohol and cannabis. In addition, the first use of cannabis still precedes the first use of cocaine and non-medical use of tranquilisers and prescription opioids. [Castaldelli-Maia JM, Nicastri S, Cerdá M, Kim JH, Oliveira LG, Andrade AG, Martins, SS. In-transition culture of experimentation with cannabis in Latin American college students: A new role within a potential drug use sequencing pattern. Drug Alcohol Rev 2017;00:000-000].
AB - Introduction and Aims: Given a scenario of intense discussion about the legal situation of cannabis users worldwide, this paper aims to investigate the role of cannabis within a drug use sequencing pattern. Design and Methods: Data came from a representative sample of college students from 27 Brazilian capitals (n = 12 711). We analysed the patterns of transition from/to the first use of cannabis to/from the first use of alcohol, tobacco and seven other illegal drugs. Survival analysis methods were used to analyse age of onset data on all potential drug pairs. Drugs that were not specified as the target drug pair tested in each survival model were included as time-varying covariates in all models. Results: We found significant transitions from alcohol [adjusted hazard ratio (aHR) = 1.41, 95% confidence interval (CI) 1.15–1.73, P < 0.001] and inhalants (aHR = 1.56, 95% CI 1.26–1.93, P < 0.001) to cannabis. Moreover, we found significant transitions from cannabis to alcohol (aHR = 2.40, 95% CI 1.47–3.91, P < 0.001), cocaine (aHR = 7.47, 95% CI = 4.26–13.09, P < 0.001), prescription opioids (aHR = 2.16, 95% CI 1.29–3.63, P < 0.01) and tranquilisers (aHR = 1.51, 95% CI 1.11–2.06, P < 0.01). Discussion and Conclusions: Overall, our findings point to a strategic role of cannabis within drug first use sequence pattern. We had an important and unexpected finding—the bi-directional relationship between alcohol and cannabis. In addition, the first use of cannabis still precedes the first use of cocaine and non-medical use of tranquilisers and prescription opioids. [Castaldelli-Maia JM, Nicastri S, Cerdá M, Kim JH, Oliveira LG, Andrade AG, Martins, SS. In-transition culture of experimentation with cannabis in Latin American college students: A new role within a potential drug use sequencing pattern. Drug Alcohol Rev 2017;00:000-000].
KW - cannabis
KW - college
KW - cross-sectional
KW - epidemiology
KW - experimentation
KW - gateway
KW - onset
UR - http://www.scopus.com/inward/record.url?scp=85019018141&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85019018141&partnerID=8YFLogxK
U2 - 10.1111/dar.12556
DO - 10.1111/dar.12556
M3 - Article
C2 - 28485092
AN - SCOPUS:85019018141
VL - 37
SP - 273
EP - 281
JO - Drug and Alcohol Review
JF - Drug and Alcohol Review
SN - 0959-5236
IS - 2
ER -