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Outcomes of occasional cannabis use in adolescence: 10-year follow-up study in Victoria, Australia

  • Louisa Degenhardt (a1), Carolyn Coffey (a2), John B. Carlin (a3), Wendy Swift (a1), Elya Moore (a4) and George C. Patton (a5)...

Abstract

Background

Regular adolescent cannabis use predicts a range of later drug use and psychosocial problems. Little is known about whether occasional cannabis use carries similar risks.

Aims

To examine associations between occasional cannabis use during adolescence and psychosocial and drug use outcomes in young adulthood; and modification of these associations according to the trajectory of cannabis use between adolescence and age 20 years, and other potential risk factors.

Method

A 10-year eight-wave cohort study of a representative sample of 1943 secondary school students followed from 14.9 years to 24 years.

Results

Occasional adolescent cannabis users who continued occasional use into early adulthood had higher risks of later alcohol and tobacco dependence and illicit drug use, as well as being less likely to complete a post-secondary qualification than non-users. Those using cannabis at least weekly either during adolescence or at age 20 were at highest risk of drug use problems in young adulthood. Adjustment for smoking in adolescence reduced the association with later educational achievement, but associations with drug use problems remained.

Conclusions

Occasional adolescent cannabis use predicts later drug use and educational problems. Partial mediation by tobacco use raises a possibility that differential peer affiliation may play a role.

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Copyright

Corresponding author

Correspondence: Louisa Degenhardt, National Drug and Alcohol Research Centre, University of New South Wales, 2052, NSW, Australia. Email: l.degenhardt@unsw.edu.au

Footnotes

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Funding has been provided by the Australian National Health and Medical Research Council and the Australian Government Department of Health and Ageing. The funding body had no role in the design, analysis or interpretation of study findings, nor in the decision to submit this paper for publication.

Declaration of interest

None.

Footnotes

References

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Outcomes of occasional cannabis use in adolescence: 10-year follow-up study in Victoria, Australia

  • Louisa Degenhardt (a1), Carolyn Coffey (a2), John B. Carlin (a3), Wendy Swift (a1), Elya Moore (a4) and George C. Patton (a5)...
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eLetters

So What?

Subas Pradhan, Doctor
10 May 2010

Dear editor,

I read the above article by Degenhardt et al titled "Outcomes of occasional cannabis use in adolescence: 10-year follow-up study in Victoria, Australia" published in the current issue of the journal with interest. It discusses a very pertinent topic of public health importance from Australia. I have few comments and concerns regarding this article.

It is a 10 year prospective population based cohort study which is the main attraction for the paper. The authors have used various statistics to measure a number of important psychosocial variables of the occasional cannabis users after 10 years from their inception.

However the following are some of my concerns re the study and it's implications.

First question that comes to the mind is; so what? What is the new thing the study revealed that we did not know? Essentially it speaks abouta common clinical experience that if you use more cannabis it is bad for you in the long run and it is good to remain abstinent. If you used occasionally your outcome is somewhere in between.

Is this result generalizable? We do not know if the schools in the prosperous state of Victoria were public or private schools (to comment rethe economic status of the participants and avoid selection bias). Can we generalize the results to other parts of the Asutralia like NT or Queensland or other countries? Australia is a culturally heterogenous country having people from almost all nations in the world. But a detailedanalysis of the cultural background of the participants is not included. This could have further strengthened their conclusion of a psychosocial explanation of the 'gateway effect' as proposed by the authors.

Further, the blinding of the study is not clearly discussed. For example, did the assessors (while using CIDI/ FTND) had knowledge of the participant's past cannabis use?

While discussing the association of the background factors with cannabis abuse in table-1, one would have expected the marital status of the parents could have been used more meaningfylly as opposed to parental education which may suffer from recall bias.

In summary the authors could have discussed more limitations of the study and it's generalizability. Although it is a methodologically sophisticated and potentially costly study it is unlikey to change the existing clinical practice and our understanding of the area under study.
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Conflict of interest: None Declared

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