Forecasting Disparities with Early Substance-Use Milestones.

Substance use contributes to health disparities across race/ethnicity, gender, and socioeconomic status (SES). Although adolescent research indicates group-based differences in regular use, few studies have examined patterns when initiation is just beginning. Using a sample of 917 Rhode Island middle schools students (54% female, 26% non-Hispanic White), we collected demographic information at baseline (M age 12.2); we then examined ever-puff (cigarettes), ever-sip (alcohol), and ever-use (marijuana) behaviors three years later. For cigarette use, we found differences based on SES and race/ethnicity (prevalence was particularly high among Native American youths). Marijuana use was associated with lower SES, and alcohol use was higher among females than males. Overall, findings indicate racial/ethnic-, gender- and SES-based differences in early substance-use milestones. From a prevention standpoint, it is important to evaluate differences not only in heavy substance use, but in early milestones, as they may set the course for health disparities across the lifespan.