Alcohol or Marijuana First? Correlates and Associations With Frequency of Use at Age 17 Among Black and White Girls.

OBJECTIVE: Black youth are more likely than White youth to deviate from the typical sequence of initiating alcohol use before marijuana use. Although potentially informative for prevention efforts, sources of variation in the sequence of alcohol relative to marijuana use initiation and associations of initiation patterns with frequency of use have rarely been examined.
METHOD: Data were drawn from 2,166 Pittsburgh Girls Study participants (56.9% Black, 43.1% White), collected at ages 11-17. Multinomial logistic regression analyses were conducted to identify distinctions by race and associations of socioeconomic, neighborhood, psychosocial, and psychiatric factors with alcohol and marijuana initiation patterns: alcohol first as "typical," with "atypical" including both at the same age, marijuana first, marijuana only, and alcohol only. Separate ordinal logistic regression analyses were conducted to predict frequency of alcohol and marijuana use at age 17 as a function of initiation pattern and significant correlates.
RESULTS: Black girls were overrepresented in the atypical initiation patterns involving marijuana use. Unique associations of race, cigarette smoking, trauma exposure, religious service attendance, depression, and conduct problems with initiation patterns were observed. Compared with the typical sequence, frequency of alcohol use was lower for all other patterns (odds ratios [ORs] = 0.28-0.50), but frequency of marijuana use was lower exclusively for "marijuana only" (OR = 0.42).
CONCLUSIONS: These findings underscore the need for prevention programs to consider heterogeneity in patterns of initiating alcohol and marijuana use and correlates of patterns among both Black and White adolescents. They also indicate that initiation sequence is a stronger predictor of frequency of use for alcohol than for marijuana.