Promotive and risk factors associated with adolescent alcohol and cigarette initiation: A longitudinal analysis

Purpose: Adolescent substance initiation is associated with adverse health and may place youth on a negative life trajectory. Designing effective prevention programs may be the key to decreasing early adolescent substance initiation in the US. Alcohol and cigarette initiation are of particular concern because use of these substances is normative. The present study aimed to identify factors associated with adolescent alcohol and cigarette initiation by evaluating three conceptual models: a risk model (objective social status, subjective social status, and perceived discrimination), promotive model (family cohesion, parental monitoring, parental nurturance, and peer support), and protective model (potential risk and promotive factors).Method: Data were from 4,824 participants in the Healthy Passages study, a population-based prospective longitudinal survey of diverse U.S. adolescents in fifth, seventh, and tenth grade. Self and parent-report items and scales were used to measure alcohol and cigarette initiation and hypothesized risk and promotive factors. A series of multinomial logistic regression tests were conducted for each conceptual model separately by racial/ethnic group. All analysis controlled for child’s age, gender, and parental cigarette and alcohol use, perceived peer alcohol and cigarette use. Results: The promotive factors of family cohesion, parental nurturance, parental monitoring, and peer support were associated with decreased initiation of both alcohol and cigarette use, which varied slightly by racial/ethnic group. Notably, parental nurturance and family cohesion were consistent among all racial/ethnic group and across alcohol and cigarette initiation. Among the variables examined, there were no significant risk factors detected in this 5-year prospective longitudinal study and thus there was no support for a protective model. Conclusion: Promotive factors, especially family cohesion and parental nurturance, remained consistent in being associated with reduced alcohol and cigarette initiation. Thus, prevention programs aimed at early adolescence may be most fruitful by focusing on enhancing these promotive factors