Does elementary school alcohol, tobacco, and marijuana use increase middle school risk?

Purpose: To assess whether alcohol, tobacco, and other drug (ATOD) use in elementary school may have serious implications for continued ATOD use in middle school and beyond. Methods: Longitudinal analyses were conducted on questionnaire data from 331 middle school students who had previously provided ATOD-use data during elementary school. Non-school personnel administered questionnaires in three participating school districts in three different states. The sample of students was ethnically and geographically diverse, including students from a range of low socioeconomic status backgrounds living in rural, urban or inner-city environments. Results: Middle school alcohol use was almost three times as likely to occur if alcohol use had occurred in elementary school (OR = 2.94, p < .001). Elementary school use of tobacco and marijuana also greatly increased the likelihood of middle school use (OR = 5.35, P < .001 and OR = 4.25, p < .05, respectively). Conclusions: Early use of ATOD is associated with greatly increased odds of later use, which has important implications for the timing of drug prevention programs. Preventive interventions designed for use in pediatric practice settings should commence no later than elementary school, during the middle childhood years. (C) Society for Adolescent Medicine, 2002.