Cover: Alcohol and Marijuana Use Trajectories in a Diverse Longitudinal Sample of Adolescents

Alcohol and Marijuana Use Trajectories in a Diverse Longitudinal Sample of Adolescents

Examining Use Patterns from Age 11 to 17 Years

Published in: Addiction, 2016

Posted on Jun 17, 2016

by Elizabeth J. D'Amico, Joan S. Tucker, Jeremy N. V. Miles, Brett Ewing, Regina A. Shih, Eric R. Pedersen

Research Questions

  1. Do adolescents who report using alcohol and marijuana report worse outcomes in high school?
  2. Do the outcomes differ by race/ethnicity?

AIMS: We tested race/ethnic differences in alcohol and marijuana (AM) trajectories (comprising an intercept term, reflecting overall probability of use, and a slope term, reflecting change in probability of use) during adolescence, whether AM use trajectories predicted high school outcomes, and whether outcomes differed by race/ethnicity after controlling for trajectory of AM use. DESIGN: This longitudinal study involved 6509 youth from 16 middle schools in Southern California surveyed from age 11.5 (2008) to age 17 (2015) years; all surveys assessed AM use, and the final survey also examined high school outcomes. SETTING: Youth completed five surveys in middle school and two on-line surveys in high school. PARTICIPANTS: The sample was 50% male and 80% non-white. MEASUREMENTS: Intercept (at 2.75 years post-baseline) and slope of AM use were examined as outcomes for race/ethnic differences. AM use trajectories were examined as predictors of academic performance and unpreparedness, social functioning, mental and physical health and delinquency. FINDINGS: We found differences in trajectories of use by race/ethnicity, with white youth reporting a higher overall intercept of alcohol use compared to all other groups (versus Asian P < 0.001, black P = 0.001, multi-ethnic P = 0.008). Overall, examination of trajectories of use showed that adolescents with a higher alcohol use intercept term reported greater academic unpreparedness (P < 0.001) and delinquency (P < 0.001) at wave 7 in high school. In addition, youth with a higher intercept for marijuana use reported greater academic unpreparedness (P < 0.001) and delinquency (P < 0.001), and poorer academic performance (P = 0.032) and mental health (P = 0.002) in high school. At wave 7, compared to white youth, Hispanic and multi-ethnic youth reported poorer academic performance (P < 0.001 and P = 0.034, respectively); Asian, black and Hispanic youth reported higher academic unpreparedness (P < 0.001, P = 0.019, and P = 0.001); and Asian youth and multi-ethnic youth reported poorer physical health (P = 0.012 and P = 0.018) controlling for AM use. CONCLUSIONS: Greater AM use was associated with worse functioning in high school for all youth. After controlling for AM use, non-white youth reported worse outcomes in high school for academics and health.

Key Findings

  • Greater use of alcohol and marijuana is associated with worse functioning in high school for all youth.
  • Youth who reported higher probability of marijuana use were less prepared for school, engaged in more delinquent behavior, and had poorer mental health.
  • Non-white youth who report a similar likelihood of alcohol and marijuana use as white youth reported worse academic outcomes in high school, and worse health.


  • Intervention programs need to target both alcohol and marijuana use during this developmental period, particularly among non-white youth, in order to ameliorate disparities in functioning.

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