Bucholz, K. K

Heath, A. C

Madden, P. A.F.

Waldron, M.

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Washington University School of MedicineDigital Commons@BeckerPosters 2009: Translating Basic Science Findings to GuidePrevention Efforts2009Early use of alcohol, tobacco, and illicit substances:Risks from parental separation and parentalalcoholismM. WaldronWashington University School of Medicine in St. LouisK. K. BucholzWashington University School of Medicine in St. LouisP. A.F. MaddenWashington University School of Medicine in St. LouisA. C. HeathWashington University School of Medicine in St. LouisFollow this and additional works at: http://digitalcommons.wustl.edu/guzeposter2009Part of the Medicine and Health Sciences CommonsThis Poster is brought to you for free and open access by the 2009: Translating Basic Science Findings to Guide Prevention Efforts at DigitalCommons@Becker. It has been accepted for inclusion in Posters by an authorized administrator of Digital Commons@Becker. For more information,please contact engeszer@wustl.edu.Recommended CitationWaldron, M.; Bucholz, K. K.; Madden, P. A.F.; and Heath, A. C., "Early use of alcohol, tobacco, and illicit substances: Risks fromparental separation and parental alcoholism" (2009). Posters. Paper 32 Samuel B. Guze Symposium on Alcoholism.http://digitalcommons.wustl.edu/guzeposter2009/32Early use of alcohol, tobacco, and illicit substances: Risks from parental separation and parental alcoholism†Supported by K01DA023696M. Waldron†, K. K. Bucholz, P. A. F. Madden & A. C. HeathABSTRACTWe examine early use of alcohol, tobacco, marijuana and other illicitsubstances as a function of parental alcoholism and singleparenthood during childrearing years using data on 3282 adolescentand young-adult female twins from the Missouri Adolescent FemaleTwin Study (MOAFTS). Results from Cox proportional hazardsregression models predicting onset of substance use from dummyvariables coding for parental alcoholism and marital history show amarked increase in risk of very early onset use in single-parentfamilies. Compared to offspring of continuously marriednonalcoholic parents, offspring of divorced alcoholic parents weremuch more likely to consume alcohol, drink to intoxication, smokecigarettes, smoke regularly, and use marijuana and other illicit drugsby ages 12 and 14. Offspring of divorced nonalcoholic parents werealso more likely to drink to intoxication and use marijuana and otherillicit drugs by ages 12 and 14. No significant increase in risk wasobserved for offspring of continuously married alcoholic parents andwith the exception of onset of regular smoking, no significantincrease in risk was observed for offspring of nevermarriednonalcoholic parents.Use of alcohol and other substances by young as well as older adolescents is widespread. Approximately 41%, 25%, and 16% of 8th graders in the U.S. report use of alcohol, cigarettes, and marijuana, respectively, at some point in their life and over 20% of 8th graders report lifetime use of any illicit drug. By 12th grade, approximately 75%, 50%, 50%, and 45% of students report lifetime use of alcohol, cigarettes, marijuana, and any illicit drug1.Given early onset substance use is one of more well-documented predictors of alcohol (and drug) use disorders2-8, identifying risks contributing to early use is essential for targeted prevention and preventive interventions.1Johnston et al. (2006); 2Anthony & Petronis (1995); 3Grant (1998); 4Grant & Dawson (1997); 5Hawkins et al. (1997); Kandel (1985); 6Kandel & Davies (1992); 7Robins & Przybeck (1985); 8Wagner & Anthony (2002)Early Alcohol and Other Substance UseEarly Use and Parental RisksChildren of alcoholics (COAs) are at especially high risk for early and problem substance use1-4. Compared with children of non-alcoholic parents, COAs report earlier onset of alcohol use and are at greater risk for alcohol problems later adolescence and adulthood. COAs also report earlier marijuana and other drug use. History of heavy and problem drinking is strongly associated with divorce5-9 and children of divorced parents also report greater alcohol and drug involvement compared with children from intact, married families10-12.1Chassin et al. (2002); 2Lieb et al. (2002); 3Sher et al. (1991); 4Schuckit & Smith (1996); 5Chilcaot & Breslau (1996); 6Hajema & Knibbe (1998); 7Power, Rodgers, & Hope (1999); 8Wang & El-Guebaly (2004); 9Yamaguchi & Kandel (1985); 10Doherty & Needle (1991); 11Fergusson, Horwood, & Lynskey (1994); 12Short (1998)Present StudyParental alcoholism and single parenthood resulting from divorce or never-marriage share a number of correlated environmental risks. Whether and to what extent single parenthood works to mediate associations between parental alcoholism and early substance use or qualify observed risks to COAs is unknown.  The present study examines onset of alcohol, tobacco, marijuana and other illicit substance use as a function of both parental alcoholism and single parenthood during childrearing years using Cox proportional hazards regression models predicting substance use onset by offspring of married, divorced, or never-married parents with and without a history of alcohol use disorder (AUD).Missouri Adolescent Female Twin Study (MOAFTS) Missouri-born same-sex female twin pairs born between January 1975 and December 1985 to Missouri-resident parents identified through state birth records Cohort-sequential design with initial cohorts of 13, 15, 17 and 19 during first two years of data collection and continued recruitment of 13+ year-olds Baseline interviews with one- and five-year (“Wave 4”, N = 3282) follow-up assessmentSampleWave 4Age, M (SD) 21.64 (2.72)African American 15%High school degree or equivalent 91%Marital status of twin respondentNevermarried 78%Married 20%Separated or divorced 2%MeasuresParental Alcohol Use Disorder (AUD) Maternal history of DSM-IV Alcohol Abuse (AB) or Dependence (AD), and/or paternal AD assessed using telephone adaptation of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA)1 – see Table 1Parental Marital History Biological parents continuously married, never-married (and not cohabiting), or separated/divorced during childrearing years – see Table 1Offspring Substance Use Onset – see Table 2 Alcohol – age at first use, age at first intoxication Cigarettes – age at first use, age at first regular use Marijuana – age at first use Other illicit substances (e.g., cocaine, heroin, hallucinogens) – age at first useCovariates Ethnicity (African American) Offspring history of conduct problems (DSM-IV Conduct Disorder)1Bucholz et al. (1994)Table 1. Parental AUD and single parenthoodAUDMaternal AB or AD 15%Paternal AD 19%Maternal or paternal AUD 30%Marital historyContinuously married 62%Divorced or separated 29%Never-married 9%Table 2. Ever/used and age of onsetEver/used%Age of OnsetM (SD)Alcohol 86 16.39 (2.36)Alcohol Intoxication 73 17.34 (2.42)Cigarettes 71 14.35 (3.03)Regular smoking 36 16.12 (2.45)Marijuana 43 16.65 (2.36)Other illicit drugs 18 17.72 (2.83)ResultsResults from Cox proportional hazards regression predicting onset of alcohol and other substance from parental AUD and single parenthood during childrearing years suggest a marked increase in risk of very early onset alcohol and other substance use in single-parent families – see Tables 3-8 Compared to offspring of continuously married nonalcoholic parents, offspring of divorced alcoholic parents are much more likely to consume alcohol, drink to intoxication, smoke cigarettes, smoke regularly, and use marijuana and other illicit drugs by ages 12 and 14, as are offspring of nevermarried alcoholic parents. Offspring of divorced nonalcoholic parents are also more likely to consume alcohol, drink to intoxication, smoke cigarettes, smoke regularly, and use marijuana and other illicit drugs by ages 12 and 14. No significant increase in risk is observed for offspring of continuously married alcoholic parents; with the exception of first regular smoking, no significant increase in risk is observed for offspring of nevermarried nonalcoholic parents.Table 3. Hazard ratios (HR) and 95% CIs for first alcohol use as a function of parental AUD and single parenthoodParental AUD+ Parental AUD-Age in years DivorcedNever-Married Married DivorcedNever-Married≤ 121.86 (1.53-2.26) 2.71 (1.41-5.23)1.25 (1.10-1.42)5.25 (2.10-13.15)0.99 (0.79-1.24)13-141.28 (1.12-1.46)15-171.20 (1.02-1.41) 1.26 (0.98-1.63)≥ 18Table 4. Hazard ratios (HR) and 95% CIs for first alcohol intoxication as a function of parental AUD and single parenthoodParental AUD+ Parental AUD-Age in years DivorcedNever-Married Married DivorcedNever-Married≤ 95.11 (2.77-9.44)41.77 (2.61-667.95)1.31 (1.14-1.52)3.61 (1.88-6.93)0.86 (0.63-1.17)10-121.48 (1.09-2.02)13-14 1.83 (1.32-2.53) 1.42 (1.00-2.01)15-17 1.36 (1.12-1.65) 1.26 (1.04-1.52)≥ 18 1.10 (.83-1.46) 0.98 (0.74-1.29)Table 5. Hazard ratios (HR) and 95% CIs for first cigarette use as a function of parental AUD and single parenthoodParental AUD+ Parental AUD-Age in years DivorcedNever-Married Married DivorcedNever-Married≤ 92.89 (2.33-3.60) 3.98 (2.68-5.91) 1.66 (1.30-2.11)2.75 (1.86-4.04)2.01 (1.30-3.10)10-12 1.62 (1.37-1.92)13-141.82 (1.49-2.21) 1.84 (1.29-2.62) 1.19 (.98-1.46) 1.04 (.56-1.94) 1.39 (0.99-1.96)15-17≥ 18Table 6. Hazard ratios (HR) and 95% CIs for first regular cigarette use as a function of parental AUD and single parenthoodParental AUD+ Parental AUD-Age in years DivorcedNever-Married Married DivorcedNever-Married≤ 124.72 (3.49-6.38) 4.01 (2.22-7.23)1.49 (1.18-1.88)3.87 (2.38-6.28)2.11 (1.29-3.45)13-14 2.04 (1.60-2.59)15-172.04 (1.59-2.60) 2.14 (1.22-3.74) 1.14 (0.60-2.19)≥ 18Table 7. Hazard ratios (HR) and 95% CIs for first use of marijuana as a function of parental AUD and single parenthoodParental AUD+ Parental AUD-Age in years DivorcedNever-Married Married DivorcedNever-Married≤ 123.12 (2.31-4.20)3.79 (1.62-8.83)1.37 (1.11-1.64)2.94 (1.68-5.15)1.38 (.93-2.06)13-141.80 (1.23-2.65) 1.59 (1.28-1.97)15-17 1.75 (1.34-2.28)≥ 18 1.09 (.65-1.83) 1.19 (0.54-2.64) 0.78 (0.48-1.26) 0.37 (0.14-0.97)Table 8. Hazard ratios (HR) and 95% CIs for first use of other illicit substances as a function of parental AUD and single parenthoodParental AUD+ Parental AUD-Age in years DivorcedNever-Married Married DivorcedNever-Married≤ 122.17 (1.57-3.00)1.89 (1.03-3.46)8.26 (2.04-33.45) 15.58 (4.78-50.80)1.51 (0.80-2.85)13-141.38 (0.99-1.93) 1.37 (1.00-1.87)15-17≥ 18 1.58 (0.97-2.58)ConclusionBoth parental alcoholism and parental marital history are strongly associated with onset of substance use by age 14, and particularly with onset by age 12. With the exception of other illicit drug use, the increased risk associated with parental alcoholism is limited to single-parent families.  In the absence of parental alcoholism, parental divorce (and for some outcomes, parental never-marriage) is also associated with increased risk of early onset substance use.These analyses together underscore the importance of parental single parenthood, sometimes in conjunction with parental alcoholism, as a risk factor for very early use of alcohol, tobacco, marijuana and other illicit substances. 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Early use of alcohol, tobacco, and illicit substances: Risks from parental separation and parental alcoholism

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Early use of alcohol, tobacco, and illicit substances: Risks from parental separation and parental alcoholism

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