Background: Alcohol and marijuana are psychoactive substances commonly used by young adults and are independently associated with numerous acute and long-term consequences. Many young adults engage in simultaneous alcohol and marijuana (SAM) use to cross-fade (i.e., to enhance the effects of intoxication), although the extent to which alcohol use and alcohol-related consequences increase on SAM occasions compared to alcohol-only occasions is unclear. This study examines daily data among a sample of SAM users comparing SAM days to other days when young adults only used alcohol. Methods: A sample of 409 young adults (age 18 to 25; Mage = 21.6, SD = 2.2; 50.9% women) who reported SAM use in the past month completed 2 bursts of 14 days of daily surveys (28 days in total) assessing alcohol use, alcohol-related consequences, and SAM use. Results: Multilevel models based on alcohol-only and SAM days (n = 3,016 days; 391 individuals) indicated young adults drank more alcohol on SAM days compared to alcohol-only days (with no marijuana use). Similarly, days with SAM use were associated with more alcohol-related positive and negative consequences. The daily association between SAM use and positive consequences was statistically significant, after accounting for the amount of alcohol consumed; in contrast, the association between SAM use and negative consequences was diminished and nonsignificant. Conclusions: Among young adult SAM users, days with SAM use were associated with more alcohol use and positive consequences compared to days they only drank alcohol. Further examination of the motivational context for engaging in SAM use, as well as potential physiological interactions between alcohol and marijuana use on alcohol’s effects, is warranted. Alcohol interventions might benefit from addressing increased alcohol use and alcohol-related consequences as risks associated with SAM use.

Externalizing psychopathology in early adolescence is a highly heritable risk factor for drug use, yet how it relates to marijuana use development is not well-characterized. We evaluate this issue in independent twin samples from Colorado (N = 2608) and Minnesota (N = 3630), assessed from adolescence to early adulthood. We used a biometric latent growth model of marijuana use frequency with data from up to five waves of assessment from ages 14 to 30, to examine change in marijuana use and its relationship with a factor model of adolescent externalizing psychopathology. The factor structure of adolescent externalizing psychopathology was similar across samples, as was the association between that common factor and early marijuana use (Minnesota r = 0.67 [0.60, 0.75]; Colorado r = 0.69 [0.59, 0.78]), and increase in use (Minnesota r = 0.18 [0.10, 0.26]; Colorado r = 0.20 [0.07, 0.34]). Early use was moderately heritable in both samples (Minnesota h2 = 0.57 [0.37, 0.79]; Colorado h2 = 0.42 [0.14, 0.73]). Increase in use was highly heritable in Minnesota (h2 = 0.82 [0.72, 0.88]), less so in Colorado (h2 = 0.22 [0.01, 0.66]), and shared environmental effects were larger in Colorado (c2 = 0.55 [0.14, 0.83]) than Minnesota (c2 = 0 [0, 0.06]). We found moderate genetic correlations between externalizing psychopathology and early use in both samples. Finally, additional analyses in the Minnesota sample indicated that marijuana use decreased during the late 20s. This decline is strongly heritable (h2 = 0.73 [0.49, 0.91]) and moderately negatively correlated with adolescent externalizing psychopathology (r = − 0.41 [− 0.54, − 0.28]). Adolescent externalizing psychopathology is genetically correlated with change in late adolescent marijuana use (late teens, early 20s), as well as maintenance of use in early adulthood (late 20 s) even after controlling for the effects of early use.

Purpose: Limited research exists on tobacco taxes and cigarette smoking initiation and progression, particularly across different sociodemographic groups in young adulthood. This project examines how cigarette pack price in late adolescence prospectively relates to smoking initiation and progression by 21 years of age, focusing on differences across demographics. Methods: Data are from the longitudinal Monitoring the Future project (2001–2017). Monitoring the Future examines drug use behaviors with nationally representative samples of 12th graders annually. Subsamples of 12th graders are followed up longitudinally. We examined past 30-day cigarette smoking among baseline never smokers (N = 9,232) and daily smoking among youths who were not daily cigarette smokers at baseline (N = 15,141). Using logistic regression, we examined state-level cigarette pack price at a modal age of 18 years and smoking at follow-up ages 19–20 years; we used interaction terms to assess differences across sociodemographic groups (by gender, race/ethnicity, and parental education). Results: For each dollar increase in price at baseline, the odds of initiation by age 19–20 years were reduced by 12% (adjusted odds ratio =.88; 95% confidence interval =.78,.99) and the odds of progression to daily smoking were reduced by 16% (adjusted odds ratio =.84; 95% confidence interval =.76,.92). After adjusting for multiple testing, for both outcomes there were no statistically significant interactions between price and demographics. Conclusions: Cigarette prices in late adolescence were associated with a prospective reduction in cigarette smoking initiation and progression among young adults, with limited differences across sociodemographic characteristics. Higher cigarette prices can prevent smoking initiation and progression; however, complementary interventions are needed to reduce initiation and progression among subgroups disproportionately affected by tobacco.

To investigate prognostic factors in pediatric and young adult patients with localized osteosarcoma that could predict the development of subsequent pulmonary metastases and lead to an ability to risk-stratify therapy. We performed a systematic review of the literature published since January 1990 to establish common evidence-based prognostic factors. Methods. PubMed and Embase searches (Jan 1990–Aug 2018) were performed. Two reviewers independently selected papers for patients with localized osteosarcoma with subsequent metastatic development and then reviewed for quality of methods and prognostic factors. Results. Database searches yielded 216 unique results. After screening, 27 full-text articles were studied in depth, with 9 items fulfilling predetermined inclusion and exclusion criteria. Age, tumor location, tumor size/volume, and histologic response carried independent prognostic value in the majority of the studies. Conclusions. Several prognostic factors seemed to be consistent amongst the studies, but the heterogeneity and smaller sizes of the study populations made pooling of results difficult. Standardization of larger patient populations and consistent definitions/cutoffs for prognostic factors are needed to further assess for consistent prognostic factors and potential predictive models to be developed.

Objective This study examines the extent to which cigarette taxes affect smoking behaviour and disparities in smoking among adolescents by gender, socioeconomic status (SES) and race/ethnicity. Methods We used US nationally representative, repeated cross-sectional data from the 2005 to 2016 Monitoring the Future study to evaluate the relationship between state cigarette taxes and past 30-day current smoking, smoking intensity, and first cigarette and daily smoking initiation using modified Poisson and linear regression models, stratified by grade. We tested for interactions between tax and gender, SES and race/ethnicity on the additive scale using average marginal effects. Results We found that higher taxes were associated with lower smoking outcomes, with variation by grade. Across nearly all of our specifications, there were no statistically significant interactions between tax and gender, SES or race/ethnicity for any grades/outcomes. One exception is that among 12th graders, there was a statistically significant interaction between tax and college plans, with taxes being associated with a lower probability of 30-day smoking among students who definitely planned to attend college compared with those who did not. Conclusion We conclude that higher taxes were associated with reduced smoking among adolescents, with little difference by gender, SES and racial/ethnicity groups. While effective at reducing adolescent smoking, taxes appear unlikely to reduce smoking disparities among youth.

<p>Individuals’ reasons for marijuana use have been linked to their risk for continued use and development of disordered use. Although individuals tend to have multiple reasons for use, co-occurrence of reasons is not always accounted for in analytic approaches. Latent transition analysis (LTA) is ideal for modeling transitions in co-occurring reasons. Using longitudinal panel data from Monitoring the Future, LTA was used to identify profiles of self-reported reasons for marijuana use among young adults, examine transitions between profiles, and determine whether cohort, gender, race/ethnicity, parent education, grade of first marijuana use, and 4-year college attendance predicted transitions between profiles. Data included senior year cohorts from 1976–2009 and were collected at ages 19/20, 21/22, and 23/24 (weighted n = 7,294; 55.9% female; 79.3% White). Five latent classes were identified: Non-Users and individuals with Experimental, Typical, Get High + Relax, and Escape + Coping Reasons. Transitions among Non-Users, Experimental Reasons, and Typical Reasons were common; generally, those with earlier cohort membership, early initiation, college non-attending parents, and college attendance were more likely to make transitions to higher-risk classes. As the legalization of recreational marijuana use continues to expand, change over time in reasons for use should be considered carefully as interventions are developed and implemented.</p>

Adolescent Vaping and Nicotine Use in 2017–2018 A national survey revealed a large increase in nicotine vaping among high school students; more than 20% of 12th-graders reported that they vaped nicotine in 2018. The increase in adolescent nicotine use from 2017 to 2018 was explained by an increase in vaping; the use of other nicotine products declined.

AbstractBackground: Age of first marijuana use is a key predictor of later educational outcomes, but limited work has identified demographic factors that impact this association across continuous ages of first use. The purpose of this study was threefold: (1) to identify the age-varying prevalence of later college degree attainment as a function of age of first marijuana use; (2) to examine the age-varying association of gender and college degree attainment as a function of age of first use; and (3) to examine the age-varying association of parent education and college degree attainment as a function of age of first use. Methods: Data were from the panel portion of the Monitoring the Future (MTF) study, an ongoing longitudinal study of adolescents and young adults. Those who used marijuana by age 22 were included in analyses. Among these participants (N = 2134), 47.0% were male, 67.5% were white, 53.2% reported having at least one parent with a bachelor’s degree or higher, and 44.1% attained a bachelor’s ...

ABSTRACT.Objective: Research on substance use motivestypically examines each substance separately. However, simultaneous alcohol and marijuana (SAM) use—thatis, using alcohol andmarijuanaatthe same timesothattheireffects overlap—iscommonamongyoungadults. This study examines day-to-day fluctuations in motivesfor using alcohol and/ or marijuana among young adult substance users as predictors of alco- hol, marijuana, and SAM use across days. Method: Data were from a community sample of young adults whoreported SAM use in the past month (analytic sample: N=399,mean[SD]age =21.63 [2.17];50.9% women). Participants reported alcohol, marijuana, and SAM use, and also motives“for alcohol and/or marijuanause” for14consecutive days. Results: Multilevelmodels showedthat elevated enhancement motives were associated withheavy episodic drinking, drinkingmore, and more hours high from marijuana. Elevated social motiveswere associated with heavy episodic drinking and drinking more, and also with fewerhours high.Elevated conformity motives were associated with drinking more. SAM usewas more likely:onalcohol days and on marijuana days with elevated enhancement and conformity motives, on alcohol days with elevatedcoping motives, and on marijuana days with elevated social motives. Conclusions: SAM useonagiven daywas primarily associated with enhancement and conformity motives. Social motiveswere more stronglylinked to alcohol use, and to some extent coping motiveswere linked to marijuana use in this young adult sample.Further examination of situation-specific motivesand contexts of use is needed to inform development of real-time interventions for SAM use and consequences.

Introduction: Age of first drink is a key risk factor for adolescent high-risk alcohol use. The current study examined whether speed of escalation from first drink to first intoxication is an additional risk factor, and whether these two factors are associated with binge and high-intensity drinking among adolescents. Methods: Data collected in 2005–2017 from a nationally-representative sample of 11,100 U.S. 12th grade students participating in the Monitoring the Future study were coded to indicate grade of first drink, grade of first intoxication, and speed of escalation from first drink to first intoxication. Logistic regression models estimated bivariate and multivariable odds of past 2-week binge (5+ drinks in a row) and high-intensity (10+ drinks in a row) drinking in 12th grade. Results: Of those who reported intoxication by 12th grade, almost 60% reported first drunkenness in the same grade in which they first drank. The likelihoods of 12th grade binge and high-intensity drinking were significantly associated with both grade of first drink and speed of escalation to intoxication. Past two-week high-intensity drinking prevalence was 17.4% among those with immediate (same-grade) escalation from first drink to first intoxication; 15.8% among those with a 1-grade delay, and 12.6% among those with a 2+ grade delay to intoxication. Conclusions: The majority of students escalate quickly from having their first drink to being intoxicated for the first time. Both earlier age of first drink and a faster escalation from first drink to first intoxication are important indicators of binge and high-intensity drinking risk among adolescents.

© 2018 Society for Prevention Research Latent class analysis (LCA) has proven to be a useful tool for identifying qualitatively different population subgroups who may be at varying levels of risk for negative outcomes. Recent methodological work has improved techniques for linking latent class membership to distal outcomes; however, these techniques do not adjust for potential confounding variables that may provide alternative explanations for observed relations. Inverse propensity score weighting provides a way to account for many confounders simultaneously, thereby strengthening causal inference of the effects of predictors on outcomes. Although propensity score weighting has been adapted to LCA with covariates, there has been limited work adapting it to LCA with distal outcomes. The current study proposes a step-by-step approach for using inverse propensity score weighting together with the “Bolck, Croon, and Hagenaars” approach to LCA with distal outcomes (i.e., the BCH approach), in order to estimate the causal effects of reasons for alcohol use latent class membership during the year after high school (at age 19) on later problem alcohol use (at age 35) with data from the longitudinal sample in the Monitoring the Future study. A supplementary appendix provides evidence for the accuracy of the proposed approach via a small-scale simulation study, as well as sample programming code to conduct the step-by-step approach.

Alcohol consumption is increasing in the United States, as is alcohol-attributable mortality. Historically, men have had higher rates of alcohol consumption than women, though evidence for birth cohort effects on gender differences in alcohol consumption and alcohol-related harm suggest that gender differences may be diminishing. We review studies using U.S. national data that examined time trends in alcohol consumption and alcohol-related harm since 2008. Utilizing a historical-developmental perspective, here we synthesize and integrate literature on birth cohort effects from varying developmental periods (i.e. adolescence, young adulthood, middle-adulthood, and late adulthood), with a focus on gender differences in alcohol consumption. Findings suggest that recent trends in gender differences in alcohol outcomes are heterogeneous by developmental stage. Among adolescents and young adults, both males and females are rapidly decreasing alcohol consumption, binge and high intensity drinking, and alcohol-related outcomes, with gender rates converging because males are decreasing consumption faster than females. This pattern does not hold among adults, however. In middle-adulthood, consumption, binge drinking, and alcohol-related harms are increasing, driven largely by increases among women in their 30s and 40s. The trend of increases in consumption that are faster for women than men appears to continue into older adult years (60 and older) across several studies. We conclude by addressing remaining gaps in the literature and offering directions for future research. This article is protected by copyright. All rights reserved.

High-intensity drinking (HID; ie, having 10+ drinks in a row) is a recognized public health concern due to the individual and public risks (eg, alcohol-related injuries, alcohol poisoning, memory loss, sexual risk) associated with consumption of a large quantity of alcohol over a relatively short time period. Using nationally representative samples of US 8th, 10th, and 12th grade students, and follow-up of subsamples of 12th graders, we present overall and sex-specific prevalence estimates of past 2-week HID from 29 966 individuals at the modal ages of 14 to 30 in 2016-2017. Similar data for the more commonly studied measure of binge drinking (having 5+ drinks in a row) is provided for comparison. HID prevalence ranged from 1% to 11.5% and was significantly higher for males than females at all ages other than modal age 14 (8th grade). Binge drinking prevalence ranged from 3.5% to 32.5%; males reported a higher prevalence than females at approximately half of the ages examined. Peak binge drinking and HID age for males was earlier (modal age 21/22) than that for females (modal age 21-24 for binge drinking and 25/26 for HID). The observed rapid increase in HID from adolescence through the early to mid-20s highlights the importance of prevention and intervention efforts targeted to these ages.

Background: This study examined the extent to which the developmental pattern of prevalence of binge drinking in the past 2 weeks from ages 18 through 30 has changed across 29 cohorts of U.S. young adults, and whether the changes differed by gender. Methods: Analyses used national longitudinal data from 58,019 12th‐grade students (from graduating high school classes 1976 to 2004) participating in the Monitoring the Future study followed through modal age 30 (with age 29/30 data collected from 1987 to 2016). Weighted time‐varying effect modeling was used to model cohort group differences in age‐related patterns of binge drinking. Results: The age of peak binge drinking prevalence increased across cohorts (from age 20 in 1976 to 1985 to 22 in 1996 to 2004 for women, and from 21 in 1976 to 1985 to 23 in 1996 to 2004 for men). Historical change in the developmental pattern of binge drinking across all ages of young adulthood differed for men and women. Even after controlling for key covariates, women in the more recent cohort group reported significantly higher binge drinking prevalence than women in earlier cohorts from ages 21 through 30. Men in the more recent cohort group reported higher binge drinking prevalence at ages 25 to 26, but prevalence levels then converged to those seen in earlier cohort groups by age 30. Conclusions: An older age of peak binge drinking and a decreased rate of decline in the prevalence of binge drinking in later young adulthood among more recent cohorts have resulted in an extension of individual and societal risks associated with binge drinking, particularly for women, across young adulthood. High‐risk alcohol use prevention efforts are needed throughout at least the third decade of life. Age of peak binge drinking (5+ drinks per occasion) prevalence has increased from 20 to 22 for women and 21 to 23 for men among high school graduating classes from 1976 to 2004. Women from more recent cohorts reported significantly higher binge drinking prevalence from ages 21 to 30 than women in earlier cohorts. Increased age of peak binge drinking and a longer time period during which young adults are engaging in binge drinking likely confer greater risks.

Objective: The current study examines the prevalence, stability, and correlates of simultaneous alcohol and marijuana (SAM) use among underage US young adults, a population at high risk for participating in this behavior. Method: Analyses used data from 1719 respondents (46.8% men) who participated in the nationally representative 12th-grade Monitoring the Future study and provided responses to SAM use items at longitudinal follow-up at modal ages 19/20 between 2007 and 2016. Prevalence estimates and covariate associations with SAM use were estimated. Results: SAM use prevalence at modal age 19/20 was 22.5%. Multivariable models indicated that odds of age 19/20 SAM use were significantly (p <.05) higher for men (vs. women) and for respondents who started alcohol use by age 18 (vs. those who delayed uptake until after high school). Odds of SAM use were especially high for individuals attending college full-time and not living with parents. Among those who reported SAM use at modal age 18, 56.2% continued to report SAM use at modal age 19/20. Among those who did not report SAM use at modal age 18, only 14.2% reported SAM use at modal age 19/20. Conclusions: SAM use among young adults aged 19/20 in the US is relatively common, but especially so for those who began such use by age 18, highlighting the early onset and stability of this behavior. Among underage drinkers, SAM risk varies by sex, race/ethnicity, college status, and living arrangements.