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Official websites use. Share sensitive information only on official, secure websites. Box 41, Helsinki, Finland. E-mail address: tellervo. Although use of illicit drugs shows varying degree of heritability, the influence of shared and unique environmental factors predominate among adolescents. We explored factors predicting use of cannabis and other illicit drugs among Finnish adolescent twins. The potential predictors were measures reported by the twins, their parents or teachers. As individual factors we tested smoking, alcohol use, behavioral and emotional problems; as peer factors: number of smoking friends and acquaintances with drug experience; as family factors: parental substance use, socio-economic status and prenatal exposure to nicotine. We used logistic regression models, controlling for twinship, age and sex, to compute Odds Ratios OR for each potential predictor. To adjust for within-family confounds, we conducted conditional logistic regressions among twin pairs discordant for drug use. When adjusted for within-family confounds, smoking, drinking, and aggressiveness, as well as smoking and drug use among peers predicted use of illicit drugs. Early onset smoking is a powerful predictor for subsequent use of illicit drugs among Finnish adolescents, but the causal nature of this relationship needs to be clarified. Use of psychoactive substances causes a significant health and social burden worldwide. In developed countries most of illicit drug use is approximated to be cannabis products marijuana, hashish Compton et al. Also in Finland, like in other developed countries, most of illicit drug use is cannabis. It should be noticed, that in comparison to many other developed countries Brook et al. This may be because cannabis is clearly an illegal substance in Finland, while alcohol as a legal substance has played a central role in Finnish substance use and abuse culture for generations. Among illicit drugs, the numerous adverse health consequences of cannabis products have been investigated more specifically Khalsa et al. Adolescent cannabis use poses risk for subsequent depression and substance use disorders in young adulthood Brook et al. Further, there is consistent evidence that cannabis use increases risk of psychotic outcomes Moore et al. Alarmingly, early onset of cannabis use during adolescence seems to be an even stronger risk factor for later schizophrenia Arseneault et al. Earlier analyses among Finnish adolescent and young adult twins indicate the presence of substantial genetic effects and shared environmental effects. Also, the gene-environment interactions need to be further explored Kaprio, a. Given that environmental influences are known to be important, it seems relevant to further analyze which specific factors predict strongest use of cannabis or other illicit drugs among Finnish adolescents. Among individual factors, use of licit substances Agrawal et al. Characteristics related broadly to externalizing behaviors, such as impulsivity Conway et al. Further, influences of peers Agrawal et al. Finally, there is evidence that pre-natal exposure to marijuana may be a predictor of marijuana use in adolescence Day et al. Also, there is evidence that prenatal nicotine exposure is related to increased risk of early onset smoking or nicotine dependence among offspring Huizink and Mulder, Although there is quite a rich literature available on predictors of drug use worldwide, there is only one longitudinal study published among the Finnish population Poikolainen et al. Thus, predictors of cannabis use in Finland are not well known, and might be different from countries with easier access or higher frequency of cannabis use. Also, determinants of onset during adolescence are of particular interest because it is a strong predictor of subsequent substance use or mental health disorders Arseneault et al. More importantly, studying these variables in a twin population allows one to dismiss some known within-family confounds by testing relationships in discordant twin pairs. Finnish longitudinal twin data offer a unique source for learning more about the causal nature and role of putative risk factors using multivariate models of genetic informative data. We are aware of only one other genetically informative longitudinal study of marijuana use, one conducted among female adolescent twins Agrawal et al. That study found that among girls alcohol use and peer attitudes towards cannabis were significant predictors of cannabis use. Moreover, that analysis was done among girls only Agrawal et al. Another twin study was a retrospective cross-sectional investigation among young adults comparing escalation of drug use among early-onset cannabis users and their co-twin controls, i. This study suggested that escalation of drug use cannot be solely explained by common predisposing genetic or shared environmental factors and highlighted the role of peer influences on drug use Lynskey et al. In summary, earlier studies suggest a wide variety of factors associated with use of illicit drugs, particularly use of cannabis. Most of them can be identified within individual, family and peer related influences. The aim of the present study was to identify factors predicting use of cannabis and other drugs among the Finnish adolescent twin population. To fulfill this aim we considered individual, peer and family factors which we selected based on earlier studies. In comparison to an earlier Finnish investigation Poikolainen et al. In doing this, we will enrich the current knowledge on predictors of illicit drug use among adolescents. The longitudinal FinnTwin12 — 17 study, including five consecutive birth cohorts, was started in to examine genetic and environmental determinants of precursors of health-related behaviors in initially 11—year-old twins twins born — The study has a two-stage sampling design. Thus, the epidemiological first stage includes some twins and some parents. The second stage nested within this epidemiological study is an intensive assessment of a sub-sample with families. The parents provided written informed consent for participation Kaprio et al. For the current study, we used data collected within the epidemiological first stage baseline at ages 11—12 and two follow-ups at target ages of 14 and The predictors were measured at baseline and first follow-up, except age of smoking onset reported retrospectively at age of The outcome variable was measured at the second follow-up, which was initiated in autumn of and was completed in spring of for the five birth cohorts. The questionnaire was sent to the twins of each twin family that returned the family questionnaire. In all, questionnaires were returned out of mailed, a response rate of However, due to missing values in the outcome variable, most analyses included total of individuals boys and girls. Finally, due to missing values in some predictors, the final multivariate model of drug use predictors was based on individuals. The outcome variable was self-reported ever use of cannabis or other similar drugs at age 17 follow-up. To define ever use of cannabis or other illicit drugs, we considered all who reported experimenting or using at least once. The potential predictors were chosen based on earlier research literature. These were self-reported measures at ages 11—12, 14 or We considered several individual, peer and family factors. Following earlier literature, we considered other substance use , as well as behavioral and emotional problems. Among licit substance use we tested cigarette smoking Guxens et al. Own ever smoking was asked prospectively at the age 14 survey. The age of smoking onset was asked retrospectively at the age 17 survey. Among behavioral problems we considered externalizing behavior , such as aggressiveness and symptoms of Attention Deficit Hyperactivity Disorder ADHD , i. As internalizing behavior we tested emotional problems , such as depressive symptoms and social anxiety Buckner et al. The MPNI covers a wide spectrum of externalizing and internalizing behaviors consisting of scales for aggression, hyperactivity-impulsivity, and inattention, forming a factor for externalizing problem behaviors; anxiety and depression, forming a factor for internalizing problem behaviors Pulkkinen et al. Among peer factors we considered substance use among friends Agrawal et al. First, we used a question regarding number of smoking friends asked at the age 14 year follow-up. Second, we used a question regarding number of acquaintances who had experimented with cannabis or other drugs. As family factors reported by the parents themselves at the time of the baseline survey, i. Alcohol consumption was a variable describing frequency of drinking to intoxication drinking more than 5 beers, a bottle of wine or half a bottle of spirits or the equivalent on the one and same occasion. For mothers, the frequency categories were never, sometimes but less often than monthly , and monthly or more often. For fathers they were never, sometimes but less often than weekly , and weekly or more often. As there is also evidence that poor socio-economic circumstances of the family may be a risk factor for drug use Compton et al. Based on the occupation reported, the SES was coded for mother and father according to the categories published by the Central Statistical Office of Finland. SES was coded into seven categories as follows: employer, self-employed, upper-level employee, lower-level employee, manual worker, pensioner, student and other. Finally, although not found in earlier literature, we considered prenatal exposure to nicotine as a novel predictor of subsequent use of drugs shared by the twins. There is earlier evidence that prenatal exposure to marijuana predicts marijuana use in adolescence Day et al. We considered exposure to be positive if the mother reported smoking during her twin pregnancy for one month or more. We used logistic regression models as the main method of analysis. Although the study population consisted of twins, most analyses considered the subjects as individuals, but statistically accounted for twinship. Because observations on twins within twin pairs may be correlated, we used robust estimators of variance and the cluster option in STATA when estimating standard errors Williams, The preliminary logistic regression models tested the strength and significance of each potential predictor. The OR is a measure of the strength of the association between a risk factor and outcome, i. Because a wide array of predictive factors in drug use, yet more specifically in cannabis use, have been found to differ largely by age and sex Guxens et al. Also, before dropping out non-significant predictors from the multiple logistic regression models, we first analyzed the interaction with sex of each variable. If the interaction was significant the variable was further included in the model, even if it did not show a significant direct predictive effect. First, we analyzed the age-sex adjusted Odds Ratios OR of each potential predictor of drug use. If this OR was significant, we further explored the causal nature of that potential predictor. In order to control for familial factors, we utilized the fact that our population consisted of twins. We conducted series of conditional logistic regression analyses where we used the McNemar Test as an unadjusted test in order to assess the risk of using drugs given the potential predictor Thomas, Correspondingly, if a predictor is found to significantly explain drug use considering twins as individuals but not within discordant pairs, that potential predictor probably would have no direct effect on the risk of drug use. Rather, the association found in the individual-level analysis would be related to factors shared by the co-twins. However, this kind of test for within family confounds was not conducted for family factors, as the twins share these factors. Thus, only those individual and peer factors showing significant associations within families with the outcome, were taken into further consideration to be entered into the full multiple model. Thus, among those variable pairs, only the one showing stronger unadjusted association with the outcome was entered into the full model. The full model included individual factors, such as age, sex, age at smoking onset, drinking to intoxication and aggressive behavior, peer factors, such as number of smoking friends and number of acquaintances who had experimented with drugs, as well as family factors, such as parental alcohol use and pre-natal exposure to tobacco. In backwards stepwise selection approach any non-significant variable was dropped one by one. However, before dropping a predictor, interaction with sex was tested. Thus, the final model included, in addition to sex and age, only significant predictors and those with significant sex interactions. Due to missing values in some predictors, the final model was based on individuals. The mean age at second follow-up among boys was In this sample, For continuous variables the means M with standard deviations S. In both analyses the significance of differences are tested adjusting for correlated twinship. Means M with standard deviations S. For sex adjusted for age, for all other variables adjusted for age and sex. All relevant candidates were entered simultaneously into the full multiple logistic regression model. However, some of those significant predictor candidates were intercorrelated, i. These intercorrelations were taken into account when putting together the multivariate models. Among these pairs of intercorrelated factors, the one with stronger risk estimate on outcome was taken into the full model, i. However, the same variables turned out to be dropped out from the final model. After this a backwards stepwise procedure was applied to drop nonsignificant predictors until only significant ones were in the final model or those having significant interaction with sex. Actually two factors, i. Analysis of the interaction showed that the effect of aggressiveness was significantly weaker among girls than boys. As peer factors, both number of smoking friends and knowing others who have experimented with drugs remained highly significant predictors. The function of conditional logistic regressions conducted among twin pairs discordant for drug use was to further investigate causal nature of individual an peer predictors. Only those individual and peer factors which were significant in the preliminary analyses were further investigated. The results among the discordant twin pairs where applicable , controlling for familial factors, are shown in table 5. In general, the risk estimates were clearly attenuated after controlling for familial influences. Further, some of the variables did not remain significant, such as inattention and anxiety, suggesting that correlated within-family factors contribute to these associations. However, other variables tested, i. In this adolescent longitudinal twin study we explored factors predicting lifetime use of cannabis or other illicit drugs in Finland. Aggressive behavior predicted drug use among boys only. Importantly, some of the individual predictors were replicated in analysis of co-twins discordant for lifetime use of drugs. Methodological strengths of this study include longitudinal design, high participation rates, and analysis among discordant twin pairs as matched cases and controls. Thus, this study includes a two phased analysis, i. This approach allowed us to take into account some known within-family confounds in substance use, such as family status and structure. By doing so the risk estimates for early smoking onset, drinking to intoxication, aggressiveness, smoking peers and acquaintances with drug experience were reduced but still remained significant. Because within-family factors, such as family status and structure, are major issues in substance use we consider this approach very important. Naturally, this approach was applicable for individual and peer factors only, because for family factors, reported by the parents, all twin pairs were concordant in our study. In Finland, Poikolainen and co-authors have previously reported on cannabis use among young adults aged In their sample cannabis use was related to male gender, absence of mother, frequent lack of interest and early age at first sexual intercourse. The prevalence of lifetime cannabis use was higher, i. However, our participants were younger and this age difference may explain the differences in the prevalence. We found that girls had initiated use of cannabis or other drugs more often than boys, which is not consistent with earlier Finnish findings that boys initiated more often. Also this difference may be related to age, as we have found a similar pattern for alcohol use early in adolescence, whereby girls are more likely to initiate at a younger age Rose et al. Another explanation may be the timing of outcome data collection. In the earlier study, data collection happened in , whereas in our study that data collection took place from late to early More recent data seems to show more risk taking health behaviors among girls than earlier seen. This may be partly because of pubertal development differences between girls and boys becoming more visible in risk taking behavior patterns than earlier. In all, however, our finding that girls initiated use of cannabis or other drugs more than boys is in contrast with most literature on this topic e. Guxens et al. Early exposure to tobacco had a strong effect on use of cannabis or other drugs during adolescence. Moreover, even in the analysis among discordant twin pairs the effect of smoking initiation by the age of 12 was a powerful predictor for subsequent drug use. Age of first drug use at a lower stage is suggested to be a strong predictor of further progression Kandel and Yamaguchi, Further support comes from a recent study conducted among women Agrawal et al. Our result raises a further question, whether this strong relationship reflects the gateway hypothesis suggested by Kandel and Yamakuchi where cigarette smoking is seen as a gateway for more serious and illegal drug use. It is also possible that shared genetic or environmental influences could explain that vulnerability for early onset of cigarette smoking is shared with vulnerability for drug use during adolescence. Further, drinking to intoxication at age 14 predicted later drug use in our sample, which is consistent with earlier longitudinal studies Guxens et al. However, alcohol use had much lower OR, which may suggest that smoking is a more powerful risk behavior. Other consistently significant predictors in the current study were peer related substance use variables, i. There is recent and consistent evidence suggesting that peer substance use predicts own drug use later Agrawal et al. More importantly, our genetically informative data allowed exploring the causal nature of these predictors. Also, Agrawal and co-authors found among a genetically informative sample of female adolescent twins that the multivariate stepwise modeling adjusted for zygosity retained only influences of peers towards substance use. Although both cigarette smoking and drug use among peers were significant predictors in our analyses, drug use seemed to be much more powerful, as knowing at least one individual who had used drugs increased the likelihood of own drug use. The influence of smoking peers became significant only if at least five of the friends were smokers. This may be associated with the fact that smoking under the age of 18 is not illegal in Finland, although buying cigarettes is, whereas drug experimentation and use is more clearly related to deviant behavior. Although we discovered that peer influences consistently, maybe even causally i. Influences of peers are not uniform across different families and adolescents and socialization effects of peers are more seen as processes that modulate the dispositional tendencies of adolescents. Some shared environmental effects are unique to the reciprocal interactions of siblings growing together. Moreover, adolescents tend to choose as their friends peers who are similar in terms of their behavior Rose, Externalizing behavior was not as important predictor of lifetime use of cannabis or other illicit drugs in our sample as in earlier literature Brook et al. The analyses among discordant twins suggested that the association only remained significant for hyperactivity-impulsivity and aggressiveness, but not for inattention symptoms. Thus, the association of inattention symptoms with the onset of illicit drug use is probably not causal in nature. Further, when adjusted for all other variables and significant interactions, aggressiveness was a significant predictor among boys only. However, in other countries, such as The Netherlands, cannabis use has been associated with aggression and delinquency independent of gender Monshouwer et al. Our result that, at least some predictors of lifetime drug use differ by sex is supported by earlier literature Guxens et al. The current study did not find evidence for internalizing behavior as predictor of subsequent drug use. In previous studies early symptoms of anxiety and depression were related to illicit drug use in adolescence or in young adulthood Buckner et al. It is possible that in this age group externalizing behavior is more easily observed by the teacher than internalizing behavior. Thus, internalizing behavior may be somewhat underreported. Moreover, earlier studies among Finnish adolescents have suggested that other substance use, such as alcohol drinking, and delinquent behaviour are associated with peer-oriented behaviours and aggression, but low anxiety Pulkkinen et al. Socially anxious adolescents are not peer-oriented and do not make early experiments with substances. Perhaps self-medication aspect in substance use becomes more visible at a later age. Finally, prenatal exposure to nicotine was our novel predictor candidate for subsequent drug use. When adjusted for sex and age only, this type of exposure almost doubled the chances of later drug use. However, when adjusted for other significant predictors, this exposure did not have an independent role. Although earlier studies show that prenatal exposure to marijuana predicts marijuana use in adolescence Day et al. It is possible that the effect of prenatal exposure is substance specific or that other factors in our multiple model, such as early onset of own smoking mediated the effect of prenatal exposure. Earlier literature includes also other factors predicting use of illicit drugs. Some individual factors related to leisure time patterns have been earlier suggested as risk factors of cannabis use, such as spending time in bars and discos Guxens et al. Although we included several family factors in the current analyses, there are others which were not considered, such as low parental involvement and higher coercive parental discipline Chen et al. However, when testing our individual predictors among the discordant twin pairs, we actually controlled also for those potential family related factors shared by the twins. Further, although beyond the scope of our paper, some neighborhood and community factors describing unfavorable social environment, such as poverty, drug availability, acceptance of drug use, lack of community support structures, lack of social cohesion Compton et al. Again, our analyses among discordant pairs partly accounted for these factors. Thus, only very few Finnish adolescents would have used any illicit drug if they had not also at least experimented with cannabis. However, we are not able to disentangle which proportion used cannabis only and which proportion both cannabis and other illicit drugs. Moreover, in order to study factors predicting cannabis use only vs. In summary, we confirmed earlier findings on importance of earlier use of other licit substances and peer influences predicting use of cannabis or other illicit drugs, even when controlling for family confounding. We conclude that initiation of cigarette smoking by the age of 12 seems to be a powerful predictor for subsequent drug use among Finnish adolescents. These relationships were found even after adjusting for within-family confounds, which includes the influences of shared childhood effects. Further studies should investigate whether this relationship reflects the causal gateway hypothesis or whether shared genetic or environmental influences explain the co-morbidity. As a library, NLM provides access to scientific literature. Drug Alcohol Depend. Published in final edited form as: Drug Alcohol Depend. Find articles by Tellervo Korhonen. Find articles by Anja C Huizink. Find articles by Danielle M Dick. Find articles by Lea Pulkkinen. Find articles by Richard J Rose. Find articles by Jaakko Kaprio. Issue date Sep 1. PMC Copyright notice. The publisher's version of this article is available at Drug Alcohol Depend. Open in a new tab. Age b Declaration of interest None declared. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Ever smoking c. Age of smoking initiation d. Drinking to intoxication c. Number of smoking peers c. Number of acquaintances with drug experience d. Pre-natal exposure to nicotine e. Hyperactivity-Impulsivity c. Inattention c. Aggressiveness c. Depressiveness c. Social anxiety c. Ever smoking at age 14 b. Age of smoking initiation reported at age 17 b. Hyperactivity-impulsivity at age 12 b. Aggressiveness at age 12 b. Pre-natal exposure b. Ever smoking a. Smoking initiation a. Hyperactivity-impulsivity b. Aggressiveness b.

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Buying Ecstasy Jyvaskyla

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Buying Ecstasy Jyvaskyla