Among 3,805 Italian students aged 9-17, cannabis use at ages 14-15 was associated with a dramatically higher likelihood of also using new psychoactive substances.
Parents, educators, and public health professionals interested in adolescent substance use patterns.
26x higher risk of NPS use among 14-15-year-old cannabis users
What the researchers found
Cannabis use at ages 14-15 was associated with a 26-fold increased risk of using new psychoactive substances or non-prescribed drugs (OR 26.3, 95% CI 15.97-43.33).
Why it matters
The strength of the association between early cannabis use and subsequent use of other substances in this large school-based sample adds to the evidence on adolescent substance use patterns and potential gateway effects.
The numbers in context
3,805 students surveyed; cannabis use at 14-15 associated with OR 26.3 for NPS/NPD use; 53% of 14-15-year-olds and 68% of 16-17-year-olds hid substance use from parents and psychologists.
How the study worked
Anonymous questionnaire administered to 3,805 students aged 9-17 across 14 schools in the Genoa metropolitan area of Italy between December 2021 and May 2022. Logistic regression assessed associations between substance use and psychological outcomes.
What this study cannot tell us
Cross-sectional design prevents determining causation. Anonymous self-report may still underestimate use. Single metropolitan area limits generalizability. No control for confounding factors like socioeconomic status or family environment.
How to read the evidence
Large sample size but cross-sectional design limits causal inference.
When this study was published
Published in 2022 with data from the 2021-2022 school year.
The bigger picture
These findings from Italian schools mirror patterns seen globally: early adolescent cannabis use clusters with use of other substances, and the majority of young users do not disclose their use to adults.
Questions still open
- Does the strong statistical association reflect a causal pathway, shared risk factors, or simply co-occurring behaviors? Would school-based prevention programs change these patterns?
Common questions
What age group showed the strongest association between cannabis and other drug use?
How many students hid their substance use from adults?
Read the original research
Alcohol, smoke, cannabis, new psychoactive substances, and non-prescribed drugs consumption among school student in an area of Nord-West of Italy.
Minerva gastroenterology, 68(4), 421-425
Citation
Balbinot, Patrizia; Pellicano, Rinaldo; Testino, Gianni. (2022). Alcohol, smoke, cannabis, new psychoactive substances, and non-prescribed drugs consumption among school student in an area of Nord-West of Italy.. Minerva gastroenterology, 68(4), 421-425. https://doi.org/10.23736/S2724-5985.22.03253-3
Explore the wider topic
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