Alcohol, Not Marijuana, Was the Most Common First Substance Among US 12th Graders
In a nationally representative sample of US 12th graders, alcohol was the most commonly used first substance, and students who started drinking in 6th grade reported significantly more illicit drug use than those who started in 9th grade or later.
Quick Facts
What This Study Found
Researchers examined data from 2,835 US 12th graders to determine which substance adolescents use first and how the age of first use relates to later drug involvement.
Alcohol was the most commonly used substance, and the majority of polysubstance users consumed alcohol before trying tobacco or marijuana. This challenges the popular "gateway drug" narrative that typically focuses on marijuana.
Students who started drinking in 6th grade reported significantly more lifetime illicit substance use and more frequent illicit substance use than those who began in 9th grade or later. The effect sizes for these differences were large (eta squared = 0.30 and 0.28).
Key Numbers
2,835 12th graders sampled. Alcohol was the most common first substance. 6th-grade alcohol initiators: mean 1.9 illicit substances (SD 1.7) and mean frequency of 6.0 (SD 6.5). 9th-grade-or-later initiators had significantly lower use. Effect sizes: eta squared = 0.30 and 0.28 (large).
How They Did This
The study analyzed data from a nationally representative sample of 2,835 US 12th graders. Researchers examined the sequence of substance initiation (alcohol, tobacco, marijuana) and used statistical analysis to compare illicit drug use outcomes based on age of first alcohol use.
Why This Research Matters
The finding that alcohol, not marijuana, is the most common entry point to substance use has implications for prevention priorities. It suggests that school-based prevention programs targeting alcohol use, potentially starting as early as third grade, could have a greater impact on reducing later illicit drug use.
The Bigger Picture
The "gateway drug" concept has long been debated in drug policy. This study's finding that alcohol is the most common first substance in the progression toward polysubstance use challenges the framing that typically places marijuana in this role and has implications for how prevention resources are allocated.
What This Study Doesn't Tell Us
The cross-sectional design captures associations at one time point rather than following students over time. Self-reported substance use may be inaccurate. The study cannot determine whether early alcohol use causes later illicit drug use or whether both reflect common underlying risk factors.
Questions This Raises
- ?Would targeted alcohol prevention in elementary school reduce later illicit drug use?
- ?Is the sequence of substance initiation changing as cannabis becomes more accessible?
Trust & Context
- Key Stat:
- Alcohol, not marijuana, was the most common first substance in the path to polysubstance use
- Evidence Grade:
- This is a cross-sectional analysis of nationally representative data with large effect sizes. It provides moderate evidence on substance use sequence but cannot establish causation.
- Study Age:
- Published in 2016. Substance use patterns among adolescents may have shifted with changing cannabis legalization and vaping trends.
- Original Title:
- Prioritizing Alcohol Prevention: Establishing Alcohol as the Gateway Drug and Linking Age of First Drink With Illicit Drug Use.
- Published In:
- The Journal of school health, 86(1), 31-8 (2016)
- Authors:
- Barry, Adam E, King, Jessica, Sears, Cynthia, Harville, Cedric, Bondoc, Irina, Joseph, Kessy
- Database ID:
- RTHC-01098
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Is marijuana the gateway drug?
This study found that alcohol, not marijuana, was the most commonly used first substance, and most polysubstance users consumed alcohol before either tobacco or marijuana. The "gateway" concept is more complex than typically portrayed, with alcohol playing a more prominent role in the sequence.
Why does starting young matter so much?
Students who began drinking in 6th grade had substantially more illicit drug use than those who started in 9th grade. Early substance use may occur during a more vulnerable developmental period, or it may be a marker for other risk factors that also predict later drug use.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-01098APA
Barry, Adam E; King, Jessica; Sears, Cynthia; Harville, Cedric; Bondoc, Irina; Joseph, Kessy. (2016). Prioritizing Alcohol Prevention: Establishing Alcohol as the Gateway Drug and Linking Age of First Drink With Illicit Drug Use.. The Journal of school health, 86(1), 31-8. https://doi.org/10.1111/josh.12351
MLA
Barry, Adam E, et al. "Prioritizing Alcohol Prevention: Establishing Alcohol as the Gateway Drug and Linking Age of First Drink With Illicit Drug Use.." The Journal of school health, 2016. https://doi.org/10.1111/josh.12351
RethinkTHC
RethinkTHC Research Database. "Prioritizing Alcohol Prevention: Establishing Alcohol as the..." RTHC-01098. Retrieved from https://rethinkthc.com/research/barry-2016-prioritizing-alcohol-prevention-establishing
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.