Early Marijuana Use Before Age 13 Linked to More Risky Behaviors, Especially Among Teen Gamblers
Adolescents who started using marijuana before age 13 had higher odds of using other substances and engaging in violence, with gambling status modifying several of these relationships.
Quick Facts
What This Study Found
Early marijuana use (before age 13) was associated with higher odds of cigarette smoking, alcohol use, heavy drinking, lifetime cocaine use, e-cigarette use, and physical fighting compared to no use. Among gambling adolescents, early use was specifically linked to greater odds of prescription opiate misuse and any substance use. Gambling status modified associations with opiate misuse, substance use, school bullying, and forced sexual intercourse.
Key Numbers
2,015 adolescents from 2019 YRBS. Early MU linked to higher odds of cigarette smoking, alcohol, heavy drinking, cocaine, e-cigarettes, and fighting. Gambling adolescents with early MU had greater odds of prescription opiate misuse. Gambling status moderated associations with opiate misuse, substance use, bullying, and forced sexual intercourse.
How They Did This
Analysis of 2019 Youth Risk Behavior Surveillance survey data (n=2,015) examining relationships between early (<13 years), later (>=13 years), and no marijuana use with substance use and violence, stratified by gambling status. Adjusted multivariate logistic regression models.
Why This Research Matters
Early initiation of any substance is a well-known risk factor, but the interaction with gambling behavior suggests that adolescents who engage in multiple risk behaviors may face compounding vulnerabilities.
The Bigger Picture
This study highlights that early marijuana use is not an isolated risk factor but part of a cluster of risky behaviors. The gambling interaction suggests that some adolescents may have a general vulnerability to multiple risk behaviors rather than substance-specific risk.
What This Study Doesn't Tell Us
Cross-sectional survey design limits causal conclusions. Self-reported data from adolescents. YRBS is school-based, missing out-of-school youth. Gambling measure not standardized. Cannot determine directionality between marijuana use and other behaviors.
Questions This Raises
- ?What drives the specific interaction between gambling and early marijuana use?
- ?Would prevention programs targeting multiple risk behaviors be more effective than substance-specific programs?
Trust & Context
- Key Stat:
- Evidence Grade:
- National survey data with adequate sample and multivariate modeling, but cross-sectional design and self-report limit to moderate.
- Study Age:
- Data from the 2019 Youth Risk Behavior Surveillance survey.
- Original Title:
- The Relationships of Early Use of Marijuana With Substance Use and Violence in Adolescent Gamblers and Non-Gamblers.
- Published In:
- Journal of the Korean Academy of Child and Adolescent Psychiatry, 36(3), 89-105 (2025)
- Authors:
- Sirek, Greta, Stefanovics, Elina A(2), Iyer, Rasika, Potenza, Marc N, Zhai, Zu Wei
- Database ID:
- RTHC-07672
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
Why is starting marijuana before age 13 particularly risky?
Adolescents who started before 13 had consistently higher odds of using other substances and engaging in violence compared to those who started later or never used, suggesting early initiation marks a particularly vulnerable group.
Does gambling make marijuana use worse?
The study found that gambling status modified the relationship between marijuana use and certain outcomes like opiate misuse, suggesting that gambling and early marijuana use may represent overlapping risk behavior patterns.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-07672APA
Sirek, Greta; Stefanovics, Elina A; Iyer, Rasika; Potenza, Marc N; Zhai, Zu Wei. (2025). The Relationships of Early Use of Marijuana With Substance Use and Violence in Adolescent Gamblers and Non-Gamblers.. Journal of the Korean Academy of Child and Adolescent Psychiatry, 36(3), 89-105. https://doi.org/10.5765/jkacap.250012
MLA
Sirek, Greta, et al. "The Relationships of Early Use of Marijuana With Substance Use and Violence in Adolescent Gamblers and Non-Gamblers.." Journal of the Korean Academy of Child and Adolescent Psychiatry, 2025. https://doi.org/10.5765/jkacap.250012
RethinkTHC
RethinkTHC Research Database. "The Relationships of Early Use of Marijuana With Substance U..." RTHC-07672. Retrieved from https://rethinkthc.com/research/sirek-2025-the-relationships-of-early
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.