Article information
Abstract
Objective
To determine the factors associated with the onset of cannabis use through a systematic review of cohort studies.
MethodsAn internet-based search was performed using several keywords and their combinations. Original studies with longitudinal design and the onset of cannabis use as dependent variable, as well as review studies were included, published between January 1980 and May 2004. Methodology quality of the studies was assessed independently by two reviewers, according to pre-established criteria, in order to classify studies in high, mid or low quality. Agreement between reviewers was assessed through kappa coefficient.
ResultsA total of 32 relevant studies were identified, of which 13 were of higher quality. Selection bias for the inclusion of consumers at the baseline measurement and lack or insufficient adjustment for confounders were the causes of exclusion. The factors of great evidence related to the onset of cannabis use were masculine sex, consumption of tobacco or alcohol, having a problematic relationship with parents, and cannabis consumption by friends.
ConclusionResults highlight the importance of different individual, family and environmental factors on the onset of cannabis use. These must be considered to properly arrange intervention programs focusing on primary prevention among teenagers.
Keywords:
Cannabis
Systematic review
Longitudinal studies
Resumen
Objetivo
Determinar los factores asociados al inicio del consumo de cannabis a partir de una revisión sistemática de estudios de cohortes.
MétodosSe realizó una búsqueda bibliográfica informatizada utilizando diversas palabras clave y sus combinaciones. Entre los estudios identificados se seleccionaron los estudios originales de diseño longitudinal que utilizaran como variable dependiente el inicio de consumo de cannabis, así como los estudios de revisión, publicados entre enero de 1980 y mayo de 2004. Se evaluó la calidad metodológica de los estudios mediante 2 revisores, de manera independiente y a partir de unos criterios prestablecidos, clasificando los artículos en 3 categorías: alta, intermedia o baja calidad. Se midió el nivel de concordancia de los revisores a partir del coeficiente kappa.
ResultadosSe identificaron 32 estudios que cumplían los criterios de selección, de los cuales 13 fueron determinados de alta calidad. Las causas de exclusión fueron el sesgo de selección, por la inclusión de consumidores al inicio de la cohorte estudiada, y la falta de ajuste por los potenciales confusores. Los factores que se relacionaron con una mayor evidencia con el inicio del consumo de cannabis fueron el sexo masculino, el consumo de tabaco y alcohol, tener una relación problemática con los padres y el consumo de cannabis por parte de los amigos.
ConclusionesLos resultados señalan la importancia de diversos factores individuales, familiares y del entorno en el inicio del consumo de cannabis, que deberían considerarse de forma conjunta en el abordaje preventivo entre los adolescentes.
Palabras clave:
Cannabis
Revisión sistemática
Estudios longitudinales
Full text is only aviable in PDF
Bibliografía
[1.]
H. Ashton.
Cannabis or health?.
Curr Opin Psychiatry, 15 (2002), pp. 247-253
[2.]
J. Bobes, A. Calafat.
Monografía del cannabis.
Addiciones, 12 (2000), pp. 5-329
[3.]
H. Kalant.
Adverse effects of cannabis on health: an update of the literature since 1996.
Prog Neuropsychopharmacol Biol Psychiatry, 28 (2004), pp. 849-863
[4.]
Minister of Public Health of Belgium. Cannabis. 2002 Report. A joint international effort at the initiative of the Ministers of Public Health of Belgium, France, Germany, The Netherlands, Switzerland. Brussels: Technical Report of the International Scientific Conference; 2002.
[5.]
D.M. Fergusson, L.J. Horwood, A.L. Beautrais.
Cannabis and educational achievement.
Addiction, 98 (2003), pp. 1681-1692
[6.]
J. Macleod, R. Oakes, A. Copello, I. Crome, M. Egger, M. Hickman, et al.
Psychological and social sequelae of cannabis and other illicit drug use by young people: a systematic review of longitudinal, general population studies.
Lancet, 363 (2004), pp. 1579-1588
[7.]
C. Henquet, L. Krabbendam, J. Spauwen, C. Kaplan, R. Lieb, H.U. Wittchen, et al.
Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people.
BMJ, 330 (2005), pp. 11
[8.]
D.M. Semple, A.M. McIntosh, S.M. Lawrie.
Cannabis as a risk factor for psychosis: systematic review.
J Psychopharmacol, 19 (2005), pp. 187-194
[9.]
European Monitoring Centre for Drugs and Drug. Addiction Annual Report 2004: the state of the drugs problem in the European Union and Norway. Office for Official Publications of the European Communities, Luxembourg, pp. 28-30 [citado 12 Jun 2006]. Disponible en: http://annualreport.emcdda. eu.int/download/ar2004-en.pdf
[10.]
Observatorio Español sobre Drogas. Informe 2004. Ministerio del Interior Delegación del Gobierno para el Plan Nacional sobre Drogas, España, pp. 22-37 [citado 31 Dic 2004]. Disponible en: http://www.pnsd.msc.es/Categoria2/publica/pdf/oed-2004.pdf
[11.]
Observatorio Español sobre Drogas. Informe n.° 5, julio 2002. Ministerio del Interior Delegación del Gobierno para el Plan Nacional sobre Drogas, España, p. 25-26 [citado 31 Dic 2004]. Disponible en: http://www.pnsd.msc.es/Categoria2/publica/pdf/oed-5.pdf
[12.]
S. Cabrera.
Drug use among hispanic youth: examinig comon and unique contributing factors.
Hisp J Behav Sci, 21 (1999), pp. 89-103
[13.]
T. Glynn.
From family to peer: a review of transitions of influence among drug using youth.
J Youth Adolesc, 10 (1981), pp. 363-383
[14.]
J.D. Hawkins, R.F. Catalano, J.Y. Miller.
Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention.
Psychol Bull, 112 (1992), pp. 64-105
[15.]
D.B. Kandel.
Drug and drinking behavior among youth.
Ann Rev Sociol, 6 (1980), pp. 235-285
[16.]
D.B. Kandel.
The parental and peer contexts od adolescent deviance: an algebra of interpersonal influences.
J Drug Issues, 26 (1996), pp. 289-315
[17.]
K. Von Sydow, R. Lieb, H. Pfister, M. Hofler, H.U. Wittchen.
What predicts incident use of cannabis and progression to abuse and dependence? A 4-year prospective examination of risk factors in a community sample of adolescents and young adults.
Drug Alcohol Depend, 68 (2002), pp. 49-64
[18.]
D.M. Fergusson, M.T. Lynskey, L.J. Horwood.
Conduct problems and attention deficit behaviour in middle childhood and cannabis use by age 15.
Aust NZ J Psychiatry, 27 (1993), pp. 673-682
[19.]
R. McGee, S. Williams, R. Poulton, T. Moffitt.
A longitudinal study of cannabis use and mental health from adolescence to early adulthood.
Addiction, 95 (2000), pp. 491-503
[20.]
W. Pedersen.
Adolescents initiating cannabis use: cultural opposition or poor mental health?.
J Adolesc, 13 (1990), pp. 327-339
[21.]
C. Coffey, M. Lynskey, R. Wolfe, G.C. Patton.
Initiation and progression of cannabis use in a population-based Australian adolescent longitudinal study.
Addiction, 95 (2000), pp. 1679-1690
[22.]
S.S. Aitken, J. DeSantis, T.C. Harford, M.F. Cases.
Marijuana use among adults. A longitudinal study of current and former users.
J Subst Abuse, 12 (2000), pp. 213-226
[23.]
N.K. Morojele, J.S. Brook.
Adolescent precursors of intensity of marijuana and other illicit drug use among adult initiators.
J Genet Psychol, 162 (2001), pp. 430-450
[24.]
J.S. Brook, R.C. Kessler, P. Cohen.
The onset of marijuana use from preadolescence and early adolescence to young adulthood.
Dev Psychopathol, 11 (1999), pp. 901-914
[25.]
R. Kosterman, J.D. Hawkins, J. Guo, R.F. Catalano, R.D. Abbott.
The dynamics of alcohol and marijuana initiation: patterns and predictors of first use in adolescence.
Am J Public Health, 90 (2000), pp. 360-366
[26.]
L.M. Siqueira, J.S. Brook.
Tobacco use as a predictor of illicit drug use and drug-related problems in Colombian youth.
J Adolesc Health, 32 (2003), pp. 50-57
[27.]
J.A. Andrews, H. Hops, D. Ary, E. Tildesley, J. Harris.
Parental influence on early adolescent substance use: Specific and nonspecific effects.
J Early Adolesc, 13 (1993), pp. 285-310
[28.]
T. Hammer, P. Vaglum.
Users and nonusers within a high risk milieu of cannabis use. A general population study.
Int J Addict, 26 (1991), pp. 595-604
[29.]
D.M. Fergusson, L.J. Horwood.
Early onset cannabis use and psychosocial adjustment in young adults.
Addiction, 92 (1997), pp. 279-296
[30.]
S.L. Bailey, R.L. Hubbard.
Developmental variation in the context of marijuana initiation among adolescents.
J Health Soc Behav, 31 (1990), pp. 58-70
[31.]
J.S. Brook, I.F. Lukoff, M. Whiteman.
Initiation into adolescent marijuana use.
J Genet Psychol, 137 (1980), pp. 133-142
[32.]
J.A. Andrews, E. Tildesley, H. Hops, F. Li.
The influence of peers on young adult substance use.
Health Psychol, 21 (2002), pp. 349-357
[33.]
R.H. Aseltine Jr.
A reconsideration of parental and peer influences on adolescent deviance.
J Health Soc Behav, 36 (1995), pp. 103-121
[34.]
D.W. Brook, J.S. Brook, Z. Rosen, I. Montoya.
Correlates of marijuana use in Colombian adolescents: a focus on the impact of the ecological/cultural domain.
J Adolesc Health, 31 (2002), pp. 286-298
[35.]
J.S. Brook, D.W. Brook, O. rencibia-Mireles, L. Richter, M. Whiteman.
Risk factors for adolescent marijuana use across cultures and across time.
J Genet Psychol, 162 (2001), pp. 357-374
[36.]
A.L. Bryant, J.E. Schulenberg, P.M. O’Malley, J.G. Bachaman, L.D. Johnston.
How academic achievement, attitudes, and behaviors relate to the course of substance use during adolescence: a 6-year, multiwave national longitudinal study.
J Res Adol, 13 (2003), pp. 361-397
[37.]
J.P. Fleming, S.G. Kellam, C.H. Brown.
Early predictors of age at first use of alcohol, marijuana, and cigarettes.
Drug Alcohol Depend, 9 (1982), pp. 285-303
[38.]
K.W. Griffin, G.J. Botvin, L.M. Scheier, T.R. Nichols.
Factors associated with regular marijuana use among high school students: a long-term follow-up study.
Subst Use Misuse, 37 (2002), pp. 225-238
[39.]
M. Hofler, R. Lieb, A. Perkonigg, P. Schuster, H. Sonntag, H.U. Wittchen.
Covariates of cannabis use progression in a representative population sample of adolescents: a prospective examination of vulnerability and risk factors.
Addiction, 94 (1999), pp. 1679-1694
[40.]
H. Hops, T.E. Duncan, S.C. Duncan.
Parent substance use as a predictor of adolescent use: a six-year lagged analysis.
Ann Behav Med, 18 (1996), pp. 57-64
[41.]
D.B. Kandel.
On processes of peer influences in adolescent drug use: a developmental perspective.
Adv Alcohol Subst Abuse, 4 (1985), pp. 139-163
[42.]
B.S. Molina, W.E. Pelham Jr.
Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD.
J Abnorm Psychol, 12 (2003), pp. 497-507
[43.]
M.D. Newcomb, M. Félix-Ortiz.
Multiple protective and risk factors for drug use and abuse: cross-sectional and prospective findings.
J Pers Soc Psychol, 63 (1992), pp. 280-296
[44.]
K. Poikolainen, A. Tuulio-Henriksson, T. Alto-Setala, M. Marttunen, T. Anttila, J. Lonnqvist.
Correlates of initiation to cannabis use: a 5-year follow-up of 15-19-year-old adolescents.
Drug Alcohol Depend, 62 (2001), pp. 175-180
[45.]
M.F. Sieber, J. Angst.
Alcohol, tobacco and cannabis: 12-year longitudinal associations with antecedent social context and personality.
Drug Alcohol Depend, 25 (1990), pp. 281-292
[46.]
A.W. Stacy, P.M. Bentler, B.R. Flay.
Attitudes and health behavior in diverse populations: drunk driving. Alcohol use, binge eating, marijuana use, and cigarette use.
Health Psychol, 13 (1994), pp. 73-85
[47.]
T.N. Sullivan, A.D. Farrell.
Identification and impact of risk and protective factors for drug use among urban African American adolescents.
J Clin Child Psychol, 28 (1999), pp. 122-136
[48.]
K. Yamaguchi, D.B. Kandel.
Patterns of drug use from adolescence to young adulthood (III). Predictors of progression.
Am J Public Health, 74 (1984), pp. 673-681
[49.]
M. Nebot, E. Giménez, C. Ariza, Z. Tomás.
Tendencias en el consumo de tabaco, alcohol y cannabis en los adolescents de Barcelona entre 1987 y 2004.
Med Clin (Barc), 126 (2006), pp. 159
[50.]
M.L. Van Etten, J.C. Anthony.
Comparative epidemiology of initial drug opportunities and transitions to first use: marijuana, cocaine, hallucinogens and heroin.
Drug Alcohol Depend, 54 (1999), pp. 117-125
[51.]
M.L. Van Etten, J.C. Anthony.
Male-female differences in transitions from first drug opportunity to first use: searching for subgroup variation by age, race, region, and urban status.
J Womens Health Gend Based Med, 10 (2001), pp. 797-804
[52.]
D.B. Kandel, K. Yamaguchi, K. Chen.
Stages of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory.
J Stud Alcohol, 53 (1992), pp. 447-457
[53.]
G.C. Patton, C. Coffey, J.B. Carlin, S.M. Sawyer, M. Lynskey.
Reverse gateways? Frequent cannabis use as a predictor of tobacco initiation and nicotine dependence.
Addiction, 100 (2005), pp. 1518-1525
[54.]
A. Amos, S. Wiltshire, Y. Bostock, S. Haw, A. McNeill.
«You can’t go without a fag... you need it for your hash»: a qualitative exploration of smoking, cannabis and young people.
Addiction, 99 (2004), pp. 77-81
[55.]
L.M. Tullis, R. Dupont, K. Frost-Pineda, M.S. Gold.
Marijuana and tobacco: a major connection?.
J Addict Dis, 22 (2003), pp. 51-62
[56.]
A.R. Morral, D.F. McCaffrey, S.M. Paddock.
Reassessing the marijuana gateway effect.
Addiction, 97 (2002), pp. 1493-1504
[57.]
J.C. Anthony.
Death of the «stepping-stone» hypothesis and the «gateway» model? Comments on Morral, et al.
Addiction, 97 (2002), pp. 1505-1507
[58.]
M.T. Lynskey, D.M. Fergusson, L.J. Horwood.
The origins of the correlations between tobacco, alcohol, and cannabis use during adolescence.
J Child Psychol Psychiatry, 39 (1998), pp. 995-1005
[59.]
H. DeVries, A.N. Mudde, A. Dijkstra, M.C. Willemsen.
Differential beliefs, perceived social influences, and self-efficacy expectations among smokers in various motivational phases.
Prev Med, 27 (1998), pp. 681-689
[60.]
M.K. Rothbart, S.A. Ahadi.
Temperament and the development of personality.
J Abnorm Psychol, 103 (1994), pp. 55-66
[61.]
M.Q. Wang, J.M. Eddy, E.C. Fitzhugh.
Smoking acquisition: peer influence and self-selection.
Psychol Rep, 86 (2000), pp. 1241-1246
[62.]
T.A. Wills, S.D. Cleary.
Peer and adolescent substance use among 6th-9th graders: latent growth analyses of influence versus selection mechanisms.
Health Psychol, 18 (1999), pp. 453-463
[63.]
E.R. Oetting, J.F. Donnermeyer.
Primary socialization theory: the etiology of drug use and deviance (I).
Subst Use Misuse, 33 (1998), pp. 995-1026
[64.]
L. Green, M.W. Kreuter.
Health promotion planning: an educational and environmental approach. 2001.
2nd ed, Mayfield Publishing Company, (1991),
[65.]
G.J. Botvin, E. Baker, L. Dusenbury, E.M. Botvin, T. Díaz.
Longterm follow-up results of a randomized drug abuse prevention trial in a white middle-class population.
JAMA, 273 (1995), pp. 1106-1112
Copyright © 2007. Sociedad Española de Salud Pública y Administración Sanitaria
