Drug and alcohol dependence · 2026
Predicting transitions in alcohol use among adolescents and young adults by nicotine and tobacco products used.
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Ruleman Ashlynn M, Mantey Dale S, Sokolovsky Alexander W, Chen Baojiang, Clendennen Stephanie L, Harrell Melissa B
Аннотация
OBJECTIVE: To characterize transitions in alcohol consumption behaviors by nicotine and tobacco products (NTPs) used across a diverse cohort of adolescents and young adults.
METHODS: A three-state Markov model was applied to six waves of data (2019-2021) collected biannually for 2608 (Nobs=14,152) participants in the Texas Adolescent Tobacco and Marketing Surveillance System 2.0. We examined nine possible transitions across three exclusive states of alcohol use (none, past 30-day drinking, and past 14-day binge drinking). We estimated the probability of transitioning between alcohol use behaviors by NTPs used (none, exclusive e-cigarette, exclusive combustible tobacco, dual use), controlling for age, race/ethnicity, sex, depression symptoms, and current cannabis use. Results were additionally stratified by sex.
RESULTS: Any NTP use resulted in a significantly greater risk of transitioning from non-drinking to binge drinking. Combustible tobacco and dual use predicted a lower risk of transitioning from binge drinking to current drinking. Dual use among females predicted onset of current or binge drinking from non-drinking. In contrast, female dual use also predicted discontinuation of binge drinking to non-drinking. Among males, the rapid onset of binge drinking from non-drinking was predicted by exclusive combustible or e-cigarette use.
CONCLUSIONS: Given findings that combustible tobacco use diminishes the probability of alcohol de-escalation among young adults, interventions should address both substances. Further research is needed to understand the moderating effect of sex on the relationship between NTP use and alcohol consumption.
METHODS: A three-state Markov model was applied to six waves of data (2019-2021) collected biannually for 2608 (Nobs=14,152) participants in the Texas Adolescent Tobacco and Marketing Surveillance System 2.0. We examined nine possible transitions across three exclusive states of alcohol use (none, past 30-day drinking, and past 14-day binge drinking). We estimated the probability of transitioning between alcohol use behaviors by NTPs used (none, exclusive e-cigarette, exclusive combustible tobacco, dual use), controlling for age, race/ethnicity, sex, depression symptoms, and current cannabis use. Results were additionally stratified by sex.
RESULTS: Any NTP use resulted in a significantly greater risk of transitioning from non-drinking to binge drinking. Combustible tobacco and dual use predicted a lower risk of transitioning from binge drinking to current drinking. Dual use among females predicted onset of current or binge drinking from non-drinking. In contrast, female dual use also predicted discontinuation of binge drinking to non-drinking. Among males, the rapid onset of binge drinking from non-drinking was predicted by exclusive combustible or e-cigarette use.
CONCLUSIONS: Given findings that combustible tobacco use diminishes the probability of alcohol de-escalation among young adults, interventions should address both substances. Further research is needed to understand the moderating effect of sex on the relationship between NTP use and alcohol consumption.