University of Oulu

W. Alex Mason, Irina Patwardhan, Gail L. Smith, Mary B. Chmelka, Jukka Savolainen, Stacy-Ann A. January, Jouko Miettunen, Marjo-Riitta Järvelin, Cumulative contextual risk at birth and adolescent substance initiation: Peer mediation tests, Drug and Alcohol Dependence, Volume 177, 2017, Pages 291-298, ISSN 0376-8716,

Cumulative contextual risk at birth and adolescent substance initiation : peer mediation tests

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Author: Mason, W. Alex1; Patwardhan, Irina1; Smith, Gail L.1;
Organizations: 1Boys Town, National Research Institute for Child and Family Studies, Boys Town, NE 68010, USA
2Inter-University Consortium for Political and Social Research (ICPSR), Institute for Social Research, University of Michigan, Ann Arbor, MI 48106, USA
3Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
4Center for Life Course Health Research, University of Oulu, Oulu, Finland and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
5Department of Epidemiology and Biostatistics, MRC PHE Centre for Environment and Health, School of Public Health, Imperial College London, UK
6Center for Life Course Epidemiology, Faculty of Medicine, P.O. Box 5000, FI-90014 University of Oulu, Finland
7Biocenter Oulu, University of Oulu, Finland
8Unit of Primary Care, Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link:
Language: English
Published: Elsevier, 2017
Publish Date: 2019-05-09


Background: Children who experience multiple adversities, such as prenatal exposure to drugs and poverty, early in development are at increased risk for the early initiation of alcohol and cigarette use. However, studies that examine potentially malleable processes associated with substance use initiation in the context of exposure to cumulative stressors are scant. This study examined associations between cumulative contextual risk at birth and initiation of alcohol and cigarette use in adolescence, testing childhood peer marginalization and peer aggression and behavior problems as mediating mechanisms. Analyses further adjusted for fearfulness/inhibition and hyperactivity/distractibility to determine if the hypothesized mediating mechanisms were significant after accounting for temperamental characteristics associated with substance initiation.

Methods: Participants were 6190 adolescents from the Northern Finland Birth Cohort 1986 Study. Data were collected on cumulative contextual risk (parent reports), substance initiation (adolescent reports), childhood peer processes and behavior problems (teacher reports), and temperamental characteristics (teacher reports). Novel discrete-time survival mediation analysis was conducted to test the hypothesized mediating mechanisms.

Results: Initial analyses showed that the associations between cumulative contextual risk and both alcohol and cigarette initiation were mediated by childhood peer processes and behavior problems; however, the indirect effects became statistically non-significant after adding the temperament variables, which themselves predicted substance initiation.

Conclusions: Targeting peer processes may not be an effective way to interrupt pathways leading from early contextual risk to substance initiation. Instead, early screening and intervention efforts to delay substance initiation may need to be tailored to the individual temperamental characteristics of targeted participants.

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Series: Drug and alcohol dependence
ISSN: 0376-8716
ISSN-E: 1879-0046
ISSN-L: 0376-8716
Volume: 177
Pages: 291 - 298
DOI: 10.1016/j.drugalcdep.2017.03.045
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: The analyses were supported by National Institute on Drug Abuse (NIDA), National Institutes of Health, Grant # R01 DA038450. Support for the Northern Finland Birth Cohort was provided by the European Commission (Grant DynaHEALTH—H2020—633595), EU QLG1-CT-2000-01643 (EUROBLCS) Grant no. E51560, NorFA Grant no. 731, 20056, 30167, and USA/NIHH 2000 G DF682 Grant no. 50945. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. The funders played no role in the research design, data collection, analysis, or writing and submission process.
EU Grant Number: (633595) DYNAHEALTH - Understanding the dynamic determinants of glucose homeostasis and social capability to promote Healthy and active aging
Copyright information: © 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license