{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T13:05:45Z","timestamp":1765976745528,"version":"3.40.5"},"reference-count":65,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T00:00:00Z","timestamp":1710720000000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T00:00:00Z","timestamp":1710720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1041867","APP1045318","APP1109366","APP1146634","APP1174630","GNT0188568","GNT1009381","GNT1064893"],"award-info":[{"award-number":["APP1041867","APP1045318","APP1109366","APP1146634","APP1174630","GNT0188568","GNT1009381","GNT1064893"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000923","name":"Australian Research Council","doi-asserted-by":"publisher","award":["DP1096668"],"award-info":[{"award-number":["DP1096668"]}],"id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007281","name":"National Drug and Alcohol Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Adolescent polysubstance use has been associated with adverse social and health outcomes. Our aim was to measure rates and transitions to polysubstance use during adolescence and identify factors associated with initiation and discontinuation of polysubstance use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective cohort study. Multistate Markov modelling was used to estimate rates and identify correlates of transitions between substance use states.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and participants<\/jats:title><jats:p>Adolescent\u2010parent dyads (<jats:italic>n<\/jats:italic>\u2009=\u20091927; adolescents in grade 7, age \u224813\u2009years) were recruited from Australian schools during 2010\/11 (Wave 1). Adolescents were surveyed annually until 2016\/17 (<jats:italic>n<\/jats:italic>\u2009=\u20091503; age \u224819\u2009years; Wave 7) and parents were surveyed annually until 2014\/15 (Wave 5).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Alcohol, tobacco, cannabis and 3,4\u2010methylenedioxymethamphetamine (MDMA) use outcomes were collected at Waves 3\u20137. Potential confounders were collected at Waves 1\u20136 and consisted of sex, anxiety and depression symptoms and externalizing problems, parental monitoring, family conflict and cohesion, parental substance use and peer substance use. Covariates were age and family socioeconomic status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Few adolescents engaged in polysubstance use at earlier waves (Wave 3: 5%; Wave 4: 8%), but proportions increased sharply across adolescence (Waves 5\u20137: 17%, 24%, 36%). Rates of transitioning to polysubstance use increased with age, with few (&lt;9%) adolescents transitioning out. More externalizing problems (odds ratio [OR]\u2009=\u20091.10; 99.6% confidence interval [CI]\u2009=\u20091.07\u20131.14), parental heavy episodic drinking (OR\u2009=\u20091.22; 99.6% CI\u2009=\u20091.07\u20131.40), parental illicit substance use (OR\u2009=\u20093.56; 99.6% CI\u2009=\u20091.43\u20138.86), peer alcohol use (OR\u2009=\u20095.68; 99.6% CI\u2009=\u20091.59\u201320.50) and peer smoking (OR\u2009=\u20094.18; 99.6% CI\u2009=\u20091.95\u20138.81) were associated with transitioning to polysubstance use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Polysubstance use in Australia appears to be rare during early adolescence but more common in later adolescence with low rates of transitioning out. Externalizing problems and greater parental and peer substance use are risk factors for adolescent polysubstance use that may be suitable intervention targets.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16468","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T03:44:31Z","timestamp":1710819871000},"page":"1100-1110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Transitions to polysubstance use: Prospective cohort study of adolescents in Australia"],"prefix":"10.1111","volume":"119","author":[{"given":"Nicola","family":"Black","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Health and Human Sciences Macquarie University  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2263-2108","authenticated-orcid":false,"given":"Firouzeh","family":"Noghrehchi","sequence":"additional","affiliation":[{"name":"Biomedical Informatics and Digital Health The University of Sydney  Camperdown Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2791-6858","authenticated-orcid":false,"given":"Wing See","family":"Yuen","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Kensington Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Aiken","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Kensington Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2009-7386","authenticated-orcid":false,"given":"Philip J.","family":"Clare","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Kensington Australia"},{"name":"Prevention Research Collaboration The University of Sydney  Camperdown Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7569-1948","authenticated-orcid":false,"given":"Gary","family":"Chan","sequence":"additional","affiliation":[{"name":"National Centre for Youth Substance Use Research The University of Queensland  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9657-9904","authenticated-orcid":false,"given":"Kypros","family":"Kypri","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health University of Newcastle  Newcastle Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1714-6631","authenticated-orcid":false,"given":"Nyanda","family":"McBride","sequence":"additional","affiliation":[{"name":"National Drug Research Institute Curtin University  Shenton Park Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raimondo","family":"Bruno","sequence":"additional","affiliation":[{"name":"School of Psychological Sciences University of Tasmania  Hobart Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1725-9188","authenticated-orcid":false,"given":"Tim","family":"Slade","sequence":"additional","affiliation":[{"name":"The Matilda Centre for Research in Mental Health and Substance Use The University of Sydney  Camperdown Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6872-7770","authenticated-orcid":false,"given":"Veronica","family":"Boland","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Kensington Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Mattick","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Kensington Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5705-2026","authenticated-orcid":false,"given":"Amy","family":"Peacock","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Kensington Australia"},{"name":"School of Psychological Sciences University of Tasmania  Hobart Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2020.00569"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.11.035"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2478\/nsad-2014-0026"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2017.01.006"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12829"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2013.12.011"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826084.2017.1323926"},{"volume-title":"National Drug Strategy Household Survey 2019","year":"2020","author":"Australian Institute of Health & Welfare","key":"e_1_2_11_9_1"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3998\/2027.42\/162579"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2013.08.007"},{"volume-title":"Australian guidelines to reduce health risks from drinking alcohol","year":"2020","author":"National Health and Medical Research Council","key":"e_1_2_11_12_1"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/002204261004000106"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2016.08.004"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2017.09.011"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00048674.2010.501759"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2007.01.022"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmft.12111"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1037\/0893-3200.8.3.347"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-3737.2000.00175.x"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01857657"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14547"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2010.01.013"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000068"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2013.06.015"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106545"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2022.100389"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.05.015"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15161"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/1179173X20949271"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv051"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291716002373"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"volume-title":"Australian guidelines to reduce health risks from drinking alcohol","year":"2009","author":"National Health Medical Research Council","key":"e_1_2_11_34_1"},{"volume-title":"Manual for the youth self\u2010report and 1991 profile","year":"1991","author":"Achenbach TM","key":"e_1_2_11_35_1"},{"volume-title":"Meeting of the Society of Research in Child Development","year":"1991","author":"Silverberg S","key":"e_1_2_11_36_1"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(98)00133-8"},{"volume-title":"Socio\u2010economic indexes for areas (seifa): Technical paper","year":"2006","author":"Pink B","key":"e_1_2_11_38_1"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177699147"},{"key":"e_1_2_11_40_1","unstructured":"R Core Team.R: A language and environment for statistical computing.Vienna Austria:R Foundation for Statistical Computing;2019. Available from:https:\/\/www.R-project.org\/"},{"volume-title":"Multiple imputation for nonresponse in surveys","year":"2004","author":"Rubin DB","key":"e_1_2_11_41_1"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280206074463"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4067"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-007-0070-9"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0031173"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.59.1.48"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2017.09.022"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.05.031"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.933488"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-6892-0"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-019-00515-8"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-018-1645-4"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckz029"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(17)30240-2"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1080\/17437199.2016.1168268"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.11.002"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)00002-X"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12497"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2016.03.007"},{"volume-title":"Key substance use and mental health indicators in the United States: Results from the 2020 national survey on drug use and health","year":"2021","author":"Substance Abuse and Mental Health Services Administration","key":"e_1_2_11_61_1"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15987"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-019-0981-2"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1359-6357.2003.00586.x"},{"key":"e_1_2_11_65_1","unstructured":"WhiteV WilliamsT.Australian secondary school students' use of tobacco alcohol and over\u2010the\u2010counter and illicit substances in 2014. In:WhiteV WilliamsT editorsCentre for Behavioural Research in Cancer The Cancer Council Victoria:Victoria;2016."},{"key":"e_1_2_11_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12679"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.16468","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.16468","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T02:52:20Z","timestamp":1715050340000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.16468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,18]]},"references-count":65,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1111\/add.16468"],"URL":"https:\/\/doi.org\/10.1111\/add.16468","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"type":"print","value":"0965-2140"},{"type":"electronic","value":"1360-0443"}],"subject":[],"published":{"date-parts":[[2024,3,18]]},"assertion":[{"value":"2022-11-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}