{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T22:03:48Z","timestamp":1759961028434,"version":"3.37.3"},"reference-count":52,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,5,8]],"date-time":"2017-05-08T00:00:00Z","timestamp":1494201600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001807","name":"FAPESP","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Secretaria Nacional Anti-Drogas"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction and Aims<\/jats:title><jats:p>Given a scenario of intense discussion about the legal situation of cannabis users worldwide, this paper aims to investigate the role of cannabis within a drug use sequencing pattern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Methods<\/jats:title><jats:p>Data came from a representative sample of college students from 27 Brazilian capitals (n\u00a0=\u00a012\u00a0711). We analysed the patterns of transition from\/to the first use of cannabis to\/from the first use of alcohol, tobacco and seven other illegal drugs. Survival analysis methods were used to analyse age of onset data on all potential drug pairs. Drugs that were not specified as the target drug pair tested in each survival model were included as time\u2010varying covariates in all models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found significant transitions from alcohol [adjusted hazard ratio (aHR)\u00a0=\u00a01.41, 95% confidence interval (CI) 1.15\u20131.73, P\u00a0&lt;\u00a00.001] and inhalants (aHR\u00a0=\u00a01.56, 95% CI 1.26\u20131.93, P\u00a0&lt;\u00a00.001) to cannabis. Moreover, we found significant transitions from cannabis to alcohol (aHR\u00a0=\u00a02.40, 95% CI 1.47\u20133.91, P\u00a0&lt;\u00a00.001), cocaine (aHR\u00a0=\u00a07.47, 95% CI\u00a0=\u00a04.26\u201313.09, P\u00a0&lt;\u00a00.001), prescription opioids (aHR\u00a0=\u00a02.16, 95% CI 1.29\u20133.63, P\u00a0&lt;\u00a00.01) and tranquilisers (aHR\u00a0=\u00a01.51, 95% CI 1.11\u20132.06, P\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Overall, our findings point to a strategic role of cannabis within drug first use sequence pattern. We had an important and unexpected finding\u2014the bi\u2010directional relationship between alcohol and cannabis. In addition, the first use of cannabis still precedes the first use of cocaine and non\u2010medical use of tranquilisers and prescription opioids. [Castaldelli\u2010Maia JM, Nicastri S, Cerd\u00e1 M, Kim JH, Oliveira LG, Andrade AG, Martins, SS. In\u2010transition culture of experimentation with cannabis in Latin American college students: A new role within a potential drug use sequencing pattern. Drug Alcohol Rev 2017;00:000\u2010000]<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.12556","type":"journal-article","created":{"date-parts":[[2017,5,9]],"date-time":"2017-05-09T01:06:43Z","timestamp":1494292003000},"page":"273-281","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["In\u2010transition culture of experimentation with cannabis in Latin American college students: A new role within a potential drug use sequencing pattern"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9621-2291","authenticated-orcid":false,"given":"Jo\u00e3o Mauricio","family":"Castaldelli\u2010Maia","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Medical School University of S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Department of Neuroscience, Medical School ABC Foundation Santo Andr\u00e9 Brazil"},{"name":"ABC Center for Mental Health Studies Santo Andr\u00e9 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9rgio","family":"Nicastri","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Medical School University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Cerd\u00e1","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health Columbia University New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"June H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health Columbia University New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00facio Garcia","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Medical School University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur Guerra","family":"de Andrade","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Medical School University of S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Department of Neuroscience, Medical School ABC Foundation Santo Andr\u00e9 Brazil"},{"name":"ABC Center for Mental Health Studies Santo Andr\u00e9 Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia S.","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health Columbia University New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,5,8]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_5_2_1","DOI":"10.1016\/j.drugpo.2014.01.017"},{"doi-asserted-by":"publisher","key":"e_1_2_5_3_1","DOI":"10.1016\/j.drugpo.2014.09.007"},{"key":"e_1_2_5_4_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3389\/fpsyt.2013.00007","article-title":"Marijuana, feijoada and the debate on drug legalization","volume":"4","author":"Crippa JA","year":"2013","journal-title":"Front Psychiatry"},{"doi-asserted-by":"publisher","key":"e_1_2_5_5_1","DOI":"10.1590\/S0102-311X2003000100008"},{"doi-asserted-by":"publisher","key":"e_1_2_5_6_1","DOI":"10.1016\/j.drugalcdep.2012.12.012"},{"doi-asserted-by":"publisher","key":"e_1_2_5_7_1","DOI":"10.1590\/S1413-81232010000300008"},{"doi-asserted-by":"publisher","key":"e_1_2_5_8_1","DOI":"10.1590\/0102-311XPE01081"},{"doi-asserted-by":"publisher","key":"e_1_2_5_9_1","DOI":"10.1111\/j.1470-9856.1999.tb00139.x"},{"doi-asserted-by":"publisher","key":"e_1_2_5_10_1","DOI":"10.1016\/j.forsciint.2005.08.011"},{"unstructured":"CarliniELA NotoAR SanchezZM et al.VI Levantamento Nacional sobre o Consumo de Drogas Psicotr\u00f3picas entre Estudantes do Ensino Fundamental e M\u00e9dio das Redes P\u00fablica e Privada de Ensino nas 27 Capitais Brasileiras. 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