Childhood weight status and timing of first substance use in an ethnically diverse sample

Abstract

Background: We examined associations between weight status during childhood and timing of first cigarette, alcohol, and marijuana use in an ethnically diverse sample.

Methods: Data were drawn from child respondents of the 1979 National Longitudinal Survey of Youth, including 1448 Hispanic, 2126 non-Hispanic Black, and 3304 non-Hispanic, non-Black (White) respondents aged 10 years and older as of last assessment. Cox proportional hazards regression was conducted predicting age at first use from weight status (obese, overweight, and underweight relative to healthy weight) assessed at ages 7/8, separately by substance class, sex, and race/ethnicity. Tests of interactions between weight status and respondent sex and race/ethnicity were also conducted.

Results: Compared to healthy-weight females of the same race/ethnicity, overweight Hispanic females were at increased likelihood of alcohol and marijuana use and overweight White females were at increased likelihood of cigarette and marijuana use. Compared to healthy-weight males of the same race/ethnicity, obese White males were at decreased likelihood of cigarette and alcohol use and underweight Hispanic and Black males were at decreased likelihood of alcohol and marijuana use. Significant differences in associations by sex and race/ethnicity were observed in tests of interactions.

Conclusions: Findings highlight childhood weight status as a predictor of timing of first substance use among Hispanic and Non-Hispanic Black and White female and male youth. Results suggest that collapsing across sex and race/ethnicity, a common practice in prior research, may obscure important within-group patterns of associations and thus may be of limited utility for informing preventive and early intervention efforts.

Keywords: Childhood weight status; First substance use; Race/ethnicity; Sex/gender.