6.10 Nicotine and other drug use
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Nicotine use commonly precedes or co-exists with other forms of drug use. This does not necessarily mean that the relationship between nicotine and other drug use is causal, although familiarity with the techniques involved with smoking may facilitate experimentation with and ultimate addiction to other substances, such as the smokable forms of cannabis (the most common), heroin, cocaine, methamphetamine and phencyclidine. Clustering of behaviour connected with other drug usage may also reflect individual biological, social, educational and other environmental risk factors.50
Australian survey data on tobacco and alcohol use among secondary school students in 2005 shows that widespread experience with alcohol occurs at an earlier age than does tobacco. At the age of 12, 39% of schoolchildren reported having consumed alcohol in the past year,64 compared to 8% of children of the same age reporting having smoked.48 Combining all age groups, alcohol is by far the most widely used drug among schoolchildren of both sexes, followed by tobacco.48, 64
Although most Australian secondary schoolchildren have not come into direct contact with illicit drugs, 15% of students aged between 12–15 and 33% of students aged 16 or 17 had tried at least one of cannabis, hallucinogens, amphetamines, ecstasy, opiates and cocaine. Of these, cannabis was the most widely used substance, with 32% of 17 year olds reporting having tried it.65 Tobacco consumption was commonly associated with use of cannabis, amphetamines, hallucinogens and ecstasy, between 40%50% of users of these substances reporting having smoked tobacco at the same time.65
The National Drug Strategy Household Survey for 2004 shows that tobacco users aged 14 and over have a higher incidence of other drug use across all drug categories. The majority of smokers and non-smokers drank alcohol (92% compared to 81%). One third of tobacco users reported using cannabis in the past 12 months, compared to 7% of non-tobacco users. Nineteen percent of tobacco smokers had used an illicit drug other than cannabis in the preceding 12 months, compared to 6% of non-smokers.66
Cannabis and tobacco are often combined by their users to facilitate consumption. With declining rates of cigarette smoking, it is now becoming more common for cannabis dependence to lead to tobacco dependence than was previously the case.67, 68 Combining cannabis with tobacco has been identified as a factor that contributes to co-existing addictions in Australian Aboriginal and Torres Strait Islander communities69—see also Chapter 8, Section 8.11.
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