6.10 Nicotine and other drug use
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Tobacco use commonly precedes the use of illicit drugs.1 This does not necessarily mean that tobacco use causes other drug use. Familiarity with smoking as a technique may facilitate experimentation with and ultimate addiction to other smoked substances, such as cannabis (the most commonly used illicit drug), heroin, cocaine, methamphetamine and phencyclidine.2 The clustering of smoking and other types of drug use may also reflect shared biological, social, educational and other environmental risk factors.3,4
Australian surveys of tobacco and alcohol use among secondary school students in 2005 showed that first experience with alcohol occurs at an earlier age than tobacco. By the ages of 12 and 13, more than 20% of school children reported consuming alcohol in the past month5 but fewer than 5% of 12 and 13-year old reported smoking cigarettes.5 Across all age groups, alcohol is by far the most widely used illicit drug among school children of both sexes, followed by tobacco.5
The prevalence of smoking among those who had used various illicit substances was not reported for the 2008 survey,6 but in 2005 of those who had used any one of the following illicit substances (cannabis, amphetamines, hallucinogens and ecstasy) 40–50% reported having smoked tobacco at the same time.7
In the 2004 National Drug Strategy Household Survey tobacco smokers aged 14 and over were more likely to use all other drugs. The majority of both smokers and non-smokers drank alcohol (92% vs. 81%). One-third of tobacco smokers reported using cannabis in the past 12 months, compared to only 7% of non-tobacco users. Nineteen per cent of tobacco smokers had used an illicit drug other than cannabis in the preceding 12 months, compared to only 6% of non-smokers.8 (Data on concurrent use of drugs has not been included in reports on the 20079 or 2010 surveys10, but figures extracted from the data file on concurrent use among those 18 plus are provided in Chapter 1, Section 1.10.6)
Tobacco is often mixed with cannabis to make cannabis easier to smoke. With declining rates of cigarette smoking, it is now more common for cannabis dependence to lead to tobacco dependence than vice versa.11, 12 The practice of combining cannabis and tobacco has been identified as a factor for co-existing addictions in Australian Aboriginal and Torres Strait Islander communities13—see also Chapter 8, Section 8.11.
References
1. Kandel D. Stages and pathways of drug involvement: examining the gateway hypothesis. Cambridge, UK: Cambridge University Press, 2002.
2. Agrawal A and Lynskey M. Tobacco and cannabis co-occurrence: does route of administration matter? Drug and Alcohol Dependence 2009;99(1–3):240–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18926646
3. Kendler KS, Schmitt E, Aggen SH and Prescott CA. Genetic and environmental influences on alcohol, caffeine, cannabis, and nicotine use from early adolescence to middle adulthood. Archives of General Psychiatry 2008;65(6):674–82. Available from: http://archpsyc.ama-assn.org/cgi/content/abstract/65/6/674
4. US Department of Health and Human Services. Preventing tobacco use among young people: a report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/1994/index.htm/
5. White V and Smith G. 6. Comparisons of the types of substances used by students in 2008. Australian secondary school students' use of tobacco, alcohol, and over-the-counter and illicit substances in 2008. Canberra: Drug Strategy Branch Australian Government Department of Health and Ageing, 2009;Available from: http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/Publishing.nsf/content/2C4E3D846787E47BCA2577E600173CBE/$File/sch6.pdf
6. White V and Smith G. 3. Tobacco use among Australian secondary students (PDF 87 KB) Australian secondary school students' use of tobacco, alcohol, and over-the-counter and illicit substances in 2008. Canberra: Drug Strategy Branch Australian Government Department of Health and Ageing, 2009;Available from: http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/Publishing.nsf/content/school08
7. White VM and Hayman J. Australian secondary school students' use of over-the-counter and illicit substances in 2005. Report prepared for Drug Strategy Branch, Australian Government Department of Health and Ageing. National Drug Strategy monograph series. Melbourne: Centre for Behavioural Research in Cancer, Cancer Control Research Institute, The Cancer Council Victoria, 2006. Available from: http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/publishing.nsf/Content/mono60
8. Australian Institute of Health and Welfare. 2004 National Drug Strategy Household Survey: detailed findings. Drug strategy series no.16, AIHW cat. no. PHE 66. Canberra: AIHW, 2005. Available from: http://www.aihw.gov.au/publications/phe/ndshsdf04/ndshsdf04.pdf
9. Australian Institute of Health and Welfare. 2007 National Drug Strategy Household Survey: detailed findings. Drug statistics series no. 22, AIHW cat. no. PHE 107. Canberra: AIHW, 2008. Available from: http://www.aihw.gov.au/publications/index.cfm/title/10674
10. Australian Institute of Health and Welfare. 2010 National Drug Strategy Household Survey: survey report. Drug statistics series no. 25, AIHW cat. no. PHE 145. Canberra: AIHW, 2011. Available from: http://www.aihw.gov.au/publication-detail/?id=32212254712&libID=32212254712&tab=2
11. Amos A, Wiltshire S, Bostock Y, Haw S and McNeill A. 'You can't go without a fag...you need it for your hash'-a qualitative exploration of smoking, cannabis and young people. Addiction 2004;99(1):5–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14678065
12. Patton G, Coffey C, Carlin J, Sawyer S and Lynskey M. Reverse gateways? Frequent cannabis use as a predictor of tobacco initiation and nicotine dependence. Addiction 2005;100(10):1518–25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16185213
13. Lindorff KJ. Tobacco time for action: National Aboriginal and Torres Strait Islander Tobacco Control Project final report. Canberra: National Aboriginal Community Controlled Organisations, 2002. Available from: http://www.naccho.org.au/Files/Documents/NACCHO_Tobacco_report.pdf
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