Does marijuana use serve as a gateway to cigarette use for high-risk African-American youth?

BACKGROUND/OBJECTIVES The purpose of this investigation was to test whether the gateway hypothesis of drug initiation sequencing applies equally well to high-risk African-American and Caucasian youth. METHODS The study sample (N = 618, mean age = 15.5, SD = 1.2) represented the population of residents in the Missouri Division of Youth Services (DYS) who had initiated marijuana and nicotine use. RESULTS As hypothesized, African-American youth were significantly more likely to initiate marijuana use before cigarette use. Over one-third of African Americans reported initiating marijuana before cigarettes (37.9%), compared to less than one-quarter of youth in the other ethnic groups (Caucasian = 17.3%, Latino/Latina = 21.7%, Biracial/Other = 20.8%). Further, multinomial simulation and logistic regression models revealed that African-American youth were significantly more likely than other ethnic groups to initiate marijuana before cigarettes (Adjusted OR = 3.53, CI = 1.92-6.46). CONCLUSIONS/SCIENTIFIC SIGNIFICANCE: Findings suggest that the hypothesized gateway sequence may not apply equally well to African-Americans, and that prevention efforts based on this theory may need to be amended for these youth.