Methods: The study sample (N= 723, mean age = 15.5, SD = 1.2) represented the population of residents in the Missouri Division of Youth Services (DYS) residential rehabilitation system. The analytic sample was comprised of youth (N = 618) who had initiated marijuana and nicotine use. Chi-square proportional tests, logistic regression, and multinomial simulation test were conducted to assess marijuana and cigarette use sequences among racial and ethnic groups.
Results: Findings revealed that 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).
Implications for policy and practice: Despite the influence of the gateway hypothesis as the conceptual foundation for many current prevention approaches, the data presented here suggest that the gateway theory may not be equally applicable to African American young people. Findings of this study support notions that marijuana can serve as a gateway drug for nicotine dependence. Moreover, there is no developmental reason to believe that the gateway sequence is invariant. The practical implication is that universal prevention strategies predicated on specified gateway sequences might need to be amended for African-American youth. For example, a greater focus on preventing marijuana initiation as a means for interrupting future nicotine dependence may be of great utility.