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The great decline in adolescent cigarette smoking since 2000: consequences for drug use among US adolescents
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  • Published on:
    Declines in Adolescent Use of Cigarettes and Other Substances Consistent With Common Liability Model
    • Richard A Grucza, Professor of Family and Community Medicine and Health Outcomes Research Saint Louis University
    • Other Contributors:
      • Robert F Krueger, Hathaway Distinguished Professor of Psychology

    NOT PEER REVIEWED
    Miech and colleagues demonstrate declines in prevalence of non-medical use of prescription drugs among US high school students and show that these declines can be explained by trends in cigarette smoking.1 These observations are taken as support of the gateway hypothesis in which cigarette smoking increases the likelihood of subsequent other drug use. The authors further argue that these results are inconsistent with a ‘common liability’ model, and that the common liability model predicts that adolescent drug use would have “stayed steady or even increased as adolescents continued to use these drugs regardless of whether they smoked.” In this scenario, adolescents with a predilection toward substance might substitute cigarettes with other drugs as smoking rates decline.

    However, this conceptualization of the common liability model is inconsistent with how such models are typically understood. Models that posit a common liability do not assert that the degree of liability is fixed in the population, such that changes in risk for use of one drug increases risk for other drug use. Instead, common liability can be influenced by environmental factors and environmental changes can coherently impact multiple outcomes, resulting in trends similar to those observed by Miech and colleagues.

    For over 40 years, Problem Behavior Theory has provided a comprehensive theory and empirical approach to common liability. “Problem behaviors” (later termed...

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    Conflict of Interest:
    None declared.