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Brainy teens less likely to smoke, more likely to drink and use cannabis

In a sample of over 6,000 young people in England, high childhood academic at age 11 is associated with a reduced risk of cigarette smoking but an increased risk of drinking alcohol regularly and cannabis use, a nine-year study by University College London found.

These patterns persist into adulthood, and would seem to refute the notion that academic prowess is associated with a greater tendency to ‘experiment’ for a brief period, suggest the researchers.

Smoking, drinking, and cannabis use are fairly common among teenagers. And the evidence suggests that these behaviours boost the risk of immediate and longer term health problems.

But the data on potential links between cleverness and substance use are somewhat mixed, and no study has tracked patterns with use of all three substances from early adolescence into early adulthood.

In a bid to rectify this, the researchers used data from a representative sample of more than 6,000 11 year olds from 838 state, and 52 fee-paying, schools across England. The teens’ use of tobacco, alcohol, and cannabis, obtained through questionnaire responses, was regularly tracked until they reached the ages of 19-20.

Depending on their answers, use of tobacco and alcohol was categorised as persistent and regular; occasional and regular; and none. Alcohol use was further quantified by the number of times respondents had got drunk – with more than 52 times in a year categorised as hazardous drinking. Cannabis use was categorised as early (13-17) or late (18-20) and as occasional or persistent.

Academic prowess was defined by results achieved in Key Stage 2, a national test taken at the age of 11, which assesses ability in English, maths, and science.

During their early teens, brainy pupils were less likely to smoke cigarettes than their less academically gifted peers, after taking account of potentially influential factors. And they were more likely to say they drank alcohol during this period too. They were also more likely to say they used cannabis, but this wasn’t statistically significant. But those of average academic ability were 25%more likely to use cannabis occasionally and 53% more likely to use it persistently than those who were not as academically gifted.

During their late teens, brainy pupils were more than twice as likely to drink alcohol regularly and persistently than those who were not as clever. These patterns were similar, but weaker, when those of average and low academic abilities were compared.

But academic prowess was associated with a lower risk of hazardous drinking.

As for the use of cannabis, clever pupils were 50% more likely to use this substance occasionally and nearly twice as likely to use persistently than those who weren’t as clever. Similar patterns were seen for those of average academic ability.

This is an observational study, so no firm conclusions can be drawn about cause and effect. And the results may not be applicable to pupils in fee-paying schools as a full set of data was only available for a third of the teens attending these schools, say the researchers.

They highlight other caveats, including the lack of detail on quantities of substances typically consumed, and the absence of data on cigarette smoking after the age of 16. Nevertheless, they say: “Our finding that adolescents with high academic ability are less likely to smoke but more likely to drink alcohol regularly and use cannabis is broadly consistent with the evidence base on adults.”

And they offer various possible explanations, including the link between braininess and openness to experience, and a more affluent/highly educated family background, which may make it easier to get hold of alcohol, for example.

But they conclude, the fact that alcohol and cannabis use among brainy-pupils persisted into early adulthood, provides “evidence against the hypothesis that high academic ability is associated with temporary experimentation with substance use.”

Abstract
Objectives Our aim was to determine the association between childhood academic ability and the onset and persistence of tobacco, alcohol and cannabis use across adolescence in a representative sample of English schools pupils. Previous research has produced conflicting findings.
Design Data from 7 years of the Longitudinal Study of Young People in England (LSYPE), 2004–2010 (age 13/14–19/20).
Setting Self-completion questionnaires during home visits, face-to-face interviews and web-based questionnaires.
Participants Data from 6059 participants (3093 females) with information on academic ability around age 11 and health behaviours from age 13/14 to 16/17 (early adolescence) and from age 18/19 to 19/20 (late adolescence).
Outcome measures Regularity of cigarette smoking, alcohol drinking and cannabis use from early to late adolescence.
Results In multinomial logistic regression models adjusting for a range of covariates, the high (vs low) academic ability reduced the risk of persistent cigarette smoking (RR=0.62; CI 95% 0.48 to 0.81) in early adolescence. High (vs low) academic ability increased the risk of occasional (RR=1.25; CI 95% 1.04 to 1.51) and persistent (RR=1.83; CI 95% 1.50 to 2.23) regular alcohol drinking in early adolescence and persistent (RR=2.28; CI 95% 1.84 to 2.82) but not occasional regular alcohol drinking in late adolescence. High academic ability was also positively associated with occasional (RR=1.83; CI 95% 1.50 to 2.23) and persistent (RR=1.83; CI 95% 1.50 to 2.23) cannabis use in late adolescence.
Conclusions In a sample of over 6000 young people in England, high childhood academic at age 11 is associated with a reduced risk of cigarette smoking but an increased risk of drinking alcohol regularly and cannabis use. These associations persist into early adulthood, providing evidence against the hypothesis that high academic ability is associated with temporary ‘experimentation’ with substance use.

Authors
James Williams, Gareth Hagger-Johnson

 

Dr James Williams from the UCL Medical School said there has been a general downward trend in smoking cannabis and drinking alcohol among teenagers. He is quoted in The Independent as saying: “These risky health behaviours present a large problem in terms of public health as substance use is a risk factor for immediate and long-term health problems, as well as negative non-health outcomes such as poor educational and employment outcomes.

“The outcomes of cannabis use were found to be worsened by early onset and increased frequency of use.

“Understanding the risk factors for adolescent substance use can inform public health policy-making and help target interventions for those in high-risk groups.”

[link url="http://www.bmj.com/company/newsroom/smart-teens-more-likely-to-drink-and-use-cannabis/"]BMJ material[/link]
[link url="http://bmjopen.bmj.com/content/7/2/e012989"]BMJ Open abstract[/link]
[link url="http://www.independent.co.uk/news/education/education-news/clever-teenagers-cannabis-twice-likely-marijuana-weed-study-ucl-bmj-open-journal-a7594956.html"]The Independent report[/link]

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