Adverse childhood experiences and adolescent cannabis use trajectories: Findings from a Longitudinal UK Birth Cohort

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Abstract

Background
Adverse childhood experiences (ACEs) are classically defined as physical abuse, sexual abuse, emotional abuse, emotional neglect, bullying, parental substance use or abuse, violence between parents, parental mental health problems or suicide, parental separation, or a parent convicted of criminal offence. Exposure to ACEs can be associated with cannabis use, but no comparisons across all adversities have been made while also considering timing and frequency of cannabis use. We aimed to explore the association between ACEs and cannabis use timing and frequency in adolescence, considering the cumulative number of ACEs and individual ACEs.
Methods
We used data from the Avon Longitudinal Study of Parents and Children, a longitudinal UK birth cohort study. Longitudinal latent classes of cannabis use frequency were derived from self-reported data at multiple timepoints in participants aged 13–24 years. ACEs between ages 0 years and 12 years were derived from prospective and retrospective reports at multiple timepoints by parents and the participant. Multinomial regression was used to analyse the effect of both cumulative exposure to all ACEs and the ten individual ACEs on cannabis use outcomes.
Findings
5212 participants (3132 [60·0%] were female and 2080 [40·0%] were male; 5044 [96·0%] were White and 168 [4·0%] were Black, Asian, or minority ethnic) were included in this study. After adjustment for polygenic risk and environmental risk factors, participants who had 4 or more ACEs at age 0–12 years were at increased risk of early persisting regular cannabis use (relative risk ratio [RRR] 3·15 [95% CI 1·81–5·50]), later onset regular use (1·99 [1·14–3·74]), and early persisting occasional use (2·55 [1·74–3·73]) compared with low or no cannabis use. After adjustment, early persisting regular use was associated with parental substance use or abuse (RRR 3·90 [95% CI 2·10–7·24]), parental mental health problems (2·02 [1·26–3·24]), physical abuse (2·27 [1·31–3·98]), emotional abuse (2·44 [1·49–3·99]), and parental separation (1·88 [1·08–3·27]) compared with low or no cannabis use.
Interpretation
Risks for problematic adolescent cannabis use are highest for individuals reporting 4 or more ACEs, and were particularly raised for those with parental substance use or abuse. Public health measures to address ACEs might reduce adolescent cannabis use.
Funding
The Wellcome Trust, UK Medical Research Council, Alcohol Research UK.
Original languageEnglish
Pages (from-to)E442-E452
JournalThe Lancet Public Health
Volume8
Issue number6
DOIs
Publication statusPublished - 1 Jun 2023

Bibliographical note

Funding Information:
The UK Medical Research Council (MRC) and the Wellcome Trust (grant 217065/Z/19/Z), and the University of Bristol provide core support for ALSPAC. Genome-wide association study data was generated by Sample Logistics and Genotyping Facilities at Wellcome Sanger Institute and LabCorp (Laboratory Corporation of America) using support from 23andMe. A comprehensive list of grant funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf ); this research was specifically funded by the MRC (MR/M006727/1) and Alcohol Research UK (MR/L022206/1) and was funded in whole, or in part, by the Wellcome Trust (grant 209158/Z/17/Z). This work forms part of LAH's fellowship, which is funded by the Wellcome Trust (grant 209158/Z/17/Z). HJJ, SZ, and MH are supported by the UK National Institute for Health and Care Research (NIHR) Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust. HJJ and SZ are supported by the University of Bristol. LDH is supported by a career development award from the MRC (MR/M020894/1). The views expressed in this publication are those of the authors and not necessarily those of the UK National Health Service, NIHR, or the UK Department of Health and Social Care.

Funding Information:
The UK Medical Research Council (MRC) and the Wellcome Trust (grant 217065/Z/19/Z), and the University of Bristol provide core support for ALSPAC. Genome-wide association study data was generated by Sample Logistics and Genotyping Facilities at Wellcome Sanger Institute and LabCorp (Laboratory Corporation of America) using support from 23andMe. A comprehensive list of grant funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf); this research was specifically funded by the MRC (MR/M006727/1) and Alcohol Research UK (MR/L022206/1) and was funded in whole, or in part, by the Wellcome Trust (grant 209158/Z/17/Z). This work forms part of LAH's fellowship, which is funded by the Wellcome Trust (grant 209158/Z/17/Z). HJJ, SZ, and MH are supported by the UK National Institute for Health and Care Research (NIHR) Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust. HJJ and SZ are supported by the University of Bristol. LDH is supported by a career development award from the MRC (MR/M020894/1). The views expressed in this publication are those of the authors and not necessarily those of the UK National Health Service, NIHR, or the UK Department of Health and Social Care.

Publisher Copyright:
© 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license

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