@article{ref1,
title="Early substance use initiation and psychological distress among adolescents in five ASEAN countries: a cross-sectional study",
journal="Psychology research and behavior management",
year="2019",
author="Pengpid, Supa and Peltzer, Karl",
volume="12",
number="",
pages="1003-1008",
abstract="AIM: The study aimed to assess the associations between substance use early initiation (<12 years) (smoking cigarettes, alcohol and drug use) with psychological distress among adolescents in five ASEAN countries. <br><br>METHODS: Cross-sectional data were analysed from 33,184 school adolescents, with a median age of 14 years, from Indonesia, Laos, Philippines, Thailand and Timor-Leste that took part in the &quot;Global School-Based Student Health Survey (GSHS)&quot; in 2015. <br><br>RESULTS: The overall prevalence of pre-adolescent (<12 years) cigarette use was 10.6%, 8.1% pre-adolescent current alcohol use, and 4.2% pre-adolescent drug use initiation. In adjusted multinomial logistic regression analysis, pre-adolescent initiation of cigarette smoking, pre-adolescent initiation of alcohol use, pre-adolescent initiation of drug use and multi-substance pre-adolescent initiation were highly associated with medium (=1) and high (=2-5) psychological distress (of five psychological distress items: no close friends, loneliness, anxiety, suicidal ideation and suicide attempt). Late initiation of cigarette use and late initiation of drug use were not associated with medium and/or high psychological distress. <br><br>CONCLUSION: Early prevention programmes should target concurrent early substance use initiation in order to prevent possible subsequent psychological distress.<br><br>© 2019 Pengpid and Peltzer.<p /> <p>Language: en</p>",
language="en",
issn="1179-1578",
doi="10.2147/PRBM.S223624",
url="http://dx.doi.org/10.2147/PRBM.S223624"
}