Evidence map›Paper›PMID 42563619›Full record

ArticleThe Journal of adolescent health : official publication of the Society for Adolescent Medicine2026

Co-Use of Some Substances Associated With Higher Doses in Adolescents: Findings From the Adolescent Brain Cognitive Development Study.

Colbey Ricklefs, Kristen E Kim, Ari Thompson, Glenn-Milo Santos, Claire D Brindis, Kyle T Ganson, Alexander Testa, Timothy M Piatkowski, Jason M Nagata

Abstract read
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In one paragraph

Article in The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Colbey RicklefsDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California; Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California. Electronic address: colbey.ricklefs@ucsf.edu.
Kristen E KimDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California.
Ari ThompsonDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California; School of Medicine, University of California, San Francisco, San Francisco, California.
Glenn-Milo SantosDivision of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, California; Department of Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California.
Claire D BrindisDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California.
Kyle T GansonFactor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
Alexander TestaDepartment of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas.
Timothy M PiatkowskiSchool of Public Health and Centre for Community Health and Wellbeing, Faculty of Health, Medicine, and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia.
Jason M NagataDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California.

Funding

TRAINEESHIPS IN AIDS PREVENTION STUDIEST32MH019105 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Carol Suzanne Camlin, Glenn-Milo Santos · 1989 to 2026
$15.3M
Longitudinal pathways between adolescent social media use and substance use: Informing evidence-based guidanceR01DA064134 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Jason M Nagata · 2025 to 2026
$1.5M
NIDA NIH HHS R01 DA064134NIMH NIH HHS T32 MH019105
6 · The paper itself

Abstract

purposeAdolescence is a critical developmental period marked by heightened vulnerability to initiating substance use, with long-term implications for health and behavior. Nicotine, alcohol, and cannabis are the most commonly used substances among adolescents. Their use often co-occurs but few studies have described or quantified the patterns and doses of substance co-use in this vulnerable population.

methodsWe used data from six waves of the Adolescent Brain Cognitive Development study. Substance use was measured through a web-based timeline followback interview, and outcomes are operationalized into substance use quantity (in standard units), single use, and co-use (use of two substances on the same day) of alcohol, cannabis, and nicotine. Group differences of average dose in standard units between single use and co-use for each substance class were analyzed using linear mixed-effects modeling in years 4-6.

resultsThe average dose of nicotine was significantly higher when co-used with alcohol (4.32; 95% confidence interval [CI]: 2.55-6.09; p < .001) or when co-used with cannabis (4.41; 95% CI: 2.76-6.05; p < .001) in year 6; nicotine trends were similar in years four and five. In year 6, the average dose of alcohol was higher when co-used with cannabis (1.87; 95% CI: 0.37-3.36; p = .004) or co-used with nicotine (1.64; 95% CI: 0.06-3.22; p = .03) compared to single use of alcohol. The average dose of cannabis was not significantly different when used singularly or co-used with either alcohol or nicotine in our study years. DISCUSSION: During adolescence, the co-use of substances (namely alcohol and nicotine) may lead to higher average doses compared to single-substance use.

Indexed as

Adolescent BehaviorAlcohol DrinkingCognitionNicotineSubstance-Related DisordersAdolescentFemaleHumansMaleNicotineAdolescenceAlcoholCannabisCo-dependenceNicotineSubstance use

Identifiers

PMID42563619
PMCPMC13632705

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.