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Question: Are attention-deficit hyperactivity disorder (ADHD) symptoms in children associated with early-onset substance use?
People: 1480 twin pairs born in Sweden between May 1985 and December 1986 who were alive and lived in Sweden at the time of data collection.
Setting: The Twin Study of Child and Adolescent Development (TCHAD), Sweden; 1994–2005.
Risk factors: ADHD symptoms, and conduct problem behaviours (CPB) at ages 8–9 years (wave 1) and at ages 13–14 years (wave 2). ADHD symptoms were measured using parent-reported checklists including 14 Diagnostic and Statistical Manual of Mental Disorder (DSM)-IV-based items at wave 1 and 17 at wave 2. To assess CPB, parents completed a questionnaire with elements from the Child Behavior Checklist for Ages 6–18 (CBCL/6–18)—DSM-oriented conduct problems scale. ORs were adjusted for gender, the other ADHD symptom dimension and CPBs.
Outcomes: Substance use in the past 12 months, including tobacco, alcohol and illicit drug use, assessed at ages 13–14 years using self-report that was adopted from the Finnish longitudinal study of adolescent twins (FinnTwin12). Tobacco use ‘1–2 times’ or ‘once in a while’ in the past 12 months was classified as …