BACKGROUND Recent analyses of data from the US found that young people were increasingly engaging in cannabis use before alcohol and cigarettes. These shifts are important for public health, but it is not clear whether such trends extend beyond the US. The aim of this study is to examine whether and how the age and sequencing of initiation into alcohol, cannabis and cigarette use has changed in Australia since the early 2000s. METHODS Data came from six waves of the Australian National Drug Strategy Household Survey, spanning 2001-2016. We used data from 18 to 21 year-olds (n = 6849) and examined trends in the age at first use for each of the three substances plus any changes in the order of initiation. RESULTS The mean age of initiation increased steadily for all three substances (e.g. from 14.9 in 2001 to 16.4 in 2016 for alcohol), while the prevalence of any use declined. There were some changes in ordering of use. For example, in 2001, 62 % of respondents who used both cigarettes and cannabis had first used cigarettes at an earlier age than cannabis, compared with 41 % in 2016. Young people who used both alcohol and cannabis remained more likely to try alcohol before cannabis across the study period. CONCLUSIONS Our results partly replicated US findings, with differences potentially reflecting the substantially different environment around these substances in the US compared to Australia. The age of initiation for alcohol, cigarette and cannabis use in Australia has increased sharply over the past 15 years.

中文翻译：

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2001-2016 年澳大利亚首次饮酒、大麻和香烟使用顺序趋势。

背景 最近对美国数据的分析发现，年轻人越来越多地吸食大麻，而不是酗酒和吸烟。这些转变对公共卫生很重要，但尚不清楚这种趋势是否会扩展到美国以外。本研究的目的是调查自 2000 年代初以来澳大利亚开始使用酒精、大麻和香烟的年龄和顺序是否以及如何变化。方法 数据来自 2001 年至 2016 年期间六轮澳大利亚国家药物战略家庭调查。我们使用了 18 至 21 岁青少年 (n = 6849) 的数据，并检查了三种物质首次使用的年龄趋势以及开始使用顺序的任何变化。结果 所有三种物质的平均开始年龄均稳步上升（例如，酒精从 2001 年的 14.9 岁增加到 2016 年的 16.4 岁），而任何使用的流行率均有所下降。使用顺序发生了一些变化。例如，2001 年，62% 的同时吸食香烟和大麻的受访者首次吸食香烟的年龄比吸食大麻的年龄要早，而 2016 年这一比例为 41%。同时吸食酒精和大麻的年轻人仍然更有可能在吸食大麻之前尝试饮酒。整个学习期间。结论 我们的结果部分重复了美国的研究结果，差异可能反映了美国与澳大利亚相比这些物质周围环境的显着不同。过去 15 年来，澳大利亚开始吸食酒精、香烟和大麻的年龄急剧增加。