Background: The Gateway Drug Theory suggests that licit drugs, such as tobacco and alcohol, serve as a "gateway" toward the use of other, illicit drugs. However, there remains some discrepancy regarding which drug-alcohol, tobacco, or even marijuana-serves as the initial "gateway" drug subsequently leading to the use of illicit drugs such as cocaine and heroin. The purpose of this investigation was to determine which drug (alcohol, tobacco, or marijuana) was the actual "gateway" drug leading to additional substance use among a nationally representative sample of high school seniors.
Methods: This investigation conducted a secondary analysis of the 2008 Monitoring the Future 12th-grade data. Initiation into alcohol, tobacco, and other drug use was analyzed using a Guttman scale. Coefficients of reliability and scalability were calculated to evaluate scale fit. Subsequent cross tabulations and chi-square test for independence were conducted to better understand the relationship between the identified gateway drug and other substances' use.
Results: Results from the Guttman scale indicated that alcohol represented the "gateway" drug, leading to the use of tobacco, marijuana, and other illicit substances. Moreover, students who used alcohol exhibited a significantly greater likelihood of using both licit and illicit drugs.
Conclusion: The findings from this investigation support that alcohol should receive primary attention in school-based substance abuse prevention programming, as the use of other substances could be impacted by delaying or preventing alcohol use. Therefore, it seems prudent for school and public health officials to focus prevention efforts, policies, and monies, on addressing adolescent alcohol use.
© 2012, American School Health Association.
Tullis LM, Dupont R, Frost-Pineda K, Gold MS. Tullis LM, et al. J Addict Dis. 2003;22(3):51-62. doi: 10.1300/J069v22n03_05. J Addict Dis. 2003. PMID: 14621344
Barry AE, King J, Sears C, Harville C, Bondoc I, Joseph K. Barry AE, et al. J Sch Health. 2016 Jan;86(1):31-8. doi: 10.1111/josh.12351. J Sch Health. 2016. PMID: 26645418
Martínez-Aguayo A, Araneda JC, Fernandez D, Gleisner A, Perez V, Codner E. Martínez-Aguayo A, et al. Pediatr Diabetes. 2007 Oct;8(5):265-71. doi: 10.1111/j.1399-5448.2007.00307.x. Pediatr Diabetes. 2007. PMID: 17850469
Candido FJ, Souza R, Stumpf MA, Fernandes LG, Veiga R, Santin M, Kluthcovsky A. Candido FJ, et al. Rev Assoc Med Bras (1992). 2018 May;64(5):462-468. doi: 10.1590/1806-9282.64.05.462. Rev Assoc Med Bras (1992). 2018. PMID: 30304147 Review.
Lamy S, Delavene H, Thibaut F. Lamy S, et al. Rev Prat. 2014 Mar;64(3):317-20. Rev Prat. 2014. PMID: 24851359 Review. French.
Hanewinkel R, Hansen J. Hanewinkel R, et al. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 Apr;67(4):439-445. doi: 10.1007/s00103-024-03861-1. Epub 2024 Mar 19. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024. PMID: 38502361 German.
Nalugya JS, Skylstad V, Babirye JN, Ssemata AS, Ndeezi G, Bangirana P, Engebretsen IMS, Nakasujja N. Nalugya JS, et al. BMC Public Health. 2023 Oct 27;23(1):2114. doi: 10.1186/s12889-023-17016-5. BMC Public Health. 2023. PMID: 37891544 Free PMC article.
Ávila-Burgos L, Guzmán-Saldaña R, Márquez-Corona ML, Pontigo-Loyola AP, Márquez-Rodríguez S, Mora-Acosta M, Acuña-González GR, Hernández-Morales A, Medina-Solís CE. Ávila-Burgos L, et al. ScientificWorldJournal. 2023 Jul 3;2023:3604004. doi: 10.1155/2023/3604004. eCollection 2023. ScientificWorldJournal. 2023. PMID: 37434965 Free PMC article.
Kugbey N. Kugbey N. Subst Abuse Treat Prev Policy. 2023 Jul 7;18(1):44. doi: 10.1186/s13011-023-00542-1. Subst Abuse Treat Prev Policy. 2023. PMID: 37420290 Free PMC article.
Parker MA, Zapolski TC, Carson I, Waldron MC. Parker MA, et al. Addict Behav. 2023 Apr;139:107594. doi: 10.1016/j.addbeh.2022.107594. Epub 2022 Dec 21. Addict Behav. 2023. PMID: 36566680 Free PMC article.