Table 3.
Multinomial regression associations between exposure to ACEs at age 0–12 years and cannabis use frequency at age 13–24 years
| Unadjusted RRR of early persisting regular use, n=135 (95% CI); p value | Adjusted RRR of early persisting regular use, n=135*(95% CI); p value | Unadjusted RRR of later onset regular use, n=236 (95% CI); p value | Adjusted RRR of later onset regular use, n=236*(95% CI); p value | Unadjusted RRR of early persisting occasional use, n=394 (95% CI); p value | Adjusted RRR of early persisting occasional use, n=394*(95% CI); p value | Unadjusted RRR of later onset occasional use, n=868 (95% CI); p value | Adjusted RRR of later onset occasional use, n=868*(95% CI); p value | Low or no cannabis use, n=3616 (reference class) | |
|---|---|---|---|---|---|---|---|---|---|
| Cumulative ACE exposures age 0–12 years | |||||||||
| One ACE (n=1508);† dummy variable reference: no ACEs, 2–3 ACEs, 4 or more ACEs | 0·59 (0·34–1·01); p=0·054 | 0·69 (0·39–1·19); p=0·181 | 0·62 (0·39–1·00); p=0·051 | 0·64 (0·39–1·05); p=0·080 | 0·74 (0·53–1·03); p=0·074 | 0·75 (0·53–1·06); p=0·105 | 0·93 (0·71–1·22); p=0·617 | 0·95 (0·72–1·25); p=0·710 | 1·0 (ref) |
| 2–3 ACEs (n=1657);†‡ dummy variable reference: no ACEs, 1 ACE, 4 or more ACEs | 1·70 (1·09–2·65); p=0·02 | 1·46 (0·91–2·35); p=0·119 | 1·70 (1·15–2·50); p=0·008 | 1·69 (1·14–2·53); p=0·010 | 1·60 (1·19–2·14); p=0·002 | 1·52 (1·12–2·06); p=0·007 | 1·13 (0·86–1·48); p=0·372 | 1·13 (0·86–1·50); p=0·385 | 1·0 (ref) |
| 4 or more ACEs (n=542);†§ dummy variable reference: no ACEs, 1 ACE, 2–3 ACEs | 4·31 (2·64–7·04) p≤0·001 | 3·15 (1·81–5·50) p≤0·001 | 2·32 (1·43–3·74) p≤0·001 | 1·99 (1·14–3·46) p=0·016 | 2·65 (1·84–3·82) p≤0·001 | 2·55 (1·74–3·73) p≤0·001 | 1·17 (0·75–1·83) p=0·47 | 1·16 (0·72–1·86) p=0·542 | 1·0 (ref) |
| ACE exposure | |||||||||
| Parental substance use or abuse (n=469)§ | 7·16 (4·38–11·68); p≤0·001 | 3.90 (2·10–7·24); p≤0·001 | 2·62 (1·54–4·46); p≤0·001 | 1·82 (0·97–3·40); p=0·061 | 3·07 (2·03–4·63); p≤0·001 | 2·38 (1·51–3·73); p≤0·001 | 2·02 (1·34–3·05); p≤0·001 | 1·81 (1·15–2·83); p=0·01 | 1·0 (ref) |
| Parental mental health problems or suicide attempt (n=2168)¶ | 2·39 (1·54–3·70); p≤0·001 | 2·02 (1·26–3·24); p=0·003 | 1·29 (0·91–1·85); p=0·15 | 1·20 (0·81–1·76); p=0·36 | 1·52 (1·15–2·00); p=0·003 | 1·50 (1·11–2·03); p=0·008 | 1·16 (0·91–1·48); p=0·24 | 1·15 (0·88–1·49); p=0·305 | 1·0 (ref) |
| Parent with criminal conviction (n=370) | 1·33 (0·57–3·08); p=0·51 | 1·15 (0·47–2·81); p=0·754 | 1·31 (0·62–2·77); p=0·48 | 1·23 (0·55–2·74); p=0·607 | 1·91 (1·22–3·01); p=0·005 | 1·90 (1·20–3·01); p=0·006 | 1·24 (0·76–2·03); p=0·39 | 1·26 (0·75–2·10); p=0·38 | 1·0 (ref) |
| Parental separation (n=1095)§ | 2·28 (1·42–3·63); p≤0·001 | 1·88 (1·08–3·27); p=0·025 | 1·98 (1·36–2·89); p≤0·001 | 2·00 (1·30–3·05); p≤0·001 | 1·82 (1·32–2·51); p≤0·001 | 1·78 (1·27–2·48); p≤0·001 | 1·06 (0·77–1·46); p=0·71 | 1·10 (0·79–1·53); p=0·58 | 1·0 (ref) |
| Interpartner violence between parents (n=980)§ | 1·95 (1·14–3·35); p=0·016 | 1·70 (0·96–3·00); p=0·069 | 1·69 (1·09–2·61); p=0·019 | 1·59 (0·99–2·56); p=0·056 | 2·04 (1·46–2·85); p≤0·001 | 1·96 (1·39–2·76); p≤0·001 | 1·05 (0·73–1·52); p=0·79 | 1·03 (0·71–1·52); p=0·86 | 1·0 (ref) |
| Bullying (n=662) | 1·92 (1·11–3·31); p=0·02 | 1·75 (0·98–3·12); p=0·059 | 1·57 (0·98–2·54); p=0·062 | 1·47 (0·90–2·43); p=0·13 | 1·13 (0·76–1·68); p=0·56 | 1·11 (0·73–1·68); p=0·62 | 0·75 (0·49–1·14); p=0·18 | 0·76 (0·51–1·15); p=0·20 | 1·0 (ref) |
| Physical abuse (n=714)§ | 2·47 (1·50–4·06); p≤0·001 | 2·27 (1·31–3·93); p=0·004 | 1·75 (1·10–2·78); p=0·018 | 1·69 (1·04–2·75); p=0·034 | 1·47 (1·00–2·16); p=0·051 | 1·49 (1·00–2·21); p=0·048 | 1·23 (0·87–1·76); p=0·24 | 1·25 (0·87–1·80); p=0·23 | 1·0 (ref) |
| Sexual abuse (n=162) | 0·43 (0·04–4·81); p=0·49 | 0·57 (0·06–5·75); p=0·63 | 1·74 (0·76–3·98); p=0·19 | 2·09 (0·85–5·10); p=0·106 | 2·05 (1·13–3·73); p=0·018 | 2·02 (1·10–3·72); p=0·024 | 0·94 (0·42–2·12); p=0·88 | 1·23 (0·55–2·74); p=0·62 | 1·0 (ref) |
| Emotional abuse (n=1006)§ | 2·84 (1·78–4·52); p≤0·001 | 2·44 (1·49–3·99); p≤0·001 | 1·53 (0·99–2·36); p=0·06 | 1·42 (0·90–2·24); p=0·14 | 1·91 (1·36–2·67); p≤0·001 | 1·84 (1·30–2·61); p≤0·001 | 1·13 (0·82–1·57); p=0·45 | 1·13 (0·81–1·60); p=0·47 | 1·0 (ref) |
| Emotional neglect (n=318) | 1·20 (0·51–2·83); p=0·68 | 1·22 (0·51–2·92); p=0·65 | 0·98 (0·45–2·14); p=0·95 | 0·93 (0·42–2·10); p=0·87 | 0·88 (0·49–1·58); p=0·67 | 0·85 (0·47–1·54); p=0·601 | 0·57 (0·30–1·10); p=0·09 | 0·61 (0·32–1·17); p=0·14 | 1·0 (ref) |
Correction for alpha inflation needs to be applied (p=0·002), for assessing the results based on p values. ACE=adverse childhood experience. RRR=relative risk ratio.
*
Adjusted for sex, participant socioeconomic position age 0–12 years, mother and partner's mental health before or during pregnancy, mother and partner's substance use during pregnancy, financial difficulties during pregnancy, and participant polygenic risk for cannabis initiation.
†
Coded as dummy variables; comparison group is all other levels of ACE exposure, including no ACEs.
‡
Results of omnibus Wald test for pairwise comparisons, conducted on fully adjusted models: p≤0·05.
§
Results of omnibus Wald test for pairwise comparisons, conducted on fully adjusted models: p≤0·001.
¶
Results of omnibus Wald test for pairwise comparisons, conducted on fully adjusted models: p≤0·01.