NEW YORK (Reuters Health) - Children who take up smoking cigarettes, using marijuana or start drinking alcohol in elementary school are considerably more likely than other children to use such substances in middle school, researchers say.

Therefore, prevention programs should begin in elementary school rather than in middle school, as the majority in the US now do, according to lead author Dr. Nance Wilson of the University of California School of Public Health in Berkeley.

To investigate, Wilson's team interviewed 331 elementary school children about their experiences, if any, with smoking cigarettes and marijuana or drinking alcohol. The same children were interviewed again when they were in middle school, which included children in grades 6 through 8.

Students who initiated alcohol, cigarette, or marijuana use were 3 times, 5 times and 4 times, respectively, more likely to be using these substances when they were in middle school compared with kids who reported never using any of the substances, the investigators report in the June issue of the Journal of Adolescent Health.

"Our data suggest that the early use of alcohol, tobacco and marijuana by children of elementary school age may not represent transient experimentation," Wilson and colleagues write.

Moreover, "that such early use is associated with greatly increased odds of later use, when the children are in middle school, suggests that early prevention programs are of great importance," the authors conclude.

SOURCE: Journal of Adolescent Health 2002;30:442-447.

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