Performance of Substance Use Screens for Identifying Tobacco Dependence and Alcohol, Cannabis, and Other Illicit Drug Use Disorder
| Age 12 to 15 Years N = 79,170 | Age 16 to 17 Years N = 42,356 | Age 18 to 20 Years N = 48,460 | ||||
|---|---|---|---|---|---|---|
| Se | Sp | Se | Sp | Se | Sp | |
| Smoking* | ||||||
| ≥1 day | 1.00 | 0.97 | 1.00 | 0.90 | 1.00 | 0.79 |
| ≥2 days | 0.91 | 0.98 | 0.96 | 0.92 | 0.97 | 0.82 |
| ≥4 days | 0.81 | 0.99 | 0.89 | 0.94 | 0.94 | 0.86 |
| ≥25 days | 0.48 | 1.00 | 0.68 | 0.98 | 0.80 | 0.95 |
| AUC (SE) | 0.99 (0.0002) | 0.98 (0.0003)‡ | 0.96 (0.0004)‡§ | |||
| Alcohol† | ||||||
| ≥1 day | 1.00 | 0.85 | 1.00 | 0.57 | 1.00 | 0.38 |
| ≥2 days | 1.00 | 0.88 | 1.00 | 0.62 | 1.00 | 0.41 |
| ≥3 days | 1.00 | 0.90 | 1.00 | 0.66 | 1.00 | 0.44 |
| ≥12 days | 0.88 | 0.95 | 0.92 | 0.80 | 0.96 | 0.60 |
| ≥52 days | 0.49 | 0.98 | 0.58 | 0.92 | 0.73 | 0.79 |
| ≥270 days | 0.04 | 1.00 | 0.03 | 1.00 | 0.04 | 0.99 |
| AUC (SE) | 0.97 (0.0004) | 0.91 (0.0008)‡ | 0.84 (0.0010)‡§ | |||
| Cannabis† | ||||||
| ≥1 day | 1.00 | 0.94 | 1.00 | 0.79 | 1.00 | 0.71 |
| ≥2 days | 1.00 | 0.95 | 1.00 | 0.82 | 1.00 | 0.73 |
| ≥3 days | 1.00 | 0.96 | 1.00 | 0.83 | 1.00 | 0.75 |
| ≥12 days | 0.93 | 0.97 | 0.95 | 0.88 | 0.97 | 0.81 |
| ≥52 days | 0.66 | 0.99 | 0.74 | 0.93 | 0.83 | 0.87 |
| ≥270 days | 0.14 | 1.00 | 0.20 | 0.98 | 0.36 | 0.96 |
| AUC (SE) | 0.99 (0.0002) | 0.95 (0.0006)‡ | 0.93 (0.0007)‡§ | |||
| Other Illicit Drugs† | ||||||
| ≥1 day | 1.00 | 0.93 | 1.00 | 0.88 | 1.00 | 0.84 |
| ≥2 days | 0.95 | 0.94 | 0.97 | 0.90 | 0.98 | 0.87 |
| ≥3 days | 0.92 | 0.95 | 0.93 | 0.92 | 0.96 | 0.88 |
| ≥12 days | 0.75 | 0.97 | 0.80 | 0.95 | 0.85 | 0.93 |
| ≥52 days | 0.48 | 0.98 | 0.57 | 0.98 | 0.64 | 0.97 |
| ≥270 days | 0.14 | 1.00 | 0.19 | 1.00 | 0.26 | 1.00 |
| AUC (SE) | 0.98 (0.0004) | 0.97 (0.0005)‡ | 0.97 (0.0005)‡§ | |||
AUC, Area under Receiver Operating Characteristic (ROC) Curve for Tobacco Dependence (Nicotine Dependence Syndrome Scale/Fagerström Test of Nicotine Dependence) or DSM-IV Alcohol, Cannabis, or Other Drug Use Disorders; Se, Sensitivity; Sp, Specificity.
Bolded screening cut-points are shown that have high values of sensitivity and specificity and minimize the number of different age- and substance-specific cut-points.
↵* Frequency is coded as days of use in the past month.
↵† Frequency is coded as days of use in the past year.
χ2 test for independence (relative to age 12 to 15 years),
↵‡ P < .0001.
χ2 test for independence (comparing 16–17- and 18–20-year-olds),
↵§ P < .0001.