Performance of Substance Use Screens for Identifying Tobacco Dependence and Alcohol, Cannabis, and Other Illicit Drug Use Disorders, by Age and Gender
| Males | Females | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 12 to 15 Years | 16 to 17 Years | 18 to 20 Years | 12 to 15 Years | 16 to 17 Years | 18 to 20 Years | |||||||
| Se | Sp | Se | Sp | Se | Sp | Se | Sp | Se | Sp | Se | Sp | |
| Smoking* | ||||||||||||
| ≥1 day | 1.00 | 0.98 | 1.00 | 0.90 | 1.00 | 0.76 | 1.00 | 0.97 | 1.00 | 0.91 | 1.00 | 0.83 |
| ≥2 days | 0.89 | 0.98 | 0.95 | 0.92 | 0.97 | 0.80 | 0.93 | 0.98 | 0.96 | 0.93 | 0.98 | 0.85 |
| ≥4 days | 0.79 | 0.99 | 0.88 | 0.94 | 0.94 | 0.83 | 0.83 | 0.99 | 0.91 | 0.95 | 0.95 | 0.88 |
| ≥25 days | 0.45 | 1.00 | 0.65 | 0.98 | 0.77 | 0.94 | 0.51 | 1.00 | 0.72 | 0.99 | 0.84 | 0.96 |
| AUC (SE) | 0.99 | (0.0002) | 0.97 | (0.0005)‡ | 0.95 | (0.0007)‡ | 0.99 | (0.0002) | 0.98 | (0.0005) | 0.96 | (0.006) |
| Alcohol† | ||||||||||||
| ≥1 day | 1.00 | 0.85 | 1.00 | 0.58 | 1.00 | 0.37 | 1.00 | 0.84 | 1.00 | 0.56 | 1.00 | 0.38 |
| ≥2 days | 1.00 | 0.88 | 1.00 | 0.62 | 1.00 | 0.41 | 1.00 | 0.87 | 1.00 | 0.61 | 1.00 | 0.42 |
| ≥3 days | 1.00 | 0.90 | 1.00 | 0.66 | 1.00 | 0.44 | 1.00 | 0.89 | 1.00 | 0.66 | 1.00 | 0.45 |
| ≥12 days | 0.89 | 0.95 | 0.94 | 0.80 | 0.97 | 0.58 | 0.88 | 0.95 | 0.91 | 0.81 | 0.95 | 0.62 |
| ≥52 days | 0.50 | 0.98 | 0.58 | 0.92 | 0.75 | 0.77 | 0.48 | 0.98 | 0.57 | 0.92 | 0.71 | 0.82 |
| ≥270 days | 0.03 | 1.00 | 0.03 | 1.00 | 0.05 | 0.99 | 0.04 | 1.00 | 0.03 | 1.00 | 0.03 | 0.99 |
| AUC (SE) | 0.97 | (0.0008) | 0.90 | (0.0012) | 0.82 | (0.0014)‡ | 0.97 | (0.0006) | 0.90 | (0.0012) | 0.83 | (0.0015) |
| Cannabis† | ||||||||||||
| ≥1 day | 1.00 | 0.94 | 1.00 | 0.78 | 1.00 | 0.68 | 1.00 | 0.94 | 1.00 | 0.81 | 1.00 | 0.74 |
| ≥2 days | 0.99 | 0.95 | 1.00 | 0.80 | 1.00 | 0.70 | 1.00 | 0.95 | 1.00 | 0.83 | 1.00 | 0.76 |
| ≥3 days | 0.99 | 0.95 | 1.00 | 0.82 | 1.00 | 0.72 | 1.00 | 0.96 | 1.00 | 0.85 | 0.99 | 0.78 |
| ≥12 days | 0.93 | 0.97 | 0.96 | 0.87 | 0.98 | 0.78 | 0.93 | 0.98 | 0.94 | 0.90 | 0.96 | 0.85 |
| ≥52 days | 0.66 | 0.98 | 0.78 | 0.92 | 0.85 | 0.84 | 0.66 | 0.99 | 0.67 | 0.94 | 0.79 | 0.90 |
| ≥270 days | 0.16 | 1.00 | 0.22 | 0.98 | 0.39 | 0.95 | 0.13 | 1.00 | 0.19 | 0.99 | 0.32 | 0.98 |
| AUC (SE) | 0.98 | (0.0004)‡ | 0.94 | (0.0009)‡ | 0.91 | (0.0010)‡ | 0.99 | (0.0004) | 0.95 | (0.0008) | 0.94 | (0.0009) |
| Other Illicit Drugs† | ||||||||||||
| ≥1 day | 1.00 | 0.94 | 1.00 | 0.88 | 1.00 | 0.82 | 1.00 | 0.92 | 1.00 | 0.88 | 1.00 | 0.86 |
| ≥2 days | 0.94 | 0.95 | 0.96 | 0.90 | 0.98 | 0.85 | 0.96 | 0.94 | 0.97 | 0.91 | 0.98 | 0.88 |
| ≥3 days | 0.92 | 0.95 | 0.92 | 0.92 | 0.96 | 0.87 | 0.92 | 0.94 | 0.94 | 0.92 | 0.96 | 0.90 |
| ≥12 days | 0.67 | 0.97 | 0.80 | 0.95 | 0.86 | 0.92 | 0.80 | 0.96 | 0.80 | 0.95 | 0.86 | 0.94 |
| ≥52 days | 0.45 | 0.98 | 0.56 | 0.98 | 0.65 | 0.96 | 0.50 | 0.98 | 0.58 | 0.98 | 0.65 | 0.97 |
| ≥270 days | 0.13 | 1.00 | 0.18 | 1.00 | 0.27 | 1.00 | 0.15 | 1.00 | 0.21 | 1.00 | 0.24 | 1.00 |
| AUC (SE) | 0.98 | (0.0005) | 0.97 | (0.0008) | 0.96 | (0.0008)‡ | 0.98 | (0.0005) | 0.97 | (0.0007) | 0.97 | (0.0007) |
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 (within age group, male relative to female adolescents),
↵‡ P < .0001.