A study published in the American Journal of Psychiatry (2024) examined predictors of substance use initiation by age 12 in a large longitudinal dataset of 6,829 adolescents. The study used a penalized logistic regression with elastic net to analyze 420 variables across multiple domains, including sociodemographic factors, self and peer involvement with substance use, parenting behaviors, mental and physical health, culture and environment, hormones, neurocognitive functioning, and structural neuroimaging. The results showed that sociodemographic factors were the most robust predictors of substance use initiation, followed by cultural and environmental factors, physical health factors, and parenting behaviors. The top predictor was a religious preference of Mormon, followed by Jewish and Black youths. Adding resource-intensive measures such as hormones, neurocognitive factors, and neuroimaging did not improve prediction performance compared to self-report measures. The study highlights the importance of sociodemographic variables in predicting substance use initiation and suggests that clinical applications of these findings could help streamline and tailor prevention and early intervention efforts. The findings indicate that factors such as religion, race, and income are significant predictors of substance use initiation, while modifiable risk factors such as sensation seeking, substance use availability, and peer use of alcohol and nicotine also play a role. The study underscores the complex interactions between individual, microsystem, and macrosystem factors in influencing early substance use initiation.A study published in the American Journal of Psychiatry (2024) examined predictors of substance use initiation by age 12 in a large longitudinal dataset of 6,829 adolescents. The study used a penalized logistic regression with elastic net to analyze 420 variables across multiple domains, including sociodemographic factors, self and peer involvement with substance use, parenting behaviors, mental and physical health, culture and environment, hormones, neurocognitive functioning, and structural neuroimaging. The results showed that sociodemographic factors were the most robust predictors of substance use initiation, followed by cultural and environmental factors, physical health factors, and parenting behaviors. The top predictor was a religious preference of Mormon, followed by Jewish and Black youths. Adding resource-intensive measures such as hormones, neurocognitive factors, and neuroimaging did not improve prediction performance compared to self-report measures. The study highlights the importance of sociodemographic variables in predicting substance use initiation and suggests that clinical applications of these findings could help streamline and tailor prevention and early intervention efforts. The findings indicate that factors such as religion, race, and income are significant predictors of substance use initiation, while modifiable risk factors such as sensation seeking, substance use availability, and peer use of alcohol and nicotine also play a role. The study underscores the complex interactions between individual, microsystem, and macrosystem factors in influencing early substance use initiation.