Aims: To explore the process of applying counterfactual thinking in examining causal predictors of substance use trajectories in observational cohort data. Specifically, we examine the extent to which quality of the parent-adolescent relationship and affiliations with deviant peers are causally related to trajectories of alcohol, tobacco, and cannabis use across adolescence and into young adulthood. Methods: Data were drawn from the Australian Temperament Project, a population-based cohort study that has followed a sample of young Australians from infancy to adulthood since 1983. Parent-adolescent relationship quality and deviant peer affiliations were assessed at age 13-14 years. Latent curve models were fitted for past month alcohol, tobacco, and cannabis use (n = 1,590) from age 15-16 to 27-28 years (5 waves). Confounding factors were selected in line with the counterfactual framework. Results: Following confounder adjustment, higher quality parent-adolescent relationships were associated with lower baseline cannabis use, but not alcohol or tobacco use trajectories. In contrast, affiliations with deviant peers were associated with higher baseline binge drinking, tobacco, and cannabis use, and an earlier peak in the cannabis use trajectory. Conclusions: Confounding adjustments weakened several estimated associations and the interpretation of such associations as causal is not without limitations. Nevertheless, findings suggested causal effects of both parent-adolescent relationships and deviant peer affiliations on the trajectory of substance use. Causal effects were however more pervasive (i.e., more substance types) and protracted for deviant peer affiliations. The current study encourages the exploration of causal relationships in observational cohort data, when relevant limitations are transparently acknowledged.
Asymptotic behavior of the unconditional NPMLE of the length-biased survivor function from right censored prevalent cohort data
