Effects of pubertal timing on alcohol and tobacco use in the early adulthood: A longitudinal cohort study in Taiwan.
Early puberty bumps later smoking and drinking risk even in neurotypical Asian youth.
01Research in Context
What this study did
Tsai et al. (2015) followed a large group of Taiwanese teens from seventh grade to age twenty. They tracked who started puberty early, on time, or late. Then they checked who smoked or drank by age twenty.
The study used surveys and medical exams. It is quasi-experimental, so it shows links, not cause.
What they found
Early-maturing teens had 43 % higher odds of smoking and 34 % higher odds of drinking by age twenty. The effect was modest but clear.
Girls and boys showed the same pattern. Family income did not change the result.
How this fits with other research
Sirao et al. (2026) meta-analysis agrees that pubertal timing matters. It shows kids with ASD face higher odds of very early puberty, yet absolute risk stays low. Tsai et al. (2015) extends this by showing that early puberty raises substance use even in neurotypical youth.
Boets et al. (2011) found the opposite direction: neurotypical girls with autistic-like traits started periods later, not earlier. This contrast is expected because O et al. looked at traits, not timing, as the starting point.
Huang et al. (2014) used the same Taiwanese youth pool and linked family fights to later substance use. Together, the two Taiwanese studies suggest both family stress and early puberty add risk.
Why it matters
If you work with tweens, add a quick puberty-timing question to your intake. Early developers may need refusal-skills training before high school. Share the finding with parents: starting puberty early is not a problem, but it is a flag. A five-minute screen can guide you to whom you watch more closely.
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02At a glance
03Original abstract
We aimed to examine the effects of pubertal timing on adolescents' alcohol and tobacco use from late adolescence to young adulthood. In addition, we separately explored associative factors of the use of these substances stratified by pubertal timings. A longitudinal cohort of 7th- and 9th-grade students was recruited in Taiwan. Pubertal timing was classified according to the Pubertal Developmental Scale. Effects of pubertal timing on self-reported drinking and smoking at age 20 were evaluated using generalized estimating equation analysis. Furthermore, we assessed the predictive roles of parental monitoring, parent-child relationships, peer influence, and school adhesion among participants, stratified by pubertal timing using multiple logistic regression analysis. A survey of 2290 participants was analyzed, with 51.2% being female. The smoking rate is 19.2% (adjusted odds ratio [OR] 1.43, 95% confidence interval [CI] 1.03-2.00) and the alcohol drinking rate is 41.6% (adjusted OR 1.34, 95% CI 1.07-1.69) for early maturing adolescents as compared to 12.3% and 41.6% respectively for on-time peers. A satisfactory parent-child relationship is a protective factor and strict parental monitoring is a risk factor for future tobacco and alcohol use in logistic regression analyses. Early maturation confers risk for cigarette smoking and alcohol consumption in young adulthood. Health professionals and parents should be advised of the potential associative factors with future substance use among adolescents with different maturation tempo. Emphasis could be placed on promoting positive parenting strategies and intra-familial interactions.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2014.10.026