Teens Who Smoke, Drink Alone at Higher Risk

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However, "these are not the loner kids," Tucker said. In fact, most of these high-risk youngsters also spent significantly more time going to parties and dating than other substance-using youth. "They focus less on school and more on activities with their peers," Tucker said.

Moreover, these solitary substance abusers felt that substance use had positive effects on their behavior, helping them relax, have more fun and feel better, Tucker said. Also, they were less likely to think substance use is harmful.

But at 23, more of these solitary users had developed substance abuse problems and were involved in crimes, such as selling drugs and stealing, Tucker said. They also had more physical health problems. "So, across the board, they were faring worse in young adulthood," she said.

One expert believes that a combination of addiction and existing psychological problems account for these behaviors among this subset of youth.

"People who are more likely to be addicted are more likely to use solitarily as well as socially," said Bonnie Halpern-Felsher, an associate professor of pediatrics at the University of California, San Francisco. "In addition, kids who are at risk are more likely to use solitarily."

Halpern-Felsher thinks it is important that health-care providers ask adolescents about their smoking and drug use behaviors -- not only if they use drugs and alcohol but where. "It may be that asking these questions will help identify those teens at risk for other developmental problems," she said.

"It's not just the fact that they are using the substances, but what's going on behind it," Halpern-Felsher said. "Either they are lonely or there is depression or there is something going on at home. It could be that this is a marker for other behavioral and social problems that are going on," she said.

More information

There's more on teens and substance abuse at the U.S. National Institute on Drug Abuse (teens.drugabuse.gov ).