Risk/protective factors associated with substance use among runaway/homeless youth utilizing emergency shelter services nationwide.

Rates of alcohol, tobacco, and marijuana use among runaway/homeless youth are substantially higher than found among American high school students. To understand the risk and protective factors associated with substance use, this study (1) assessed cigarette, alcohol, and marijuana use among a national sample of runaway/homeless youth, (2) identified risk/protective factors associated with lifetime substance use, and (3) examined risk/protective factors associated with six month frequency of substance use. Unduplicated cases (n = 11,841) from the 1997 Runaway/ Homeless Youth Management Information System (RHY MIS) were analyzed. Results showed that substance use levels are greater than previously reported for this population. Predictors of cigarette, alcohol, and marijuana use and frequency were predominately individual youth risk factors and demographics rather than family risk factors. Providers in emergency youth shelters are in a prime position to assess substance use behaviors, as well as the associated risk factors. Provision of appropriate screening and referral to other services is essential to meet the needs of these youth.     

Alcohol and Cigarette Use Among Warsaw Adolescents: Factors Associated With Risk and Resilience

Background: Youth in Poland are at notable risk for substance use. Guided by resiliency theory, we examine if developmental risk and promotive factors are associated with substance abuse risk. Objectives: We examined the association between adolescent cigarette and alcohol use and related risk and promotive factors including maternal support, neighbors' informal social control, friends' acceptance of substance use, and alcohol and cigarette use by nonparental adults. Method: Data were collected from a random sample of 13- to 14-year-old students attending Warsaw middle schools (N = 3029). We used hierarchical regression models and examined compensatory and protective models of resilience, controlling for sociodemograhic factors. Results: Our results indicated that friends' acceptance of substance use and perceived drug use among nonparental adults was associated with increased risk cigarette and alcohol use among youth. We found that maternal support moderated the relationship between friends' acceptance of substance use and cigarette use (protective model of resilience). Thus, mother support buffered the negative effects of friends' acceptance of substance use on youths' cigarette use. Neighbor's informal social control and maternal support were associated with reduced risk of alcohol use (compensatory model of resilience). Conclusion: Collectively, results of the study support compensatory and protective models of resilience in a large representative sample of Warsaw adolescents.     

Adolescent Sexual Minority Girls Are at Elevated Risk for Use of Multiple Substances

Background: Sexual minority youth, especially girls, are at risk for alcohol, cigarette, and marijuana use when these substances are examined individually. However, little is known about concurrent use of these substances (i.e., three-substance use) in relation to sexual orientation. Objectives: The present study compared profiles of past year alcohol, cigarette, and marijuana use between SMGs and heterosexual girls. In addition, because internalizing and externalizing symptoms are associated with substance use, we examined whether sexual orientation was associated with substance use profile over and above co-occurring psychopathology. Methods: Mixture modeling was used to identify patterns of alcohol (including binge drinking), cigarette, and marijuana use in the past year using a cross-sectional sample of urban adolescent girls (Pittsburgh Girls Study; N = 2,064; mean age = 17). Approximately 8% (n = 173) of the girls endorsed a lesbian or bisexual identity. Results: Five substance using classes were identified: low-level substance use (72%), marijuana use (5%), cigarette use (8%), alcohol use (8%), and three-substance use (7%). SMGs were at an increased risk for substance use than heterosexual girls, particularly three-substance use (OR = 6.69, p < .001), cigarette use (OR = 6.26, p < .001), and marijuana use (OR = 3.86, p < .001) classes. Substance use patterns were regressed on sexual orientation, internalizing symptoms (i.e., depression, anxiety), and externalizing symptoms (i.e., conduct problems, oppositional defiant disorder). The disparities remained robust after controlling for internalizing and externalizing symptoms. Conclusions/Importance: Clinicians and researchers should be aware of potential three-substance use among SMGs. Substance use interventions for SMG may benefit from targeting risk factors that cut-across several substances, particularly externalizing symptoms.     

Racial bullying and adolescent substance use: An examination of school-attending young adolescents in the United States

This article examines the association between race and racial bullying (bullying due to one's race), in relation to youth substance use in school attending young adolescents in the United States. Weighted unadjusted and adjusted logistic regression models were run to assess if racial bullying involvement was associated with youth substance use. Data for this study come from the Health Behaviors in School-Aged Children survey (n = 7,585). An association between racial bullying status (not involve, bullying victim, bullying perpetrator, or mixed bullying victim/perpetrator) and youth substance was identified in this study. Racial bully perpetrators were most likely to have used cigarettes, alcohol, and marijuana, followed by youth in the mixed victim/perpetrator group. When analyses were stratified by race, non-Hispanic White and Hispanic youth experienced an increased risk of cigarette, alcohol, and marijuana use if in the perpetrator or mixed group (compared to those not involved with racial bullying). Non-Hispanic White and Asian youth were also more likely to report marijuana use if in the victim group. Non-Hispanic Black youth were more likely to use alcohol and marijuana if they were a perpetrator or in the mixed group, but they were not more likely to use cigarettes. Differences appear to exist in relation to racial bullying experience and substance across racial/ethnic group among youth in grades 7–10. Implications for prevention and educational professionals are discussed.     

Outcomes associated with adolescent marijuana and alcohol use among urban young adults: A prospective study

ObjectiveThis study identifies and compares outcomes in young adulthood associated with longitudinal patterns of alcohol and marijuana use during adolescence among urban youth.MethodData come from a cohort of 678 urban, predominantly Black children followed from ages 6–25 (1993–2012). Analyses are based on the 608 children who participated over time (53.6% male). Longitudinal patterning of alcohol and marijuana use were based on annual frequency reports from grades 8–12 and estimated through latent profile analysis.ResultsWe identified four classes of alcohol and marijuana use including Non-Use (47%), Moderate Alcohol Use (28%), Moderate Alcohol/Increasing Marijuana Use (12%) and High Dual Use (13%). A marijuana only class was not identified. Analyses show negative outcomes in adulthood associated with all three adolescent substance use classes. Compared to the non-use class, all use classes had statistically significantly higher rates of substance dependence. Those in the ‘High Dual Use’ class had the lowest rate of high school graduation. Comparing classes with similar alcohol but different marijuana patterns, the ‘Moderate Alcohol/Increasing Marijuana Use’ class had a statistically significant increased risk of having a criminal justice record and developing substance use dependence in adulthood.ConclusionAmong urban youth, heterogeneous patterns of alcohol and marijuana use across adolescence are evident, and these patterns are associated with distinct outcomes in adulthood. These findings suggest a need for targeted education and intervention efforts to address the needs of youth using both marijuana and alcohol, as well as the importance of universal early preventive intervention efforts.     

Risk and Protective Factors for Alcohol and Marijuana Use among African-American Rural and Urban Adolescents

The purpose of this study was to examine individual, family, peer, and community risk and protective factors associated with past-30-days alcohol and marijuana use among African-American adolescents living in rural and urban communities. This study used data collected from 907 tenth- and twelfth-grade African-American students who completed the 2005 Community Youth Survey. Peer and individual risk/protective factors were more influential for urban youths while family and community risk/protective factors were more influential for rural youths. This pattern held for alcohol and marijuana use. Implications for substance use prevention programming are discussed.     

Electronic cigarette and marijuana use among youth in the United States

BackgroundThere are growing concerns over the high rate of electronic cigarette (e-cigarette) use and decreases in perceived harm of marijuana use among youth. We seek to identify risk factors associated with e-cigarette and marijuana use among U.S. middle and high school students.MethodsEstimates of e-cigarette use only, marijuana use only, dual use of both substances as well as frequency of substance use were calculated for 8th, 10th and 12th grades with the typical age of 13, 15, 17 years old respectively by using the 2014 Monitoring the Future survey (n = 16,184).ResultsOverall, 7.9% of students only used e-cigarettes, 9.3% of students only used marijuana, and 6.6% of students used both e-cigarettes and marijuana in the last 30 days. E-cigarette use only was most prevalent among 8th and 10th graders while marijuana use only was most prevalent among 12th graders. The dual use of e-cigarettes and marijuana rapidly increased from 8th graders (2.6%) to 10th graders (7.3%) and maintained a high level for 12th graders (8.5%). Students' sociodemographic factors, school performance and work intensity were associated with e-cigarette and marijuana use in the multivariate analysis. Being a dual user of e-cigarettes and marijuana was associated with increased risk of a medium level or a high level of e-cigarette use and a medium level of marijuana useConclusionsThis study raised the possibility that youth start to use e-cigarettes at an earlier age and then progress to other substances. Education campaigns with tailored messages to prevent youth from vaping and drug use are critically needed.     

Prevalence of Substance Use among Lesbian,Gay, Bisexual,and Transgender Youth in Military Families: Findings from the California Healthy Kids Survey

Background: In addition to the challenges associated with military life, lesbian, gay, bisexual, and transgender (LGBT) youth in military families may face stressors associated with having a stigmatized sexual orientation and/or gender identity or expression, placing them at risk of substance use. To the authors' knowledge, this is the first study exploring substance use outcomes among LGBT youth in military families. Objectives: This study assessed the role of military connection, LGB identity, and transgender identity on lifetime and past 30-day substance use. Methods: This study is a secondary data analysis of the 2013–2015 California Healthy Kids Survey (CHKS). The study's participants (n = 634,978) were students attending middle and high schools in nearly all school districts in California. The study outcomes were lifetime and past 30-day cigarette, alcohol, tobacco, and marijuana use. Chi-square tests of associations (including cross-tabulations) and multivariate logistic regressions were conducted to address the study aims. Results: Multivariate logistic regression results indicated that military connection, LGB identity, and transgender identity were significantly associated with an increased odd of lifetime and past 30-day substance use. Compared to military non-transgender youth, military transgender youth had an increased likelihood of past 30-day cigarette use and past 30-day alcohol use. In addition, military LGB youth were 3.62 times as likely as military non-LGB youth to report past 30-day cigarette use. Conclusions/Importance: This study provides researchers with knowledge about the behavioral health of LGBT youth in military families, a vulnerable subgroup within the military-connected youth population, thus informing substance use prevention programs.     

Factors Associated with Substance Use Among Homeless Young Adults

ABSTRACT

The purpose of this study was to investigate factors associated with substance use among homeless young adults. Multinomial logistic regression analyses examined the influence of social networks and economic factors among a group of homeless young adults with differing levels of alcohol and drug use. In addition, for those with an alcohol use disorder, the role of future time expectancies was examined. A sample (n = 185) of homeless young adults aged 18 to 23 were recruited from a community drop-in center and interviewed utilizing self-report instruments. Findings suggest that social networks, economic factors, and future expectancies are significant predictors of the level of substance use among homeless young adults. Being able to identify those areas that place homeless young adults at risk for substance abuse and dependence has implications for effective intervention.     

Risk and protective factors associated with adolescent girls' substance use: Data from a nationwide Facebook sample

ABSTRACT

Background: Despite overall reductions in teenage substance use, adolescent girls' rates of substance use remain unacceptably high. This article examines whether girls' substance use is associated with general risk and protective factors (goal setting, problem solving, refusal skills, peer use, and self-efficacy) and gender-specific risk and protective factors (communication style, coping skills, self-esteem, body image, perceived stress, anxiety, and depression). Methods: Cross-sectional data were collected in 2013 via online surveys from a nationwide sample of adolescent girls (N = 788), aged 13 and 14 years, who were recruited through Facebook. Results: In multivariate analyses, controlling for correlates of adolescent substance use, 11 of the 13 general and gender-specific risk and protective factors were consistently associated with past-month alcohol, cigarette, and other drug use in the expected direction; past-month marijuana use was associated with 8 of the 13 factors. Refusal skills, peer use, coping, and depressive mood were most consistently and strongly associated with substance use. Conclusions: Substance abuse prevention programs targeting adolescent girls should focus on such general risk and protective factors as problem solving, refusal skills, peer influences, and self-efficacy, as well as such gender-specific risk and protective factors as communication style, coping, self-esteem, body image, perceived stress, and mood management.     

Early onset of drug and polysubstance use as predictors of injection drug use among adult drug users

Early onset of alcohol, marijuana, and cigarette use is an indicator of later substance use problems in adulthood such as alcohol or other drug dependence. This paper seeks to address the association between early onset alcohol, marijuana, cigarette, and polysubstance use with injection drug use among recent illicit drug users. The current study used baseline data from the Baltimore site of the NEURO-HIV Epidemiologic Study, an investigation of neuropsychological and social-behavioral risk factors of HIV, hepatitis A, hepatitis B, and Hepatitis C among both injection and non-injection drug users in Baltimore, Maryland. The present study used a subset (N=651) of the larger parent study that identified as White or Black, and reported any drug use in the past 6 months. In the full sample slightly more than half (52.5%) of study participants were IDUs. IDUs differed from non-IDUs on age of initiation for cigarettes, marijuana, and alcohol, with IDUs initiating the use of all three substances significantly earlier than non-IDUs. IDUs also had significantly greater proportions of early onset of alcohol (χ(2)=19.71, p<.01), cigarette (χ(2)=11.05, p<.01), marijuana (χ(2)=10.83, p<.01), and polysubstance use (χ(2)=23.48, p<.01) than non-IDUs. After adjusting for age, gender, and race/ethnicity, only participants identified as early onset alcohol users (AOR=1.47, 95% CI: 1.00-2.18) and early onset polysubstance users (AOR=1.62, 95% CI: 1.10-2.38) were more likely to have IDU status than those who reported initiating substance use later. IDU status was then stratified by race/ethnicity. After controlling for age and gender, only early polysubstance use was a significant predictor of IDU status for Whites (AOR=2.06, 95% CI: 1.07-3.93). Consistent with literature on early substance initiation and later illicit substance use, early onset of alcohol and polysubstance use is an important risk factor for IDU in adulthood.     

Prevalence of marijuana and other substance use before and after Washington State's change from legal medical marijuana to legal medical and nonmedical marijuana: Cohort comparisons in a sample of adolescents

ABSTRACT

Background: A growing number of states have new legislation extending prior legalization of medical marijuana by allowing nonmedical marijuana use for adults. The potential influence of this change in legislation on adolescent marijuana and other substance use (e.g., spillover or substitution effects) is uncertain. We capitalize on an ongoing study to explore the prevalence of marijuana and other substance use in 2 cohorts of adolescents who experienced the nonmedical marijuana law change in Washington State at different ages. Methods: Participants were 8th graders enrolled in targeted Tacoma, Washington public schools and recruited in 2 consecutive annual cohorts. The analysis sample was 238 students who completed a baseline survey in the 8th grade and a follow-up survey after the 9th grade. Between the 2 assessments, the second cohort experienced the Washington State nonmedical marijuana law change, whereas the first cohort did not. Self-report survey data on lifetime and past-month marijuana, cigarette, and alcohol use were collected. Results: Multivariate multilevel modeling showed that cohort differences in the likelihood of marijuana use were significantly different from those for cigarette and alcohol use at follow-up (adjusting for baseline substance initiation). Marijuana use was higher for the second cohort than the first cohort, but this difference was not statistically significant. Rates of cigarette and alcohol use were slightly lower in the second cohort than in the first cohort. Conclusions: This exploratory study found that marijuana use was more prevalent among teens shortly after the transition from medical marijuana legalization only to medical and nonmedical marijuana legalization, although the difference between cohorts was not statistically significant. The findings also provided some evidence of substitution effects. The analytic technique used here may be useful for examining potential long-term effects of nonmedical marijuana laws on adolescent marijuana use and substitution or spillover effects in future studies.     

Sexual Minority Disparities in Substance Use Willingness Among Youth

Background: Disparities in substance use have been observed in sexual minority youth, but less is known about willingness to use substances, an important precursor to actual use. Objective: The goal of this study was to examine willingness to use cigarettes, alcohol, and marijuana among sexual minority youth compared to their non-sexual minority counterparts using both cross-sectional and longitudinal data. Methods: The present study drew on two waves (Times 1 and 2; 6 months apart) of data collected during high school as part of a prospective study of substance use initiation and progression in Rhode Island. At Time 1, participants (N = 443) ranged in age from 15 to 20 years (M age = 16.7 years, 26.6% sexual minority, 59.5% female, 72.0% White). Participants self-reported their sexual identity and attraction, lifetime use of alcohol, cigarettes and marijuana, and cigarette, alcohol, and marijuana use willingness (i.e., if offered by a best friend or group of friends). Results: In cross-sectional multivariate regression models, sexual minority youth were more likely to report willingness to use cigarettes (p <.05) and marijuana (p <.01) compared to their non-sexual minority counterparts. Longitudinal multivariate regression models revealed that sexual minorities were only significantly more likely to report cigarette willingness at Time 2 compared to their non-sexual minority counterparts (p <.01). There were no significant differences in alcohol use willingness in multivariable cross-sectional or longitudinal models by sexual minority status. Conclusions: Sexual minority youth reported more willingness than non-sexual minority youth to use substances offered by peers; however, longitudinal analyses revealed that peers appear to play a role only in willingness to smoke cigarettes for these youth, and thus peer influence may be a contributing factor in explaining tobacco-related disparities among sexual minority youth. Given that stigma and peer groups may a particular risk factor for tobacco among sexual minority youth, our findings highlight the importance of prevention programs such as social marketing approaches that correct social norms, reduce stigma, and provide refusal-skills training to reduce tobacco-related disparities among sexual minorities.     

Age of first cigarette,alcohol, and marijuana use among U.S. biracial/ethnic youth: A population-based study

This study examines age of first cigarette, alcohol, and marijuana use among self-identified biracial youth, using data from the National Longitudinal Study of Adolescent Health (Add Health). We found an intermediate biracial phenomenon in which some biracial youth initiate substance use at ages that fall between the initiation ages of their 2 corresponding monoracial groups. When controlling for the covariates, our findings show that White-Asian biracial youth begin smoking marijuana and drinking alcohol at earlier ages than Whites and engaging in all forms of substance use at earlier ages than Asian youth. Results indicate that White-American Indian youth start smoking cigarettes at earlier ages than all biracial and monoracial groups. Our findings underscore the need for future research to examine substance-use initiation and progression among biracial/ethnic youth.     

Culture and Context: Buffering the Relationship Between Stressful Life Events and Risky Behaviors in American Indian Youth

The Sacred Mountain Youth Project was conducted to investigate risk and protective factors related to alcohol and drug use among American Indian youth. Findings indicated that stressful life events were positively associated with depressed mood, substance use, and risky behavior; cultural identity had no direct effects, but a secondary model showed that social support and protective family and peer influences were related to cultural identity. These findings suggest that the relationships between stressors and their negative sequelae are complex. Emphasis on protective processes that are culturally specific to American Indian youth may lead to effective alcohol and drug use prevention programs.     

A comparison of Cambodian-American adolescent substance use behavior to national and local norms

Introduction

This study was designed to compare rates of alcohol, marijuana, and cigarette use in Cambodian-American adolescents with norms from nationally- and regionally-representative peers.

Methods

Substance use data from 439 10th grade Cambodian-American adolescents in Long Beach, California were compared to grade- and gender-matched nationally representative data from the Monitoring the Future study and data from the California Healthy Kids Survey of students within the same school district.

Results

Overall, the Cambodian-American youth were less likely than nationally- and regionally-representative youth to use alcohol, marijuana, and cigarettes. Specifically, relative to estimates obtained for the general population and students attending school in the same school district, Cambodian-American youth were significantly less likely to use alcohol and marijuana. Cambodian-American youth were also less likely than youth in the general population to smoke cigarettes, but did not differ statistically from youth within their same school district.

Conclusions

As a group, Cambodian-American youth may not be at especially high risk for substance use. As is the case with virtually all populations, some individuals within the Cambodian-American group are likely to have more difficulty than others with substance use concerns. Thus, additional research is needed to identify factors that might help to identify high users with potential service needs.     

The relations of trait anxiety, anxiety sensitivity, and sensation seeking to adolescents'' motivations for alcohol, cigarette, and marijuana use

The present study investigated relations of anxiety sensitivity and other theoretically relevant personality factors to Copper's [Psychological Assessment 6 (1994) 117.] four categories of substance use motivations as applied to teens' use of alcohol, cigarettes, and marijuana. A sample of 508 adolescents (238 females, 270 males; mean age = 15.1 years) completed the Trait subscale of the State-Trait Anxiety Inventory for Children, the Childhood Anxiety Sensitivity Index (CASI), and the Intensity and Novelty subscales of the Arnett Inventory of Sensation Seeking. Users of each substance also completed the Drinking Motives Questionnaire-Revised (DMQ-R) and/or author-compiled measures for assessing motives for cigarette smoking and marijuana use, respectively. Multiple regression analyses revealed that, in the case of each drug, the block of personality variables predicted "risky" substance use motives (i.e., coping, enhancement, and/or conformity motives) over-and-above demographics. High intensity seeking and low anxiety sensitivity predicted enhancement motives for alcohol use, high anxiety sensitivity predicted conformity motives for alcohol and marijuana use, and high trait anxiety predicted coping motives for alcohol and cigarette use. Moreover, anxiety sensitivity moderated the relation between trait anxiety and coping motives for alcohol and cigarette use: the trait anxiety-coping motives relation was stronger for high, than for low, anxiety sensitive individuals. Implications of the findings for improving substance abuse prevention efforts for youth will be discussed.     

Racial/Ethnic Differences in the Protective Effects of Self-Management Skills on Adolescent Substance Use

Abstract

A variety of cognitive and behavioral self-management skills have been posited as protective in terms of adolescent substance use. This study examined whether these skills measured in the 7th grade served a protective function in 9th grade substance use across ethnically diverse samples of adolescents. Participants consisted of Black (n = 461) and Hispanic (n = 320) urban youth and White suburban youth (n = 757). Structural equation modeling indicated that a second order Self-Management Skills latent factor consisting of first order latent factors of Decision-Making, Self-Regulation, and Self-Reinforcement skills was protective for adolescent substance use across racial/ethnic subgroups. However, Self-Management Skills were more strongly protective for suburban White youth and less protective for urban minority youth. These findings are consistent with previous research showing that predictive power of risk and protective factors derived from psychosocial theories varies widely across racial/ethnic subgroups of youth and is weaker among racial/ethnic minority youth compared to White youth. An important next step is to broaden the focus of etiology research from individual-level determinants to studying adolescent substance use behavior in the context of the cultural background and primary social settings of young people, such as family, school, and community environments.