Preventing alcohol, marijuana, and cigarette use among adolescents: peer pressure resistance training versus establishing conservative norms

BACKGROUND. Two strategies for preventing the onset of alcohol abuse, and marijuana and cigarette use were tested in junior high schools in Los Angeles and Orange Counties, California. The first strategy taught skills to refuse substance use offers. The second strategy corrected erroneous normative perceptions about prevalence and acceptability of use among peers and established conservative groups norms regarding use. METHODS. Four experimental conditions were created by randomly assigning schools to receive (a) neither of the experimental curricula (placebo comparison), (b) resistance skill training alone, (c) normative education alone, or (d) both resistance skill training and normative education. Students were pretested prior to the program and post-tested 1 year following delivery of the program. RESULTS. There were main effects of normative education for summary measures of alcohol (P = 0.0011), marijuana (P = 0.0096), and cigarette smoking (P = 0.0311). All individual dichotomous measures of alcohol, marijuana, and tobacco use indicated significant reductions in onset attributable to normative education. There were no significant main effects of resistance skill training. CONCLUSION. These results suggest that establishing conservative norms is an effective strategy for preventing substance use.     

Associations between parent awareness, monitoring, enforcement and adolescent involvement with alcohol

In a statewide random telephone survey of 454 parents and their 14- to 19-year-old adolescents, we examined the associations between various parenting strategies and self-reported teen drinking. Less teen drinking was associated with parents' reports of checking to see if other parents would be present at teen parties, particularly among White parents. Parents' monitoring of teens' activities was associated with feelings of competence at doing so. There was, however, no difference in drinking between teens with parents who did or did not report restricting their teens due to teen misbehavior. These findings suggest that a proactive parental monitoring approach may be associated with less adolescent drinking. Prospective research is needed to clarify the causal relationship between parental monitoring, efficacy and teen alcohol-related behavior.     

Longitudinal influence of perceptions of peer and parental factors on African American adolescent risk involvement

To explore the long-term contributions of perceived peer and parental influences on adolescent risk and protective behaviors (sexual involvement, condom use, and drug use), we assessed self-reported behaviors and perceptions of peer risk involvement and parental supervision and communication among 383 low-income, urban African Americans aged 9 to 15 years at baseline over a 4-year, period. Baseline perceptions of peer sexual involvement were significantly associated with youth sexual behavior at baseline and were predictive of sexual involvement through all 4 years of follow-up. Perceived parental monitoring was inversely correlated with sexual involvement ment through 3 years of follow-up. Perceptions of peer condom use were associated with increased levels of condom use at baseline and through 6 months of follow-up. Positive parental communication was correlated with increased condom use. Drug use was higher among youths who perceived peers or family members to be using drugs and was inversely correlated with increased parental monitoring and supervision. Stepwise regression revealed peer and parental influences for all three behaviors. Perceptions of both peer and parental behaviors influence long-term risk and protective behaviors of adolescents. Therefore, parents should be included in adolescent riskreduction intervention efforts. Inclusion of friends and/or changing youth perceptions of peer involvement may also be effective intervention strategies.     

Controlling for the endogeneity of peer substance use on adolescent alcohol and tobacco use

This study examines whether the effects of peer substance use on adolescent alcohol and tobacco use are due to endogeneity of adolescents selecting their peer group. We analyzed data collected for a longitudinal analysis of a drug-use prevention programme for upper elementary school students. We used a two-step probit regression to control for the potentially endogenous explanatory variable peer substance use. Rigorous tests of endogeneity and the validity of the instrumental variables showed that controlling for the endogeneity of peer substance use to reduce bias is not worth the reduction in mean squared error in these data. Peer substance use has a positive and significant effect on adolescent substance use for both drinking and smoking. These results imply that peer influence is empirically more important than peer selection (endogeneity) in our sample of adolescents in grades 6–9. Living in a single-parent family was by far the strongest predictor of adolescent drinking and smoking. © 1998 John Wiley & Sons, Ltd.     

The relationship between exposure to alcohol advertising in stores, owning alcohol promotional items, and adolescent alcohol use

AIM: This paper describes adolescents' exposure to alcohol advertising in stores and to alcohol-branded promotional items and their association with self-reported drinking. METHODS: A cross-sectional survey was administered in non-tracked required courses to sixth, seventh, and eighth graders (n = 2125) in three California middle schools. Logistic regressions compared the odds of ever (vs. never) drinking and current (vs. ever) drinking after controlling for psychosocial and other risk factors for adolescent alcohol use. RESULTS: Two-thirds of middle school students reported at least weekly visits to liquor, convenience, or small grocery stores where alcohol advertising is widespread. Such exposure was associated with higher odds of ever drinking, but was not associated with current drinking. One-fifth of students reported owning at least one alcohol promotional item. These students were three times more likely to have ever tried drinking and 1.5 times more likely to report current drinking than students without such items. CONCLUSIONS: This study provides clear evidence of an association of adolescent drinking with weekly exposure to alcohol advertising in stores and with ownership of alcohol promotional items. Given their potential influence on adolescent drinking behaviour, retail ads, and promotional items for alcohol deserve further study.     

A model of the effects of protective parent and peer factors on young adolescent alcohol refusal skills

This paper describes the specification and testing of a model of protective parent and peer factors in peer refusal skills. Two modifiable protective factors suggested by relevant research on adolescent substance use—child attachment with parents and association with peers having prosocial norms—were incorporated as independent variables in the model. The effects of parent and child attendance at skills training interventions were also assessed. Covariance structure modeling of data from a sample of 209 families participating in a controlled study of a family-oriented skills intervention was used to test two versions of the model, one version addressing attachment and skills training attendance specific to mothers and one specific to fathers. Following two indicated modifications of the original model, strong fits with the data were achieved for both mother and father versions of the model; hypothesized protective factor effects and skills training effects were significant.     

The mediating role of adolescent self-efficacy in the relationship between parental practices and adolescent alcohol use

This study investigated the mediating role of adolescent self-efficacy in the relationship between parental practices and adolescent alcohol use. Resistance self-efficacy was a perfect mediator in the relationship between parental monitoring and lower alcohol use. Resistance self-efficacy may determine the effect of parental monitoring on deterring alcohol use in adolescents.     

Ethnicity and the relationship between adolescent alcohol use and suicidal behavior

Adolescent suicide is the 3rd leading cause of death in the United States and alcohol consumption is estimated to cause adolescent males to be up to 17 times more likely to attempt suicide, and females three times more likely to attempt suicide. Suicide and suicide attempt rates vary across different ethnicities. Also, associated psychopathology, stressors and substance use differ across ethnic groups in adolescents. In an exhaustive review of the literature, we found that depressed Asian-American youth were four times more likely to display suicidal behavior when compared to other Asian youths with other diagnoses; and depressed African-American females were more likely to report suicidal ideation than male adolescents. We also found that Asian-Americans who experience high parental conflict are 30 times more likely to engage in suicidal behavior when compared to Asian-American youths with low parental conflict. African-American adolescents are 6.4 times more likely to attempt suicide as a result of parental conflict. With respect to alcohol use and dependence, Caucasian adolescents were twice as likely as the African American victims to have used alcohol before committing suicide. Alcohol use among adolescents was associated with increased suicidal behavior. Cultural differences in alcohol consumption may account for disparities, however future research is needed to further examine cultural trends in suicidal behavior and alcoholism.     

Exposure to televised alcohol ads and subsequent adolescent alcohol use

OBJECTIVE: To assess the impact of televised alcohol commercials on adolescents' alcohol use. METHODS: Adolescents completed questionnaires about alcohol commercials and alcohol use in a prospective study. RESULTS: A one standard deviation increase in viewing television programs containing alcohol commercials in seventh grade was associated with an excess risk of beer use (44%), wine/liquor use (34%), and 3-drink episodes (26%) in eighth grade. The strength of associations varied across exposure measures and was most consistent for beer. CONCLUSIONS: Although replication is warranted, results showed that exposure was associated with an increased risk of subsequent beer consumption and possibly other consumption variables.     

Dyadic alcohol use and relationship quality as predictors of condom non-use among adolescent females

We examined alcohol use concordance (respondent and partner alcohol use) and relationship quality as predictors of condom non-use among adolescent women. Both variables were significant independent predictors of condom non-use. These results suggest that both the individual’s and her partner’s behaviors should be taken into consideration in research and clinical practice.     

The relationship between youth's moral and legal perceptions of alcohol, tobacco and marijuana and use of these substances

Youth's perceptions of the morality of alcohol and other drug use and the perceived legitimacy of laws regulating such use have received scant attention in the international public health literature. To date, the focus has mainly been on emphasizing the health and social disbenefits of substance use in an attempt to counter the perceived psychological benefits (positive expectancies) of use and peer reinforcement. Following exploratory qualitative research, a structured questionnaire was administered to a sample of 611 youths aged 14-17 years. Analysis of the data found that use of alcohol, tobacco and marijuana was directly related to moral perceptions: those considering use as 'wrong under any circumstance' were less likely to be users than those who considered it 'ok under some or any circumstance'. Substance use was also related to legitimacy perceptions: those who thought laws relating to alcohol, tobacco and marijuana use were justified were less likely to be users than those who thought these laws were not justified. The implications of these findings for future research and for the design of more effective intervention strategies are discussed. It is suggested that interventions including student discussion of the moral and legal issues surrounding substance use may prove effective in postponing or even preventing substance use, particularly tobacco and marijuana consumption, or reducing the excess use of these substances.     

The role of peer networks in adolescent pornography use and sexting in Croatia

ABSTRACT

Although communication about sexuality is a significant pathway through which peers influence adolescent sexual development, little research has examined the role of peer networks in the use of sexualized media. We applied a social network approach to assess the role of close peers in adolescent pornography use and sexting in a sample of Croatian high school students. Sexual conversation networks’ characteristics did not correlate with pornography use. In contrast, sexting was associated with the proportion of same gender peers, the proportion of older peers and the proportion of sexually experienced peers in the network – pointing to the role of peer influence. Participants’ gender did not moderate these associations. Specific mechanisms underlying the observed associations and the role of peer selection remain important tasks for future research.     

The relationship of cigars, marijuana, and blunts to adolescent bidi use

OBJECTIVE: Previous research suggests that bidi, cigar, and marijuana use may be interrelated, but to date, this hypothesis has not been empirically tested. METHODS: We explored the relationships among use of these products using data from 17,429 youths who completed the 2001 National Household Survey on Drug Abuse. Variables of interest included demographics, tobacco use (i.e., cigarettes, cigars), marijuana use, and blunting (i.e., cigars filled with marijuana). Adjusted odds ratios (AOR) for past-month bidi use were generated for each variable; regression models were also generated separately by race/ethnicity. RESULTS: Overall, 1.1% of the youths surveyed reported past month bidi use; higher prevalence was noted for those who were past-month users of cigarettes (4.6%), cigars (7.0%), marijuana (5.8%), and blunts (7.3%). Logistic regression yielded significant odds ratios for all tobacco products, marijuana, and blunts, with the greatest odds associated with past-month cigarette use. Interestingly, the pattern varied notably by race. Among white youth, the greatest odds for past-month bidi use were associated with cigarette use (AOR=3.9), while among black youth the greatest odds were associated with blunting (AOR=9.5). CONCLUSION: The findings demonstrate that the use of cigars and blunts is highly associated with bidi use among youths and these patterns differ by race/ ethnicity. Tobacco control efforts that target youths must address other tobacco products and marijuana and should be tailored appropriately and effectively, with consideration of racial, ethnic, and cultural variations.     

Risk and protective factors related to native Hawaiian adolescent alcohol use

The present study examined protective and risk factors in the prediction of alcohol use for Hawaiian and non-Hawaiian (i.e. Caucasian, Japanese, Filipino, 'other') adolescents. Comparable rates of approximately 25% were found for both the Hawaiian and non-Hawaiian samples regarding sometimes drinking too much alcohol. However, Hawaiians reported a statistically significantly higher rate (3.7%) of taking 'a drink in the morning to steady my nerves or to get rid of a hangover' than non-Hawaiians (1.3%). The reason for this is unknown but might indicate a higher rate of dependent alcohol use. The overall results supported the traditional model of protective and risk factors predicting alcohol use (R(2) > 15.0%), with relatively few differences found between the two ethnic groups. Further research is needed in assessing possibly unique cultural variables such as Hawaiian acculturation.     

Perceptions of social norms and exposure to pro-marijuana messages are associated with adolescent marijuana use

Despite consistent declines in rates of cigarette use among adolescents in the last five years, rates of marijuana use have remained constant, with marijuana being the most widely used illegal drug among adolescents. More work is needed to understand how social norms, perceived risks and benefits, and social media messaging impact use of marijuana. This study compared perceptions and social norms related to marijuana, blunts and cigarettes. Additionally, we assessed how perceptions related to social norms, risks and benefits, and exposure to pro- versus anti-marijuana messaging is related to use. Participants were 786 adolescents from Southern and Northern California (36.7% male, 63.21% females; mean age = 16.1 years; SD = 1.6). Participants came from diverse ethnic backgrounds, with 207 (26.61%) White, 171 (21.98%) Asian/Pacific Islander, 232 (29.82%) Hispanic, and 168 (21.59%) other. Results indicated that marijuana and blunts were consistently perceived as more socially acceptable and less risky than cigarettes (p < 0.01). Participants who reported that their friends used marijuana had a 27% greater odds of using marijuana themselves. Further, seeing messages about the good things or benefits of marijuana use was associated with a 6% greater odds of use [OR 1.06 (CI 1.00, 1.12)]. This study's findings offer a number of important public health implications, particularly as states move towards legalization of marijuana for recreational use. As this occurs, states need to take adolescents' perceptions of risks, benefits, social norms, and peer influences into account as they implement strategies to reduce youth use of marijuana and blunts.     

The neurobiological and neurocognitive consequences of chronic cigarette smoking in alcohol use disorders

A vast body of research attests to the adverse effects of chronic smoking on cardiac, pulmonary, and vascular function as well as the increased risk for various forms of cancer. However, comparatively little is known about the effects of chronic smoking on human brain function. Although smoking rates have decreased in the developed world, they remain high in individuals with alcohol use disorders. Despite the high prevalence of comorbid chronic smoking in alcohol use disorders, very few studies have addressed the potential neurobiological or neurocognitive effects of chronic smoking in alcohol use disorders. Here, we briefly review the existing literature on the neurobiological and neurocognitive consequences of chronic cigarette smoking and summarize our neuroimaging and neurocognitive studies on the effects of comorbid chronic excessive alcohol consumption and cigarette smoking in treatment-seeking and treatment-na?ve populations. Our research suggests comorbid chronic cigarette smoking modulates magnetic resonance-detectable brain injury and neurocognition in alcohol use disorders and that neurobiological recovery in our abstinent alcoholics is adversely affected by chronic smoking. Consideration of the potential separate effects and interactions of chronic smoking and alcohol consumption may foster a better understanding of specific mechanisms and neurocognitive consequences of brain injury in alcoholism and of brain recovery during sustained abstinence from alcohol. The material presented also contributes to ongoing discussions about treatment strategies for comorbid alcoholism and cigarette smoking and will hopefully stimulate further research into the neurobiological and neurocognitive consequences of chronic smoking in alcoholism and other substance use disorders.     

风险决策同伴影响抵抗对青少年问题网络使用预测效应的随访研究

探讨同伴影响抵抗和风险决策对青少年问题网络使用的预测效应,为早期发现青少年网络成瘾高危人群及制定有针对性干预措施提供参考依据.方法 在广州和沈阳两市分别抽取5所和3所初中.每所初中选取初一年级全体学生为研究对象,对其随访调查12个月.采用同伴影响抵抗问卷(RPIS)和风险决策问卷(YDMQ)评价青少年同伴影响抵抗和风险决策水平及其对问题网络使用的影响.结果 基线调查2 103名青少年,问题网络使用发生率为14.3%.1 a后随访1 853名,失访率为11.9%.新发PIU为307名(16.6%),持续PIU为150名(8.1%),116名(6.3%)青少年在基线时报告PIU,1 a随访后报告无PIU(终止组).与对照组相比,PIU新发组和持续组风险决策得分高、同伴影响抵抗得分低(P值均<0.01).Logistic回归模型中控制基线PIU、性别、地区、父母文化程度和家庭经济后,风险决策高、同伴影响抵抗低均是随访PIU和新发PIU的危险性预测因素(B值分别为0.904,0.650,0.936,0.741,P值均<0.01),同伴影响抵抗高是PIU中止的保护性预测因素(B=-0.625,P<0.05).结论 同伴影响抵抗能力较差和风险决策较高的青少年可作为健康危害行为早期筛查和干预的重点人群.