Adverse Childhood Experiences Predict Alcohol Consumption Patterns Among Kenyan Mothers

Objective: We analyze whether adverse childhood experiences predict weekly alcohol consumption patterns of Kenyan mothers and their partners. Method: Randomly selected respondents (n = 1,976) were asked about adverse childhood experiences and alcohol consumption patterns for themselves and their partners. Fixed effect models were used to determine odds of reporting weekly alcohol consumption and the number of beverages typically consumed, controlling for wealth, age, education, and partner alcohol consumption. Results: Cumulative adverse childhood experiences predicted higher odds of weekly alcohol consumption of the respondent and her partner. Childhood exposure to physical abuse, emotional neglect, and mental illness in the household significantly increased odds of weekly alcohol consumption by the respondent. More drinks consumed per typical session were higher among respondents with more cumulative adversities. Physical and emotional abuse significantly predicted number of drinks typically consumed by the respondent. Conclusions: To our knowledge, this is the first study to explore and find associations between adverse childhood experiences and alcohol consumption in Kenya. Consistent with high-income settings, exposure to childhood adversities predicted greater alcohol consumption among Kenyan women.     

Demographic Moderators of the Relationship Between Adverse Childhood Experiences and Cigarette Smoking

Background: Research suggests that there is a dose–response relationship between Adverse Childhood Experiences (ACEs) and cigarette smoking, such that as ACE score increases, so do the odds of smoking behavior, but little is known about what factors moderate this relationship. Objectives: The goal of this study was to examine demographic characteristics as potential moderators of relationship between ACE score and cigarette smoking. Methods: A secondary data analysis was conducted using the 2013 California Behavioral Risk Factor Surveillance System data. The sample included 2,604?U.S. adults (54.8% female; Age: M?=?53.3, SD?=?8.10). We used multinomial logistic regression to test sex, race, income, and education as moderators of the relationship between ACE score and smoking. Results: ACEs were not significantly associated with smoking behavior. No interactions between ACE score and sex, race, education, or income significantly predicted smoking outcomes. Sex, race, education, and income were significantly and independently associated with smoking outcomes. Men, individuals with lower income and education, and certain ethnic/racial groups reported greater odds of smoking. Conclusions/Importance: Results suggest that there may not be a relationship between ACEs and smoking later in life. Additionally, the relationship between ACEs and smoking in adulthood may not depend on basic demographic features. Knowing which populations are more vulnerable to smoking can help clinicians better assess and tailor interventions to meet the needs of their patients by using culturally sensitive interventions and obtaining resources to help improve treatment access, motivation, and success.     

Adverse Childhood Experiences (ACEs) and Alcohol Abuse among South Carolina Adults

Background: Adverse childhood experiences (ACEs) have been associated with negative adult health outcomes, including alcohol misuse. The impact of ACEs on alcohol use may vary by gender, with ACEs impacting women more than men in coping with adulthood stressors. Objectives: The objective of this study is to examine the gender-specific relationships between ACEs and self-reported binge drinking and heavy drinking in adulthood among South Carolina residents. Methods: This study analyzed a sample of 8492 respondents who completed the 2014 or 2015 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) survey. Logistic regression was used to examine the impact of types and the number of ACEs on binge drinking and heaving drinking in adulthood. Results: Thirty-seven percent of men and 22.8% of women survey respondents reported binge drinking and 12.2% of men and 4.1% of women reported heavy drinking. Almost all categories of ACE were associated with increased odds of reporting binge and heavy drinking; household mental illness had the greatest odds for men (aOR 1.31, 95% CI 1.30–1.33) and emotional abuse had the greatest odds for women (aOR 1.42, 95% CI 1.40–1.43). Men and women with four or more ACEs had greater odds of reporting binge and heavy drinking compared to their counterparts. Conclusions/Importance: Given the potential for negative outcomes associated with alcohol misuse and transmission of risky alcohol-related behaviors from parent to child, strategies that utilize a multigenerational approach could have a large impact on population health.     

Adverse Childhood Experiences and Early Initiation of Marijuana and Alcohol Use: The Potential Moderating Effects of Internal Assets

Introduction: Early adolescence is a critical risk period for initiation of substance use. Internal assets (IAs), which are individual qualities guiding positive choices, and adverse childhood experiences (ACEs) are important protective and risk factors, respectively, against substance use. The purpose of this study is to investigate whether IAs modify associations between ACEs and early initiation of alcohol and marijuana use. Method: Data were from 9th and 11th graders who completed the 2013 Minnesota Student Survey (n = 79,339). Students reported on experiences of abuse, household dysfunction, and substance use. Multivariable logistic regressions examined associations between different types of ACEs and substance use. Interactions between IAs and ACEs were added to models to test effect modification. For significant interactions, main effects models were re-estimated at different percentiles of IAs. Result: IAs moderated associations of both abuse and household dysfunction with early initiation of marijuana (p <.003) and alcohol (p =.007) for females but not for males. For females with low IAs, odds of early initiation of marijuana were approximately twice as high as students without any ACEs. A similar pattern was detected for females' initiation of alcohol use. No effect modification was detected for IAs and experiencing only abuse or household dysfunction on initiation. Conclusion: Special attention should be paid to improving IAs among girls who have already experienced ACEs. Future research should examine protective factors that buffer the effects of ACEs for boys.     

Associations Between Initial Subjective Experiences with Tobacco and Self-Reported Recent Use in Young Adulthood

Background: Youth tobacco use behaviors are predictive of patterns in adulthood and effect long-term health outcomes. Yet, few studies have examined the effect of initial subjective experiences (ISEs) during first tobacco use, which has been found to be an indicator of individuals. sensitivity to nicotine and vulnerability to dependence. Objective: The present study aimed to determine the prevalence of ISEs across a variety of tobacco products, evaluate the factor structure of ISEs by first tobacco product used, and examine the relationship between ISEs and recent (30-day) use of tobacco products across time, using a university sample. Methods: Exploratory factor analyses were conducted to identify latent factors present with respect to items measuring ISEs with tobacco, separately by tobacco product (e.g. cigarettes, cigars, hookah, e-cigarettes). Factor scores for positive and negative ISEs were calculated. Multiple logistic regression analyses were conducted to examine associations between ISEs and recent use of each tobacco product, adjusted for age at first use, sex, race/ethnicity, and cohort. Results: ISEs differ by the first tobacco product used. Associations between factor scores for positive and negative ISEs and recent use were found across a variety of tobacco products. Overall, positive ISEs were more strongly associated with recent use, relative to negative ISEs. Conclusions: Further research is needed to identify genetic and biological pathways and social contexts influencing initial subjective experiences with tobacco use, in efforts to delay the initiation for tobacco use and reduce risk for continued use among young adults.     

Childhood Experiences and Complicated Grief: A Study of Adult Children of Alcoholics

For the most part, grief research concentrates on type of loss (e.g., LOSS of spouse, parent, or child) and/or type of death (e.g., EXPECTED or sudden). In contrast, the present paper focuses on a category of per- sons generally assumed to have had troubled childhoods, adult children of alcoholics (ACOAs). Because of assumed problematic histories, the grief process of ACOAs should be expected to differ from the grief process of non-ACOAs. Using both quantitative and qualitative techniques, 27 ACOAs and 20 non-ACOAs, recruited by newspaper, radio, and word-of-mouth, are compared across characteristics generally associated with ACOAs and/or unresolved grief. Implications for counseling are presented.     

Three Types of Adverse Childhood Experiences,and Alcohol and Drug Dependence Among Adults: An Investigation Using Population-Based Data

Background: There are several gaps in the literature on the link between adverse childhood experiences (ACEs) and substance use, including the impact of less direct forms of abuse, such as witnessing domestic violence, and the role of gender as a moderator of the relationship. Objectives: To estimate associations between three types of ACEs (sexual abuse, physical abuse, and exposure to parental domestic violence), when mutually adjusted, and two substance dependence outcomes (alcohol and drug dependence), while considering the potential moderating role of gender and the effects of a range of potential explanatory factors. Methods: Secondary analysis of the nationally representative Canadian Community Health Survey-Mental Health (2012) using logistic regression (n = 21,554). A series of models were tested separately for each outcome, including ACEs, gender, race, and age. First, gender interactions were tested. Next, potential explanatory factors were entered into the models and the extent of attenuation was noted. These factors included: depression, anxiety, smoking, pain, insomnia, social support, and socioeconomic status Results: All three ACEs are associated with significantly higher odds of alcohol and drug dependence, even when controlling for all factors simultaneously; however, no strong evidence for gender interactions was found. In the fully adjusted model, odds ratios for drug dependence vary from 2.52 (sexual abuse) to 1.34 (exposure to domestic violence). The comparable range for alcohol dependence is 2.13 (physical abuse) to 1.49 (exposure to domestic violence). Conclusions/Importance: Three types of ACEs, including direct and indirect forms of violence, are independently related to lifetime drug and alcohol dependence among adult Canadians.     

Childhood obesity, hypertension, the metabolic syndrome and adult cardiovascular disease

1. The worldwide epidemic of obesity in adults has been mirrored in children in developed and developing countries. 2. Central obesity appears to be driving a cluster of abnormalities often referred to as the metabolic syndrome. 3. The definition of the metabolic syndrome in children is not suited to arbitrary cut-offs and a definition using the significant clustering of risk factors that is already evident in childhood and adolescent populations may be preferable. 4. An Australian population study showed that 25% of 8-year-olds and 29% of 14-year-olds could be described by the high risk cluster with features similar to adult metabolic syndrome. 5. The high risk cluster was significantly linked to high and low birthweight, shorter duration of breast-feeding, larger postnatal weight gains after 12 months of age and raised C-reactive protein, gamma glutamyl transferase and alanine transaminase levels. At-risk young adults have also been shown to have macroscopic atherosclerosis in post-mortem studies. 6. Identification of at-risk children has obvious benefits for the individual and as well, for prevention of a future cohort with raised cardiovascular morbidity and mortality; however, complexities and controversies exist in doing so. Familial, genetic and lifestyle risk factors aggregate and labelling children with predisease may be problematic. Committed political and societal changes are necessary to reduce childhood obesity and subsequent adult cardiovascular disease.     

Genetic and Environmental Risk Factors for Cannabis Use: Preliminary Results for the Role of Parental Care Perception

Background: Vulnerability to cannabis use (CU) initiation and problematic use have been shown to be affected by both genetic and environmental factors, with still inconclusive and uncertain evidence. Objective: Aim of the present study was to investigate the possible interplay between gene polymorphisms and psychosocial conditions in CU susceptibility. Methods: Ninety-two cannabis users and ninety-three controls have been included in the study. Exclusion criteria were serious mental health disorders and severe somatic disorders, use of other drugs and alcohol abuse; control subjects were not screened to remove Reward Deficiency Syndrome (RDS) behaviors. A candidate gene association study was performed, including variants related to dopaminergic and endocannabinoids pathways. Adverse childhood experiences and quality of parental care have been retrospectively explored utilizing ACES (Adverse Children Experience Scale), CECA-q (Child Experience of Care and Abuse Questionnaire), PBI (Parental Bonding Instrument). Results: Our findings evidenced a significant association between rs1800497 Taq1A of ANKK1 gene and CU. Parental care was found to be protective factor, with emotional and physical neglect specifically influencing CU. Gender also played a role in CU, with males smoking more than females. However, when tested together genotypes and psychosocial variables, the significance of observed genetic differences disappeared. Conclusions: Our results confirm a significant role of Taq1A polymorphism in CU vulnerability. A primary role of environmental factors in mediating genetic risk has been highlighted: parental care could be considered the main target to design early prevention programs and strategies.     

The Relationship Between Tobacco and Cannabis Use: A Review

Background: Based on the prevalence and health implications of tobacco and cannabis use, aiming to reduce their use, especially among youth, is a sound objective at both the individual and public health level. A proper understanding of the relationships between tobacco and cannabis use may help to achieve this goal. Objectives: To review the relationships between tobacco and cannabis use. Methods: A selective review of the literature. Results: We present an overview of the motivations for tobacco and cannabis use, and their perceived harmfulness. The article then reviews the gateway theory, reverse gateway theory, route of administration theory, and common liability theory. We describe the link between co-use and dependence symptoms, and the substitution phenomenon between tobacco and cannabis use. Three forms of simultaneous use–mulling, blunt smoking, and chasing–and their impacts are explained. We summarize the impact of tobacco use on cannabis (and vice versa) treatment outcomes, and, finally, review new treatments that simultaneously target tobacco and cannabis dependence. Most of the literature reviewed here relates to substance use among adolescents and young adults. Conclusions: The use of tobacco and cannabis–two of the most widely used substances around the world–are strongly intertwined in several respects. Both health professionals and researchers should have well-informed views on this issue to better evaluate, understand, inform, and provide care to their patients.     

Physical Factors,Personal Characteristics,and Substance Use: Associations With Obesity

ABSTRACT. Background: Because obesity has become a major public health problem, attention to a range of its predictors is needed. This study examined the association of physical factors, personal characteristics, and substance use with obesity in a sample (N = 815) of African American and Puerto Rican young adults with a mean age of 32. Methods: Body mass index (BMI) was calculated to assess obesity. Bivariate and multivariate logistic regression analyses were conducted. Results: Bivariate analyses showed that protective factors such as physical activity (adjusted odds ratio [AOR] = .82, 95% confidence interval [CI] = .74–.91), healthy diet (AOR = .96, 95% CI = .93–.99), self-control (AOR = .93, 95% CI = .87–.98), and life satisfaction (AOR = .97, 95% CI = .95–.99) were associated with a reduced probability of being obese. Marijuana use was also associated with a decreased probability of obesity (AOR = .89, 95% CI = .80–.99), but was not considered a protective factor. Risk factors such as short sleep duration (AOR = 1.70, 95% CI = 1.24–2.33) and depressive mood (AOR = 1.05, 95% CI = 1.01–1.09) were associated with an increased probability of being obese. Conclusions: For African Americans and Puerto Ricans, programs to treat obesity should focus on increasing sleep, physical activity, and life satisfaction.     

The Effect of Adverse Childhood Experience on Clinical Diagnosis of a Substance Use Disorder: Results of a Nationally Representative Study

Background: Substance abuse is one of the most common health outcomes associated with adverse childhood experience, and poses a significant public health threat. Objectives: The purpose of this study is to demonstrate a relationship between adverse childhood experience and a substance use disorder using nationally representative data as well as to test whether religion moderates this relationship. Methods: We conducted a secondary analysis using data from the National Longitudinal Study of Adolescent to Adult Health (n = 11,279). Three types of adverse childhood experiences were considered; physical, emotional, and sexual abuse. Logistic regression was used to determine whether risk for developing an alcohol use, cannabis use, or other drug use disorder in adulthood increased as exposure to multiple types of adverse childhood experiences increased while controlling for prior substance use and other demographic variables that have shown associations with substance use. In addition, religiosity was investigated as a possible moderator of the relationship between adverse childhood experience and substance abuse. Results: The likelihood of developing a substance use disorder later in life increased as the score on the adverse childhood experience index increased. While religiosity did significantly reduce the likelihood of developing a substance use disorder, no moderating effects were observed. Conclusions/importance: This study underscores the long-term consequences of exposure to childhood adversity.     

Khat Use is Associated with Tobacco,Alcohol, and Illicit Drug Use: A Cross-Sectional Examination in the United States

No study has systematically examined khat (Catha edulis) use and its linkages with other substance use in the United States. This study provides novel findings related to the associations of khat with other substance use among immigrants in metropolitan areas of Minnesota where large East African communities reside. Using a convenience sampling, a total of 261 individuals completed a brief face-to-face interview during which demographic information and substance use were assessed. The proportion of lifetime and current use were 30% and 6.6% for khat, 35% and 18% for tobacco, 35% and 21% for alcohol, and 13% and 10% for other illicit drugs. Self-report history of khat use was associated with tobacco, alcohol, and other drug use. Tobacco use was related to alcohol and use of other drugs. The results suggest that a history of khat use is useful in identifying individuals who are vulnerable to substance-use-related problems. The findings indicate the need for more research on khat in the U.S.     

Dual Tobacco Use among College Students: Contexts of Use,Self-Perceptions,and Attitudes Toward Quitting

Aggressive marketing of smokeless tobacco (SLT) appears to have led to an increase in dual tobacco use. The current study examines the situational contexts, self-perceptions, and cessation attitudes/behaviors that relate to dual use. Participants (N = 1,242) at a large, Southwestern university completed a self-report measure of demographic and tobacco use variables in 2010. Data were analyzed using chi-square and one-way ANOVA techniques. Findings suggest that type of tobacco use varies by setting and that dual users are more likely than sole users to perceive themselves as regular tobacco users. Limitations and implications for future research and interventions are discussed.     

School-Level Correlates of Adolescent Tobacco,Alcohol, and Marijuana Use

Background: School-level characteristics are related to students’ substance use, but little research systematically examined multiple school characteristics in relation to different types of substance use across grade levels. Objectives: This study examines multiple school-level characteristics as correlates of students’ tobacco, alcohol, marijuana, and combined substance use across three grade levels. Methods: Students (N = 23,615) from 42 urban and suburban middle schools and 24 high schools in the U.S. reported on their tobacco, alcohol, and marijuana use. Students’ mean age was 14 years; 47% were male, 53% African American, and 41% Caucasian. School-level data included poverty, racial composition, academic achievement, student-teacher ratio, absenteeism, and school size. Multilevel logistic and Poisson regressions tested associations between school-level predictors and adolescent substance use in middle school, early high school, and late high school. Results: School-level poverty, more ethnic minority students, low achievement, and higher absenteeism were related to alcohol, marijuana, and combined substance use, particularly at lower grade levels. By contrast, cigarette smoking was more prevalent in more affluent high schools with more White students. After adjusting for other school characteristics, absenteeism emerged as the most consistent predictor of student substance use. Conclusions/Importance: Interventions addressing absenteeism and truancy in middle and high schools may help prevent student substance use. Schools serving poor, urban, and mostly minority students may benefit from interventions targeting alcohol and marijuana use, whereas interventions focusing on tobacco use prevention may be more relevant for schools serving more affluent and predominantly White students.     

Tobacco Use,Heavy Use,and Dependence Among Adolescents and Young Adults in the United States

Tobacco involvement among US youth was investigated in a national survey conducted in 2005–2007 of 2,274 respondents aged 14–21, including those not in school. Logistic regressions predicted tobacco involvement. Males had higher rates of tobacco use than females, but males and females had equal rates of heavy use and dependence. Tobacco involvement increased with age. Whites were more tobacco involved than minorities. Tobacco involvement declined with increasing socioeconomic status. Reduced tobacco use was associated with being married and with being a student. Smokeless tobacco use was associated with being male, older, white, and lower socioeconomic status. The implications of these results are discussed.     

Use of Alcohol,Illicit Drugs,and Tobacco Among Characters on Prime-Time Television

Previous research of addictive substances suggests that use of alcohol, illicit drugs, and tobacco is overrepresented on prime-time television (TV). These studies, however, have relied on frequency counts of the substance, rather than the prevalence of use among characters. Therefore, the objectives of this study were to compare the prevalence of alcohol, illicit drug, and tobacco users among characters on prime-time TV during 1995 and 1996 with rates of use in the United States. In addition, we determined if the ratio of male to female, young to old, and white to minority addictive substance users on prime-time TV were similar to the equivalent U.S. ratios. Comparing results for prime-time TV characters versus the U.S. population (respectively), 11.0% (99% CI, 9.8–12.1) drank alcohol versus 51.0%; 0.8% (99% CI, 0.5–1.1) used illicit drugs versus 6.1%; and 2.5% (99% CI, 2.0–3.1) smoked tobacco versus 28.9%. In addition, no consistent pattern was evident in our analyses that assessed whether addictive substance users on prime-time TV were more frequently represented as men, young, or minority compared to the similar U.S. ratio. These results indicate that contrary to prevailing beliefs, alcohol, illicit drug, and tobacco users are uncommon on prime-time TV and are less prevalent than in the U.S. population.     

Factors Predicting Alcohol Consumption in Adolescents Attending a Faith-Based School System in Australia: A Multigroup Structural Equation Analysis

Abstract

Structural equation modeling was used to explore the direct and indirect association of childhood experiences, attitudes, subjective norms, and intentions on the alcohol consumption of adolescents attending faith-based Seventh-day Adventist schools in Australia. Data were collected on 1,266 adolescents and the structural model developed explained 48% of the variance for alcohol consumption. Intentions had the highest degree of association with Alcohol Consumption Status (ACS) (β?=?0.52). Attitudes were more strongly associated to ACS (β_total = 0.36) than subjective norms (β_total = 0.17). Adverse Childhood Experiences (ACEs) were associated with every variable in the model and had a combined direct and indirect association with ACS of β_total = 0.14. Multigroup analysis found significant pathway differences in the model for gender and age with regards to the association of intentions, attitudes, ACEs, and Childhood Family Dynamics with alcohol consumption status. The study fills a gap in the alcohol literature by presenting a model describing the complex network of factors that predict alcohol consumption in a low-ACS population. The outcomes of the study highlight the importance of early intervention for children and their families to delay or minimize alcohol consumption in adolescents.     

Psychological Risk Factors for Alcohol,Cannabis, and Various Tobacco Use among Young Adults: A Longitudinal Analysis

Background: Alcohol, cannabis, and tobacco use are prevalent in young adults and may be differentially related to psychological symptoms characterized as externalizing or internalizing. Objectives: This study examined the use of alcohol, cannabis, and various tobacco products in relation to externalizing (ADHD) versus internalizing factors (depression, anxiety), hypothesizing alcohol and cannabis use are associated with externalizing factors whereas tobacco use is related to internalizing factors. Methods: Data from a 2-year longitudinal study of 2,397?US college students (aged 18–25) launched in 2014 were analyzed. Adult ADHD Self-Report Scale, Patient Health Questionnaire-9 item (assessing depressive symptoms), and the Zung Self-Rating Anxiety Scale scores were examined in relation to subsequent past 30-day use of alcohol, cannabis, and tobacco products (cigarettes, little cigars/cigarillos, smokeless tobacco, e-cigarettes, hookah), as well as nicotine dependence per the Hooked on Nicotine Checklist. Results: Participants were 20.49 (SD = 1.93) years old, 64.7% female, and 65.5% White. In multivariable analyses, greater ADHD symptoms predicted alcohol and cannabis use (p = .042 and p = .019, respectively). Cigarette and little cigar/cigarillo use were predicted by greater depressive (p = .001 and p = .002, respectively), and anxiety symptoms (p = .020 and p = .027, respectively). Nicotine dependence was correlated with greater anxiety symptoms (p = .026). Counter to hypotheses, smokeless tobacco use was predicted by greater ADHD symptoms (p = .050); neither e-cigarette nor hookah use were predicted by these psychological symptoms. Conclusions/Importance: Research examining risk factors for tobacco use must distinguish among the various tobacco products. Moreover, interventions may need to differentially target use of distinct substances, including among the range of tobacco products.     

Adolescent Tobacco and Alcohol Use: The Influence of Body Image

The association between body image and adolescent substance use is underexplored despite the established relationship between body image and risky behaviors. The current study utilized data from the Health Behavior in School-Aged Children 2001–2002 survey, a nationally representative survey of youths in the United States. Measures included perceived size/weight, perceived attractiveness, ever tried smoking, currently a smoker, currently a drinker, and binge drinking in the previous 30 days. Size and attractiveness perceptions were related to substance use, although the association differed by gender. The significant findings and implications are discussed.