The use of tobacco, alcohol and other drugs by young Aboriginal people in Albany, Western Australia

Abstract: This paper describes patterns of tobacco, alcohol and other drug use among Aboriginal people aged 8 to 17 years in the town of Albany, Western Australia. Of a total of 110 young Aboriginal people residing in the town at the time of the study, 105 were interviewed by two trained Aboriginal research assistants using interview schedules that included questions based on the national guidelines for the comparability of studies of drug use among young people. The most commonly used drugs were tobacco, alcohol and cannabis. Use of other substances was usually experimental. The majority (57 per cent) of this population had not used any drugs, 13 per cent made some use of alcohol and/or tobacco, 15 per cent were polydrug users, and 15 per cent were frequent poly–drug users. Use of drugs increased with age: 48 per cent of those aged 15 to 17 were frequent polydrug users. Tobacco consumption was greater and alcohol use less than that reported among Western Australian secondary school children of comparable age.     

DRUG USE AMONG SYDNEY TEENAGERS IN 1985 AND 1986

To investigate adolescent drug use behaviour, a random community sample of Sydney teenagers aged 14 to 19 years was interviewed at home in 1985 (N=996) and again in 1986 (N=756). Respondents were asked about current use of alcohol, tobacco, marijuana, other illicit drugs, medications and inhalants. Drug use was common: 16 per cent of respondents were heavy drinkers, 28 per cent smoked tobacco, 10 per cent used marijuana and 4 per cent used drugs other than alcohol, tobacco or marijuana. Seventeen per cent were multiple drug users. Drug use was more common among boys than girls, except for tobacco smoking, and increased with age: older males had particularly high prevalences of heavy drinking, tobacco and marijuana use. The prevalence of heavy drinking, tobacco and marijuana use increased by 2–3 percent over the one year follow-up period. About half of the heavy drinkers and marijuana users, and 80 per cent of tobacco smokers had not changed one year later, which indicates the stability of these behaviours. One-third of eligible teenagers contacted at the first interview declined to participate: it is likely that this study underestimates the prevalence of drug use in the community. Heavy drinking, tobacco smoking and marijuana use remain important target behaviours for adolescent drug use prevention programs.     

Ethnic and gender differences in drinking and smoking among London adolescents

Objectives. The study examines stages of drinking and smoking careers and transitions from initiation to regular use among adolescents, as a function of ethnic status and gender. Design. The data were collected using a confidential, self-completion questionnaire assessing onset and frequency of drinking and smoking. The sample consisted of 1777 adolescents, between the ages of 11 and 14, drawn from eight secondary schools in south-west London. Results. For both smoking and drinking, white children were more likely to have ever smoked tobacco and drunk alcohol, and were also more likely to progress from initiation to regular use than were either black or Asian children. Asian children reported the latest onset and the lowest prevalence rates for both drinking and smoking. Males reported experimenting with both cigarettes and alcohol at an earlier age than females, although a lower proportion of males report regular and lifetime involvement with both alcohol and tobacco. Furthermore, a significantly higher proportion of females who try smoking go on to do so regularly. Discussion. The importance of sociocultural factors in relation to race and gender in predicting onset and escalation of substance use is discussed. The fact that age of onset does not appear to be a significant determinant of transition rate from initiation to regular use is also explored.     

Teenage smoking and substance use as predictors of severe alcohol problems in late adolescence and in young adulthood.

PURPOSE: To study the association between adolescent alcohol use, smoking, other substance use, and later substance-use-related problems in a large general population sample in Northern Finland. METHODS: Data from the Northern Finland 1966 Birth Cohort (n = 11,017) were linked with National Crime Registers and the Finnish Hospital Discharge Register. Information on adolescent alcohol use, smoking, and other substance use was gathered via a questionnaire in 1980 and 1981, when subjects' age was 14 years. Logistic regression analyses were performed to examine the association between alcohol use frequency, tendency for heavy drunkenness, smoking and other substance use in adolescence, and drunk driving offenses between ages 15 and 32 years and hospital-treated substance use disorders between ages 16 and 31 years, adjusting for parental social class, family type, and school performance. RESULTS: The most powerful predictor for drunk driving was regular smoking at the age of 14 years (AOR 6.8, 95% CI 4.6-10.1 for males and 6.3, 95% CI 1.9-20.6 for females). Hospital-treated substance use disorders were associated with male regular smoking (AOR 9.4, 95% CI 4.6-19.2) and female regular alcohol use (AOR 7.5, 95% CI 2.6-21.5), and having often been heavily drunk (AOR 12.7, 95% CI 4.0-40.4) at the age of 14 years. CONCLUSIONS: Teenage regular and heavy alcohol use and smoking are important predictors for substance-use-related problems later in adolescence and in young adulthood. Adolescents with early onset regular smoking and with drunkenness-oriented alcohol use are especially at risk for developing hazardous substance use later in life.     

The accuracy of general practitioner records of smoking and alcohol use: comparison with patient questionnaires

BACKGROUND: General practitioner (GP) records are increasingly being used as sources of information on potential confounders such as smoking use and alcohol intake in epidemiological studies. The aim of this study was to assess the accuracy of GP records on smoking use and alcohol intake compared with data from patient questionnaires. METHODS: Patients registered with 42 practices in Oxfordshire that agreed to take part in a post-marketing surveillance study of omeprazole were sent a postal questionnaire that included questions about alcohol and tobacco use. Two years later, data on these aspects of lifestyle were abstracted from the GP records. RESULTS: A total of 892 patients agreed to take part in the study; 804 (90 per cent) completed the postal questionnaire, and the records of 856 (96 per cent) were reviewed. Information on smoking and alcohol use was present in 74 per cent and 63 per cent of GP records, respectively. Agreement between the two data sources was moderate for both smoking (kappa = 0.50) and alcohol use (kappa = 0.52). With regard to smoking, the main discrepancy between the two data sources was that 46 per cent (94/206) of patients who reported themselves as exsmokers were recorded as being never smokers in the GP record. With regard to alcohol, there were no systematic differences between the two data sources. CONCLUSION: Data from GP records on smoking status and alcohol use are incomplete and subject to some misclassification. This is a source of potential failed adjustment for confounding, which should be considered in epidemiological studies that make use of these records.     

Associations between individual and contextual factors and smoking in 13,293 Mexican students

OBJECTIVE: Factors correlated with cigarette smoking in young people have yet to be documented in most developing countries. This study assesses the correlates of smoking in Mexican young people. METHODS: School-based, cross-sectional study in the central Mexican state of Morelos during the 1998-1999 school year of 13,293 public school students aged 11 to 24 years. Multinomial logistic regression models were constructed with smoking as the dependent variable. RESULTS: Regular smoking (one or more cigarettes daily) prevalence was 13.1% (95% confidence interval [CI]=12.2-13.9) in males, and 6.1% (95% CI=5.6-6.6) in females. Frequent alcohol intoxication was strongly associated with regular smoking (females, odds ratio [OR]=68.5, 95% CI=37.6-125.2; males, OR=34.5, 95% CI=22.6-52.7). Regular smoking was associated with illegal drug use and smoking by both parents in females, and with illegal drug use in males (males, OR=4.9, 95% CI=3.7-6.5). Also associated with tobacco smoking were high socioeconomic status, low academic achievement, illegal drug use by peers, marijuana use by parents, and depression in adolescents. CONCLUSIONS: This study documents a strong correlation between tobacco smoking and other health risk behaviors, especially alcohol and drug abuse. In young women especially, the risk of tobacco use increased with alcohol abuse and higher socioeconomic status. School-based interventions are needed that focus on preventing smoking and also take into account other unhealthy behaviors.     

Early tobacco and alcohol consumption as modifying risk factors on marijuana use

OBJECTIVE: To assess the relationship between early tobacco and alcohol use and the risk of marijuana consumption among schoolchildren. METHODS: A cross-sectional study comprising data from the Fourth National Study on Drug Use in the Chilean School Population (2001). There were studied 54,001 schoolchildren aged between eight and 20 years. Predictors were self-reported tobacco and alcohol use (ever users), age at initiation of tobacco and/or alcohol use, and intensity of tobacco use. The study outcome was self-reported marijuana use (ever users versus never users) and age at initiation of marijuana use. Poisson regression and Weibull regression were used for data analysis. RESULTS: Lifetime prevalence of tobacco use was high: 77%, alcohol 79%, and marijuana 23%. Tobacco consumption increased the likelihood of marijuana use (PR=10.4; 95% CI: 8.9;12.2). Later initiation of tobacco (HR=0.85; 95% CI: 0.84;0.86) and alcohol (HR=0.90; 95% CI: 0.89;0.91) decreased the risk of marijuana use. Marijuana use was higher in heavy smokers compared to light smokers (PR=3.11; 95% CI: 2.96;3.26 versus PR=1.70; 95% CI: 1.58;1.83). CONCLUSIONS: Tobacco use is strongly associated with marijuana use, which is significantly associated with the age at initiation of tobacco use, intensity of tobacco use and concurrent use of alcohol. Prevention strategies should target prevention of adolescent early tobacco use.     

The economic impact of smoking in Canada.

A cost-benefit analysis of smoking, using an attributable risk approach, has been carried out for Canada and for three regions within Canada. The total cost of the consequences of tobacco use--in terms of extra deaths, disability, hospitalization, physician services, and fire losses due to tobacco use--in all cases exceeded the total consumer expenditure for tobacco products. The excess was estimated to have a range from $14 to $127 (1983 Canadian dollars) per person per year. This represents the amount that an individual in society would gain, on average, if tobacco use was eliminated from the society for one year. Tobacco use was also found to be responsible for 12 to 17 per cent of all adult deaths, 4 to 5 per cent of all adult disability days, 12 to 14 per cent of all days of hospitalization, and 2 to 3 per cent of all physician visits.     

Changing trends of tobacco use in a teenage population in western Pennsylvania

Information on tobacco use was obtained from an anonymous questionnaire distributed to 609 8th, 9th, and 10th grade students in the Pittsburgh area. The data disclosed that 22 per cent of the girls and 11 per cent of the boys were smoking. However, 35 per cent of the young men reported using smokeless tobacco; snuff dipping (6 per cent), tobacco chewing (10 per cent), and snuff and/or tobacco chewing (19 per cent).     

Family Meals and Substance Use: Is There a Long-Term Protective Association?

PURPOSE: To examine 5-year longitudinal associations between family meal patterns and subsequent substance use in adolescents. METHODS: A total of 806 Minnesota adolescents were surveyed in public schools in 1998-1999 (mean age, 12.8 years) and again by mail in 2003-2004 (mean age, 17.2 years) as part of a longitudinal population-based study. Logistic regression was used to estimate the odds of tobacco, alcohol, and marijuana use at follow-up for adolescents reporting regular family meals at baseline compared with those without regular family meals, adjusting for family connectedness and prior substance use. RESULTS: Family meal frequency at baseline was associated with significantly lower odds of cigarette smoking, alcohol use, and marijuana use at follow-up among female adolescents, even after adjusting for baseline substance use and additional covariates. Family meals were not associated with use of any substance at follow-up for male adolescents after adjusting for baseline use. CONCLUSIONS: Results from this study suggest that regular family meals in adolescence may have a long-term protective association with the development of substance use over 5 years among females. Parents should be encouraged to establish a pattern of regular family meals, as this activity may have long lasting benefits.     

Secular trends in underreporting of cigarette consumption

Information on the cigarette smoking habits of all New Zealanders aged 15 years and over was collected in two consecutive national censuses in 1976 and 1981. These data show that the self-reported per capita consumption of cigarettes declined by 9.4 per cent during this five-year period. A comparison of census data with national cigarette sales data for the corresponding years indicated considerable underreporting of cigarette use in the two censuses. However, there was little change in the degree of underreporting between 1976 (28 per cent) and 1981 (30 per cent) and the estimated decline in per capita consumption of cigarettes based on sales data (8.6 per cent) was similar to the census-based estimate. These findings suggest that trends in self-reported consumption are a reliable indicator of national trends in cigarette smoking habits.     

A content analysis of tobacco control policy in the U.S. Department of Defense

We conducted a content analysis of the US military tobacco policies at the Department of Defense, each respective military service (Army, Air Force, Navy, and Marine Corps), and their Major Commands (MAJCOM). Ninety-seven policies were evaluated using the Military Tobacco Policy Rating Form (MTPRF). More than three quarters addressed the following domains: (1) deleterious health effects of tobacco use; (2) environmental tobacco smoke; (3) designation of smoking areas; (4) tobacco prevention/cessation programs; and (5) smokeless tobacco. Few policies (2.1 per cent) mentioned relevant Department of Defense and respective service tobacco use prevalence statistics. Smoking as non-normative or incompatible with military service, the impact of tobacco use on military readiness, and the tobacco industry were addressed infrequently (6.2 per cent, 33.0 per cent, and 8.2 per cent, respectively). Future military tobacco policies should address important omissions of critical information such as the current service tobacco use prevalence, effects on readiness, and smoking as non-normative.     

Declines in tobacco brand recognition and ever-smoking rates among young children following restrictions on tobacco advertisements in Hong Kong

BACKGROUND: We compared the recognition of tobacco brands and ever-smoking rates in young children before (1991) and after (2001) the implementation of cigarette advertising restrictions in Hong Kong and identified continuing sources of tobacco promotion exposure. METHODS: A cross-sectional survey of 824 primary school children aged from 8 to 11 (Primary classes 3-4) living in two Hong Kong districts was carried out using self-completed questionnaires examining smoking behaviour and recognition of names and logos from 18 tobacco, food, drink and other brands common in Hong Kong. RESULTS: Ever-smoking prevalence in 2001 was 3.8 per cent (1991, 7.8 per cent). Tobacco brand recognition rates ranged from 5.3 per cent (Viceroy name) to 72.8 per cent (Viceroy logo). Compared with 1991, in 2001 never-smoker children recognized fewer tobacco brand names and logos: Marlboro logo recognition rate fell by 55.3 per cent. Similar declines were also seen in ever-smoker children, with recognition of the Marlboro logo decreasing 48 per cent. Recognition rates declined amongst both boys and girls. Children from non-smoking families constituted 51 per cent (426) of the sample, whereas 34.5 per cent (284), 8.5 per cent (70), 1.7 per cent (14) and 4.4 per cent (36) of the children had one, two, three or more than three smoking family members at home, respectively. Tobacco brand recognition rates and ever-smoking prevalence were significantly higher among children with smoking family members compared with those without. Among 12 possible sources of exposure to cigarette brand names and logos, retail stalls (75.5 per cent; 622), indirect advertisements (71.5 per cent; 589) and magazines (65.3 per cent; 538) were ranked the most common. CONCLUSION: Advertising restrictions in Hong Kong have effectively decreased primary-age children's recognition of tobacco branding. However, these children remain vulnerable to branding, mostly through exposure from family smokers, point-of-sale tobacco advertisement and occasional promotions. Action to curb these is now required.     

Smoking habits in early pregnancy and attitudes towards smoking cessation among pregnant women and their partners.

One-hundred and eighty-seven general practitioners in western Norway recorded smoking habits among 2379 women, consulting for their first regular medical check-up in pregnancy. Forty-six per cent had been daily smokers the last 3 months before pregnancy. Thirty-nine per cent were still smoking at the time of their first check-up. Sixteen per cent of the daily smokers stopped smoking spontaneously during the first few weeks of pregnancy. Fifty-seven per cent of women younger than 20 and 28% of women 30 years and older, did smoke at the first check-up. Single women smoked more often than women living with a partner (58% versus 38%). Smoking habits were not associated with number of previous pregnancies. At the first check-up, 530 pregnant women, still smoking daily, 18-34 years of age, living with a partner, accepted to participate in a smoking intervention study. They filled in a questionnaire about their smoking habits, the smoking habits of their partners and their attitudes towards smoking cessation. Sixty-five per cent reported a reduction in their use of cigarettes after becoming pregnant. The mean reduction in the number of cigarettes smoked daily was 4.0 (31%). Most of the respondents expressed a strong motivation to quit or reduce their smoking habits during their pregnancy. Seventy-two per cent of the partners were daily smokers. Reduction in the consumption of cigarettes, negative attitudes towards smoking and determination to stop smoking was significantly higher among women who were encouraged by their partners to stop smoking and in those who perceived that their partners were willing to reduce their consumption.     

Tobacco Use in Silent Film: Precedents of Modern-Day Substance Use Portrayals

Much research has been done into tobacco use portrayals in film since the mid-twentieth century, but the earlier years of Hollywood history have been overlooked. Yet the first decades of the twentieth century saw annual per capita cigarette consumption increase from under 100 in 1900 upto 1,500 in 1930. The current study looks at frequency and context (gender, age range, socioeconomic status, type of portrayal) of tobacco use in 20 top-grossing silent films spanning the silent feature era (1915-1928). The sample averaged 23.31 tobacco uses per hour. Tobacco use was most often associated with positive characterizations, working/middle class status, masculinity, and youth. Previous research has verified the influence of the film industry on tobacco consumption in modern years, and this potential connection should not be ignored for the silent film era. Top-grossing silent films set a precedent for positive media portrayals of substance use that have persisted to the present day.     

Cigarette smoking, alcohol consumption, and serum lipid profile among medical students in Greece

BACKGROUND: The lack of data regarding health habits of medical students in Greece prompted a cross-sectional study to assess tobacco use, alcohol consumption and serum lipoprotein levels among students in the University of Crete School of Medicine. METHODS: A self-administered questionnaire on smoking and alcohol consumption was distributed to third-year medical students for twelve consecutive years (1989-2000). A total of 849 students (462 males, 387 females) participated in the survey. Biochemical measurements were taken and multi-variant analysis of the data was performed. RESULTS: The prevalence of smoking among males and females was 33.2% (N = 150) and 28.4% (N = 108), respectively (mean cigarette consumption 13/day). As many as 349 males (77.2%) and 220 females (58.0%) reported consuming alcohol on a regular basis. The prevalence of low HDL-cholesterol (< 0.9 mmol/l) was 14.5% in males and 5.1% in females, and of high LDL-cholesterol levels (> 4.1 mmol/l) in 11.1% of male and 5.5% of female participants. Smoking was related to higher triglyceride (p = 0.032), and lower HDL-cholesterol (p = 0.037) serum levels. Total cholesterol, LDL-cholesterol, and the TC/HDL-cholesterol ratio were strongly related with the level of smoking (p = 0.006, p = 0.008, and p = 0.006 respectively). CONCLUSIONS: The results document a high prevalence of smoking among physicians-to-be in Greece. Tobacco use was strongly associated with a lipid profile predisposing to increased risk for cardiovascular disease. Health promotion programmes should therefore be instituted not only during the first years of medical studies, but rather at a much earlier stage in life.     

Factors in Adolescent Drinking/Driving: Binge Drinking, Cigarette Smoking, and Gender

ABSTRACT: During three consecutive years, 3,137 high school seniors from three graduating classes in one Michigan county were surveyed. The primarily White sample reported their use of alcohol and cigarettes, driving experience, and drinking/driving experience. Survey data were linked with state driver history records. Fully one-third of the high school seniors reported driving after drinking in the past six months. To identify factors associated with self-reported drinking/driving, correlation and regression analyses were conducted. Frequent binge drinking and riding with a drinking driver were consistent factors in driving after drinking frequency. Being male, smoking cigarettes, having frequent use of a motor vehicle, having a driving offense on record, and number of years licensed were important correlates, varying by year of graduation. Comprehensive interventions to moderate drinking, smoking, and driving after drinking are needed.     

Tobacco smoking habits among Chinese medical students and their need for health promotion initiatives

Although the community smoking rate within most industrialised countries is undergoing a continuous decline, in developing regions it is actually increasing by around 3% per year. China represents one such area where tobacco use has boomed, largely because of an increasingly affluent society and aggressive marketing by tobacco companies. It is now the world's largest consumer of tobacco and tobacco‐related products, with more than 300 million regular smokers. The community smoking rate has risen to alarming levels, with around two‐thirds of adult males being current smokers. China's smoking epidemic is also worsening, with more people taking up the habit at younger ages and consuming greater quantities of cigarettes per day. Tobacco has become a major cause of death in this country, with lung cancer rates increasing at approximately 5% per year and about half of China's 300 million smokers predicted to die from tobacco‐related diseases in future.     

Accuracy of recalled smoking data.

Validity of recalled cigarette data was assessed among 87 middle-aged adults by comparing recall to longitudinal records. Agreement on smoking status and amount smoked 20 years ago occurred for 87 per cent and 71 per cent of subjects, respectively. Corresponding proportions for 32-year recall were 84 per cent and 55 per cent. Gender did not influence recall accuracy. Ex-smokers tended to make the most errors. Accuracy of recalled smoking information 20 years ago was comparable to that of alcohol status and consumption frequency category.     

The relative importance of social versus commercial sources in youth access to tobacco, alcohol, and other drugs

BACKGROUND: Youth substance use began to increase in 1992 following a decade-long decline, leading to increased interest in controlling access to tobacco, alcohol, and other drugs. METHODS: The anonymous and voluntary Minnesota Student Survey was administered to 133,794 public school students in grades 6, 9, and 12. Questions addressed current frequency of use of tobacco, alcohol, and other drugs and how students obtained these substances. Data were analyzed to determine the relationship between grade level, gender, race/ethnicity, use frequency, and access to substances through social and commercial sources. (Tobacco analyses were limited to students under age 18 years.) RESULTS: Social sources (especially friends) predominate across all age groups and substances. Students are much more likely to obtain tobacco than alcohol from commercial sources but few rely exclusively on commercial sources for either. Females and infrequent users are more likely to depend on social sources exclusively while males and frequent users are more likely to use commercial sources. CONCLUSIONS: Because substances are easily accessible through social sources, prevention policies directed at retail outlets may not have the desired effect on reducing teen smoking and drinking. Greater attention to reducing access to all substances from social sources is needed.