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Monitoring the Future National Survey Results on Drug Use, 1975-2000. Volume I: Secondary School Students
Abstract
Each year since 1975, about 17,000 seniors have participated in a national survey conducted in some 130 high schools to assess students' changing lifestyles, values, and preferences. This publication is one in a series of annual monographs to disseminate many of the epidemiological findings from the study. It reports the results of the national survey of drug use and related attitudes and beliefs among 8th, 10th, and 12th graders. Distinctions are made among important demographic subgroups in these populations based on gender, college plans, region of the country, population density, parents' education, and race and ethnicity. Following the introductory chapter, chapter 2 presents key findings. Study design is reviewed in chapter 3. Chapters 4 and 5 explain the prevalence and trends in drug use. Chapter 6 discusses the initiation rates by grade level. Chapter 7 explains the degree and duration of drug highs. Chapter 8 discusses attitudes about drug use, and chapter 9 reviews the social milieu. Chapter 10 sums up other findings from the study. Volume 1 was preceded by an advance summary publication of its key findings. (Contains 5 appendixes, 146 tables and 103 figures.) (JDM)
... Monitoring the Future (MTF) includes an annually conducted cross-sectional national survey, since 1991, of 8th, 10th, and 12th grade students in ~ 400 US public and private schools in the 48 contiguous United States [40]. Included measurement years were 1991 through 2018, consisting of birth cohorts 1973-2005 and ages 13 through 18. Schools are selected under a multi-stage random sampling design, and are invited to participate for 2 years. ...
... Self-administered questionnaires are given to students. Detailed description of design and procedures are provided elsewhere [40,41]. The present study focuses on students who were randomized to a questionnaire that included questions regarding depressive symptoms, including a random one-half of the 8th and 10th graders and a random one-sixth of the 12th graders. ...
... The increases in mental health problems in adolescence stand in contrast to trends in substance use in adolescence. Binge drinking among adolescents is at historic lows, across multiple national data sources [4,40,51]. While an epidemic of addiction and opioid overdose continues to plague adults in the US, heroin use in adolescence is lower than at any point in the last 20 years, and non-medical prescription opioid use has declined since 2009 [40,52,53]. ...
Background
Mental health problems and mental health related mortality have increased among adolescents, particularly girls. These trends have implications for etiology and prevention and suggest new and emerging risk factors in need of attention. The present study estimated age, period, and cohort effects in depressive symptoms among US nationally representative samples of school attending adolescents from 1991 to 2018.Methods
Data are drawn from 1991 to 2018 Monitoring the Future yearly cross-sectional surveys of 8th, 10th, and 12th grade students (N = 1,260,159). Depressive symptoms measured with four questions that had consistent wording and data collection procedures across all 28 years. Age–period–cohort effects estimated using the hierarchical age–period–cohort models.ResultsAmong girls, depressive symptoms decreased from 1991 to 2011, then reversed course, peaking in 2018; these increases reflected primarily period effects, which compared to the mean of all periods showed a gradual increase starting in 2012 and peaked in 2018 (estimate = 1.15, p < 0.01). Cohort effects were minimal, indicating that increases are observed across all age groups. Among boys, trends were similar although the extent of the increase is less marked compared to girls; there was a declining cohort effect among recently born cohorts, suggesting that increases in depressive symptoms among boys are slower for younger boys compared to older boys in recent years. Trends were generally similar by race/ethnicity and parental education, with a positive cohort effect for Hispanic girls born 1999–2004.Conclusions
Depressive symptoms are increasing among teens, especially among girls, consistent with increases in depression and suicide. Population variation in psychiatric disorder symptoms highlight the importance of current environmental determinants of psychiatric disorder risk, and provide evidence of emerging risk factors that may be shaping a new and concerning trend in adolescent mental health.
... Pharmaceutical drugs are now the third most commonly used substance by juveniles, behind alcohol and marijuana (Stogner & Miller, 2015). Ethnic background characteristics appear to play an important role in the unfolding epidemic, as this crisis has disproportionally impacted White Americans (Johnston, O'Malley, Miech, Bachman & Schulenberg, 2015). The present paper is a "proof of concept" paper that attempts to examine the role of ethnicity in non-medical prescription drug (NMPD) use. ...
... Studies that have examined the relationship between race, ethnicity, and substance use show that Whites are more likely to use drugs than Blacks, Hispanics, or Asian groups (Blum et al., 2000;Chen & Jacobson, 2012;Kirkpatrick Johnson, 2004;McCabe et al., 2007d;Wallace & Bachman, 1991). Johnston et al. (2015) compared substance use rates among Black, Hispanic, and White adolescents and found that Whites in the 12th grade reported the highest rates of use for most substances, including prescription drugs, in comparison to Blacks and Hispanics. Hispanic students reported the highest rates of marijuana use and other drugs including crack cocaine, crystal meth, and inhalants. ...
... However, overall rates of use for these "hard drugs" were very low for all three racial/ethnic categories. Whites and Hispanics were found to use almost all substances at higher rates than Blacks (Johnston et al., 2015). The literature shows consistent trends in terms of overall substance use among adolescents and young adults; Whites report the highest rates of use for most substances, Hispanics report rates that are similar to Whites, and Blacks and Asians report the lowest rates of use (Chen & Jacobson, 2012;Johnston et al., 2015;McCabe et al., 2007d). ...
Background:
National data demonstrate significant differences in non-medical prescription drug (NMPD) use, with Whites seeming to be more likely to use compared to non-Whites. College students also appear to be at an increased risk for NMPD use.
Objectives:
This study examines NMPD use using a component of social identity theory. We propose that a stronger sense of ethnic identity may reduce the likelihood of NMPD use among college students due to ethnic identity's ties to self-esteem and self-efficacy. We also propose that the protective power of ethnic identity may vary according to one's race.
Methods:
Data for this study were collected from a survey of undergraduate students at a Midwestern university (N = 530). Poisson regression analyses were used to test the relationship between ethnic identity and NMPD use. Of our sample, 135 participants (25.5%) indicated NMPD use over the past year. This percentage is high compared to findings from national college data.
Results:
Results indicate that a stronger sense of ethnic identity reduced the frequency of NMPD use among young adults. The findings also reveal that the relationship between ethnic identity and NMPD use is moderated by race. Ethnic identity was found to be a protective factor for non-White participants only.
Conclusions:
This study suggests that ethnic belonging may act as a protective factor against NMPD use among non-White young adults. These findings build upon our understanding of the relationship between ethnic identity and substance use. We conclude with a discussion of directions for future research and intervention programs.
... As a result the young people are characterized by increased exploration and experimentation with various types of behaviours including drug abuse, Adams and Berzonsky (2006). Drug abuse among the adolescents is a challenge world over for example studies in America has found some students in 12 th grade to be abusing cigarettes, alcohols and other drugs including marijuana ( Johnston et al., 2002). According to Stagman et al. (2011) ...
... In the United States cannabis is among the commonly abused drug by adolescents. By their senior year in high school 54% of American adolescents report having used cannabis ( Johnston et al., 2002). In sub Sahara Africa studies shows that cannabis use is prevalent among young people ( Gabriel et al., 2016). ...
... The findings show that the drug abuse problem in secondary schools in Embu County is widespread. The findings confirm the findings by Johnston et al. (2002) that drug abuse among students is a global challenge. Results also revealed that another 5.9% of respondents hand taken drugs at least twice in the past and those who had taken drugs once was 26.6% which makes a total of 70.5 % of those who had at least taken drugs. ...
... Initiation of substance use often occurs during adolescence (1), and adolescents commonly report using substances to feel good or get high and to relieve pain or aid with sleep problems (2,3). Adverse consequences of adolescent substance use include overdose, risk for development of substance use disorder (SUD), negative impact on brain development, and death. ...
... Corresponding author: Sarah Connolly, SConnolly@cdc.gov. 1 Epidemic Intelligence Service, CDC; 2 Division of Overdose Prevention, National Center for Injury Prevention and Control, CDC; 3 Inflexxion, Irvine, California. ...
Substance use often begins during adolescence, placing youths at risk for fatal overdose and substance use disorders (SUD) in adulthood. Understanding the motivations reported by adolescents for using alcohol, marijuana, and other drugs and the persons with whom they use these substances could guide strategies to prevent or reduce substance use and its related consequences among adolescents. A cross-sectional study was conducted among adolescents being assessed for SUD treatment in the United States during 2014-2022, to examine self-reported motivations for using substances and the persons with whom substances were used. The most commonly reported motivation for substance use was "to feel mellow, calm, or relaxed" (73%), with other stress-related motivations among the top reasons, including "to stop worrying about a problem or to forget bad memories" (44%) and "to help with depression or anxiety" (40%); one half (50%) reported using substances "to have fun or experiment." The majority of adolescents reported using substances with friends (81%) or using alone (50%). These findings suggest that interventions related to reducing stress and addressing mental health concerns might reduce these leading motivations for substance use among adolescents. Education for adolescents about harm reduction strategies, including the danger of using drugs while alone and how to recognize and respond to an overdose, can reduce the risk for fatal overdose.
... In drug prevention studies, controls represent normative development and depict the natural course of drug use onset. National surveillance data show that prevalence increases as young people grow older ( Miech et al., 2016). As evidence accumulates and predictive models are developed, the expected course of normal development becomes less obscure and, given sufficient appropriate data, the normal onset of use can be modeled. ...
... This analytic framework is consistent with a prevention trial where the focus rests with relations between target mediators and behavior outcomes adjusted for covariates. Moreover, trends in drug prevalence fluctuate from year-to- year; nonetheless, past research has shown that the strength of relations between psychosocial variables and substance use has remained remarkably constant over decades (Hansen & Hansen, 2016;Miech et al., 2016). We postulate that when data from multiple generations of research are inte- grated, variables that have lasting importance will emerge. ...
We introduce a strategy for creating virtual control groups—cases generated through computer algorithms that, when aggregated, may serve as experimental comparators where live controls are difficult to recruit, such as when programs are widely disseminated and randomization is not feasible. We integrated and harmonized data from eight archived longitudinal adolescent-focused data sets spanning the decades from 1980 to 2010. Collectively, these studies examined numerous psychosocial variables and assessed past 30-day alcohol, cigarette, and marijuana use. Additional treatment and control group data from two archived randomized control trials were used to test the virtual control algorithm. Both randomized controlled trials (RCTs) assessed intentions, normative beliefs, and values as well as past 30-day alcohol, cigarette, and marijuana use. We developed an algorithm that used percentile scores from the integrated data set to create age- and gender-specific latent psychosocial scores. The algorithm matched treatment case observed psychosocial scores at pretest to create a virtual control case that figuratively “matured” based on age-related changes, holding the virtual case’s percentile constant. Virtual controls matched treatment case occurrence, eliminating differential attrition as a threat to validity. Virtual case substance use was estimated from the virtual case’s latent psychosocial score using logistic regression coefficients derived from analyzing the treatment group. Averaging across virtual cases created group estimates of prevalence. Two criteria were established to evaluate the adequacy of virtual control cases: (1) virtual control group pretest drug prevalence rates should match those of the treatment group and (2) virtual control group patterns of drug prevalence over time should match live controls. The algorithm successfully matched pretest prevalence for both RCTs. Increases in prevalence were observed, although there were discrepancies between live and virtual control outcomes. This study provides an initial framework for creating virtual controls using a step-by-step procedure that can now be revised and validated using other prevention trial data.
... Substance use poses a signi cant public health concern in the United States, impacting individual well-being and incurring substantial economic costs annually (Chen & Jacobson, 2012;General, 2023). It stands as a leading cause of preventable death, contributing to the U.S. holding the highest mortality rate among 17 highincome nations by age 50 (Miech et al., 2023). ...
Background:
Adolescent substance use is a significant public health concern, with homeless high school students being particularly vulnerable. However, the relationship between homelessness and substance use among this population remains understudied.
Methods:
This study used data from the 2021 Youth Risk Behavior Survey (YRBS) to investigate substance use behaviors among high school students in Georgia. Substance use prevalence, and the association between homelessness and substance use were analyzed using weighted chi-square tests with Rao-Scott correction.
Results:
Among 604 surveyed high school students, 4.9% were homeless adolescents who exhibited notably higher substance use rates than housed peers. Homelessness showed moderate associations with current electronic vapor product use (Phi=0.1274), lifetime methamphetamine use (Phi=0.1155), and cigarettes (Phi=0.1204). Homeless adolescents reported significantly higher rates of current electronic vapor product use (36.9% vs. 15.2%), current cigarette smoking (10.4% vs. 2.0%), lifetime methamphetamine use (13.1% vs. 3.1%), and lifetime ecstasy use (11.0% vs. 3.8%). While not statistically significant, trends indicated elevated rates among homeless adolescents for cigar smoking, smokeless tobacco, lifetime prescription pain medication, and lifetime cocaine use.
Conclusion:
Our findings underscore the urgent need for comprehensive support services and targeted interventions to address substance use disparities among homeless adolescents. Long-term research is crucial to clarify the relationship between homelessness and substance use and mitigate adverse health outcomes.
... Marijuana availability has promoted the initiation of use in the past (Miech et al., 2015;Swahn & Hammig, 2000;Swaim, 2003;von Sydow et al., 2002), leading to concerns over legalization (Damrongplasit et al., 2010;Joffe & Ya ncy, 2004;MacCoun & Reuter, 2001;Pacula et al., 2004). At the outset of sales, the U.S. Department of Justice (DOJ) notified states that they must create strong controls to prevent distribution to youth (Cole, 2013) (although this memorandum was rescinded, prosecutors are still adhering to it ;Firestone, 2020). ...
Objective:
An online training in responsible marijuana vendor (RMV) practices was evaluated for effects on compliance with ID checking regulations.
Method:
A random sample of state-licensed recreational marijuana stores (n = 175) in Colorado and Washington State was selected in 2016-2017 and was enrolled in a randomized pretest-posttest controlled design. After baseline assessment, 75 stores were randomly assigned to a usual and customary training control group, stratified by state and region. The remaining stores (n = 100) were invited to use the RMV training. Stores were posttested at 3 and 9 months postrandomization. The primary outcome was refusal of sale measured with pseudo-underage patrons who attempted to enter stores and purchase cannabis without a state-approved ID.
Results:
There was no difference by treatment group in refusal of pseudo-underage patron buyers (baseline: 92.5% intervention vs. 94.7% control; 3-month posttest 94.8% vs. 97.5%; 9-month posttest 97.5% vs. 97.1%, p = .286 [one tailed, adjusted for covariates]). The use of training increased refusals at store entry (trained: 65.9% baseline 82.5%, 3 months 79.9%, 9 months; not trained: 82.6%, 83.1%, 84.5%, p = .020 [two tailed, adjusted for covariates]). This difference was especially evident in Washington State (trained: 40.3%, 65.1%, 60.4%; not trained: 57.9%, 68.5%, 72.3%) but not in Colorado (trained: 95.2%, 101.0%, 101.4; not trained: 95.7%, 98.6%, 99.2%, p = .033 [two tailed, adjusted for covariates]).
Conclusions:
When used by store personnel, online RMV training increased refusal of buyers who appeared young and did not provide a state-approved ID. However, it did not improve refusal rates overall. Stores that had lower refusals at baseline and used the training may have benefited from it.
... A cross-sectional study was conducted from 2016-2017 in the north of the West Bank, Palestine, to examine the prevalence, patterns, and risk factors associated with tobacco smoking and ED intake among 10 th grade female students, as well as to describe knowledge, attitudes, and motivations associated with their use. The current study used a modified version of the European School Survey Project on Alcohol and other Drugs and the Monitoring the Future Study questionnaire (Johnston, O'Malley, Bachman, & Schulenberg, 2003; The European Monitoring Centre for Drugs and Drug Addiction, 2009). The questionnaire was translated into the Arabic language, as it is considered the native official language in Palestine, and then translated back to English. ...
A cross-sectional study was conducted in 2017 in the West Bank, Palestine to examine the prevalence and the risk factors associated with tobacco smoking and energy drink (ED) intake among 10 th grade female students. 382 participants were randomly selected; 16.2% were current tobacco smokers (18.1% cigarette smokers, 36.1% waterpipe smokers), 41.4% were current ED consumers, 29.7% were current tobacco smokers and ED users,15.7% intended to smoke tobacco, and 29.2% intended to consume ED. Most of the adolescents (93.3%) were knowledgeable about the dangers of smoking cigarettes, but not as informed surrounding waterpipe (45.7%) and ED (36.2%) risks. The majority of girls disagreed with banning waterpipe (83.4%) and ED (74.3%). Curiosity was the most frequent motivation for use. Girls who consumed ED were more likely to smoke cigarettes (Odds Ratio (OR:7.2)) and waterpipe (OR:7.6) than non-users. The mean initiation age was 12.6 years for EDs intake, and was associated with the initiation of cigarette smoking (13.6 years) and waterpipe smoking (14.0 years). This study indicates an alarming situation concerning ED intake and tobacco smoking among Palestinian female adolescents. Regular intake of ED was common and strongly associated with tobacco smoking, raising concerns about possible adverse effects, including related risk behaviors. Prevention and cessation strategies are recommended. الطاقة وبات ر مش وتناول ن التدخي عن الناتجة الصحية المخاطر الفلسطينيات اهقات المر لدى مقطعية اسة در ، ملخص العام العالم خالل الغربية الضفة ي ف الحالية اسة الدر اء إجر تم 2017 إنتشار مدى فحص بهدف وذلك ، وعوامل و التبغ بتدخي المرتبطة الخطورة تناول بي من. ر العاش الصف طالبات لدى الطاقة وبات ر مش 352 اسة بالدر للمشاركة إختيارهم تم فتاة أن النتائج أظهرت العشوائية، الطريقة خالل من (16 %) يدخن منهن و التبغ، (18.1) و للسجائر، مدخنات (36.1) نسبته وما جيلة، الن يدخن (41.4)% وبات ر مش يستخدمن الطاقة ، و (29.7 %) الطاقة وبات ر مش بن ر ويش يدخن منهن معا النتائج أشارت كما. أن نسبته ما (93.3 %) ، بالتدخي المرتبطة السلبية باألثار اية در عىل اسة بالدر كات المشار من نسبته( ما وأن 83.4) % الفتيات من بالدر كات المشار اسة كن ضد نسبته( وما األرجيلة، حظر فكرة 74.3) منهن حظر ضد وبات ر مش الطاقة كما. النتائج وأظهرت لإلستخدام، شيوعا ر األكن الدافع كان الفضول أن النتائج أظهرت أيضا ي اللوات الفتيات أن (بنسبة السجائر لتدخي ً ميال ر أكن الطاقة وبات ر مش يتناولن 7.2
... The use of electronic nicotine delivery systems (ENDS) or electronic cigarettes (e-cigarettes) has increased among youth (Miech et al., 2020). Among middle and high school students, e-cigarette use increased 900 % from 2011 to 2015 (Office of the Surgeon General, 2016). ...
Introduction
Given the recent dramatic increase among adolescents in the use of electronic nicotine delivery systems (ENDS) or electronic cigarettes (e-cigarettes), there is a growing need to identify outcome expectancies that influence the initiation or continued use of e-cigarettes. While a self-report measure exists for assessing adolescent outcome expectancies for cigarette use, there is currently not one available for e-cigarette use. Validation and use of such a measure would provide insight into the growing popularity of e-cigarettes.
Methods
The sample consisted of 264 (50.76% female, 86.36% White, 84.47% Hispanic/Latinx) freshmen and sophomores from South Florida high schools who were identified as at-risk for e-cigarette use. The current study adapted the Adolescent Smoking Consequences Questionnaire (ASCQ) to derive the Adolescent E-Cigarette Consequences Questionnaire (AECQ) to characterize e-cigarette outcome expectancies. A confirmatory factor analysis was estimated to test the underlying factor structure.
Results
The confirmatory factor analysis provided support for a seven-factor structure (negative affect reduction, taste/sensorimotor manipulation, social facilitation, weight control, negative physical feelings, boredom reduction, and negative social impression) after removing two items with low factor loadings from the social facilitation subscale. After removing these items, factor loadings ranged from 0.46 to 0.86.
Conclusion
The current study provides preliminary evidence to suggest that the Adolescent E-Cigarette Consequences Questionnaire is a psychometrically sound measure. Future work should continue to test this measure among diverse samples of adolescents (e.g., non-Latinx samples) with varying levels of use.
... In the United States, marijuana and alcohol are two of the most commonly used substances by adolescents (Johnston, O'Malley, & Bachman, 2000;Kosterman, Hawkins, Guo, Catalano, & Abbott, 2000). Extant research has demonstrated that substance use initiation in adolescence increases risk for a range of serious health and behavioral problems (Bachman, 1978;Gruber, DiClemente, Anderson, & Lodico, 1996;Kandel & Logan, 1984), including subsequent misuse of substances (Hawkins et al., 1997), and that initiation during early adolescence (age 12-14 years) is a strong predictor of later dependence (Dawson, Goldstein, Patricia Chou, June Ruan, & Grant, 2008;King & Chassin, 2007;Lopez-Quintero et al., 2011;Substance Abuse and Mental Health Services Administration, 2012). ...
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.
... Istraživanja nadalje pokazuju da su partnerske veze žena ovisnica vrlo često opterećene nasiljem i zlostavljanjem (Amaro i HardyFanta, 1995, prema Price i Simeel, 2002). Jedna druga studija (Johnston, OMalley iBachman, 1995) je također pokazala da je od 30 do 70 posto žena ovisnica bilo fizički ili seksualno zlostavljano u djetinjstvu, a mnoge od njih su bile žrtve nasilja i kao odrasle. Prema istraživanjima NIDE iz 1994., oko 70 posto žena ovisnica je tijekom djetinjstva i adoles cencije doživjelo seksualno ili fizičko zlostavljanje (Blumenthal, 2008). ...
Zlouporaba droga u zajednici je ponajprije druš tveno uvjetovani fenomen koji pogađa sve zemlje i sve društvene zajednice. Raširenost zlouporabe droga ovisi o sociodemografskim, etničkim, kul turnim i drugim obilježjima pojedinih sredina i predstavlja jedan od glavnih sociozdravstvenih problema današnjice (World Drug Report, 2004 i 2007). Prema svim epidemiološkim istraživanjima i praćenjima u svijetu i u Hrvatskoj, ovisnost o droga ma uglavnom je " muška bolest ". Od ukupno 7.773 osobe liječene u Hrvatskoj tijekom 2009., kao i pri jašnjih godina, većinu čine muškarci 6.417 (83%), dok je žena bilo 1.316 ili 17 posto. Omjer muškaraca i žena ovisnica u Hrvatskoj je 4,8:1, dok je u Europi omjer nešto manji (Izvješće o provedbi Nacionalne strategije, 2009). Stoga ne začuđuje podatak da je bilo vrlo malo istraživanja o pojavi ovisnosti među ženama, premda se velik broj stručnjaka slaže da je priroda ovisnosti kod žena drukčija te u skladu s tim zahtijeva i bitno drukčije oblike tretmana (Chen, 2009, Tuchman, 2010). U povijesnom pregledu pri stupa tretmanu žena ovisnica u Americi od 1920. do 1996. (Kandall i Petrillo, 1996) nađeno je da su žene ovisnice bile zanemarivane u pogledu iznalaženja učinkovitih oblika tretmana, ali i da znanstvena istraživanja nisu bila spolno orijentirana u pristupu istraživanju problema ovisnosti o drogama. Naime, dugo se smatralo da žene ovisnice dolaze iz mar ginalnih skupina društva koje se bave kriminalom, prostitucijom i sličnim zanimanjima koja su izvan granica društveno prihvatljivog ponašanja, te samim tim nisu bile značajna tema stručnih institucija koje su se bavile tom tematikom. 1930ih godina žene ovisnice opisivane su kao " opijumski vampiri " koje
... Future studies should also examine these associations with more recent cohorts of adolescents. Long term trends in smoking and alcohol use among youth (Johnston et al. 2011), shifting social norms regarding the perceived harmfulness of smoking and alcohol use, evolving tobacco and alcohol control policies (Hill et al. 2014;Jenson and Bender 2014), the dynamics of neighborhood socioeconomic trends (Allard 2017), or successful implementation of youth substance use prevention programming (Jenson and Bender 2014) over the past 25 years may all potentially impact the results reported by this study. In addition, while our results did show direct and mediated associations between neighborhood socioeconomic disadvantage and youth smoking and alcohol use, no unique associations were noted for residential stability in initial or fully controlled models. ...
There is broad agreement that neighborhood contexts are important for adolescent development, but there is less consensus about their association with adolescent smoking and alcohol use. Few studies have examined associations between neighborhood socioeconomic contexts and smoking and alcohol use while also accounting for differences in family and peer risk factors for substance use. Data drawn from the Seattle Social Development Project (N=808), a gender-balanced (female=49%), multiethnic, theory-driven longitudinal study originating in Seattle, WA, were used to estimate trajectories of smoking and alcohol use from 5th to 9th grade. Time-varying measures of neighborhood socioeconomic, family, and peer factors were associated with smoking and alcohol use at each wave after accounting for average growth in smoking and alcohol use over time and demographic differences. Results indicated that living in more socioeconomically disadvantaged neighborhoods, lower family income, low family general functioning, more permissive family smoking environments, and affiliation with deviant peers were independently associated with increased smoking. Low family functioning, more permissive family alcohol use environments, and deviant peers were independently associated with increased alcohol use. The effect of neighborhood disadvantage on smoking was mediated by family income and deviant peers while the effect of neighborhood disadvantage on alcohol use was mediated by deviant peers alone. The results highlight the importance of neighborhood, family, and peer factors in early adolescent smoking and alcohol use. Future studies should examine the unique association of neighborhood disadvantage with adolescent smoking net of family-level socioeconomics, family functioning, and peer affiliations. Better understanding of the role of contextual factors in early adolescent smoking and alcohol use can help bolster efforts to prevent both short and long harms from substance use.
This article empirically tests the effects of various tobacco control measures on youth cigarette demand using a 1996 nationally representative survey among U.S. high school students. Our measures of public policies allow more precise estimates of their impact compared to previous studies. The two‐part model corrects for heteroscedasticity and features a novel approach to evaluating youth access laws based on actual compliance rates. This resolves the difficulty of measuring their active enforcement, the lack of which is frequently blamed for insignificant findings with respect to their effectiveness. We found youth access laws to have a negative effect on smoking probability. Relatively strong clean indoor air laws may also reduce the probability of smoking. The presence of all tobacco control policies combined and higher cigarette prices lower both smoking participation and smoking intensity. The teen‐specific cigarette price has a larger impact on cigarette demand than commonly tested state average price.
Objective
The impact of adolescent cannabis use is a pressing public health question due to the high rates of use and links to negative outcomes. Here we consider the association between problematic adolescent cannabis use and methylation.
Method
Using an enrichment-based sequencing approach, we performed a methylome-wide association study (MWAS) of problematic adolescent cannabis use in 703 adolescent samples from the Great Smoky Mountain Study. Using epigenomic deconvolution, we performed MWASs for the main cell types in blood: granulocytes, T-cells, B-cells and monocytes. Enrichment testing was conducted to establish overlap between cannabis-associated methylation differences and variants associated with negative mental health effects of adolescent cannabis use.
Results
Whole blood identified 45 significant CpGs, and cell-type specific analyses yielded 32 additional CpGs not identified in the whole blood MWAS. We observed significant overlap between the B-cell MWAS and genetic studies of education attainment and intelligence. Furthermore, the results from both T-cells and monocytes overlapped with findings from a MWAS of psychosis conducted in brain tissue.
Conclusion
In one of the first methylome-wide studies of adolescent cannabis use, we identified several methylation sites located in genes of importance for potentially relevant brain functions. Our findings resulted in several testable hypotheses by which cannabis-associated methylation can impact neurological development, inflammation response, as well as potential mechanisms linking cannabis-associated methylation to potential downstream mental health effects.
Objective
The objective of this study was to examine associations between depression, anxiety and binge drinking among a large sample of Canadian youth, while testing the moderating effect of flourishing. This research uses data from the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, Sedentary Behaviour (COMPASS) study (2012–2021) with a large sample size collecting data on youth health behaviours within Canadian secondary schools.
Design
Cross-sectional
Setting
14 secondary schools across Ontario and British Columbia, Canada.
Participants
A sample of grade 9–12 students (n=6570) who participated in the Mental Health pilot of the COMPASS study
Primary and secondary outcome measures
Self-reported questionnaires assessed student binge drinking behaviours (5≥drinks), symptoms of depression (Center for Epidemiologic Studies Depression Scale (Revised)−10 scores≥10) and anxiety (Generalised Anxiety Disorder 7-item Scale scores≥10), and flourishing (Diener’s Flourishing Scale: 8–40).
Results
In our sample of 6570 students, 37.0% of students reported binge drinking in the last year, and 41.4% and 31.7% of students report clinically-relevant symptoms of depression and anxiety, respectively. Anxiety (adjusted OR (AOR): 0.57, (99% CI 0.15 to 2.22)) and depression (AOR: 1.98, (99% CI 0.76 to 5.13)) symptoms were not found to be associated with binge drinking and we did not detect any moderating role of flourishing. Rather, factors that were associated with increased odds of binge drinking included sports team participation (AOR: 1.67, (99% CI 1.37 to 2.03)) and use of other substances (tobacco (AOR: 3.00, (99% CI 2.12 to 4.25)) and cannabis (AOR: 7.76, (99% CI 6.36 to 9.46))). Similar associations were found for frequency of binge drinking.
Conclusions
Consistent with existing literature, binge drinking behaviours were problematic, as well as clinically-relevant symptoms of depression and anxiety. However, mental health problems and well-being may not be responsible for explaining patterns of binge drinking in youth. Targeted intervention efforts towards student athletes and concurrent substance users are necessary for addressing binge drinking in youth populations.
Objective
Although there is evidence that Attention Deficit Hyperactivity Disorder (ADHD) symptoms are positively related to alcohol use and related problems among young adults, little research has examined the mechanisms that might explain this association. In response, this study examined the mediating effects of coping and enhancement drinking motives on the prospective associations between ADHD symptoms and alcohol outcomes.
Method
Participants (N = 4,536) were young men from the Cohort Study on Substance Use Risk Factors. Measures of ADHD symptoms and those of drinking motives, heavy episodic drinking (HED) and alcohol use disorder symptoms were used from the baseline and 15-month follow-up assessments.
Results
Findings indicated that the associations of ADHD-inattention symptoms with alcohol use disorder (AUD) symptoms and with HED were partially and completely mediated through drinking motives, respectively, whereas drinking motives did not mediate the ADHD-hyperactivity/impulsivity-symptoms-alcohol outcomes associations.
Conclusion
Results indicated that coping and enhancement motives partially explained the ADHD-inattention symptoms—subsequent alcohol outcomes association. These findings suggest that interventions targeting enhancement and coping motives may help prevent problematic drinking among young men with elevated ADHD-inattention symptoms.
Background
Obese individuals are more likely to show insulin resistance (IR). However, limited population studies on marijuana use with markers of IR yield mixed results.
Methods
We abstracted data from the 2009‐2016 National Health and Nutrition Examination Survey (NHANES). We estimated the minimal lifetime marijuana use using the duration of regular exposure and the frequency of use. We used generalized linear models to determine the association of marijuana use with both fasting insulin and homeostasis model assessment of insulin resistance (HOMA‐IR) in lean, overweight and obese individuals, separately. We used interview weight years of data to account for the unequal probability of sampling and non‐response.
Results
Of the total of 129,509 adults aged 18 to 59 years, 50.3% were women. In current obese consumers, the mean insulin in those with < 4 uses/months was 52% (95% CI: 19% to 71%) lower than in never users. Former obese consumers with ≥ 8 uses/month and who stopped marijuana use < 12 months showed 47% (95% CI: 18% to 66%) lower insulin. Those with last use of 12‐119 months and ≥ 120 months had 36% (95% CI: 7% to 57%) and 36% (95% CI: 10% to 54%) lower insulin, respectively.
Conclusions
Marijuana use is associated with lower fasting insulin and HOMA‐IR in obese but not in non‐obese adults, even at low frequency of < 4 uses per month. Former consumers with high lifetime use had a significant lower insulin levels which persists, independent of the duration of time since last use.
For new students, university can be a wonderland of opportunity. But the first few weeks of the university experience are also typified by change, stress and uncertainty. From a health promotion perspective, the first few weeks of the university experience present an important yet understudied opportunity for alcohol misuse prevention. In this narrative review, we distinguish students’ alcohol use during their first year at university from what is known about their use in the first few weeks on campus. First, we outline the developmental context of the first year experience and the descriptive epidemiology of alcohol use and consequences. Second, we highlight how distinctly different the first few weeks of the university experience are relative to the rest of the academic year and overview the limited research on alcohol use and consequences during the first few weeks. Third, we overview the limited number of strategies that have focused on reducing alcohol use during the transition to university. Finally, we offer a number of suggestions for future research. A better understanding of the nature and determinants of alcohol use and consequences during the transition to university is critical to designing effective prevention and intervention strategies.
Introduction and Aims
Clerks and servers at alcohol establishments often fail to verify age. Using mystery shoppers to provide performance feedback is one approach to improving age verification. Few controlled studies have evaluated mystery shop interventions. This paper reports on a cluster randomised cross‐over trial of a mystery shop intervention in 16 communities in four US states.
Design and Methods
The intervention comprised monthly mystery shops after which clerks and servers received immediate feedback to reinforce age verification. Managers received monthly reports. Communities in each state were matched into pairs and, following a 3‐month baseline, were randomly assigned within each pair to receive the intervention beginning after the fourth (Early Intervention) or the tenth (Delayed Intervention) mystery shop. On average, 17 (range = 14–20) randomly selected on‐premises and 18 (range = 11–23) off‐premises outlets participated in each community (N = 557).
Results
Fixed effects multi‐level logistic regressions indicated that the intervention led to a two‐fold increase in the odds of age verification, odds ratio (OR) = 2.05; P < 0.001; 95% confidence interval (CI) 1.76, 2.39. Overall, ID‐checking increased from an average of 80% pre‐intervention to 94–96% by the end of the program. Significant effects were found for on‐premises, OR = 1.79; P < 0.001; 95% CI 1.43, 2.24, and off‐premises establishments, OR = 2.29; P < 0.001; 95% CI 1.86, 2.82.
Discussion and Conclusions
Mystery shop interventions can increase age verification for alcohol purchases and may be an effective supplement to compliance checks and responsible beverage service programs.
Violence and substance use disproportionately affect African American youth in urban, disadvantaged communities. Expanding positive peer and adult connections is a mechanism by which organized activity participation may reduce risk of negative outcomes. We assessed if organized activity participation decreases the likelihood of later negative outcomes through expanding positive social connections using a parallel mediation model (Wave 1: N = 681; 50% female; Mage = 14.86 years; SD = 0.65). We found indirect effects from participation to cigarette use (b = −0.04, 95% CI: −0.07, −0.01) and violent behavior (b = −0.04; 95% CI: −0.07, −0.01) through positive peer connections. We did not find indirect effects through positive adult connections. This may be because of the notable influence of peers on negative outcomes during adolescence. Organized activities can help youth expand positive peer connections, which, in turn, reduces risk of later negative outcomes. Implications for prevention are discussed.
Guided by the integrative model (García Coll et al., 1996), this study examines prospective associations between perceived ethnic discrimination by peers, parental support, and substance use from 7th to 11th grades (Mage = 12.3–16.3 years) in a community sample of 674 Mexican‐American adolescents. Results from a cross‐lagged panel model indicate that discrimination predicts relative increases in adolescent substance use. Results also revealed a transactional relation between substance use and supportive parenting over time. Supportive parenting was associated with reductions in substance use, but adolescent substance use also predicted lower levels of later parental support. The findings suggest reducing discrimination by peers and supportive parenting as potential targets for intervention in the prevention of substance use.
Introduction. In many countries, the concept of OTC drugs, among others, is defined in advance by the assumed maximum period of their use – usually 3-5 days. In fact, many patients often benefit from these opportunities too often, use medication for longer than 3-5 days and prefer symptomatic treatment rather than causal. OTC drugs give people a sense of freedom and subjectivity. Numerous doctors claim that too much freedom in this case can prove dangerous.
Aim. The aim of this study was to analyze the changes in attitudes towards the use of OTC drugs in medicine students as they acquire knowledge and medical experience.
Material and methods. The study looked at 178 students of the Faculty of Medicine, Medical University of Lublin (89 – 1 and 2 year students as well 89 – 5 and 6 year ones). A diagnostic survey was used as a tool for obtaining responses from the participants. The survey was conducted between October 2014 and November 2014.
Results. Almost 90% of medical students use OTC drugs for self-medication, while only 11% of them have never used such medicine. Analysis of students’ attitudes indicate that acquired medical knowledge has no effect on the frequency using this type of treatment. Overall, students tend to use such drugs occasionally. Only some 14-23% of them use the OTC drugs on a regular basis. The motivations for the use such drugs include: convenience, the previous experiences implying the efficacy of drugs, less frequent are other reasons. Some 28% of the students participating in the study and at least 13% of graduating medical students accept prolonged use of OTC drugs. As the consequence acquisition of medical knowledge, the students are less likely to consult their self-medication attitudes with doctors, families and friends, more often and accurately read the leaflets for drugs, and are more and more reluctant to proposals for extending the assortment of available OTC drugs.
Conclusions. 1. Almost 90% of medical students use OTC drugs for self-treatment. 2. 28% of polled 1-2 year medical students and at least 13% of graduating ones may have tendencies to abuse drugs. 3. Over the subsequent years of study, medical students more often read medicine leaflets, they become less reliant on the advice they receive from their family or friends regarding self-treatment or they are less willing to extend the range of available OTC drugs.
Purpose of Review
To review information specific to adolescents regarding trends in opioid use, risk factors for opioid misuse, medical co-morbidity, and treatment updates.
Recent Findings
Although opioid misuse in adolescents is uncommon, it is associated with morbidity and mortality such as hepatitis C and overdose. Adolescents commonly start with prescription opioid misuse before transitioning to heroin use. The existing literature supports the use of buprenorphine/naloxone for the treatment of adolescent opioid use disorders. Safe medication storage and disposal is important to decrease adolescent prescription opioid misuse.
Summary
Opioid misuse occurs in adolescents, and pediatric providers need to remain up to date.
Permissive attitudes and norms about marijuana use and perceptions of low harm from use are considered risk factors for adolescent marijuana use. However, the relationship between risk and use may be reciprocal and vary across development and socializing domains. We examined the bidirectional relationships between marijuana-specific risk factors in individual, parent, peer, and community domains and adolescent marijuana use. Longitudinal data came from a sample of 2002 adolescents in 12 communities. Controlling for sociodemographic covariates and communities in which the individuals resided, autoregressive cross-lagged models examined predictive associations between the risk factors and marijuana use. After accounting for concurrent relationships between risk and use and stability in behavior over time, early adolescence and the transition to high school were particularly salient developmental time points. Specifically, higher risk in all four domains in grades 7 and 9 predicted greater use 1 year later. Moreover, youth’s perception of lax community enforcement of laws regarding adolescent use at all time points predicted increases in marijuana use at the subsequent assessment, and perceived low harm from use was a risk factor that prospectively predicted more marijuana use at most of the time points. Finally, greater frequency of marijuana use predicted higher levels of risk factors at the next time point in most socializing domains throughout adolescence. Prevention programs should take into account developmental transitions, especially in early adolescence and during the transition to high school. They also should focus on the reciprocal relationships between use and risk across multiple socializing domains.
Objective
To explore variability in the link between peer and adolescent drinking by parental drinking. Stress and differential susceptibility perspectives led to hypotheses that adolescents with drinking parents would be more reactive to peer drinking, but also to peer abstention.
Methods
Using data from the National Longitudinal Study of Adolescent to Adult Health, regressions estimated whether the association between peer alcohol use and increased drinking among adolescents was moderated by parental drinking. A regions of significance test identified the level of peer drinking that predicted adolescent drinking in the context of parental drinking.
Results
Adolescents with binge‐drinking parents were more likely to increase drinking at every level of peer drinking, supporting the stress perspective; such adolescents did not accrue benefits from abstaining peers, going against the differential susceptibility perspective.
Conclusions
Far from monolithic, peer influences on adolescent risky behaviors may require family environments and genetic predispositions conducive to those behaviors.
Aims
To inform research on the etiology and prevention of substance use among rural African American youth by (a) identifying developmental trajectory classes of cannabis use and heavy drinking across adolescence and young adulthood and (b) examining associations between trajectory class membership and multi‐level assessments of risk factors.
Design
A prospective study spanning 9 years with assessments of cannabis use and heavy drinking, the catecholamines epinephrine and norepinephrine, perceived stress and psychosocial risk factors.
Setting
Rural communities in the southeastern United States.
Participants
African American youth (n = 518).
Measurements
Participants were assessed for cannabis use and heavy drinking at seven assessments beginning at 16 years of age and continuing to 25 years of age. At age 19, participants provided overnight urine voids that were assayed for catecholamines, a biological marker of life stress resulting from sympathetic nervous system activation. At ages 16 and 19, participants provided information on malleable psychosocial risk factors.
Findings
Latent class growth models revealed three distinct trajectory classes for cannabis use and for heavy drinking. Higher levels of circulating stress hormones and perceived stress were associated with classes reporting greater substance use over time (all Ps < 0.05). A composite of selected risk factors discriminated class membership (all Ps < 0.05). Trajectory classes characterized by rapid usage increases in early adulthood exhibited the greatest increase in deviant peer affiliations between ages 16 and 19 years.
Conclusions
Rural African American youth's cannabis use and heavy drinking across adolescence and young adulthood demonstrate distinct developmental courses; a small number of risk factors and measures of biological and perceived stress differentiate class membership prognostically. Variability over time in these measures, specifically an increase in deviant peer affiliation, may help to account for steep increases in young adulthood.
Gambling participation and low academic performance are related during adolescence, but the causal mechanisms underlying this link are unclear. It is possible that gambling participation impairs academic performance. Alternatively, the link between gambling participation and low academic performance could be explained by common underlying risk factors such as impulsivity and socio-family adversity. It could also be explained by other current correlated problem behaviors such as substance use. The goal of the present study was to examine whether concurrent and longitudinal links between gambling participation and low academic performance exist from age 14 to age 17 years, net of common antecedent factors and current substance use. A convenience sample of 766 adolescents (50.6% males) from a longitudinal twin sample participated in the study. Analyses revealed significant, albeit modest, concurrent links at both ages between gambling participation and academic performance. There was also a longitudinal link between gambling participation at age 14 and academic performance at age 17, which persisted after controlling for age 12 impulsivity and socio-family adversity as well as current substance use. Gambling participation predicts a decrease in academic performance during adolescence, net of concurrent and antecedent personal and familial risk factors.
Epidemiological research has documented a puzzling disconnect between recent alcohol-related trends in the United States. Studies comparing year-to-year prevalence of alcohol use and binge drinking have shown that drinking has been decreasing among adolescents and young adults (Center for Behavioral Health Statistics and Quality, 2015; Miech et al., 2017; Schulenberg et al., 2017).
The psychosocial consequences of living with a depressed parent have been well characterized. Less well known, however, is how this exposure is predictive of later physical health problems. The present study evaluated how parental depression across youths’ adolescence (ages 11–18) was associated with youth metabolic syndrome at age 25 (n = 391). Youth self-regulation and health behaviors were considered as possible moderators of the link between parental depression and youth metabolic syndrome. Analyses revealed that parental depression in adolescence was associated with a composite score reflecting metabolic syndrome components in early adulthood. Furthermore, self-regulation and health behaviors moderated this link, such that links between parental depression and the metabolic syndrome existed only for youth with low self-regulation or unhealthy behaviors.
Monitoring the Future is a standardized survey which collects self-reported drug-related and delinquency data from 8th, 10th, and 12th grade students enrolled in secondary schools in the United States. Since its development in 1975, this survey has been utilized in epidemiological, criminological, and drug research. Recent findings show that adolescent use of illegal drugs, cigarettes, and alcohol are declining while marijuana use is stable, maintaining a high usage rate. Similarly, the follow-up surveys show a declining rate of illicit drug usage for high school graduates up to age 55. Historical and social context, life-course changes, and maturation all account for drug use trends into adulthood.
Emerging adulthood is characterized by not only opportunity and transition but also a substantial increase in risk behaviors (Fosco et al. Journal of Family Psychology, 26(4), 565–575, 2012; Johnston et al. 2016). Building on prior research, we tested a mediational model hypothesizing that Family Check-Up (FCU) intervention effects on young adult risk would be mediated by increases in self-regulation, and that these changes would continue to affect risk behavior as high school youths transitioned to young adulthood. We also predicted that the intent-to-treat intervention would be associated with lower levels of risk in young adulthood and that this effect would be accounted for by intervention-induced improvements in self-regulation during early adolescence, which in turn would prevent young adult risk. Participants were 593 adolescents and their families recruited from three public middle schools and randomized either to the FCU or to a control group. Item response theory was applied to construct a measure of high-risk behavior at this age, including risk behaviors such as substance abuse, high-risk sexual behavior, and vocational risk. Results suggested that changes in children’s self-regulation that occurred early during the middle school years, and that were associated with the FCU, led to reductions in risk behaviors during young adulthood. This study builds on our prior research that has suggested that effects of the FCU during middle school lead to changes in a range of risk behaviors during the transition to high school (Fosco et al. Journal of School Psychology, 51(4), 455–468, 2013; Stormshak et al. School Mental Health, 2(2), 82–9, 2010).
Dieses Kapitel strebt einen Kurzüberblick des derzeitigen Verständnisses von der Verbreitung neuer psychoaktiver Substanzen (NPS) auf der Grundlage von Prävalenzschätzungen an. Berichtet werden Ergebnisse aus größeren Umfragen der letzten beiden Jahre (2013–2015). Beschrieben wird außerdem, wie verschiedene allgemeine Umfragen in der Bevölkerung versucht haben, den Gebrauch einzuschätzen. Das Review enthält sowohl große Zufallsstichproben mit Privathaushalten (inklusive sekundärer Analysen) als auch namhafte Forschung auf der Grundlage von Gelegenheitsstichproben. Es werden auch kurze Hinweise auf neue Methoden und Datenquellen des Gesundheitsmonitorings gegeben, die das Verständnis für diese Substanzen verbessern könnten. Zusammenfassend wird klar, dass die Prävalenz von NPS trotz wachsender öffentlicher und politischer Aufmerksamkeit gering bleibt und der Gebrauch einiger bekannter Substanzen sogar abnimmt. Allerdings bleibt das Gebiet methodologisch schwach und während Angaben aus allgemeinen Bevölkerungsstichproben vermutlich eine Unterschätzung des Gebrauchs darstellen, leiden Umfragen in „Hochrisikogruppen“ bezüglich der Wahrscheinlichkeit des Gebrauchs unter zahlreichen Verzerrungen (biases). Es gibt außerdem einen Mangel an Daten über NPS-Gebrauch und den damit verbundenen Verhaltensweisen in Bevölkerungsgruppen, die möglicherweise einen höheren Interventions- und Behandlungsbedarf aufweisen, wie zum Beispiel Personen mit besonderen Bedürfnissen – inklusive problematischem Drogengebrauch –, psychischen Erkrankungen, Obdachlose und jene, die in Kontakt mit dem Strafvollzugssystem sind.
Little is known about the prevalence and correlates of concussions among US adolescents. A regional study of Canadian adolescents found that approximately 20% had sustained a concussion.¹,2 Providing a national baseline of concussion prevalence and correlates is necessary to target and monitor prevention efforts to reduce these types of injuries during this important developmental period.
Background:
As predicted by self-medication theories that drinking is motivated by a desire to ameliorate emotional distress, some studies find internalizing symptoms (e.g., anxiety, depression) increase risk of adolescent drinking; however, such a risk effect has not been supported consistently. Our prior work examined externalizing symptoms as a potential moderator of the association between internalizing symptoms and adolescent alcohol use to explain some of the inconsistencies in the literature. We found that internalizing symptoms were protective against early adolescent alcohol use particularly for youth elevated on externalizing symptoms (a 2-way interaction). Our sample has now been followed for several additional assessments that extend into young adulthood, and the current study tests whether the protective effect of internalizing symptoms may change as youth age into young adulthood, and whether this age-moderating effect varied across different clusters of internalizing symptoms (social anxiety, generalized anxiety, and depression). Internalizing symptoms were hypothesized to shift from a protective factor to a risk factor with age, particularly for youth elevated on externalizing symptoms.
Methods:
A community sample of 387 adolescents was followed for 9 annual assessments (mean age = 12.1 years at the first assessment and 55% female). Multilevel cross-lagged 2-part zero-inflated Poisson models were used to test hypotheses.
Results:
The most robust moderating effects were for levels of alcohol use, such that the protective effect of all internalizing symptom clusters was most evident in the context of moderate to high levels of externalizing problems. A risk effect of internalizing symptoms was evident at low levels of externalizing symptoms. With age, the risk and protective effects of internalizing symptoms were evident at less extreme levels of externalizing behavior. With respect to alcohol-related problems, findings did not support age moderation for generalized anxiety or depression, but it was supported for social anxiety.
Conclusions:
Findings highlight the importance of considering the role of emotional distress from a developmental perspective and in the context of externalizing behavior problems.
Aim:
To estimate sexual identity differences in high-intensity binge drinking.
Design and setting:
Cross-sectional US adult health survey from 2014 and 2015.
Participants:
US adults ages 18 and older (N = 215,684; n = 203,562 heterosexual, n = 2,784 lesbian/gay, n = 2,892 bisexual, n = 686 "other" and n = 1,947 don't know/unsure).
Measurements:
Self-reported past 30-day standard binge and high-intensity binge drinking. Standard binge drinking cutoff values were 4+/5+ drinks for women and men, respectively. High-intensity binge drinking was measured as 2 and 3 times the standard level (8+ and 12+ drinks for women and 10+ and 15+ drinks for men).
Findings:
Lesbian and bisexual women were more likely than heterosexual women to report consuming 4+ drinks (adjusted odds ratio [aOR] =1.57, CI [1.18, 2.09] and aOR = 1.83, CI [1.45, 2.30] for lesbian and bisexual women, respectively); 8+ drinks (aOR = 3.86, CI [2.39, 6.24], aOR = 2.07, CI [1.39, 3.07]); and 12+ drinks (aOR = 3.81, CI [1.77, 8.19], aOR = 2.54, CI [1.25, 5.14]) in a single occasion in the past 30 days. Generally, gay and bisexual men were no more likely than heterosexual men to report standard or high-intensity binge drinking. However, bisexual men were more likely than heterosexual men to consume 15+ drinks, aOR = 1.76, 95% CI [1.01, 3.06]. Rates of standard and high-intensity binge drinking were similar between heterosexual and unsure men and women. Men and women who indicated "other" sexual identities were generally less likely than heterosexuals to report standard and high-intensity binge drinking with the exception of 4+ drinks for women and 10+ drinks for men.
Conclusions:
In the USA, sexual minority women are more likely, and sexual minority men are equally likely, to drink at standard and high-intensity binge drinking levels as their heterosexual counterparts.
Although there has been a long-standing recognition that anxiety psychopathology and substance use disorders often cooccur, scienti fic attention devoted to understanding the underlying nature of these relations has been limited (Zvolensky, Buckner, Norton, & Smits, 2011). This gap in knowledge is unfortunate, as there are (a) high prevalence rates of anxiety and substance use disorders among treatment-seeking as well as the general population; and (b) relations between these conditions are important to their onset, maintenance, and course. The present chapter summarizes key aspects of this literature with the express purpose of helping to provide an understanding of the assessment of substance use and its disorders in the context of anxiety psychopathology. To achieve this aim, we first present the overarching context, conceptual perspectives, clinical features, and developmental processes relevant to the study and treatment of substance use disorders. Second, we present a general theoretical model for better understanding anxiety-substance use relations from an assessment persepctive. Third, we highlight the prevalence of some the most commonly used substances-tobacco, alcohol, and marijuana-and their co-occurrence as well as interplay with panic psychopathology to illustrate the importance of assessment of substance use and its disorders in the context of anxiety psychopathology. Finally, we present key aspects of the assessment approach directly relevant from a conceptual perspective to persons with cooccurring anxiety-substance use disorders. © Springer Science+Business Media New York 2013. All rights reserved.
Objectives:
In this study, we examined the prevalence and correlates of current synthetic cannabinoid (SC) use among high school seniors in the United States.
Methods:
Monitoring the Future, an annual nationally representative survey of high school seniors, began querying current (30-day) SC use in 2014. Data were examined from the 2 most recent cohorts (2014-2015; N = 7805). Prevalence of self-reported use was examined and differences in demographics and recency and frequency of other drug use was compared between current marijuana-only users and current SC (plus marijuana) users using χ(2) and generalized linear model using Poisson.
Results:
We found that 2.9% of students reported current SC use; 1.4% of students (49.7% of users) reported using SCs on ≥3 days in the past month. SC users were more likely to report more recent (and often more frequent) use of lysergic acid diethylamide, cocaine, heroin, and/or nonmedical use of opioids compared with marijuana-only users. Compared with current marijuana-only users, SC users were more likely to report lower parent education (P < .05) and current use of a higher number of illegal drugs other than marijuana (Ps < .001). Students using SCs ≥10 times in the past month were more likely to be boys, frequent marijuana users (Ps < .01), African American, and users of multiple other illegal drugs (Ps < .001).
Conclusions:
SC use is typically part of a repertoire of polydrug use, and polydrug use is less prevalent among marijuana-only users. Current SC users are at risk for poisoning from use of the newest generation of SCs and from concurrent drug use.
Dating aggression has been identified as a priority public health concern. Although alcohol use is a known robust risk factor for dating aggression involvement, such usage is neither necessary nor sufficient for dating aggression involvement. As such, a growing topic of interest is a better understanding of when, and for whom, alcohol use increases risk. A theoretical moderator model posits that associations between alcohol use and dating aggression involvement vary depending on both background (e.g., psychopathology) and situational (e.g., relationship characteristics) risk factors. Alcohol use is thought to be more strongly associated with dating aggression in the context of these other risk factors. Using an intensive longitudinal design, we collected six waves of data spanning 6 months from 120 participants (60 females; M age W1 = 22.44). Alcohol use and relationship risk were both associated with increases in dating aggression involvement. Consistent with a moderator model, interactions emerged between alcohol use and relationship risk for subsequent dating aggression involvement. The findings underscore the importance of alcohol use and relationship risk for the development of intervention and prevention programs.
Harm reduction debates are important in health policy. Although it has been established that morality affects policy, this article proposes that perspectives from moral psychology help to explain the challenges of developing evidence-based policy on prohibition-only versus tobacco/nicotine harm reduction for minors. Protecting youth from tobacco is critical, especially since tobacco/nicotine products are legal for adults, who usually begin using when young. Although cigarettes and other combustibles are the deadliest tobacco products, other products such as smokeless tobacco and electronic cigarettes, though unsafe, are upward of 90 percent less harmful than cigarettes. Disgust at contaminating the "purity" of youth, especially "good," low-risk youth, with any tobacco/nicotine products opposes harm reduction, as does contempt for violating so-called community values and disrespecting authority. Support for harm reduction arises from anger at failing to provide reduced harm to "bad," high-risk individuals and denying them the "liberty" to decide. Fast-thinking, moral-emotional intuitions are supported by rationalizations arising from slow-thinking processes. The recognition of such moral psychological influences and the efforts to minimize their impact may help lead to amelioration and compromise. This example from tobacco control, with divided concerns for low-risk and high-risk youth, can be applied to other harm reduction versus prohibition-only policies directed at minors.
This study examined college students' responses to emotional anti-alcohol abuse media messages (i.e., fear vs. humor appeal) aimed at discouraging heavy/binge drinking. An experiment was conducted with 94 college students. As expected, college students generally expressed higher levels of interest in anti-alcohol abuse media messages when watching fear appeal than those watching humor appeal. However, college binge drinkers who watched the fear appeal reported lower levels of readiness to change their drinking behavior than those who watched the humor appeal. This pattern was the opposite among college nonbinge drinkers, in that college nonbinge drinkers were more likely to say they would change their drinking behaviors when exposed to fear appeal than those who were exposed to humor appeal or those who did not watch any media messages. Conventional fear appeal to scare college binge drinkers seems ineffective and even counterproductive while humor appeal, if well designed, could offer alternative ways to communicate with college binge drinkers.
Purpose of Review
The aim is to provide a detailed review of literature from studies examining the relation of electronic cigarette (e-cigarette) use to indicators of risk for cardiovascular disease. In addition to discussing clinical and cell culture studies, we discuss possible mechanisms for the observed effects.
Recent Findings
Studies have compared the effect of e-cigarette use (or vapor) and combustible cigarette smoking on a range of measures. These include heart rate, blood pressure, and vagal tone; aortic stiffness and endothelial function; platelet aggregation and adhesion; expression of genes for antioxidant defense and immune system function; and indices of oxidative stress. The majority of studies found some evidence of a significant risk effect for e-cigarettes, although the evidence was not totally consistent within and between studies. Suggestive evidence also implicates a possible effect of e-cigarettes on inflammation processes. The magnitude of the effect for e-cigarettes was sometimes lower than those found for cigarettes, but several studies showed comparable effects.
Summary
The findings overall provide evidence of some risk to the cardiovascular system from e-cigarettes, but conclusions are qualified because each study was heterogeneous in its design and evidence on cardiac morbidity from prospective human studies is not yet available. The studies have helped to identify possible agents and mechanisms for producing risk, including reactive oxygen species and oxidative stress, fine and ultrafine particles, and nicotine. Longitudinal data from clinical and epidemiological studies are needed to clarify these relationships in healthy populations and investigate the impact of e-cigarette use among persons with pre-existing cardiovascular disease.
Background and aims:
Although sexual orientation-related alcohol use disparities are well established, researchers have not identified whether disparities are diminishing as societal attitudes towards lesbian/gay and bisexual (LGB) people become more accepting. We examined changes in four alcohol-related disparities between heterosexual and LGB youth from 1998 to 2013 by (1) estimating the prevalence of these behaviors; (2) estimating disparities in alcohol-related outcomes between heterosexual and LGB youth within each wave year; and (3) testing whether the degree of difference in alcohol-related disparities between heterosexual and LGB youth has changed.
Design:
Logistic regression models and year × sexual orientation interactions with repeated, cross-sectional, provincially representative data.
Setting:
British Columbia, Canada.
Participants:
Students (ages 12-19) from the 1998 (n = 22 858), 2003 (n = 29 323), 2008 (n = 25 254) and 2013 (n = 21 938) British Columbia Adolescent Health Survey (total n = 99 373, 48.7% male, mean age = 14.84).
Measurements:
We modeled age-adjusted differences in life-time alcohol use, age of onset, past 30-day drinking and past 30-day heavy episodic drinking between heterosexual and three subgroups of sexual minority youth (i.e. mostly heterosexual, bisexual and lesbian/gay).
Findings:
Generally, alcohol use declined for all youth, although less so among LGB youth [average adjusted odds ratio (aOR) = 0.58 and aOR = 0.53 for heterosexual males and females and aOR = 0.71 and aOR = 0.57 for sexual minority males and females, respectively). Within-year comparisons demonstrated elevated rates of alcohol use among LGB compared with heterosexual youth for each of the four survey years, especially among females. Findings indicate few changes over time; however, results show an increase in risky alcohol use from 1998 to 2013 among mostly heterosexual (aOR = 1.58 for life-time alcohol use, aOR = 1.58 for 30-day alcohol use and aOR = 1.34 for 30-day heavy episodic drinking), and bisexual (aOR = 1.95 for life-time alcohol use) females.
Conclusion:
Despite the general decline in the prevalence of alcohol use among young people in Canada since 1998, lesbian/gay and bisexual youth in Canada continue to show elevated rates of alcohol use compared with heterosexual youth.
In this chapter, program evaluation is examined as a way to systematically utilize the scientific method to determine whether adolescent substance use prevention interventions implemented with families, within schools and the workplace, and at the community level achieve their intended goals. General purposes and approaches to program evaluation are described, as well as the processes associated with the planning and conduct of evaluations, with a focus on addressing common challenges for evaluators and stakeholders. Finally, a summary case involving an evaluation of a large, national school-based substance use prevention intervention is used to illustrate concepts and processes important to the evaluation of substance abuse prevention and treatment programs.
A theoretical framework about protective factors (models protection, controls protection, support protection) and risk factors (models risk, opportunity risk, vulnerability risk) was employed to articulate the content of 4 key contexts of adolescent life-family, peers, school, and neighborhood—in a cross-national study of problem behavior among 7th-, 8th-, and 9th-grade adolescents in the United States (n = 1,596) and the People’s Republic of China (n = 1,739). Results were very similar in both samples and across genders. Measures of protection and risk in each of the 4 contexts uniquely contributed to the account of problem behavior involvement even when individual-level measures of protection and risk were controlled. Context protection was also shown to moderate individual-level risk and protection in 1 context moderated risk within that context and in other contexts. Controls protection—protection provided by rules, regulations, and expected sanctions for transgression from adults and peers—was the most important measure of context protection in all but 1 context. The family and peer contexts were the most influential in the U.S. sample, and the peer and school contexts were the most influential in the Chinese sample; the neighborhood context was least influential in both samples.
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