Sibling popularity: A moderator of sibling influence for adolescent substance use

Sibling substance use is a known correlate of adolescent substance use. Yet, not all siblings are equally influential. Sibling influence has been found to vary by age gap, sex, and birth order. Little research, however, has investigated whether siblings' peer context is also a source of variation. The present study tested whether more popular siblings were more influential for adolescent use of cigarettes, alcohol, and marijuana. Data were obtained from sibling pairs in the National Longitudinal Study of Adolescent Health. Findings indicate that older siblings have more influence on younger sibling marijuana use when they have more friends. These findings contribute to prior work examining which siblings are more influential and highlight the need to consider siblings as part of a greater peer context.

Changes in substance use-related health risk behaviors on the timeline follow-back interview as a function of length of recall period

The timeline follow-back (TLFB) interview was adopted to collect retrospective data on daily substance use and violence from 598 youth seeking care in an urban Emergency Department in Flint, Michigan during 2009-2011. Generalized linear mixed models with flexible smooth functions of time were employed to characterize the change in risk behaviors as a function of the length of recall period. Our results suggest that the 1-week recall period may be more effective for capturing atypical or variable patterns of risk behaviors, whereas a recall period longer than 2 weeks may result in a more stable estimation of a typical pattern.

A behavioral economic approach to assessing demand for marijuana

In the United States, marijuana is the most commonly used illicit drug. Its prevalence is growing, particularly among young adults. Behavioral economic indices of the relative reinforcing efficacy (RRE) of substances have been used to examine the appeal of licit (e.g., alcohol) and illicit (e.g., heroin) drugs. The present study is the first to use an experimental, simulated purchasing task to examine the RRE of marijuana. Young-adult (M age = 21.64 years) recreational marijuana users (N = 59) completed a computerized marijuana purchasing task designed to generate demand curves and the related RRE indices (e.g., intensity of demand-purchases at lowest price; Omax-max. spent on marijuana; Pmax-price at which marijuana expenditure is max). Participants "purchased" high-grade marijuana across 16 escalating prices that ranged from $0/free to $160/joint. They also provided 2 weeks of real-time, ecological momentary assessment reports on their marijuana use. The purchasing task generated multiple RRE indices. Consistent with research on other substances, the demand for marijuana was inelastic at lower prices but became elastic at higher prices, suggesting that increases in the price of marijuana could lessen its use. In regression analyses, the intensity of demand, Omax, and Pmax, and elasticity each accounted for significant variance in real-time marijuana use. These results provide support for the validity of a simulated marijuana purchasing task to examine marijuana's reinforcing efficacy. This study highlights the value of applying a behavioral economic framework to young-adult marijuana use and has implications for prevention, treatment, and policies to regulate marijuana use.

Effectiveness of the 'Healthy School and Drugs' prevention programme on adolescents' substance use: a randomized clustered trial

AIM

To evaluate the effectiveness of the Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents.

DESIGN

Randomized clustered trial with two intervention conditions (i.e. e-learning and integral).

SETTING

General population of 11-15-year-old adolescents in the Netherlands.

PARTICIPANTS

A total of 3784 students of 23 Dutch secondary schools.

MEASUREMENTS

Structured digital questionnaires were administered pre-intervention and at 32 months follow-up. The primary outcome measures were new incidences of alcohol (life-time and 1-month prevalence), tobacco (life-time and 1-month prevalence) and marijuana use (life-time prevalence).

FINDINGS

Main effect analyses showed no programme effects on incidences of alcohol consumption (life-time prevalence: e-learning condition: B = 0.102, P = 0.549; integral condition: B = -0.157, P = 0.351; 1-month prevalence: e-learning condition: B = 0.191, P = 0.288; integral condition: B = -0.140, P = 0.445), tobacco consumption (life-time prevalence: e-learning condition: B = 0.164, P = 0.444; integral condition: B = 0.160, P = 0.119; 1-month prevalence: e-learning condition: B = 0.088, P = 0.746; integral condition: B = 0.261, P = 0.093), or marijuana consumption (life-time prevalence: e-learning condition: B = 0.070, P = 0.732; integral condition: B = 0.186, P = 0.214).

CONCLUSION

The non-significant impact of the Healthy School and Drugs programme (a Dutch school-based prevention programme for early adolescents) on incidences of alcohol, tobacco and marijuana use indicates that the programme is either ineffective or implemented inadequately.

Witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents

Witnessing violence has been linked to maladaptive coping behaviors such as smoking, alcohol consumption, and marijuana use. However, more research is required to identify mechanisms in which witnessing violence leads to these behaviors. The objectives of this investigation were to examine the association between witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents, to identify whether exhibiting depressive symptoms was a mediator within this relationship, and to determine if those who had adult support in school were less likely to engage in risky health behaviors. Data were collected from a sample of 1,878 urban students, from 18 public high schools participating in the 2008 Boston Youth Survey. In 2012, we used multilevel log-binomial regression models and propensity score matching to estimate the association between witnessing a violent death and smoking, alcohol consumption, and marijuana use. Analyses indicated that girls who witnessed a violent death were more likely to use marijuana (relative risk (RR) = 1.09, 95% confidence interval (CI) = 1.02, 1.17), and tended towards a higher likelihood to smoke (RR = 1.06, 95% CI = 1.00, 1.13) and consume alcohol (RR = 1.07, 95% CI = 0.97, 1.18). Among boys, those who witnessed a violent death were significantly more likely to smoke (RR = 1.20, 95% CI = 1.11, 1.29), consume alcohol (RR = 1.30, 95% CI = 1.17, 1.45) and use marijuana (RR = 1.33, 95% CI = 1.21, 1.46). When exhibiting depressive symptoms was included, estimates were not attenuated. However, among girls who witnessed a violent death, having an adult at school for support was protective against alcohol consumption. When we used propensity score matching, findings were consistent with the main analyses among boys only. This study adds insight into how witnessing violence can lead to adoption of adverse health behaviors.

Individual and Peer Correlates of the Annual Frequency of Marijuana Use Among African American Adolescents Living in US Urban Public Housing Neighborhoods

Marijuana is the most commonly used illegal drug in the United States. Urban minority youth reports the highest consumption. Using a sample of 550 African American youth living in public housing located in three large Northeastern US cities, this article examines individual and peer correlates of the annual frequency of marijuana use. Data were collected between the Fall of 2007 and the Spring of 2008. The sample reported a mean age of 15 with 48% being female. Pearson's bivariate correlation and sequential regression analysis were conducted. The model explained 35% of the variance. Limitations and implications are discussed.

"Counselor in Your Pocket": Youth and Provider Perspectives on a Mobile Motivational Intervention for Marijuana Use

Previous interventions for marijuana use have been administered out of the real-life contexts in which use occurs. In 2010, we interviewed youth aged 15-24 years who use marijuana frequently (n = 8) and providers who treat them (n = 6) on the acceptability and utility of a mobile intervention involving momentary self-monitoring of use-related contexts and responsive motivational messaging following clinic-based brief motivational enhancement therapy. Thematic analysis was used to examine youth and provider perspectives on the mobile intervention. Results suggest that mobile technology is a promising tool for brief interventions to reduce youth marijuana use and warrants further development.

Continued detention involvement and adolescent marijuana use trajectories

Justice-involved youth have high rates of marijuana use. Less is known about what may drive these rates, particularly when justice-involved youth return to the community. One factor that has been implicated is continued detention involvement. Yet, it is unknown how this factor may influence marijuana use trajectories. Using longitudinal growth curve modeling, the researchers evaluated the association between continued detention involvement and marijuana use trajectories in two large, ethnically diverse samples of community-based, justice-involved youth. Across both samples, marijuana use decreased over time for youth with continued detention involvement but did not change for youth without continued detention involvement. These findings underscore the importance of attending to the influence of detention involvement in community-based, justice-involved adolescents' marijuana use trajectories. This study also highlights the importance of coordinating prevention/intervention programming for justice-involved youth once they are in the community.

Medical marijuana and related legal aspects

State policies vary regarding the legal use of marijuana for medicinal purposes. Pharmacists, physicians, and P&T committee members must become familiar with the laws in their states before assuming that this controlled substance can be legally prescribed or dispensed to patients.

Religiosity and substance use among Asian American college students: moderated effects of race and acculturation

BACKGROUND

Religiosity is a well-established protective factor against substance use among Caucasians, but limited research has examined its role among Asian Americans. The purposes of this study were (1) to examine whether the associations between religiosity and substance use outcomes differed across Caucasians and Asian Americans, and (2) to test whether acculturation moderated the associations between religiosity and substance use outcomes among Asian Americans.

METHOD

We utilized a large and diverse cross-sectional sample of 839 college students to test whether race moderated the associations between religiosity and substance use outcomes (Study 1). We then replicated and extended our findings in a separate college sample of 340 Asian Americans, and examined the moderating role of acculturation on the associations between religiosity and substance use outcomes (Study 2).

RESULTS

Controlling for age, gender, and paternal education, religiosity was protective against alcohol use, alcohol problems, and marijuana use among Caucasians but was unrelated to these outcomes among Asian Americans in Study 1. In Study 2, religiosity was protective against alcohol problems only at high levels of acculturation. Moreover, religiosity was protective against marijuana use at both high and mean levels of acculturation, but not at low levels of acculturation.

CONCLUSIONS

The protective effects of religiosity on alcohol use and problems varied across Caucasian and Asian American college students, and religiosity protected against alcohol problems and marijuana use only among more acculturated Asian Americans. These findings underscore the need to examine culturally-specific correlates of substance use outcomes among Asian Americans.

The normative environment for substance use among American Indian students and white students attending schools on or near reservations

American Indian and White students who attended the same schools located on or near reservations were surveyed to determine the comparative normative environment for substance use. Descriptive norms increased and student injunctive norms decreased across grade in school. Female students reported higher levels of descriptive norms compared to male students. For marijuana use, a substantial decrease in student injunctive norms occurred between grades 8 and 10. Adult injunctive norms were perceived by female students to be higher than those perceived by male students, particularly among American Indian females. Somewhat surprisingly, 8th grade White female students reported high descriptive norms for inhalant use compared to 8th grade American Indian students. Overall, however, higher descriptive norms and lower injunctive norms among American Indian youth suggested that their risk for substance use is higher compared to White students because of the normative environment created by peers, family, and other adults.

Project MARS: Design of a Multi-Behavior Intervention Trial for Justice-Involved Youth

BACKGROUND

Marijuana and alcohol use are associated with increased sexual risk behavior among justice-involved youth. A multi-behavior intervention may reduce all three risk behaviors.

PURPOSE

To examine the relationships among multiple risk behaviors and the Theory of Planned Behavior (TPB) constructs guiding the development of the MARS (Motivating Adolescents to Reduce Sexual risk) intervention. We describe the MARS study design to inform the process through which a multi-behavior intervention trial can be implemented and evaluated.

METHODS

Participants completed questionnaires prior to randomization to one of three interventions.

RESULTS

Relationships were found between TPB constructs and risk behavior. A single latent variable was inadequate to capture all three risk behaviors.

CONCLUSIONS

Interventions to reduce sexual risk behavior can include content related to the role of substance use in influencing sexual risk behavior with only minimal modifications to the curriculum, and preliminary data suggest a common theory can apply across risk behaviors.

The role of perceived peer prejudice and teacher discrimination on adolescent substance use: a social determinants approach

Although Black adolescents have reported a lower prevalence of substance use relative to non-Hispanic Whites, Black youth are disproportionately affected by adverse social outcomes. Social scientists have highlighted that using a framework that includes perceived peer prejudice and teacher discrimination as social determinants of adolescent risk behaviors is essential to fully understanding substance use behaviors in adolescents. However, this area of research remains underdeveloped. This study examined whether and to what extent perceived peer prejudice and teacher discrimination affect binge drinking and marijuana use by Black (n = 514) and non-Hispanic White (n = 2,818) adolescents using data from the National Longitudinal Study of Adolescent Health, Wave 2, Public Use dataset. Findings suggest that peer prejudice increased the risk of substance use in non-Hispanic White youth only, whereas experiences of teacher discrimination increased the risk of substance use in both Black and non-Hispanic White youth. The study's limitations are noted, and implications for future research are discussed.

Marijuana expectancies and relationships with adolescent and adult marijuana use

BACKGROUND

Outcome expectancy is a central construct in models of addiction and relapse. Much expectancy research has been conducted in the context of alcohol; however, less is known about the structure of expectancies for marijuana and their associations with marijuana use outcomes.

METHODS

The data are taken from waves 3 and 4 of a longitudinal high-risk study of parents and adolescent offspring. Of those families who were retained at wave 3, 225 were high-risk and 205 were matched controls (low-risk). In the present study, we examine the factorial structure of marijuana expectancies (wave 3) in the offspring (using an instrument adapted from the alcohol literature) and test whether expectancies mediate the associations of familial risk for substance use, lifetime marijuana use in adolescence (wave 3) and current use in young adulthood (wave 4; reported approximately 5 years later).

RESULTS

We quantified four marijuana expectancy factors similar to those identified in previous studies when the offspring were adolescents (Mn age=15.2) and results of our mediation models suggest that negative marijuana expectancies (but not positive expectancies) together with lifetime adolescent marijuana use completely mediated the association between familial risk and current use of marijuana during young adulthood (Mn age=20.2).

CONCLUSION

Familial risk for current marijuana use in young adulthood appears to be transmitted through two orthogonal, prospective pathways. One pathway involves marijuana use during adolescence, and the second pathway involves reduced expectancies that using marijuana will result in cognitive and behavioral impairments.

Legalization of medical marijuana and marijuana use among youths

AIMS

This study examined the relationship of youth marijuana use and perceived ease of access with the number of medical marijuana cards at the county-level, and marijuana norms as indicated by percent of voters approving legalization of medical marijuana in 2004.

METHODS

Survey data from 17,482 youths (ages 13 - 19) in Montana and county-level archival data, including votes for the legalization of medical marijuana and the number of medical marijuana cards were analyzed using hierarchical linear modeling.

FINDINGS

Living in a county with more medical marijuana cards was not related to lifetime or 30 day marijuana use. However, voter approval of medical marijuana was positively related to lifetime and 30 day use. Perceived ease of access to marijuana was positively related to medical marijuana cards, but this relation became non-significant when voter approval was controlled. Among marijuana users, marijuana cards and voter approval were positively related to perceived ease of access.

CONCLUSIONS

The relation between medical marijuana cards and youth use may be related to an overall normative environment that is more tolerant of marijuana use. Interventions to prevent youth marijuana use should focus on adult norms regarding use by and provision of marijuana to youths.

Marijuana use development over the course of adolescence among North American Indigenous youth

This study investigated the links between marijuana use trajectories and marijuana abuse/dependence (DSM-IV) using five waves of data from 718 North American Indigenous adolescents between 10 and 17years from eight reservations sharing a common language and culture. Growth mixture models indicated that 15% of youth began using by 11-12years of age and that another 20% began shortly thereafter. These early users had odds of abuse/dependence 6.5 times larger than abstainers. Girls were also unexpectedly found to be particularly at risk of early use, and this did not reflect other background and psychosocial factors, including friend use. While the timing, patterns, and consequences of use were similar to those reported for alcohol use previously, the social influences on use differed in important ways.

Parallel Development of Risk Behaviors in Adolescence: Potential Pathways to Co-occurrence

This study used data from 5,382 adolescents from the 1997 U.S. National Longitudinal Survey of Youth (NLSY97) to investigate developmental pathways of alcohol use, marijuana use, sexual risk behaviors, and delinquency across ages 14 to 20, examine interrelationships among these risk behaviors across adolescence, and evaluate association between risk behavior trajectories and depressive symptoms in adolescence. Group-based dual trajectory modeling, examining trajectories of two outcomes over time, revealed strong interrelationships among developmental trajectories of the four risk behaviors, and indicated potential pathways to co-occurring risk behaviors. Adolescents with higher levels of alcohol use or marijuana use were more likely to engage in higher levels of early sexual risk-taking and delinquency. Moreover, adolescents involved in higher levels of delinquency were at higher risk for engaging in early sexual risk-taking. Also belonging to the highest risk trajectory of any of the four risk behaviors was positively associated with depressive symptoms in adolescence.

Trajectories of marijuana use and psychological adjustment among urban African American and Puerto Rican women

BACKGROUND

The current longitudinal study examined the developmental patterns of marijuana use and their relationship with subsequent psychological adjustment in a community-based sample of urban African American and Puerto Rican women.

METHOD

Participants were interviewed five times over a period ranging from adolescence (mean age 14.0 years) to adulthood (mean age 32.5 years). Outcome measures included depressive symptoms, anger/hostility and the presence of a substance use disorder (abuse/dependence).

RESULTS

Three distinct trajectories of marijuana use were identified: non-users, increasers and quitters. Increasers reported higher levels of depressive symptoms and anger/hostility than did non-users and were more likely to meet criteria for a substance use disorder at age 32.5 years.

CONCLUSIONS

Our findings indicate that early-starting long-term use of marijuana is associated with psychological maladjustment among women. Prevention efforts should emphasize the long-term cost associated with marijuana use, and that the best psychological health is reported by those who abstain from the drug.

Family and parenting characteristics associated with marijuana use by Chilean adolescents

OBJECTIVE: Family involvement and several characteristics of parenting have been suggested to be protective factors for adolescent substance use. Some parenting behaviors may have stronger relationships with adolescent behavior while others may have associations with undesirable behavior among youth. Although it is generally acknowledged that families play an important role in the lives of Chilean adolescents, scant research exists on how different family and parenting factors may be associated with marijuana use and related problems in this population which has one of the highest rates of drug use in Latin America. METHODS: Using logistic regression and negative binomial regression, we examined whether a large number of family and parenting variables were associated with the possibility of Chilean adolescents ever using marijuana, and with marijuana-related problems. Analyses controlled for a number of demographic and peer-related variables. RESULTS: Controlling for other parenting and family variables, adolescent reports of parental marijuana use showed a significant and positive association with adolescent marijuana use. The multivariate models also revealed that harsh parenting by fathers was the only family variable associated with the number of marijuana-related problems youth experienced. CONCLUSION: Of all the family and parenting variables studied, perceptions of parental use of marijuana and harsh parenting by fathers were predictors for marijuana use, and the experience of marijuana-related problems. Prevention interventions need to continue emphasizing the critical socializing role that parental behavior plays in their children's development and potential use of marijuana.

Morningness/eveningness, pubertal timing, and substance use in adolescent girls

The purpose of this study was to examine the associations between Morningness/Eveningness (M/E; a measure of sleep-wake preference) and alcohol, cigarette, and marijuana use as well as the interaction of M/E and pubertal timing. The data represent baseline measures from a longitudinal study examining the association of psychological functioning and smoking with reproductive and bone health in 262 adolescent girls (11-17 years). The primary measures used for this study were pubertal timing (measured by age at menarche), the Morningness/Eveningness scale, and substance use (alcohol, cigarettes, and marijuana). Multiple group path modeling showed that there was a significant interaction between pubertal timing and M/E on cigarette use. The direction of the parameter estimates indicated that for the early and on-time groups, Evening preference was associated with more cigarette use. For the late timing group the association was not significant. The results point to the need to consider sleep preference as a characteristic that may increase risk for substance use in adolescents.

Marijuana use and testicular germ cell tumors

BACKGROUND

Since the early 1970s, the incidence of testicular germ cell tumors (TGCTs) in the United States has been increasing; however, potential environmental exposures accounting for this increase have not been identified. A previous study reported a significant association between frequent and long-term current marijuana users and TGCT risk. The purpose of this study was to evaluate the relation between marijuana use and TGCTs in a hospital-based case-control study.

METHODS

TGCT patients diagnosed between January 1990 and October 1996 (n = 187) and male friend controls (n = 148) were enrolled in the study. All participants were between the ages of 18 and 50 at the time of diagnosis and resided in Texas, Louisiana, Arkansas, or Oklahoma. Associations of marijuana use and TGCTs were estimated using unconditional logistic regression, adjusting for age, race, prior cryptorchidism, cigarette smoking, and alcohol intake.

RESULTS

Overall, patients with TGCTs were more likely to be frequent marijuana users (daily or greater) compared with controls (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.0-5.1). Histological-specific analyses revealed that patients with nonseminoma were significantly more likely than controls to be frequent users (OR, 3.1; 95% CI, 1.2-8.2) and long-term (≥ 10 years) users (OR, 2.4; 95% CI, 1.0-6.1).

CONCLUSIONS

The finding of an association between frequent marijuana use and TGCTs, particularly among men with nonseminoma, was consistent with the findings of a previous report. Additional studies of marijuana use and TGCTs are warranted, especially studies evaluating the role of endocannabinoid signaling and cannabinoid receptors in TGCTs.

Paternal incarceration and trajectories of marijuana and other illegal drug use from adolescence into young adulthood: evidence from longitudinal panels of males and females in the United States

AIMS

One-eighth of young adults in the United States report that their biological father has ever been incarcerated (FEI). This study is the first to examine associations between FEI and trajectories of substance use during the transition from adolescence into young adulthood for the US population.

DESIGN

Using multi-level modeling techniques, trajectories of marijuana and other illegal drug use are examined, with FEI as the primary independent variable.

SETTING

Data are from the first three waves of the National Longitudinal Study of Adolescent Health, a nationally representative sample of US adolescents beginning in 1995.

PARTICIPANTS

Panels of 7157 males and 7997 females followed from adolescence (7th-12th grades) into early adulthood (ages 18-27 years).

MEASUREMENTS

Dependent variables included an ordinal measure of marijuana frequency of use in last thirty days, and a dichotomous measure for whether respondent had any use in the last thirty days of illegal drugs such crystal meth, cocaine, heroin, hallucinogens, PCP, LSD, speed, and ecstasy.

FINDINGS

Among males and females, respectively, FEI is associated with an increased frequency of marijuana use, and increased odds of any other illegal drug use. Interactions between FEI and age further reveal that FEI is associated with an accentuated trajectory (i.e. a steeper slope) of marijuana use, and an elevated risk (i.e. higher mean level) of other illegal drug use.

CONCLUSIONS

Analysis provides some of the first evidence that paternal incarceration is significantly associated with drug use among U.S. males and females, even after controlling for a number of family background, parental, and individual characteristics.

Young mothers' decisions to use marijuana: a test of an expanded Theory of Planned Behaviour

The current study examines the Theory of Planned Behaviour's (TPB) ability to predict marijuana use among young women who experienced a premarital pregnancy before the age of 18 years, using longitudinal data. The validity of the TPB assumption that all other variables work through TPB constructs is also tested. Indicators of four constructs that have been shown in the literature to be predictive of marijuana use-persistent environmental adversity, emotional distress, adolescent marijuana use and drug use in the social network-were tested as predictors of attitudes, norms and self-efficacy, in a structural equation modelling framework. All paths from distal predictors were through the mediating TPB constructs, in accordance with the tenets of the model. Implications of these findings for the TPB model and for understanding factors that lead to marijuana use are discussed.

Tobacco, marijuana, and sensation seeking: comparisons across gay, lesbian, bisexual, and heterosexual groups

This study examined patterns of smoked substances (cigarettes and marijuana) among heterosexuals, gays, lesbians, and bisexuals based on data from the 2000 National Alcohol Survey, a population-based telephone survey of adults in the United States. We also examined the effect of bar patronage and sensation seeking/impulsivity (SSImp) on tobacco and marijuana use. Sexual orientation was defined as lesbian or gay self-identified, bisexual self-identified, heterosexual self-identified with same-sex partners in the past 5 years, and exclusively heterosexual (heterosexual self-identified, reporting no same-sex partners). Findings indicate that bisexual women and heterosexual women reporting same-sex partners had higher rates of cigarette smoking than exclusively heterosexual women. Bisexual women, lesbians, and heterosexual women with same-sex partners also used marijuana at significantly higher rates than exclusively heterosexual women. Marijuana use was significantly greater and tobacco use was elevated among gay men compared with heterosexual men. SSImp was associated with greater use of both of these substances across nearly all groups. Bar patronage and SSImp did not buffer the relationship between sexual identity and smoking either cigarettes or marijuana. These findings suggest that marijuana and tobacco use differ by sexual identity, particularly among women, and underscore the importance of developing prevention and treatment services that are appropriate for sexual minorities.

The association of ecstasy use and academic achievement among adolescents in two U.S. national surveys

The association of ecstasy (3, 4-methylenedioxymethamphetamine, MDMA) use with low academic achievement was examined in two nationally representative surveys of adolescents. We tested whether associations with low academic achievement were of similar magnitude or of stronger magnitude for ecstasy versus marijuana use (without ecstasy use), alcohol/tobacco use (without other drug use) and non-drug use in adolescence. Data from the adolescents in the 2002-2005 National Survey of Drug Use and Health (NSDUH, n=65,294) and from the 2001-2003 Youth Risk Behavior Survey (YRBS, n=27,592) were analyzed via weighted logistic regression models. Ecstasy, marijuana, and alcohol/tobacco use were associated with moderate and low academic achievement among adolescents in both surveys. Moreover, ecstasy was more strongly associated with low academic achievement and reporting that school gave no grades than alcohol/tobacco in both samples and than marijuana (NSDUH sample only). Prevention programs should inform adolescents that ecstasy use might impair their academic achievement.

Gender differences in the correlates of adolescents' cannabis use

Adolescents' gender-specific cannabis use rates and their correlates were examined. Data were obtained via a cross-sectional survey conducted in 2004 in British Columbia, Canada, funded by the Canadian Institutes of Health Research. School districts were invited to participate, and schools within consenting districts were recruited. In total, 8,225 students (50% male) from Grades 7 to 12 participated. About 73% were "White," and 47% had used cannabis in their lifetime. Cannabis users were grouped according to their frequency of use: "never users," "frequent users," or "heavy users." Male heavy cannabis users (14.3% of boys) were more likely to be in Grade 9 or higher; be Aboriginal; report poorer economic status; never feel like an outsider; frequently use alcohol and tobacco; and have lower satisfaction with family, friends, and school compared with boys that never used. Female heavy users (8.7% of girls) were more likely to be in a higher grade; report poorer economic status, mental health, and academic performance; frequently use alcohol and tobacco; and have lower satisfaction with their school compared with female never users. Three important gender differences in the multivariate analysis of the correlates of cannabis use were noted: school grade (for boys only), Aboriginal status (for boys only), and mental health (for girls only). Despite the limitations of relying on self-reports, a subset of youth appears to be at risk for excessive cannabis use that may impair life opportunities and health. The gender differences may be important in the design and implementation of prevention or treatment programs for adolescents.

Marijuana use among young women in a primary care setting

OBJECTIVE

To evaluate the prevalence of marijuana use among young women, ages 18-24, within a primary care setting.

DESIGN

From 2/05 to 12/05, women completed a brief, anonymous self-report screening instrument in two urban primary care clinics for potential participation in a randomized controlled trial of an intervention to reduce marijuana use and sexual risk-taking behavior. During the last few months of recruitment, women who completed the screening instrument were also asked to provide a urine sample to test for the presence of marijuana and other drugs.

RESULTS

Of the 607 women who completed the screening instrument, 38.6% reported lifetime marijuana use, 8.4% used marijuana at least monthly, and 1.7% reported using marijuana daily. Within this ethnically diverse sample (45% Hispanic), women who used marijuana at least monthly were more likely to smoke cigarettes (OR = 2.03, 95% CI = 1.04, 3.96), binge drink at least once a month (OR = 2.66, 95% CI = 1.34, 5.28), and to have ever used other drugs (OR = 2.91, 95% CI = 1.31, 6.45). Of the 67 urine samples provided, 60 (89.6%) were concordant with self-reported use, but six of the seven discordant samples were positive despite negative self-report.

CONCLUSIONS

The prevalence of marijuana use and binge drinking in this ethnically diverse sample of young, female primary care patients was lower than rates reported in national surveys. Providers should consider marijuana use as a part of a process that addresses more prevalent high-risk behaviors, bearing in mind that these behaviors may be underreported during routine screening.

Comparison of indirect assessments of association as predictors of marijuana use among at-risk adolescents

In this study, the authors compared indirect measures that attempt to quantify the level of marijuana associations among adolescents. They also evaluated whether these various methods overlap or tap different aspects of associative processes that may act in concert to influence marijuana use. Automatic drug-relevant associations were assessed in 121 at-risk youth in continuation high schools in California with the use of a word association index and computer-based, reaction time measures (i.e., Implicit Association Test [IAT] and Extrinsic Affective Simon Task [EAST]). Measures of working memory capacity, sensation seeking, and explicit cognitions also were included in analyses as potential confounders. The word association index and the marijuana IAT excited D measure were significant predictors of marijuana use. The word association index accounted for more variance in marijuana use than did the IAT or EAST measures. Further, confirmatory factor analytic models of the indirect measures of marijuana use revealed a significant moderate correlation between the EAST Excitement and Word Association factors but no significant correlations between the Word Association and IAT factors. These findings suggest that there is some convergence among the different indirect measures, but these assessments also appear to tap different aspects of associative processes. The types of indirect measures evaluated in this work provide information about spontaneous cognitions related to substance use, capturing influences on behavior that are not evaluated with traditional explicit assessments of behavior. Findings from this work add to a growing body of research that implicates the importance of implicit associative processes in risk and health behaviors.

The Marijuana Ladder: measuring motivation to change marijuana use in incarcerated adolescents

The purpose of this study was to determine if a modified version of the Contemplation Ladder, a measure of motivation to change marijuana use among incarcerated adolescents (Marijuana Ladder; ML), was related to marijuana use and treatment engagement. Participants (N=122) in this study were all incarcerated at a state juvenile correctional facility in the Northeast. Adolescents were assessed at the beginning of their incarceration, 2 months into their incarceration, and 3 months after their release. There was a significant negative relationship between ML scores and marijuana use and a significant positive relationship between ML scores and treatment engagement. When controlling for prior marijuana use and age, ML scores at baseline significantly added to the prediction of marijuana use and treatment engagement among incarcerated adolescents. Results support the concurrent validity and the predictive validity of the ML. This measure has the potential to provide important information for Juvenile Justice Facilities that might aid in treatment planning and discharge planning for incarcerated adolescents. In addition, researchers may find a quick visual analog measure of motivation to change marijuana use with good psychometric properties useful.

The Effects of Parental Tobacco and Marijuana Use and Personality Attributes on Child Rearing in African-American and Puerto Rican Young Adults

This study assessed the effect of the interrelationship of mothers' and fathers' tobacco and marijuana use with their personality attributes on some of their child rearing behaviors. We used a longitudinal design to analyze the data of 258 males and females who were seen four times over a 13-year period from early adolescence through young adult parenthood. Thirty-one percent of the multiple regression analyses revealed significant interactions between the effect of tobacco or marijuana use and a personality attribute on child rearing. The majority of these significant interactions suggested that protective personality characteristics were offset by substance use risks resulting in less adequate child rearing. If these results are substantiated in an experimental intervention, it suggests that having resilient personality attributes does not protect against the negative effects of tobacco or marijuana use on child rearing.