Media exposure and marijuana and alcohol use among adolescents

Impact of COVID-19 on children

Background

The COVID-19 global pandemic has spread throughout the world, posing an extremely dangerous health risk for almost everyone. While dealing with such a large-scale viral disease, the healthcare infrastructure is under strain. Young adults who were thought to have been clinically affected fared better than their older counterparts. This pandemic has affected millions of children, especially those from low-economic backgrounds, who are otherwise highly susceptible and underprivileged. Children of frontline workers and single parents face particular challenges. Children from disadvantaged backgrounds are more vulnerable to infection and may experience long-lasting negative effects of the pandemic, such as child labor, child trafficking, child marriage, sexual exploitation, and even death. To lessen the psychological negative effects of COVID-19 on children and adolescents, parents, physicians, psychologists, social workers, and hospital administrators, government and non-governmental organizations have essential responsibilities to play. Priority one is to ensure that all children from all socioeconomic strata have access to the necessities of life, including social security, health care, and education. Moreover, some positive changes may result from the global crisis. This research paper discusses the potential consequences of this pandemic. 

Summary

Some of the hypotheses being investigated while looking at the low case fatality rate among pediatric age groups include the peak of immunity and differences in immune system response. The vulnerability of the comorbid pediatric age group, on the other hand, is comparable to that of their older counterparts. During the severe acute respiratory syndrome and Middle Eastern respiratory syndrome outbreaks, similar results were observed. The inoculation of a mother during pregnancy was found to be effective in protecting her progeny.

Results

This is a review article, thus not applicable.

Conclusions

Children are quite discouraged when school is abruptly stopped, when planned outings are canceled, when they are confined to the house, and when they are afraid of the unknown with regard to the continuing epidemic. Even though almost all studies suggest that COVID-19 has a relatively mild clinical manifestation in children, one must be cautious due to the novel coronavirus’s rapid mutation rate. More research is needed to determine the relationship between COVID-19 and pediatric age groups.

Prevalence of adolescent's risk behaviors at age 11 and 15: data from the 2004 Pelotas birth cohort

PURPOSE

The objective of this study was to investigate the prevalence of the following risk behaviors: cigarette, electronic cigarette, alcohol, substance and sexual experimentation and delinquent behavior at age 15, stratified by sex and socioeconomic position. We also investigated the prevalence of cigarette and alcohol experimentation at age 11 and the persistence and cumulative incidence of these behaviors between 11 to 15 age.

METHODS

Cohort study. We included 3,491 11-year-old and 1,949 15-year-old adolescents from the 2004 Pelotas Birth Cohort. All outcomes were identified via confidential questionnaires and were analyzed as binary variables.

RESULTS

At age 11, we found a male preponderance of cigarette experimentation. At age 15, alcohol experimentation, cigarette experimentation and substance experimentation had a female preponderance; and cigarette experimentation and sexual experimentation were more prevalent in individuals belonging to low socioeconomic position. We found high rates of cumulative incidence of 'alcohol experimentation' in male and in female adolescents; and high rates of persistence of alcohol experimentation both in male and female.

CONCLUSIONS

Further research should clarify causal paths of high prevalence of risk behaviors during adolescence and its increase in female adolescents.

The role of virtual socializing and unstructured socializing in adolescent vaping

PURPOSE

Emerging research suggests that adolescent patterns of socializing have shifted in recent years towards more virtual socializing and less traditional in-person socializing. At present, limited research has explored how this shift in socializing may influence outcomes traditionally linked with in-person socializing among adolescents (i.e., substance use).

PROCEDURES

This paper addresses this gap in the literature by utilizing logistic regression techniques to examine the relationship between virtual socializing and an emerging form adolescent substance use (i.e., vaping) using data from the 2018 Monitoring the Future (MTF) cohort.

FINDINGS

Our findings reveal that time spent socializing in the virtual sphere is significantly associated with a greater likelihood of vaping nicotine, marijuana, and flavor. In addition, our findings reveal that while the relationship between virtual socializing and vaping is attenuated by unstructured socializing (i.e., unsupervised socializing or "hanging out") in person to some degree, time spent socializing virtually is still a significant predictor of adolescent vaping activity even after taking time spent socializing in person into account.

CONCLUSIONS

In conclusion, our findings indicate that virtual socializing is an important predictor of adolescent vaping activity. The implications of these findings for policy are discussed.

Exposure to Media Messages Portraying Effects of Alcohol Use in a Young Adult Sample

Background: Young adults are prolific media users and tend to use substances, such as alcohol, more than people of other ages. Despite much research on young adults' exposure to alcohol advertisements and portrayals of alcohol use in the media, much is still unknown about the nuances of young adults' exposure to and engagement with alcohol-related media content. The present paper examined how college students' media exposure differed for messages portraying positive and negative alcohol effects, how exposure to alcohol-related content differed across media sources, which themes of alcoholrelated content were seen most, and whether exposure to alcohol-related content was associated with hazardous/harmful drinking. Method: Participants (N=500) were two- and four-year college students (Mage=20.90, SDage=1.70, 63.2% female) recruited for a longitudinal study examining the efficacy of a mobile app intervention for high-risk drinking college students. The data used here comes from the baseline survey. Results: Participants reported the greatest exposure to alcohol-related messages in movies/TV/on-demand streaming shows followed by in social media, and they reported greater exposure to messages portraying positive than negative effects of alcohol. Findings from linear regressions indicated that exposure to messages portraying positive or negative effects of alcohol generally did not predict hazardous/harmful drinking. Conclusion: This sample of high-risk college student drinkers reported seeing alcohol-related content through a variety of media sources, with most content portraying alcohol in a positive light. Future research should assess the effects that messages of different types and from different sources have on use, expectancies, norms, and other outcomes.

Effects of Risk Perception and Accessibility on Cannabis Use among Young Population in Spain: Findings from the 2016 National Survey (ESTUDES)

BackgroundCannabis use in the young population has undergone a significant increase in Europe. Empirical assessments of individual and contextual mediating variables in relation to cannabis use are informative for prevention actions and have yet to be conducted in Spain. Objectives: This study used the 2016 National Survey on Drug Use in Secondary Education in Spain (ESTUDES) to inform on potentially relevant cannabis prevention targets. We examined individual variables (sex, age, and cannabis risk perception), past 30-day legal and illicit substance use, substance-free activities, and contextual factors (perceived accessibility to cannabis) associated to past 30-day cannabis use. Methods: Data were drawn from 35,369 adolescents (% females: 50.1). Structural equation modeling (SEM) was implemented to identify predictors of cannabis use, and indirect paths were tested via bootstrapping to examine the mediating effects of cannabis risk perception and accessibility. Results: Demographics (male sex, higher age), and past 30-day tobacco, alcohol, and illicit substance use were associated with past 30-day cannabis use. Frequency of past-year engagement in hobbies and reading did also predict past 30-day cannabis use. The mediators worked on most of the relationships examined, except for hobbies and illegal substance use in the case of accessibility and reading and hobbies in the case of risk perception. Conclusions/importance: Cannabis use is more likely to emerge in the event of low risk perception and high accessibility. Lower frequency of past year reading and higher engagement in some hobbies that are often carried out alone represent risk factors, which could potentially influence prevention programs.

Using TikTok in recovery from substance use disorder

BACKGROUND

There are many effective treatment options for substance use disorder (SUD), yet most individuals with SUD do not seek formal treatment services. Given the rising popularity of TikTok and need to foster innovative means through which to attract and engage individuals with SUD with treatment, we sought to characterize how TikTok users in SUD recovery are using this platform to bolster their recovery support and/or give hope to others who are struggling with substance use.

METHODS

Our sample consisted of 82 of the most liked TikTok videos related to attempts to cut down on or abstain from substances and/or strengthen SUD recovery. We employed an iterative process to codebook development resulting in codes for demographics, user-sentiment, video type, and mechanisms of recovery-related behavior change. Videos were independently double-coded and evaluated for inter-rater reliability.

RESULTS

Video in this sample were heavily viewed, accounting for over 2 million views per video and 325,000 likes on average. Most common video themes were sharing a journey from active SUD to recovery (40.2%) and sharing/celebrating a recovery milestone (37.8%), followed by recurrence of substance use (12.2%). Commonly exemplified mechanisms of recovery-related behavior change included embracing a strong social identity as a person in recovery (81.7%), social support (45.1%), and participation in rewarding alternative activities (39.0%).

CONCLUSION

TikTok SUD recovery-focused videos can potentially reach millions with portrayed themes similar to established therapeutic mobilizers and mechanisms. More research is needed to better understand whether digital recovery narratives can effectively normalize experiences of addiction and help-seeking behaviors.

A qualitative study to understand drivers of psychoactive substance use among Nepalese youth

Background

Psychoactive substance use among youth is an emerging public health issue in Nepal. This exploratory study aimed to better understand the drivers of psychoactive substance use among Nepalese youth in Rupandehi district of Nepal.

Materials and methods

This study used a qualitative approach for data collection. Both in-depth interviews (IDI, seven participants) and focus group discussions (FGD, 13 participants) were conducted among study participants who self-reported as psychoactive substance users or had history of psychoactive substance use. Participants for IDI were aged between 11 and 24 years and between 18 and 35 years old for FGDs. Semi-structured interview guides were prepared separately for IDIs and FDGs. Interviews were conducted in Nepali language and were audio recorded, which were there transcribed and translated into English for coding and analyses. In addition, interviews notes were taken by two research assistants. An inductive thematic analysis was used to analyze the data.

Results

This study identified a range of drivers of psychoactive substances use among Nepalese youths. Themes included (i) socio-cultural factors, (ii) individual factors, (iii) academic environment, (iv) physical environment and the (v) influence of media. The socio-cultural factors were categorized into sub-themes of family relationships, ethnic identity and psychoactive substance use and lack of social acceptance. Individual factors included peer pressure, stress relief and coping with financial challenges. Accessibility and availability of psychoactive substances in the surrounding environment and lack of monitoring and reinforcement of rules/ law and regulations were other drivers to psychoactive substance use among this Nepalese youth cohort.

Conclusion

Our study identified several important drivers of psychoactive substance use among youth in the Rupandehi district of Nepal. Future works are anticipated to further explore youth initiation and use of psychoactive substances and support the design of interventions that address these risk factors to reduce and prevent subsequent harms.

Media Exposure and Substance Use Increase during COVID-19

Background: Lockdown measures because of COVID-19 are likely to result in deteriorating physical and mental health. In this study, our aim was to assess the impact of media exposure on increases in substance use during the COVID-19 pandemic. Methods: A nationally representative online survey of 1264 adults was collected during the pandemic in the United States. Logistic regression was used to explore the association between an increase in substance use since the beginning of the COVID-19 pandemic and exposure to cable news or social media together with COVID-19 knowledge, while controlling for covariates. Results: In the multivariable-adjusted models, participants with the highest exposure to social media (at least daily) and low knowledge of COVID-19 were 9.9 times more likely to experience an increase in substance use since the pandemic began (OR = 9.90, 95% CI = 4.27–23.06). Participants with the highest exposure to cable news and low knowledge of COVID-19 were over 11 times more likely to experience an increase in substance use (OR = 11.64, 95% CI = 4.01–24.45). Conclusion: Based on our findings, we recommend that media organizations should aim to reduce uncertainty and also provide positive coverage to counter the negative information associated with pandemics.

An Integrated Model of Nature and Nurture Factors that Contribute to Addiction and Recovery

BACKGROUND

In the context of the opioid epidemic and growing awareness of addiction as a public health concern, there are efforts to inform the public, patients, families, and policy makers about the factors that contribute to addiction and facilitate recovery. Several theoretical models provide useful frameworks for this discussion, but each of them has limitations.

OBJECTIVES

This paper presents an accessible yet comprehensive theoretical model that integrates empirical evidence about addiction etiology and recovery using the nature-nurture paradigm.

RESULTS

The model presents substance use along a continuum, and identifies risk and protective factors in multiple domains that have been identified by research. The domains on the nature side of the model include genetic and biological factors, comorbid psychiatric and medical disorders, physiological reinforcement of substance use, and changes to neural mechanisms. The domains on the nurture side of the model include sociocultural factors, environmental factors, personality, emotions, cognitions, psychological reinforcement of substance use, and cognitive and behavioral changes. The progression from increased or decreased substance use to addiction or recovery is mediated by changes in neural mechanisms and cognitive and behavioral changes, which have feedback loops with the physiological and psychological reinforcement.Conclusions/Importance: This model is a useful heuristic, consistent with a public health framework, for discussing addiction and recovery with patients, their families, and the public. This integrated model of nature and nurture factors has the potential to inform clinical practice, consultation, research, prevention programs, educational programs, and public policy.

Narrative Engagement and Interpersonal Communication about Substance Use on Adolescent Substance Use Behaviors: A Case Study of keepin' it REAL

The present study examined direct and indirect effects of adolescent narrative engagement on substance use behaviors via refusal self-efficacy. This study also tested moderation effects of communication about substance use with parents, siblings, and friends on substance use behaviors. Students in 8^th grade (N = 225) participated in surveys at two different time points. Path analyses revealed a positive association between identification with main characters and refusal self-efficacy as well as negative associations between refusal self-efficacy and the past 30-days substance use. Communication with parents and friends significantly moderated the relationship between refusal self-efficacy and the past 30-days substance use.

A systematic review of physical activity, sedentary behavior, and substance use in adolescents and emerging adults

The transition from adolescence into emerging adulthood is marked by changes in both physical activity and substance use. This systematic review characterized associations between movement behaviors (physical activity, sedentary behavior) and frequently used substances (alcohol, cannabis) among adolescents and emerging adults to inform lifestyle interventions that target multiple behavior change outcomes. This systematic review was guided by PRISMA. Electronic databases of PubMed, PsycINFO, and Web of Science were searched from inception through June 25, 2019. The search was designed to identify empirical studies reporting an association between physical activity or sedentary behavior and alcohol or cannabis, with search criteria determining eligibility based on several sampling characteristics (e.g., participants under 25 years of age). After identifying and screening 5,610 studies, data were extracted from 97 studies. Physical activity was positively associated with alcohol use among emerging adults, but the literature was mixed among adolescents. Sedentary behavior was positively associated with alcohol and cannabis use among adolescents, but evidence was limited among emerging adults. Self-report measures were used in all but one study to assess these behaviors. Physical activity is linked to greater alcohol use among emerging adults. Whereas existing studies demonstrate that sedentary behavior might serve as a risk marker for alcohol and cannabis use among adolescents, additional primary research is needed to explore these associations in emerging adults. Future work should also use device-based measures to account for timing of and contextual features surrounding activity and substance use in these populations.

Longitudinal Impact of Life Events on Adolescent Binge Drinking in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA)

Background: Life events experienced during adolescence are associated with risk and resilience to heavy episodic drinking (HED; i.e. binge drinking). The current study builds on prior research using latent class analysis (LCA) to examine heterogeneity in patterns of adolescent life events at baseline to HED over the course of three years (4 timepoints) as part of the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA). Methods: Life event classes were modeled using LCA that characterized NCANDA participants based upon their responses to the Life Events Questionnaire (N = 467, age: M = 14.98, SD = 1.69, 49.7% female). These baseline latent life event classes were then compared to HED at baseline and years 1, 2 and 3 using multinomial logistic regression. Results: At baseline, the LCA characterized four classes of adolescents based on endorsement of life events: negative-relational conflict (n = 65, 13.9%), negative-financial problems (n = 49, 10.5%), low life events (n = 130, 27.8%), and positive life events (n = 223, 47.8%). Life event trajectories differed for the negative life event classes compared to the other two classes, with greater odds of HED in the negative-financial problems class at year 1. Conclusion: The four latent classes derived from the life events of NCANDA youth yielded a characterization of adolescents that could aid in understanding HED over the subsequent three years, suggesting that everyday life events may inform adolescent binge drinking.

Similarities Between Alcohol and Tobacco Advertising Exposure and Adolescent Use of Each of These Substances

OBJECTIVE

Underage alcohol use is a major public health problem and substantial corporate money supports alcohol advertising across multiple venues. A diverse research literature demonstrates that adolescent exposure to such advertising is associated with drinking attitudes and behavior, but no scientific body has determined these associations to be causal. The objective of this study was to assess the association between alcohol advertising and teen drinking in the context of the "Analogy" criterion of the Bradford Hill criteria and consider a determination that the association between exposure to alcohol advertising and alcohol use is causal.

METHOD

This study was a narrative review on the association between adolescent exposure to alcohol advertising and subsequent alcohol use in the context of domains utilized in the Surgeon General's 2012 Report, Preventing Tobacco Use Among Youth and Young Adults, which concluded, "Advertising and promotional activities by tobacco companies have been shown to cause the onset and continuation of smoking among adolescents and young adults."

RESULTS

In every aspect compared (i.e., adolescent knowledge; attitudes toward; initiation of use; continuation of use; mediums of advertisement; the use of mascots, celebrities, and themes; and frequency and density of advertisements and retailers), the findings for both tobacco and alcohol and their association with exposure to advertising are analogous.

CONCLUSIONS

Application of the Analogy criterion of the Bradford Hill criteria comparing alcohol and tobacco supports a judgment that the association between exposure to alcohol advertising and increased adolescent knowledge, attitudes toward, initiation, and continuation of alcohol use are causal in nature.

The popularity of eating broadcast: Content analysis of "mukbang" YouTube videos, media coverage, and the health impact of "mukbang" on public

As "mukbang" (eating broadcast) becomes increasingly widespread, there is growing interest about the impact of mukbang on public health. This study aimed to analyze the content of mukbang YouTube videos, as well as news articles related to mukbang and the association between watching mukbang videos and health habits. We analyzed 5952 YouTube mukbang videos, 5265 news articles, and a survey of 1200 people in Korea. In this study, we confirmed that the provocative content of mukbang YouTube videos, such as overeating, was related to video popularity (p < 0.001). In addition, more exposure to mukbang was associated with greater effects on dietary health due to mukbang (p < 0.001). The prevalence of news articles on the negative effects of mukbang showed an increasing trend over time, while the articles on "Mukbang is funny" were most common in all the years evaluated. To cope with public health problems such as obesity, it will be necessary to continue to investigate the content and effects of mukbang on public health.

Anhedonia, screen time, and substance use in early adolescents: A longitudinal mediation analysis

INTRODUCTION

Screen time is associated with substance use risk among adolescents; however, less is known about the underlying factors that explain this association.

METHODS

This research examined anhedonia, a facet of depression noted by the reduced capacity to experience pleasure, as a mediating factor in the relationship between screen time (hours spent watching television, using internet, and/or playing video games outside of school) and substance use (alcohol and/or cigarettes). We used a longitudinal survey design among a sample of students aged 9-11 years in the 4th to 6th grades in Southern California, United States of America [N = 709 (354 males)].

RESULTS

Structural equation modeling (SEM) findings revealed longitudinal mediation effects of anhedonia on the association between screen time and substance use, while controlling for baseline screen time, baseline individual and peer substance use, race/ethnicity, and gender. Moderation analysis based on a multiple-group approach revealed that gender was not a significant moderator of this mediation pathway.

CONCLUSIONS

Adolescents may become desensitized and exhibit a blunted response to hedonic effects from increased screen time. This may result in increased anhedonia and greater risk for substance use through the need to compensate for the reduced experience of rewards. These findings have implications for future school-based substance use prevention and intervention programs.

The higher they go the harder they could fall: The impact of risk-glorifying commercials on risk behavior

Previous research on risk-glorifying media has provided encompassing evidence for a positive connection between risk-glorifying contents and (a) risk-positive emotions, (b) risk-positive cognitions and attitudes, and (c) risk-positive behavioral inclinations. Nevertheless, little evidence shows whether risk-glorifying content increases actual risk behavior. We conducted three experimental studies to assess whether risk-glorifying commercials increase risk behavior. In all studies, participants were randomly assigned to a risk-glorifying or a neutral commercial. Additionally, in Study 2 participants were randomly assigned to an arousal or a non-arousal condition to test the mediating effect of arousal. In Study 3, we tested the mediating effect of the accessibility to risk-positive cognitions. We measured participants’ risk behavior via the risk assessment ramp (RAR). Our results revealed that participants who watched the risk-glorifying commercial walked faster to the jumping-off point (Studies 1, 2, & 3) and would have jumped from a higher level (Studies 2 & 3), thus, indicating the exposure to risk-glorifying media content increases people’s risk behavior. Neither arousal nor the accessibility to risk-positive cognitions mediated the effect of risk-glorifying media content. Beyond our findings, we offer a new tool to assess risk behavior that is effective and easy to apply.

Depressive symptoms, alcohol and other drug use, and suicide risk: Prevention and treatment effects from a two-country online eating disorder risk reduction trial

OBJECTIVE

Eating disorders are known to have high comorbidity, and the current report outlines the impact of an online eating disorder risk reduction program on brief, self-report measures of depressive symptoms, alcohol and other drug use, and suicidality.

METHOD

An online pragmatic, randomized-controlled trial was conducted with N = 316 young-women (M age = 20.80 years) across Australia and New Zealand. Media Smart-Targeted (MS-T) was a 9-module program released weekly while control participants received positive body image tips. Prevention effects (asymptomatic at baseline) and treatment effects (symptomatic at baseline) were investigated.

RESULTS

MS-T participants were 94% and 91% less likely than controls to develop Moderate or higher depressive symptoms at 6-month (MS-T = 3.3%; controls = 35.4%) and 12-month follow-up (MS-T = 3.4%; controls = 29.4%), respectively. MS-T participants did not commence using recreational drugs at any assessment point, compared to 18.2% of controls at a least one assessment point. Regarding treatment effects, MS-T participants were 84% more likely to no longer be using recreational drugs at 12-month follow-up (MS-T = 60%; controls = 21.1%). Mutitvariate logistic regressions revealed group, depressive symptoms and alcohol use to be significant predictors of elevated suicide risk, where being an MS-T participant, without depressive symptoms and not drinking alcohol, significantly lowered likelihood of developing elevated suicide risk. Disordered eating at post-program mediated the relationship between group and depressive symptoms across post-program to 12-mnoth follow-up.

DISCUSSION

MS-T shows promise as a program with important mental health benefits in addition to previous reports of lowered eating disorder diagnosis, risk and impairment.

Content, Exposure, and Effects of Public Discourses about Marijuana: A Systematic Review

This review presents a comprehensive picture of research studies about marijuana-related content in news, social media, and advertisements. Studies that examined the extent of people's exposure to the messages and its effects were also included. A total of 27 peer-reviewed journal articles and one thesis were located, of which 16 analyzed the content, four contained information about people's exposure to the messages, and ten examined the effects. Over time, news coverage shifted from negative to slightly positive toward marijuana use. Social media and advertisements were overwhelmingly favorable toward marijuana use and legalization by claiming social, romantic, and health benefits of marijuana use while completely downplaying risks. A majority of social media accounts were also run by advocacy groups and industry interests, rather than individuals who were simply sharing opinions or experiences. Furthermore, absence of health authorities among the highly popular social media accounts about marijuana was notable. The news, social media, and advertising messages about marijuana were widely used by the members of public, which in turn generated some demonstrable effects on the audience's marijuana-related perceptions and behaviors. The public and policymakers need to become aware of this information environment for potential marijuana users and take more proactive measures to protect vulnerable populations.

Relationship of media exposure to substance use among adolescents in Saudi Arabia: Results from a national study

BACKGROUND

With limited social options, young Saudis are increasingly relying on media for entertainment. The media impact has been greatest among the younger generation, which constitutes half of the population of the Kingdom of Saudi Arabia (KSA). Therefore, this study aims to examine the association between exposure to varied types of media and substance use among adolescents in the KSA and explores whether these associations differ by gender.

METHODS

Data were obtained from a national cross-sectional survey of school students aged ten to 19 years (N = 12121). A self-administered questionnaire was used to assess exposure to three types of media: television, the Internet and video games with the use of legal substances such as cigarette/shisha smoking, solvents sniffing and misuse of medications, and illegal substances, such as alcohol, marijuana and other illicit drugs.

RESULTS

Logistic regression analyses revealed that the odds of using tobacco, legal and illegal substances were higher for students who were watching television, surfing the Internet, or playing video games for more than two hours compared with their peers who watched less than two hours (P < 0.05). For males, results showed the heavy and light use of the Internet were both significantly associated with smoking. Whereas for females, only excessive use of the Internet was associated with smoking.

CONCLUSION

Despite the conservative nature of the Saudi society, findings showed a significant association between tobacco or substance use and media exposure among adolescents. This suggests increased attention to the growing role media might play in shaping adolescents health risk behaviors in the KSA.

Music and substance use: A meta-analytic review

While previous research has documented a relation between music and substance use among consumers, to date, there are no meta-analytic reviews of the literature, making our meta-analysis the first in this area. Results from 31 studies, yielding a total of 330,652, indicated that music had a significant effect on substance use, with both music format and genre being significant contributors. The effect of music on substance use also varied by substance type. In addition, participant biological sex and location of data collection were found to moderate the effect of music on substance use. Theoretical implications are discussed along with directions for future research.

Media/Marketing Influences on Adolescent and Young Adult Substance Abuse

PURPOSE OF REVIEW

We describe the state of research on substance use portrayals in marketing and media, considering exposure to tobacco, alcohol, e-cigarette, and marijuana content. Putative mechanisms are offered, and recommendations made for effective prevention strategies for mitigating the influence of these portrayals.

RECENT FINDINGS

There is consistent evidence that adolescents and young adults are highly exposed to substance use portrayals and that these portrayals are associated with subsequent substance use. Exposure via new media (social networking sites, brand websites) has risen rapidly. Social norms and cognitions appear to at least partially account for the effects of portrayals on youth substance use.

SUMMARY

Digital media has surpassed traditional marketing, which is concerning because youth have on-demand access to content and are active consumers of digital media. Developmentally appropriate media literacy interventions that include a parenting component and target multiple substances and media domains are recommended.

Media/Marketing Influences on Adolescent and Young Adult Substance Abuse

PURPOSE OF REVIEW

We describe the state of research on substance use portrayals in marketing and media, considering exposure to tobacco, alcohol, e-cigarette, and marijuana content. Putative mechanisms are offered, and recommendations made for effective prevention strategies for mitigating the influence of these portrayals.

RECENT FINDINGS

There is consistent evidence that adolescents and young adults are highly exposed to substance use portrayals and that these portrayals are associated with subsequent substance use. Exposure via new media (social networking sites, brand websites) has risen rapidly. Social norms and cognitions appear to at least partially account for the effects of portrayals on youth substance use.

SUMMARY

Digital media has surpassed traditional marketing, which is concerning because youth have on-demand access to content and are active consumers of digital media. Developmentally appropriate media literacy interventions that include a parenting component and target multiple substances and media domains are recommended.

Parental Restriction of Movie Viewing Prospectively Predicts Adolescent Alcohol and Marijuana Initiation: Implications for Media Literacy Programs

Youth are heavy consumers of media, and exposure to mature media content is associated with initiation and progression of substance use. Parental restriction of such content has been shown to be an effective mechanism to reduce negative consequences attributed to exposure to mature media content. This study assessed the influence of parental restriction of movie watching across Motion Picture Association of America rating categories on subsequent alcohol and marijuana initiation at 1- and 2-year follow-up. Using data from a longitudinal study of adolescent substance use (N = 1023), we used logistic regression analyses to determine the odds of alcohol and marijuana initiation across movie rating categories, within R-rated restriction categories in particular, and based on changes in parental restriction of movies over time. All analyses controlled for important parental, personality, and behavioral correlates of adolescent substance use. Results suggest that restriction of R-rated movies is protective of both alcohol and marijuana initiation. Important differences among parental restriction of R-rated movie categories emerged such that being allowed to watch them with adult supervision was protective of substance use, while those who reported watching R-rated films despite parental restrictions were at heightened risk for alcohol initiation. Changes in parental movie restrictions were not predictive of substance use initiation over the subsequent year. Implications of these findings for media literacy program prevention strategies are discussed.

Exposure to Alcohol Content in Movies and Initiation of Early Drinking Milestones

BACKGROUND

Exposure to alcohol content in movies has been shown to be associated with adolescent use of alcohol, including earlier onset. This study examined the influence of movie alcohol exposure on subsequent alcohol onset, considering the social context (whether the movie was viewed with a friend or parent). We examined whether media's influence holds across a spectrum of early drinking milestones: sipping (but not consuming a full drink of) alcohol, consuming a full drink of alcohol, and engaging in heavy episodic drinking (HED).

METHODS

Data were taken from a sample of 882 middle school youth (52% female; 24% non-White) enrolled in an ongoing study on alcohol initiation and progression. Exposure to alcohol content in films was measured using a method that combines content analysis and random assignment of movie titles to youth surveys. The hazard of initiating alcohol use (sip, full drink, HED) as a function of exposure was estimated using survival analysis. Associations were adjusted for demographic, personality, and social influence factors known to be associated with both movie exposure and alcohol use.

RESULTS

Exposure to alcohol content was common. Hours of exposure prospectively predicted earlier onset of alcohol involvement across all outcomes. Viewing movies with friends appeared to augment the media exposure effect, in contrast to viewing movies with parents, which was not a significant predictor of initiation.

CONCLUSIONS

Exposure to alcohol in films is involved in the entry into early stages of alcohol involvement. Findings support further investigation into the role of the media in underage drinking, especially in the context of consuming media with friends and peers. Limiting media exposure and/or stronger Federal Trade Commission oversight of movie ratings should be a priority for preventing underage drinking.

A Longitudinal Study of Parental Anti-Substance-Use Socialization for Early Adolescents' Substance-Use Behaviors

The present study examines the role of communication in shaping norms and behaviors with significant personal and societal consequences. Based on primary socialization theory and the general theory of family communication, parental anti-substance-use socialization processes were hypothesized to influence early adolescents' substance use norms and behaviors. Using longitudinal data (N =1,059), the results revealed that parent-adolescent prevention communication about substance use in the media and parental anti-substance-use injunctive norms were positively associated with early adolescents' personal anti-substance-use norms, which, in turn, led to decreases in recent alcohol, cigarette, and marijuana use. It was also found that family expressiveness and structural traditionalism positively related to the hypothesized association between parental socialization processes and early adolescents' norms and behaviors.

The same old story? Continuity and change in Swedish print media constructions of cannabis

Aims

The purpose of the study is to describe and analyse how cannabis is constructed in Swedish print media and if this has changed over time. Sweden is known for its prohibitionist cannabis policy, but this approach seems increasingly challenged on both international and domestic arenas. It is therefore important to see if and how this international change is mirrored and processed in a key arena such as print media.

Methods

Newspaper material from two years, 2002 and 2012, was included to analyse continuity and change. The theoretical backdrop for the study is social constructionism, and methodological concepts such as discourse and subject positions from discourse theory were used to investigate how cannabis and cannabis problems are constructed.

Results

The analysis showed that print media in both years seem to draw mainly on a juridical, a social problems and a medical discourse when portraying cannabis. It is through these discourses that some subject positions become relevant as users (e.g. youth) and as experts (e.g. police). Despite a strong continuity in these cannabis constructions, the analysis also shows signs of change. For example, in 2012 there are articles drawing on economic and recreational discourses, and there is a global outlook enabling new cannabis constructions.

Conclusion

The Swedish print media generally has a crime-centred and deterrent approach towards cannabis, with prohibition at the heart of the reporting. International events do however introduce discursive alternatives in 2012. It remains to be seen if these new ways of writing about cannabis will strengthen or challenge prohibitionist constructions.

"Get drunk. Smoke weed. Have fun.": A Content Analysis of Tweets About Marijuana and Alcohol

PURPOSE

To explore the sentiment and themes of Twitter chatter that mentions both alcohol and marijuana.

DESIGN

Cross-sectional analysis of tweets mentioning both alcohol and marijuana during 1 month was performed.

SETTING

The study setting was Twitter.

PARTICIPANTS

Tweets sent from February 4 to March 5, 2014, were studied.

METHOD

A random sample (n = 5000) of tweets that mentioned alcohol and marijuana were qualitatively coded as normalizing both substances, preferring one substance over the other, or discouraging both substances. Other common themes were identified.

RESULTS

More than half (54%) of the tweets normalized marijuana and alcohol (without preferring one substance over the other), and 24% preferred marijuana over alcohol. Only 2% expressed a preference for alcohol over marijuana, 7% discouraged the use of both substances, and the sentiment was unknown for 13% of the tweets. Common themes among tweets that normalized both substances included using the substances with friends (17%) and mentioning substance use in the context of sex or romance (14%). Common themes among tweets that preferred marijuana over alcohol were the beliefs that marijuana is safer than alcohol (46%) and preferences for effects of marijuana over alcohol (40%).

CONCLUSION

Tweets normalizing polysubstance use or encouraging marijuana use over alcohol use are common. Both online and offline prevention efforts are needed to increase awareness of the risks associated with polysubstance use and marijuana use.

Alcohol use in films and adolescent alcohol use

OBJECTIVES

To investigate whether exposure to alcohol use in films (AUFs) is associated with early alcohol use, binge drinking, and alcohol-related problems in British adolescents.

METHODS

Cross-sectional study with 5163 15-year-olds from the Avon Longitudinal Study of Parents and Children in the United Kingdom. We measured adolescent exposure to AUFs, age at onset of alcohol use, and binge-drinking behavior. We adjusted for early childhood social, family and behavioral factors, adolescent tobacco use, and peer drinking.

RESULTS

After adjustment, adolescents with the highest exposure to AUFs were 1.2 (95% confidence interval [CI]: 1.1-1.3) times more likely to have tried alcohol compared with those least exposed and 1.7 (95% CI: 1.5-2.0) times more likely to binge drink. They were 2.4 (95% CI: 1.9-3.1) times more likely to drink weekly and 2.0 (95% CI: 1.7-2.4) times more likely to have alcohol-related problems than those least exposed.

CONCLUSIONS

Exposure to AUFs is associated with higher risk of alcohol use and alcohol-related problems in UK adolescents. Our findings provide evidence to support the argument that a review of film-rating categories and alcohol ratings for all films may help reduce problem-related alcohol consumption in young people.

Portrayal of alcohol intoxication on YouTube

BACKGROUND

We aimed to characterize the content of leading YouTube videos related to alcohol intoxication and to examine factors associated with alcohol intoxication in videos that were assessed positively by viewers.

METHODS

We systematically captured the 70 most relevant and popular videos on YouTube related to alcohol intoxication. We employed an iterative process to codebook development which resulted in 42 codes in 6 categories: video characteristics, character socio demographics, alcohol depiction, degree of alcohol use, characteristics associated with alcohol, and consequences of alcohol.

RESULTS

There were a total of 333,246,875 views for all videos combined. While 89% of videos involved males, only 49% involved females. The videos had a median of 1,646 (interquartile range [IQR] 300 to 22,969) "like" designations and 33 (IQR 14 to 1,261) "dislike" designations each. Liquor was most frequently represented, followed by beer and then wine/champagne. Nearly one-half (44%) of videos contained a brand reference. Humor was juxtaposed with alcohol use in 79% of videos, and motor vehicle use was present in 24%. There were significantly more likes per dislike, indicating more positive sentiment, when there was representation of liquor (29.1 vs. 11.4, p = 0.008), brand references (32.1 vs. 19.2, p = 0.04), and/or physical attractiveness (67.5 vs. 17.8, p < 0.001).

CONCLUSIONS

Internet videos depicting alcohol intoxication are heavily viewed. Nearly, half of these videos involve a brand-name reference. While these videos commonly juxtapose alcohol intoxication with characteristics such as humor and attractiveness, they infrequently depict negative clinical outcomes. The popularity of this site may provide an opportunity for public health intervention.

A comparison between brand-specific and traditional alcohol surveillance methods to assess underage drinkers' reported alcohol use

BACKGROUND

Adolescent alcohol consumption remains common and is associated with many negative health outcomes. Unfortunately, common alcohol surveillance methods often underestimate consumption. Improved alcohol use measures are needed to characterize the landscape of youth drinking.

OBJECTIVES

We aimed to compare a standard quantity-frequency measure of youth alcohol consumption to a novel brand-specific measure.

METHODS

We recruited a sample of 1031 respondents across the United States to complete an online survey. Analyses included 833 male and female underage drinkers ages 13-20. Respondents reported on how many of the past 30 days they consumed alcohol, and the number of drinks consumed on an average drinking day. Using our brand-specific measure, respondents identified which brands they consumed, how many days they consumed each brand, and how many drinks per brand they usually had.

RESULTS

Youth reported consuming significantly more alcohol (on average, 11 drinks more per month) when responding to the brand-specific versus the standard measure (p < 0.001). The two major predictors of the difference between the two measures were being a heavy episodic drinker (p < 0.001, 95% CI = 4.1-12.0) and the total number of brands consumed (p < 0.001, 95% CI = 2.0-2.8).

CONCLUSION

This study contributes to the field of alcohol and adolescent research first by investigating a potentially more accurate alcohol surveillance method, and secondly by promoting the assessment of alcohol use among adolescents vulnerable to risky alcohol use. Finally, our survey addresses the potential impact of alcohol marketing on youth and their subsequent alcohol brand preferences and consumption.

Neurobiology of adolescent substance use and addictive behaviors: treatment implications

Psychoactive substance and nonsubstance/behavioral addictions are major public health concerns associated with significant societal cost. Adolescence is a period of dynamic biologic, psychological, and behavioral changes. Adolescence is also associated with an increased risk for substance use and addictive disorders. During adolescence, developmental changes in neural circuitry of reward processing, motivation, cognitive control, and stress may contribute to vulnerability for increased levels of engagement in substance use and nonsubstance addictive behaviors. Current biologic models of adolescent vulnerability for addictions incorporate existing data on allostatic changes in function and structure of the midbrain dopaminergic system, stress-associated neuroplasticity, and maturational imbalances between cognitive control and reward reactivity. When characterizing adolescent vulnerability, identifying subgroups of adolescents at high risk for addictive behaviors is a major goal of the addiction field. Genetics, epigenetics, and intermediate phenotypes/endophenotypes may assist in characterizing children and adolescents at risk. Improved understanding of the neurobiology of adolescence and addiction vulnerability has the potential to refine screening, enhance prevention and intervention strategies, and inform public policy.

Music and suicidality: a quantitative review and extension

This article provides the first quantitative review of the literature on music and suicidality. Multivariate logistic regression techniques are applied to 90 findings from 21 studies. Investigations employing ecological data on suicide completions are 19.2 times more apt than other studies to report a link between music and suicide. More recent and studies with large samples are also more apt than their counterparts to report significant results. Further, none of the studies based on experimental research designs found a link between music and suicide ideation, prompting us to do a brief content analysis of 24 suicide songs versus 24 nonsuicide songs from the same album. Using Linguistic Inquiry and Word Count software, we found no difference in the content of the suicide songs and controls, including the percentage of sad words, negative affect, and mentions of death, thus providing an explanation for nonfindings from experimental research. In summary, ecologically based (which capture at-risk persons not in typical school-based samples) and more recent investigations (which have used superior or new methodologies) tend to demonstrate a linkage between music and suicidality. Experimental research is needed with a control group of songs from an alternative genre with low suicidogenic content.

Children, adolescents, and the media: health effects

The media can be a powerful teacher of children and adolescents and have a profound impact on their health. The media are not the leading cause of any major health problem in the United States, but they do contribute to a variety of pediatric and adolescent health problems. Given that children and teens spend >7 hours a day with media, one would think that adult society would recognize its impact on young people's attitudes and behaviors. Too little has been done to protect children and adolescents from harmful media effects and to maximize the powerfully prosocial aspects of modern media.

Addressing the critical health problem of adolescent substance use through health care, research, and public policy

The use of addictive substances-tobacco, alcohol, and other drugs-during adolescence interferes with brain development and increases the risk of serious health and mental health conditions, including addiction. Yet, adolescents live in a culture in which family, social, community, and media influences regularly bombard them with pro-substance use messages, creating an environment in which substance use is considered an expected behavior, rather than a considerable health risk. To prevent the significant harm that falls to teens and young adults because of substance use, The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia) undertook a study to explore how adolescent brain development relates to the risk of substance use and addiction; the cultural influences that create an environment in which substance use is considered normative behavior; individual factors that make some teens more disposed to substance use and addiction; and evidence-based prevention and treatment strategies for addressing this problem. The recently published report Adolescent Substance Use: America's #1 Public Health Problem concludes that risky substance use is a major public health problem that can be ameliorated through evidence-based public health measures, including education about the disease and its risk factors, screenings, and clinical interventions, and that addiction can be treated and managed effectively within routine health care practice and specialty care.

Using ecological momentary assessment to determine media use by individuals with and without major depressive disorder

OBJECTIVE

To use ecological momentary assessment techniques to measure the association of major depressive disorder (MDD) with media use.

DESIGN

Data were collected using an ecological momentary assessment protocol with cellular telephone-based brief interviews.

SETTING

Participants received as many as 60 telephone calls from a trained staff member during 5 extended weekends in an 8-week period.

PARTICIPANTS

One hundred six adolescent participants who were part of a larger neurobehavioral study of depression in Pittsburgh from January 1, 2003, through December 31, 2008.

MAIN EXPOSURE

At each call, participants were asked whether they were using the following 5 types of media: television or movies, music, video games, Internet, and print media, such as magazines, newspapers, and books.

MAIN OUTCOME MEASURES

We developed multivariable models to determine the independent association of each type of media use with MDD, controlling for sociodemographic variables.

RESULTS

Of the 106 participants, 46 were diagnosed as having MDD. In multivariable models controlling for age, sex, and race, each increasing quartile of audio use was associated with an 80% increase in the odds of having MDD (odds ratio, 1.8; 95% confidence interval, 1.1-2.8; P = .01 for trend). Conversely, each increasing quartile of print media use was associated with a 50% decrease in the odds of having MDD (odds ratio, 0.5; 95% confidence interval, 0.3-0.9; P = .009 for trend).

CONCLUSIONS

Major depressive disorder is positively associated with popular music exposure and negatively associated with reading print media such as books. Further research elucidating the directionality and strength of these relationships may help advance understanding of the relationships between media use and MDD.

Policy statement--children, adolescents, substance abuse, and the media

The causes of adolescent substance use are multifactorial, but the media can play a key role. Tobacco and alcohol represent the 2 most significant drug threats to adolescents. More than $25 billion per year is spent on advertising for tobacco, alcohol, and prescription drugs, and such advertising has been shown to be effective. Digital media are increasingly being used to advertise drugs. In addition, exposure to PG-13- and R-rated movies at an early age may be a major factor in the onset of adolescent tobacco and alcohol use. The American Academy of Pediatrics recommends a ban on all tobacco advertising in all media, limitations on alcohol advertising, avoiding exposure of young children to substance-related (tobacco, alcohol, prescription drugs, illegal drugs) content on television and in PG-13- and R-rated movies, incorporating the topic of advertising and media into all substance abuse-prevention programs, and implementing media education programs in the classroom.

Exposure to cannabis in popular music and cannabis use among adolescents

BACKGROUND

Cannabis use is referenced frequently in American popular music, yet it remains uncertain whether exposure to these references is associated with actual cannabis use. We aimed to determine if exposure to cannabis in popular music is associated independently with current cannabis use in a cohort of urban adolescents.

METHODS

We surveyed all 9th grade students at three large US urban high schools. We estimated participants' exposure to lyrics referent to cannabis with overall music exposure and content analyses of their favorite artists' songs. Outcomes included current (past 30 days) and ever use of cannabis. We used multivariable regression to assess independent associations between exposures and outcomes while controlling for important covariates.

RESULTS

Each of the 959 participants was exposed to an estimated 27 cannabis references per day [correction added on 19 January 2010, after first online publication: 40 has been changed to 27] (standard deviation = 73 [correction added on 19 January 2010, after first online publication: 104 has been changed to 73]). Twelve per cent (n = 108) were current cannabis users and 32% (n = 286) had ever used cannabis. Compared with those in the lowest tertile of total cannabis exposure in music, those in the highest tertile of exposure were almost twice as likely to have used cannabis in the past 30 days (odds ratio = 1.83; 95% confidence interval = 1.04, 3.22), even after adjusting for socio-demographic variables, personality characteristics and parenting style. As expected, however, there was no significant relationship between our cannabis exposure variable and a sham outcome variable of alcohol use.

CONCLUSIONS

This study supports an independent association between exposure to cannabis in popular music and early cannabis use among urban American adolescents.