Parent, peer and personal determinants of adolescent drinking

Perception, Attitude and Support of Society Towards Drug Abuse: Do Gender, Age and Education Matter?

This article highlights the support, attitude and perception of the general public towards drug abuse so that appropriate policies can be framed for the prevention of drug abuse among youth. The study aims to understand the relationship among variables influencing behaviour change with respect to drug abuse. Questionnaire from 1,159 respondents was administered comprising of 39 items exploring Perception, Attitude, Support pertaining to illicit drugs. Positive or negative attitude towards drug abuse is evolved out of the perception of problems associated with drug abuse and the support provided to dissuade drug-abusing behaviour, and relationship among these variables was tested using SEM-Path analysis. The perception of problems related to drug addiction significantly influences the attitude towards drug addiction. The perceived nature of the support structure augments the influence further (partial mediation). The augmenting effect of the support structure can be seen among gender, age and education. Moderator effects of age, gender and education were studied by estimating multi-group path coefficients. This article is useful to local government as they may take some of the findings of this article for framing policy related to educating youth related to drugs, creating a campaign regarding the harm of drug abuse and involving those volunteers in drug assistance programmes that are more supportive of drug addicts. This article is helpful for society to make them understand that their positive attitude and support towards drug abuse will give a second chance to drug addicts to leave drugs and live a normal life again.

Women's Self-Perceived Similarity to Their Mother and Associations with Patterns of Alcohol Misuse over 20 Years

AIMS

This study examined transgenerational transmission of risk for female alcohol misuse. Women's perceived similarity to their mother/father in adulthood was examined in terms of its influence on the expected association between perceived maternal alcohol use and female offsprings' trajectories of alcohol misuse. We hypothesized that a daughter's self-perceived similarity to her mother, in instances where her mother was perceived to be a frequent- or problem-drinker, would be associated with an increase in the daughter's count of negative consequences from alcohol use and potential symptoms of alcohol dependence across adulthood.

SHORT SUMMARY

Women's perceived similarity to their mother/father was examined as a factor influencing associations between perceived parental alcohol use during childhood and patterns of alcohol misuse in adulthood. Women's self-perceived similarity to their frequent- or problem-drinking mothers increased the risk of negative consequences from drinking over time as well as potential symptoms of alcohol dependence over time.

METHODS

Analyses utilized data from a survey of women (N = 911) who were followed over a 20-year period, beginning in 1981. Women, ages 21 or older and living in households in the contiguous USA, were eligible, and women who consumed four or more alcoholic drinks per week were oversampled. Model estimates were weighted to adjust for the oversampling of heavier drinking women and to reflect national demographics. Latent growth mixture models estimated regression parameters that captured variation in participants' alcohol misuse over time.

RESULTS

Women who reported that their mother was a frequent- or problem-drinker and who perceived themselves to be similar to their mother, in general, showed increases in alcohol misuse. The same pattern of results was not shown for fathers.

CONCLUSIONS

Results support that interventions seeking to reduce female alcohol misuse should address the role of perceived similarity to heavy-drinking female role models or 'female-drinker' prototypes to reduce problem-drinking behavior among female drinkers.

A Multi-Country Study of Harms to Children Because of Others' Drinking

OBJECTIVE

This study aims to ascertain and compare the prevalence and correlates of alcohol-related harms to children cross-nationally.

METHOD

National and regional sample surveys of randomly selected households included 7,848 carers (4,223 women) from eight countries (Australia, Chile, Ireland, Lao People's Democratic Republic [PDR], Nigeria, Sri Lanka, Thailand, and Vietnam). Country response rates ranged from 35% to 99%. Face-to-face or telephone surveys asking about harm from others' drinking to children ages 0-17 years were conducted, including four specific harms: that because of others' drinking in the past year children had been (a) physically hurt, (b) verbally abused, (c) exposed to domestic violence, or (d) left unsupervised.

RESULTS

The prevalence of alcohol-related harms to children varied from a low of 4% in Lao PDR to 14% in Vietnam. Alcohol-related harms to children were reported by a substantial minority of families in most countries, with only Lao PDR and Nigeria reporting significantly lower levels of harm. Alcohol-related harms to children were dispersed sociodemographically and were concentrated in families with heavy drinkers.

CONCLUSIONS

Family-level drinking patterns were consistently identified as correlates of harm to children because of others' drinking, whereas sociodemographic factors showed few obvious correlations.

The Influence of Current and Past Alcohol Use on Earnings: Three Approaches to Estimation

This article examines alcohol consumption and wages of males, aged 21 through 28, from three different perspectives. First, a four-equation model employs the National Longitudinal Survey of Youth to estimate a wage equation and an hours-of-work-equation for heavy drinkers and contrasts these estimates with wage and hours equations for moderate drinkers. Using a variety of drinking thresholds to distinguish "heavy" drinkers from "moderate" ones, the association between current levels of drinking, wages, and hours of work is measured. The longitudinal nature of the data is then used to study the relation between a profile of drinking over the 1982-1985 period and earnings. Last, a wage-change model investigates how the profile of drinking over the period 1982-1984 is related to the wage change between 1982 and 1985. The results from the static single-period model differ markedly from the wage-change model. Cross-sectional data show that higher drinking levels are correlated with higher wages and hours of work. Over time, however, increased drinking is associated with lower wages.

When at risk? Drinking contexts and heavy drinking in the Montreal adult population

The purpose of this study is to identify the characteristics of contexts associated with heavier alcohol intake. Data come from a telephone survey carried out in April 1993 with a random sample of the metropolitan Montreal adult population (Quebec, Canada). Drinking contexts were investigated with regard to the situational setting (circumstances, time and location) and the relational setting (drinking partners’ relationship and sociodemographic similarity) characterizing the drinking occasion. Having five or more drinks per occasion, linked by many studies to alcohol-related problems, was deemed to be heavy drinking. The results of the logistic regressions performed reveal that for men under 25 years old, drinking with other men is the only contextual characteristic associated positively with heavy drinking, while for men age 25 and over, situational characteristics as well as relational characteristics are associated positively with heavy drinking. For women, heavy drinking is only weakly associated with contextual characteristics.

Using Attitudes, Age and Gender to Estimate an Adolescent's Substance Use Risk

PURPOSE

The purpose of this paper is to present a strategy for estimating an individual's risk of alcohol, cigarette and cannabis use that relies on an assessment of an adolescent's age, gender and attitude.

METHODOLOGY

The authors assembled surveys from 35,987 11 through 17 year-olds assembled from 36 databases were analysed to examine the relationship between attitude and behaviour.

FINDINGS

Attitudes were strongly correlated with concurrent use of alcohol, drunkenness, smoking, and cannabis, with point biserial correlations of -0.555, -0.517, -0.552 and -0.476, respectively. Logistic regression provided a means for using age, gender and attitudes to estimate an individual's risk of engaging in substance use behaviour. Developmental changes in attitudes were estimated by analysing changes in scores associated with percentile rankings for each age and gender group. Projected year-to-year changes in attitude were used as a heuristic for estimating future risk.

RESEARCH LIMITATIONS

Analyses relied on cross-sectional panel data. Analyses would benefit from longitudinal data in which age-related changes in attitudes could be more precisely modelled.

PRACTICAL IMPLICATIONS

Information about estimated current and future risk may use useful for motivating the adoption and implementation of effective prevention approaches by parents and care providers.

ORIGINALITY

The authors present a novel method for estimating an individual's risk of substance use knowing attitude, age and gender.

Web-based interventions to decrease alcohol use in adolescents: a Delphi study about increasing effectiveness and reducing drop-out

BACKGROUND

Web-based computer-tailored (CT) interventions have a high potential to reach a large number of people and effectively change health risk behaviors and their determinants. However, effect studies show small and variable effect sizes, and these interventions also suffer from high drop-out. In this study we explored how Web-based CT interventions can be used effectively to reduce binge drinking in 16- to 18-year-old adolescents.

METHOD

A three-round Delphi study was conducted. We invited experts to identify strategies to be used in Web-based CT interventions that can effectively decrease binge drinking in adolescents and to rate these strategies by importance. We asked to discriminate between interventions targeted for adolescents and those targeted for parents. Furthermore, we asked experts to suggest strategies for reducing drop-out and to indicate their importance.

RESULTS

Important strategies mentioned by the experts were: encouraging parents to set appropriate rules, encouraging consistent communication, and training refusal skills among adolescents. Concerning the reduction of drop-out from Web-based CT interventions experts came up with suggestions involving the content of the intervention (e.g., relevant material, use of language, tailored messages) but also involving the use of reminders and incentives.

CONCLUSIONS

The results of this explorative study provide useful strategies to increase effectiveness and decrease drop-out in future interventions.

Perceived vs. actual friends' use of alcohol, cigarettes, marijuana, and cocaine: Which has the most influence?

Determinants of the use of alcohol, alcohol without parental knowledge, cigarettes, marijuana, and crack were assessed in predominantly black, urban, fourth- and fifth-grade students. Each subject identified three best friends. Logistic and least-square regression analyses indicated that children's perceptions of friends' use, perceptions of family use, and actual use of classmates were better predictors of substance use than friends' actual use. The pattern of predictors suggested that peer behaviors and attitudes are more influential for children's socially censured behaviors such as using alcohol without parental permission than for more socially approved behaviors such as using alcohol with parental permission. The importance of perceived friends' use vs. friends' actual use supports Behavioral Intention Theory and Cognitive Developmental Theory, while the importance of classroom use supports Social Learning Theory or may reflect social and environmental conditions including neighborhood availability of drugs and neighborhood values regarding substance use.

Determinants of binge drinking in a permissive environment: focus group interviews with Dutch adolescents and parents

Background

Compared to other European countries, the Netherlands score among the highest of binge drinking rates of 16 to 18 year old adolescents. Dutch adolescents aged 16 are legally allowed to buy and consume low strength alcoholic beverages. This study focused on determinants of binge drinking in such a permissive environment from the perspectives of adolescents and parents.

Methods

Focus group interviews were conducted with adolescents aged 16 to 18 (N = 83), and parents of adolescents from this age group (N = 24). Data was analysed using thematic analyses methods.

Results

Most reasons adolescents mentioned for drinking were to relax, increase a good mood and to be social. Also peers around them influenced and increased adolescents’ drinking. Comparing adolescents and parental statements about their perspectives how alcohol use is handled and accepted by the parents we found that generally, those perspectives match. Parents as well as adolescents stated that alcohol use is accepted by parents. However, when looking at essential details, like the acceptable amounts that children may consume, the perspectives differ enormously. Adolescents think their parents accept any amount of drinking as long as they do not get drunk, whereas parents reported acceptable limits of 1 or 2 glasses every two weeks. Parents further indicated that they felt unsupported by the Dutch policies and regulations of alcohol use. Most of them were in favour of an increase of the legal purchasing age to 18 years.

Conclusions

Parents and adolescents should both be targeted in interventions to reduce alcohol use among adolescents. In particular, communication between parents and children should be improved, in order to avoid misconceptions about acceptable alcohol use. Further, adolescents should be supported to handle difficult social situations with peers where they feel obliged to drink. Additionally, revisions of policies towards a less permissive standpoint are advised to support parents and to impede availability of alcoholic beverages for adolescents/children younger than 18 years.

An assessment of community capacity to prevent adolescent alcohol consumption

To effectively address the issue of youth alcohol use, communities need to have sufficient infrastructure and capacity in place to operate effective prevention programs. This study evaluates community capacity in the state of Hawai'i, using the Capacity Assessment Survey administered to stakeholders in the youth alcohol prevention system. Capacity is quantified with gap scores, which measure the discrepancy between an agency's performance of an attribute and the attribute's relative importance. Six assessment areas, termed capacity domains, are defined. Results are given for each county and the state overall. Based on these results, communities need to prioritize capacity-building efforts specifically in the domains of effectiveness, funding/resource availability, and sustainability. Organization, workforce skills/knowledge, and cultural competency were categorized as relative strengths in comparison, but gap scores are nevertheless significantly greater than 0 ("ideal"; p < .001), indicating these areas need improvement as well. Suggestions for improvement in each capacity domain are given. This assessment is the first step in a five-step planning process to implement youth alcohol prevention programs in communities in Hawai'i.

A mixture-model approach to linking ADHD to adolescent onset of illicit drug use

Prior research findings have been mixed as to whether attention-deficit/hyperactivity disorder (ADHD) is related to illicit drug use independent of conduct problems (CP). With the current study, the authors add to this literature by investigating the association between trajectories of ADHD symptoms across childhood and adolescence and onset of illicit drug use, with and without controlling for CP. In a longitudinal panel study of a community sample of 754 girls and boys recruited in kindergarten, this research question was examined with a combination of growth mixture modeling (to model parent-reported ADHD symptom trajectories) and survival analysis (to model youth-reported initiation of illicit drug use). Results revealed a 3-class model of ADHD trajectories, with 1 class exhibiting no or minimal symptoms throughout childhood and adolescence, another class showing a convex shape (an increase, then a decrease in symptoms) across time, and a third class showing a concave shape (a decrease, then a slight increase in symptoms) over time. The concave-trajectory class demonstrated significantly earlier onset of illicit drug use than the minimal-problem class, with the convex-trajectory class falling between (but not significantly different from either of the other two classes). These results did not change when the authors added CP to the model as a covariate. Implications of findings for theory and practice are discussed.

The roles of mothers' neighborhood perceptions and specific monitoring strategies in youths' problem behavior

The neighborhood context can interfere with parents' abilities to effectively monitor their children, but may be related to specific monitoring strategies in different ways. The present study examines the importance of mothers' perceptions of neighborhood disorganization for the specific monitoring strategies they use and how each of these strategies are related to youths' alcohol use and delinquency. The sample consists of 415 mother-child dyads recruited from urban and suburban communities in Western New York state. Youths were between 10 and 16 years of age (56% female), and were mostly Non-Hispanic White and African American (45.3 and 36.5%, respectively). Structural equation modeling shows that mothers who perceive greater neighborhood problems use more rule-setting strategies, but report lower levels of knowledge of their children's whereabouts. Knowledge of whereabouts is related to less youth alcohol use and delinquency through its association with lowered peer substance use, whereas rule-setting is unrelated to these outcomes. Thus, mothers who perceive greater problems in their neighborhoods use less effective monitoring strategies. Prevention programs could address parental monitoring needs based upon neighborhood differences, tailoring programs for different neighborhoods. Further, parents could be apprised of the limitations of rule-setting, particularly in the absence of monitoring their child's whereabouts.

A longitudinal analysis of teenage drinking patterns

This paper examines the multinomial recurrent outcome 'teenage drinking' within a statistical modeling paradigm. The proposed statistical modeling relates drinking to a set of explanatory variables, which include subjective as well as objective measures. In order to assess the degree to which explanatory variables influence smoking, an adequate statistical model must handle the possibility that substantial variation between respondents will be due to omitted variables, multicollinearity and past behavior. To address these issues, longitudinal data using appropriate statistical modeling are essential. In this paper we demonstrate the application of appropriate longitudinal modeling using data from the Yorkshire (UK) Health Related Behavior Questionnaire. The results suggest there may be substantial heterogeneity due to omitted variables in the data and complex inter-relationships between observed explanatory variables. For example, social cultures of drinking and parental involvement appear to influence heavy drinking and drug use.

Growth in alcohol use in at-risk adolescent boys: two-part random effects prediction models

BACKGROUND

Alcohol use frequently onsets and shows rapid growth during the adolescent years, but few studies have examined growth in two indicators, namely in use and in volume given use, with prediction from key risk factors measured across the adolescent years.

METHODS

Based on a dynamic developmental systems framework, we predicted that the general risk pathway associated with the development of antisocial behavior (namely poor parental practices and antisocial behavior/deviant peer association) would be associated with both indicators of use in Grade 6. Specific proximal social influences, namely alcohol use by parents and peers, were also hypothesized, with growth in peer use of alcohol expected to be predictive of growth. Predictors were assessed by youth, parent, and teacher reports, with alcohol use and volume assessed yearly by youth self-reports. Models were tested separately for the 3-year middle school period and the 4-year high school period. Hypotheses were tested for the Oregon Youth Study sample of approximately 200 at-risk boys.

RESULTS

Findings indicated that alcohol use by both parents and peers were associated with initial levels of alcohol use and volume, but increases in peer use predicted growth in these indicators. Parental monitoring showed a protective effect on growth in volume in high school.

CONCLUSION

Alcohol use by members of the adolescent's social network is critical to initiation of use, and peer use is critical to growth. With these predictors specific to alcohol use in the model, none of the general risk factors for antisocial behavior were significant.

Correlates of student substance use

Fifteen socio-demographic variables were examined as potential correlates of alcohol, tobacco, inhalant, marijuana and other illicit drug use among students in Years 7 to 11. The variables which most consistently discriminated users and non-users related to truancy, adult supervision of leisure, self-esteem, income and the quality of the mother-child relationship. Age was also a discriminator for all but the illicit group of drugs and revealed an inverse association with inhalant use. Drinking and smoking by various family members or others distinguished the users of alcohol and tobacco too. While further identification of correlates is encouraged, those highlighted should help to target interventions and validate self-report measures of substance use.

Anthropological reflections on youth drug use research in Australia: what we don't know and how we should find out

This paper outlines an anthropological/sociological view of youth drug use which complements the existing research paradigm. The limitations of the existing paradigm are identified and an argument is presented for the inclusion of ethnography as a fruitful research method and for a greater focus on the social context of drug use by youth. Finally, the implications of this re-direction for future research and prevention are outlined.

Alcohol and young people: minimizing the harm

In this paper the literature on patterns of use of alcohol by teenagers is reviewed. The model as proposed by Thorley is used to describe the specific nature of alcohol problems experienced by young people. A systemic approach to prevention is explored and recommendations are made about ways to minimise the harm associated with alcohol use by young people.

Effect of television advertising of alcohol on alcohol consumption and intentions to drive

The alcohol consumption of 120 male and female college students was measured as they viewed a 90-min videotape of popular prime-time television programmes. Independent measures were the sex of the student, their drinker classification (light or moderate-heavy) and the number of alcohol advertisements (0, 6, 12) shown during the screening of the television programmes. Dependent measures were the number of drinks consumed, and the intentions of students to drive a motor vehicle after viewing the videotaped programmes. As predicted, males consumed more alcohol than females, and moderate-heavy drinkers consumed more than light drinkers. Male and female students who viewed six alcohol advertisements consumed more alcohol than students shown no alcohol advertisements or 12 alcohol advertisements. Analysis of intentions to drive after viewing the programmes revealed that the number of drinks consumed was not a significant covariate of driving intentions. Rather light drinkers of both sexes were less likely to intend to drive than moderate-heavy drinkers. Males exposed to alcohol advertisements were less likely to intend to drive than males who did not view alcohol advertisements. Different levels of exposure to alcohol advertisements did not influence the driving intentions of college females.

Adolescent views on risky and illegal alcohol use

A sample of 1154 adolescents from central Queensland indicated their agreement or disagreement with 28 reasons why young people drink alcohol in ways that are risky or illegal. As predicted, agreement varied across the three age groups sampled, with younger respondents being most likely to agree with drinking reasons. In contrast, very few sex differences emerged in the study. This suggests that young males and females share some common views about situations related to problematic alcohol consumption, and that age differences may be the more important factor in the development of alcohol education messages.

A diary approach to analysing young adults' drinking events and motivations

Completing a diary over two weeks, 201 young adults recorded each of their drinking events, and information about the context and their motivations for alcohol use. Males reported almost twice as many drinking events and three times the number of drinks over the two-week period. At the same time, males and females mostly drank from Wednesdays to Sundays, with the majority of beer, wine and spirit consumption being between 4 p.m. and midnight. Most drinking occurred in mixed-sex peer groups, and the next greatest in family gatherings. Males mostly drank beer, while females chose either wine or spirits. Most drinking was in bars or at home. Males tended to drink for a wider range of reasons. The advantages of using prospective diaries in studies of young adults' alcohol use are discussed.

The impact of social influence on adolescent intention to smoke: combining types and referents of influence

OBJECTIVES

Theory and research suggest that the intention to smoke is the main determinant of smoking initiation and emphasizes the role of cognitive and social factors on the prediction of the intention to smoke. However, extended models such as the I-Change and results from published studies reveal inconsistencies regarding the impact of social influence on the intention to smoke. Possible explanations for this may be the definition and measurement of the constructs that have been used.

DESIGN AND METHODS

The current study was designed with two main goals: (i) to test a measurement model for social influence, combining different types of social influence (subjective norms, perceived behaviour, and direct pressure) with various referents of influence (parents, siblings, peers, and teachers); (ii) to investigate the impact of social influence on adolescent intention to smoke, controlling for smoking behaviour. LISREL was used to test these models. The sample includes 3,064 Portuguese adolescents, with a mean age of 13.5 years, at the beginning of the seventh school grade.

RESULTS

The hypothesized measurement model of social influence was supported by results and explained 29% of the variance of the intention to smoke. A more extended model, including attitude and self-efficacy, explained 55% of the variance of the intention to smoke. Perceived behaviour of peers, parental norms, and perceived behaviour of parents were the social influence factors with impact on adolescent intention to smoke.

CONCLUSIONS

Results suggest that different referents exert their influence through distinct types of social influence and recommend further work on the definition and measurement of social influence.

Trajectories of peer social influences as long-term predictors of drug use from early through late adolescence

The present study analyzed the long-term effects of perceived friend use and perceived peer use on adolescents' own cigarette, alcohol and marijuana use as a series of parallel growth curves that were estimated in two developmental pieces, representing middle and high school (N = 1,040). Data were drawn from a large drug abuse prevention trial, the Midwestern Prevention Project (MPP). Results showed that both perceived peer and friend cigarette use predicted own cigarette use within and across the adolescent years. For own alcohol and marijuana use, peer and friend influences were limited primarily to middle school. The findings suggest that strategies for counteracting peer and friend influences should receive early emphasis in prevention programs that are targeted to middle school. The findings also raise the question of whether cigarette use may represent a symbol of peer group identity that is unlike other drug use, and once formed, may have lasting adverse effects through the adolescent years.

A longitudinal study of alcohol use and antisocial behaviour in young people

Aims: To examine the direction of causation between young people's antisocial behaviour and alcohol (mis)use in the longer and shorter term, together with their joint effects on alcohol-related trouble. Methods: A longitudinal study (2586 pupils) supplied data, allowing exploration of the causal effects of alcohol (mis)use and antisocial behaviour between ages 11 and 15, using structural equation models of longer and shorter-term relationships and joint-effects models in respect of alcohol-related trouble at age 15. This method allowed us to evaluate which of three hypotheses, described as ‘disinhibition’ [alcohol (mis)use causes or facilitates antisocial behaviour], ‘susceptibility’ [antisocial behaviour causes alcohol (mis)use] or ‘reciprocal’ [alcohol (mis)use causes antisocial behaviour and the reverse] receives most support, both overall and by gender, social class, and drinking context. Results: Overall, the results support the susceptibility hypothesis, particularly in the longer-term models. There is no support for ‘pure’ disinhibition. However, in the shorter-term and joint-effects models (i.e. as the time lag becomes shorter), there is evidence that in some gender, social class, or drinking contexts, in addition to antisocial behaviour causing alcohol (mis)use, the reverse also applies. Conclusions: Antisocial behaviour is the main predictor of alcohol (mis)use and alcohol-related trouble, with alcohol (mis)use impacting only modestly on antisocial behaviour and alcohol-related trouble in the shorter term.

Children's disruptiveness, peer rejection, friends' deviancy, and delinquent behaviors: a process-oriented approach

This study examined whether peer rejection and affiliation with deviant friends throughout childhood could mediate the link between early disruptiveness and two aspects of delinquent behaviors (i.e., violence and substance use) in a sample of 375 children. Furthermore, we tested whether the two putative mediators operated in a sequential manner or in a parallel manner. Participants' disruptiveness, peer rejection, and friends' deviancy were assessed throughout childhood (ages 7 to 13). Delinquency-related outcomes were assessed at ages 14 and 15 years. Results indicate that the sequential mediational model was supported when delinquency-related violence was the outcome, but not when substance use was the outcome. The discussion stresses the differential role of peer rejection and affiliation with deviant friends in regard to the two outcomes considered in this study and in regard to the time frame when they were measured.

Genetic and environmental influences on the relationship between peer alcohol use and own alcohol use in adolescents

AIMS

Genetically influenced aspects of adolescent behaviour can play a role in alcohol use and peer affiliation. We explored the correlations between friends' alcohol use and adolescent own use with a genetically sensitive design.

DESIGN

Genetic and environmental factors were estimated on adolescent reports of their friends' alcohol use and their own use and problem use of alcohol. The correlations between the genetic and environmental factors that influence friends' alcohol use and adolescent own alcohol use and problem use were also estimated.

PARTICIPANTS

A total of 862 twin pairs aged 11-17 years sampled from the UK population-based Cardiff Study of All Wales and North-west of England Twins (CaStANET).

MEASUREMENTS

Data on adolescent own alcohol use and problem use and the alcohol use of their three best friends were obtained using self-report questionnaires.

FINDINGS

A significant genetic influence was found on adolescent friends' alcohol use (about 30%). Significant correlations of 0.60 and 0.70 were found between the genetic influences on friends' alcohol use and adolescents' own use and problem use of alcohol. Common environmental influences were almost completely correlated for friends' alcohol use and adolescents' own alcohol use and problem use (0.91 and 0.94).

CONCLUSIONS

There is considerable overlap in the common environmental and genetic factors that contribute to the relationship between adolescents' own alcohol use and that of their friends. These findings contribute to understanding of the mechanisms by which friends' alcohol use influences adolescent drinking behaviour.

Challenges to the peer influence paradigm: results for 12-13 year olds from six European countries from the European Smoking Prevention Framework Approach study

OBJECTIVE

To examine whether smoking onset in young adolescents is predicted by peer or parental smoking.

DESIGN

Longitudinal design with one pretest and one follow-up at 12 months.

SETTING

Schools in Finland, Denmark, the Netherlands, the United Kingdom, Spain and Portugal.

PARTICIPANTS

7102 randomly selected adolescents from six countries. Mean age was 12.78 years.

MAIN OUTCOME MEASURES

Smoking behaviour of adolescents, peers and parents.

RESULTS

No support was found for peer smoking as an important predictor of smoking onset in most countries. Support was found for the selection paradigm, implying that adolescents choose friends with similar smoking behaviour. Support for the impact of parents on adolescent behaviour and the choice of friends was also found.

CONCLUSIONS

Smoking uptake in this age cohort may be more strongly influenced by personal and parental influences than initially believed. Hence, social inoculation programmes teaching youngsters to resist the pressures to smoke may be less appropriate if youngsters have a positive attitude towards smoking, associate smoking with various advantages and look for peers with similar values. For this group attitudes towards smoking may thus guide future friend selection.

A latent class analysis of underage problem drinking: evidence from a community sample of 16-20 year olds

The aim of this paper is to shed light on the nature of underage problem drinking by using an empirically based method to characterize the variation in patterns of drinking in a community sample of underage drinkers. A total of 4056 16-20-year-old current drinkers from 212 communities in the US were surveyed by telephone as part of the National Evaluation of the Enforcing Underage Drinking Laws (EUDL) Program. Latent class models were used to create homogenous groups of drinkers with similar drinking patterns defined by multiple indicators of drinking behaviors and alcohol-related problems. Two types of underage problem drinkers were identified; risky drinkers (30%) and regular drinkers (27%). The most prominent behaviors among both types of underage problem drinkers were binge drinking and getting drunk. Being male, other drug use, early onset drinking and beliefs about friends drinking and getting drunk were all associated with an increased risk of being a problem drinker after adjustment for other factors. Beliefs that most friends drink and current marijuana use were the strongest predictors of both risky problem drinking (OR=4.0; 95% CI=3.1, 5.1 and OR=4.0; 95% CI=2.8, 5.6, respectively) and regular problem drinking (OR=10.8; 95% CI=7.0, 16.7 and OR=10.2; 95% CI=6.9, 15.2). Young adulthood (ages 18-20) was significantly associated with regular problem drinking but not risky problem drinking. The belief that most friends get drunk weekly was the strongest discriminator of risky and regular problem drinking patterns (OR=5.3; 95% CI=3.9, 7.1). These findings suggest that underage problem drinking is most strongly characterized by heavy drinking behaviors which can emerge in late adolescence and underscores its association with perceptions regarding friends drinking behaviors and illicit drug use.

The relationship between viewing US-produced television programs and intentions to drink alcohol among a group of Norwegian adolescents

The aim of this study was to examine the influence of exposure to US-produced television programs and family rules prohibiting alcohol use on the development of normative beliefs, expectancies, and intentions to drink alcohol in the next 12 months among a group of Norwegian adolescents who reported that they had not previously consumed alcohol. Data were collected via a survey administered to 622 eighth and ninth graders enrolled at ten junior highs in southeastern Norway. To examine these relationships we tested the fit of a structural equation model which was based on the Theory of Planned Behavior (Ajzen, 1988). Data from the non-drinkers (n= 392, 63% of the respondents) were used. To control for the influence of peer drinking on behavioral intentions, our model was tested under two group conditions: (1) those subjects reporting that they have no friends who drink alcohol and (2) those subjects reporting that they have one or more friends who drink. The findings indicate that the influence of TV exposure was a significant predictor (directly) of normative beliefs, expectancies (indirectly) and intentions to drink (both directly and indirectly) only for those subjects who reported having no friends who drink. For the group with non-drinking friends, family rules constrain intentions only indirectly by influencing normative beliefs. For those with friends who drink, however, family rules have a direct (inverse) effect on intentions. It is concluded that exposure to US-produced television programs functions as a limited knowledge source only for those subjects who had little or no personal experience with alcohol while the presence of family rules have limited impact on behavioral intentions.

Peer influences on risk behavior: an analysis of the effects of a close friend

Cross-sectional research suggests that peer influence has a moderate to strong impact on adolescent risk behavior. Such estimates may be inflated owing to third-variable confounds representing either friendship selection effects or the operation of parallel events. Approximately 1,700 peer dyads in Grades 7 to 11 were studied over a 1-year period to estimate the influence of closest friends on sexual activity and binge drinking. Analyses suggested that peer influence was small but reliable when both selection effects and parallel events were taken into account. Peer influence varied as a function of individual-peer similarity and maternal relations but not in accord with other theoretical predictions. It is suggested that the magnitude of peer effects in previous research may be overestimated in many contexts.

Exploring the effects of psychosocial and acculturation factors on drinking behavior among aboriginal adolescents in Taiwan

The purpose of this study was to examine the effects of psychosocial and acculturation factors on drinking behavior among Taiwanese aboriginal teenagers. Stratified random sampling was used to select six of the 19 aboriginal schools in Taipei, Pingtung, Hualien, and Taitung counties. A total of 495 student subjects were enrolled in the study, including 290 boys and 205 girls, with classification by tribe of 206 Amis, 97 Atayal, 94 Paiwan, 47 Bunun, 19 Rukai, 15 Yami, 10 Puyuma, two Saisiyat, one Tsou, and four unknown. The analysis indicated that the psychosocial and acculturation factors that directly influenced drinking behaviors of aboriginal teenagers were: self-efficacy, drinking behaviors of parents, peer alcohol use, social assimilation, social attitude, and territorial attitude. In this model, peer alcohol use had the most prominent impact on drinking behavior among aboriginal teenagers. The findings suggest that parents' behaviors play a significant role in the development of problematic drinking behavior in the aboriginal teenager through observation and imitation, and also that self-efficacy and the level of acculturation influences drinking behavior in aboriginal teenagers.

Estudio descriptivo del uso de drogas en adolescentes de educación media superior de la ciudad de Monterrey, Nueva León, México

Se buscó establecer el perfil de consumo de drogas lícitas e ilícitas, patrones de consumo y estrategias de afrontamiento y resistencia al alcohol, tabaco y otras drogas en adolescentes de educación media superior. El estudio se sustentó en los conceptos de autores especializados en el tema considerándose las características conductuales, psicológicas y normativas de la persona. La muestra no probabilística consistió de 325 jóvenes. Los resultados indicaron que 67%, 65% y 7% de los adolescentes aceptaron haber usado alcohol, tabaco y marihuana alguna vez en su vida respectivamente y en el último mes el 33%, 38% y 3% esas mismas substancias, 65% consideran que la mayoría de sus compañeros han hecho uso; 56% tuvieron que rechazar una vez el ofrecimiento de alcohol, 64% tabaco y 51% marihuana, en el último mes con base en esos hallazgos. Se recomienda implementar un programa de prevención orientado a apoyar los recursos del adolescente para resistir las presiones para el consumo.

Occupational level of the father and alcohol consumption during adolescence; patterns and predictors

STUDY OBJECTIVE

This paper describes and attempts to explain the association between occupational level of the father and high alcohol consumption among a cohort of New Zealand adolescents from age 11 to 21.

DESIGN

Data were obtained from the longitudinal Dunedin multidisciplinary health and development study. At each measurement wave, those who then belonged to the quartile that reported the highest usual amount of alcohol consumed on a typical drinking occasion were categorised as high alcohol consumers. Potential predictors of high alcohol consumption included environmental factors, individual factors, and educational achievement measured at age 9, 11, or 13. Longitudinal logistic GEE analyses described and explained the relation between father's occupation and adolescent alcohol consumption.

SETTING

Dunedin, New Zealand.

PARTICIPANTS

About 1000 children were followed up from birth in 1972 until adulthood.

MAIN RESULTS

A significant association between fathers' occupation and adolescent alcohol consumption emerged at age 15. Overall adolescents from the lowest occupational group had almost twice the odds of being a large consumer than the highest occupational group. The association between father's occupation and high alcohol consumption during adolescence was explained by the higher prevalence of familial alcohol problems and friends approving of alcohol consumption, lower intelligence scores, and lower parental attachment among adolescents from lower occupational groups.

CONCLUSIONS

Socioeconomic background affects adolescent alcohol consumption substantially. This probably contributes to cumulation of disadvantage. Prevention programmes should focus on adolescents from lower socioeconomic groups and make healthier choices the easier choices by means of environmental change.

The relationship between traumatic dental injuries and adolescents' development along the life course

Few models have been proposed to explain the aetiology of traumatic dental injuries. Those that have, focus on risk factors at present stage of life. The contribution of risk factors for dental injuries at different stages of life needs to be investigated.

OBJECTIVES

To test the relationship between life course experiences and the occurrence of traumatic dental injuries in adolescents.

METHODS

A cross-sectional survey was used to collect data retrospectively. Out of a total number of 764 eligible 13-year-old-adolescents enrolled in private and public schools located in urban areas in the town of Cianorte, Brazil, 652 (85%) agreed to participate in the study. They were interviewed and examined for traumatic dental injuries by two trained dental epidemiologists using validated criteria. The interviews collected information on socioeconomic circumstances, family related variables, school grade and anthropometric measures (height and weight).

RESULTS

Adolescent boys, those from non-nuclear families, those reporting high levels of paternal punishment and those who were at lower grades at school for their age were more likely to experience dental injuries than girls, adolescents from nuclear families, those reporting low levels of paternal punishment and those who were at higher grades at school.

CONCLUSION

It was concluded that adolescents who experienced adverse psychosocial environments along the life course had more traumatic dental injuries than their counterparts who experienced more favourable environments.

Peer and partner drinking and the transition to marriage: a longitudinal examination of selection and influence processes

This study examined the longitudinal relationships among adult drinking, partner drinking, and peer drinking over the transition to marriage. Newlywed couples were assessed with respect to alcohol involvement, peer drinking, and risk factors and reassessed at their 1st anniversary. Husbands' premarital drinking was predictive of wives' drinking at the 1st anniversary, indicating partner influence. The results did not support a peer-influence hypothesis in that peer drinking at marriage was not predictive of husbands' or wives' drinking at the 1st anniversary. There was evidence, however, for a peer-selection effect with husbands' premarital drinking predicting peer drinking for both husbands and wives. Wives' premarital drinking was unrelated to the subsequent drinking of their peers or their husbands' peers.

Consumption, knowledge and attitudes of high school pupils towards alcohol and alcoholism: the Israeli experience

Five hundred nine high school pupils from Holon (a city in the center of Israel) were surveyed about their consumption, knowledge and attitudes towards alcohol use and alcohol dependence. Two hundred fifty-nine pupils attended a vocational high school and 253 attended an academic high school. Forty percent of the pupils attending the academic school reported that they had drank beer between one to nine times during the last 2 months. In comparison with 72% of the vocational pupils, 42% of the academic pupils and 47% of the vocational pupils drank other alcoholic beverages (such as hard liquor, cognac, whisky or vodka) between one to nine times during the last 2 months. Boys drank alcohol more frequently than girls did. An earlier mean age of beer consumption was found among pupils in the vocational schools-12.8 years; as opposed to pupils in the academic school-13.4 years. Knowledge of most pupils concerning alcoholic beverages and its potential harmful effects was lacking and pupils in the academic school showed a higher level of knowledge in comparison with the vocational pupils. Pupils in the vocational school had more liberal attitudes concerning recurrent consumption of alcoholic beverages than pupils in the academic school. Among the three leading reasons for drinking in the two schools were helping foster a sense of belonging, wish to feel like an adult and desire to forget daily anxieties and conflicts. Pupils in vocational schools are a target population with a higher risk for consuming alcoholic beverages. Discussion groups should be held in school and include personal stories of recovering alcoholics.

Heavy cannabis use among UK teenagers: an exploration

Findings are presented from a survey of a sample of 2641 UK school students aged 15--16 years. This exercise was part of the 30 country European School Survey Project on Alcohol and other Drugs (ESPAD). The 201 students who reported using cannabis (marihuana) 40 times or more were examined using cluster analysis. They were also compared to other students. Three clusters of heavy cannabis users emerged. The smallest was largely distinguished by antisocial behaviour. Another cluster were clearly unhappy, with little support from parents and friends, high levels of depressed mood and low levels of self-esteem. The largest cluster were 'ordinary' and had little to distinguish them apart from a belief that their environment was stable and predictable and that society's rules should be obeyed. Although clear relationships emerged between heavy cannabis use and heavy use of other substances, the 'ordinary' cluster of heavy cannabis users were less likely than the others to have used other illicit drugs. It is therefore concluded that teenage heavy cannabis users have varied motivations and contexts for their usage. They should not be seen as a homogeneous group and many do not appear to use other illicit drugs.

How universal are social influences to drink and problem behaviors for alcohol use? A test comparing urban African-American and Caribbean-American adolescents

The purpose of this study is to test specifically which social influences and which problem behaviors predict drinking among a sample of African-American and Caribbean-American black adolescents residing in New York City. A total of 3212 African-American or Caribbean-American seventh graders completed questionnaires assessing their alcohol use, demographic characteristics, social influences to drink, and other behavioral measures. Logistic regression analyses examined predictors for the overall black sample and separately for each of the two black groups. The predictors of alcohol initiation were virtually identical for both groups (father's drinking, siblings' drinking, friends' drinking, peer drinking, and smoking) with the exception of marijuana use. Although there were some common predictors of alcohol consumption for the two groups (siblings' drinking, friends' drinking, and smoking), some factors only influenced alcohol consumption for African-Americans (father's drinking and marijuana use) and others only did so for Caribbean-Americans (deviance and absenteeism). These findings highlight the importance of examining the etiology of alcohol use for different black groups.

Risky parental behavior and adolescent sexual activity at first coitus

Data from the National Longitudinal Study of Adolescent Health (Add Health) were used to examine the impact of parents' behavior on adolescents' sexual experience and contraceptive use. All else being equal, adolescents whose parents engage in risky behaviors are especially likely to be sexually active and to have had sex before age 15. These findings are only partly attributable to the link between parents' risky behaviors (smoking, drinking, driving without seatbelts) and adolescents' risky behaviors (smoking, drinking, delinquent activity, association with substance-using peers). Although parental behaviors are effective predictors of adolescents' sexual activity, they are not effective predictors of contraceptive use or of method choice at first coitus. Overall, parents with low levels of self-efficacy seem to be especially likely to have children at risk of engaging in problem behaviors.

Social influences as explanations for substance use differences among Asian-American and European-American adolescents

The present study examines the social influences in the Asian-American and European-American adolescent environment to provide a greater understanding of effect of ethnic differences on the prevalence of substance abuse. Participants were 957 Asian-American and 3705 European-American seventh grade adolescents. It was found that Asian-American students were less likely to use alcohol and cigarettes, and had a more abstinence-promoting environment than European-American adolescents. This difference in Asian-American adolescents appeared to be the result of less adult and peer influence to use alcohol or cigarettes, less offers of alcohol, and an increased likelihood of having an intact family when compared to European-American adolescents. Additionally, Asian-American adolescents reported having fewer friends and spending less time with their friends than European-American adolescents. It was concluded that social influences play an important role in explaining why Asian-American adolescents have lower rates of substance use.

Prevention of high-risk behaviors in adolescent women

PURPOSE

To better delineate the impact of health risk behaviors on adolescent women's current and future health and development.

METHOD

The Commonwealth Fund Survey of Adolescent Health, a national survey of adolescents in Grades 5-12 designed to better understand their health and health care needs, was used as the basis for this study. Survey data were collected in 1997 from a total of 6730 adolescents (3568 females, 3162 males). Areas examined include smoking, drinking, use of other drugs, violence, safety, reproductive risks, and the prevention of risk behaviors in adolescent women.

RESULTS

Adolescent women are almost equally likely to smoke, drink, and engage in other substance use as their male counterparts, but with increased health risks. Different motivations for engaging in risk behavior also are evident. Adolescent women are also more likely than adolescent men to experience physical abuse, and they are twice as likely to be sexually abused.

CONCLUSIONS

Effective prevention programs need to recognize that the motivations for engaging in risk behaviors may differ by gender. Developmental awareness, proper assessment, and pivotal institutions can provide and shape what is needed for healthy development.

Evaluation of In Focus: a computer software resource for drug education in schools

This paper presents the main findings of an evaluation study that measured the impact of “In Focus”, a drug education resource for use by teachers working in lessons with 12‐13‐year old children. The resource, which comprised an interactive drug education computer program and associated lesson plans, was evaluated for outcomes using a controlled pre‐ and post‐test pupils’ questionnaire and processes by means of focus groups (pupils) and semi‐structured interviews (teachers). Questionnaires were completed both at pre‐ and post‐test by 762 pupils, in nine schools. After the lessons, small increases in knowledge were found in the intervention group. No significant changes in attitudes or intended behaviour patterns were discernible. The pupils felt they had learned a lot and had enjoyed using the In Focus program. The teachers involved in using the resource had not been provided with training to familiarise them with the use of the resource. Furthermore, many did not use the computer program within the context of the lessons contained in the resource. However, they considered the computer program to be useful in generating discussion in the classroom. This paper concludes that the In Focus resource had a limited impact on knowledge levels of pupils and no impact on attitudes, probably on account of the resource not being used in accordance with instructions. The resource was acceptable to teachers and pupils and is considered worthy of further development.