Alcohol and other drug use among adolescent students in the Atlantic provinces

Adolescent passengers of drunk drivers: a multi-level exploration into the inequities of risk and safety

AIMS

This study determined the individual-, neighbourhood- and provincial-level effects of rural residence, socio-economic status (SES), substance use and driving behaviours on adolescents' riding with a drunk driver (RDD).

DESIGN

Multi-level study based on cross-sectional self-reported anonymous data from the Student Drug Use Survey in the Atlantic Provinces (SDUSAP) and Census Canada data, merged on the postal code of participating schools. The sample design of the SDUSAP was a single-stage cluster sample of randomly selected classes stratified by grade and region.

SETTING

The Atlantic provinces of Canada.

PARTICIPANTS

A total of 12 990 students in junior and senior high schools, with an average age of 15 years, participated in the 2002 SDUSAP.

MEASUREMENTS

The outcome variable was past-year RDD. The main individual-level independent variables were SES, rural residence, substance use and driving behaviours. The school-neighbourhood independent variables were the prevalence of heavy episodic drinking, driving under the influence of alcohol, driver's licence, highest level of educational attainment and low income.

FINDINGS

The prevalence of RDD was 23.3% in 2002. Among students in grades 9-12, lower family SES, rural residence, substance use and driving under the influence were found to be independent individual-level risk factors for RDD; having a driver's licence was found to be protective. At the provincial and school-neighbourhood levels, a high prevalence of driving under the influence of alcohol and low educational attainment were found to be independent risk factors for RDD after taking into account individual characteristics.

CONCLUSIONS

This study provides evidence that inequities exist in the options for adolescents to be ensured of passenger safety, and that interventions aimed at decreasing the extent to which adolescents engage in riding with a drunk driver should be based on conceptual approaches that recognize ecological factors as well as individual-level susceptibility.

Motor vehicle collision risk and driving under the influence of cannabis: evidence from adolescents in Atlantic Canada

OBJECTIVE

Employing a sample of 6087 senior students in Atlantic Canada, this paper examines the relationship between driving under the influence of cannabis (DUIC) and motor vehicle collision (MVC) risk. A series of models were analyzed adjusting for demographic characteristics, driver experience, and substance use.

METHODS

Participants were drawn from the 2002/2003 Student Drug Use Survey in the Atlantic Provinces, an anonymous cross-sectional survey of adolescent students in the Atlantic provinces of Canada. Logistic regression techniques were employed in the analysis of unadjusted and adjusted models.

RESULTS

Among senior students, the prevalence of DUIC in the past year was 15.1% while the prevalence of MVCs was 8.1%. The predictors of DUIC were gender, driver experience, use of a fake ID, and driving under the influence of alcohol (DUIA). The predictors of MVC were gender, driver experience, DUIC, and DUIA.

CONCLUSIONS

These findings extend our knowledge of DUIC as a socio-legal and public health issue with implications on road safety. Effort must be placed on educating new drivers about cannabis use in the context of driving.

Gender differences in the association between substance use and elevated depressive symptoms in a general adolescent population

AIMS

This study explores gender differences in the association between substance use and elevated depressive symptoms in the general adolescent population.

DESIGN

Cross-sectional self-reported anonymous survey, the 2002/2003 Student Drug Use Survey in the Atlantic Provinces. The sample design was a single-stage cluster sample of randomly selected classes stratified by grade and region.

SETTING

The four Atlantic provinces of Canada.

PARTICIPANTS

A total of 12 771 students in junior and senior high schools of the public school systems, representing a response rate of about 97%. The average age of participants was 15.2 years.

MEASUREMENTS

The measure of elevated depressive symptoms was a 12-item version of the CES-D with three categories of depression risk validated in a companion study.

FINDINGS

The prevalence of very elevated depressive symptoms was 8.6% in females and 2.6% in males. Alcohol use and cigarette smoking were found to be independent predictors of elevated depressive symptoms in females, but not males; cannabis use was found to be an independent predictor of elevated depressive symptoms in both males and females. Age was found to have a curvilinear relationship with elevated depressive symptoms in females but not in males. The adolescent's academic performance and province of residence were found to be independent risk factors of elevated depressive symptoms among both males and females. About 10.3% of adolescents considered to be potential candidates for needing help reported having received help because they felt depressed.

CONCLUSIONS

The association between depression risk and age, alcohol use, cigarette smoking and cannabis use in the general adolescent population is not straightforward and may differ according to gender. There is unmet need for help for depression among adolescents.

Cigarette use among Canadian undergraduates

OBJECTIVE

To describe the prevalence of daily cigarette use among Canadian undergraduates. Estimates are also compared to earlier Ontario surveys.

METHODS

Data are drawn from the Canadian Campus Survey, a national mail survey, conducted in the fall of 1998, with a random sample of 7,800 students from 16 universities.

RESULTS

Overall, 17.1% reported daily cigarette smoking and 10.4% reported occasional smoking. Rates of daily smoking differed significantly by region (with rates above average among those attending university in the Atlantic and below average among those attending university in British Columbia and the Prairies), residence (those residing off campus without family reported the highest prevalence rate), and year of study (those in the final year typically reported lower rate of use).

INTERPRETATION

University campuses represent an environment with potential gains to be made by tobacco control policies.

Cigarette use among Canadian undergraduates

OBJECTIVE

To describe the prevalence of daily cigarette use among Canadian undergraduates. Estimates are also compared to earlier Ontario surveys.

METHODS

Data are drawn from the Canadian Campus Survey, a national mail survey, conducted in the fall of 1998, with a random sample of 7,800 students from 16 universities.

RESULTS

Overall, 17.1% reported daily cigarette smoking and 10.4% reported occasional smoking. Rates of daily smoking differed significantly by region (with rates above average among those attending university in the Atlantic and below average among those attending university in British Columbia and the Prairies), residence (those residing off campus without family reported the highest prevalence rate), and year of study (those in the final year typically reported lower rate of use).

INTERPRETATION

University campuses represent an environment with potential gains to be made by tobacco control policies.

Medical and nonmedical stimulant use among adolescents: from sanctioned to unsanctioned use

BACKGROUND

The past decade has seen a generalized upward trend in the prevalence of adolescent use of substances, including stimulants. The purpose of this article was to determine the prevalence of and risk factors for the medical and nonmedical use of stimulants, and the diversion of prescribed stimulants among adolescent students, and to demonstrate links between medical use, nonmedical use and the diversion of stimulants.

METHODS

A self-reported anonymous questionnaire was administered in 1998 to a random sample of students in grades 7, 9, 10 and 12 in New Brunswick, Nova Scotia, Prince Edward Island, and Newfoundland and Labrador about their medical and nonmedical use of stimulants (Benzedrine, Dexedrine, Ritalin, Cylert, diet pills, "speed," "uppers," "bennies" and "pep pills"). A total of 13,549 students completed the questionnaire, representing a 99% participation rate among the students present at school on the day of the survey.

RESULTS

Of the 5.3% of students who reported medical use of stimulants in the 12 months before the survey, 14.7% reported having given some of their medication, 7.3% having sold some of their medication, 4.3% having experienced theft and 3.0% having been forced to give up some of their medication. Nonmedical stimulant use by students who did not have a prescription for stimulants was significantly related to increased numbers of students who gave or sold some of their prescribed stimulants, at both the school class and individual student levels (p < 0.001).

INTERPRETATION

Although the vast majority of adolescent students taking prescribed stimulants appeared to be using their medication as sanctioned, a link was found between medical and nonmedical stimulant use and the diversion of medication from sanctioned to unsanctioned use.

Nonmedical drug use among adolescent students: highlights from the 1999 Ontario Student Drug Use Survey

BACKGROUND

During the 1990s, rates of nonmedical drug use among adolescents escalated. We assessed data from 5 cycles of the Ontario Student Drug Use Survey for overall trends in the proportion of students reporting illegal drug use between 1991 and 1999.

METHODS

The survey is a repeated, cross-sectional, 2-stage cluster-design survey of students enrolled in grades 7, 9, 11 and 13. Outcome measures were prevalence of use of 17 drugs, including alcohol and tobacco, over the 12 months preceding the survey.

RESULTS

The rates of drug use increased between 1993 and 1999. The 95% confidence intervals (CIs) for the differences in proportions between 1997 and 1999 indicated significant increases in the overall use of 6 drugs: alcohol (95% CIdiff 6.1, 1.9-10.3), cannabis (95% CIdiff 46.3, 0.2-8.4), glue (95% CIdiff 2.3, 1.3-3.3), other solvents (95% CIdiff 5.0, 3.1-6.3), barbiturates (95% CIdiff 1.9, 0.4-3.4) and hallucinogens such as mescaline and psilocybin (95% CIdiff 3.5, 0.8-6.9). Fewer grade 7 students in 1999 than in earlier cohorts reported using alcohol or cigarettes by age 9.

INTERPRETATION

The public health implications of the findings are mixed. On the positive side, there is no evidence of increases in early onset of drug use. On the negative side, the overall proportion of students reporting illegal drug use has continued to rise.