Parental Restriction of Mature-rated Media and Its Association With Substance Use Among Argentinean Adolescents

Tailoring parenting styles and family-based interventions cross-culturally as an effective prevention strategy for youth substance use: a scoping review

Background

The challenge of substance use among youth continues to be a highly concerning public health issue across the globe. The notion that parenting lifestyles and family-based intervention can help in the prevention of adolescent substance use have received robust attention from policy makers, researchers' clinicians and general public, nonetheless, there is scarcity of high quality evidence to support these concepts.

Objective

To review available literature which assessed the effects of parenting styles and family-based interventions on the prevention of adolescent substance use.

Methods

A scoping review of literature to identify studies published in English between 2012 and 2022 was conducted searching Scopus, MEDLINE, PsychInfo, and CINAHL databases focused on effects of parenting styles and family-based interventions in the prevention of adolescent substance use.Keywords of family-based intervention strategies and possible outcomes of parenting styles on youth substance use were coded from the results, discussion, or conclusion. Strategies were inductively categorized into themes according to the focus of the strategy.

Results

A total of 47 studies, published between 2012 and 2022 in English language included. Narrative synthesis illustrated that parental involvement, restriction of mature-rated content, parental monitoring, authoritative parenting styles, and parental support and knowledge can help in the prevention of adolescent substance use. On the contrary, poor parent-child bonding, overprotection, permissive parenting, parental frustrations, authoritarian and harsh parenting styles promoted adolescent substance use disorders. Proximal risk factors like peer influence, previous use of other substances, and risky behaviours had more effect than just parenting styles. Culturally tailored family-based intervention strategies such as "Preventive Parenting", "Parent Training", and "Parent Involvement", with focus on "Technology Assisted Intervention", particularly "SMART "(Substance Misuse among Adolescents in Residential Treatment) are found as effective family-based intervention strategies to mitigate substance use in youth.

Conclusion

Culturally tailored family-based behavioural strategies psychosocial intervention strategies can be considered of the most effective strategies to prevent substance use disorders in youth.

Mechanisms Underlying Associations between Media Alcohol Exposure, Parenting, and Early Adolescent Drinking: A Moderated Sequential Mediation Model

Exposure to alcohol content in the media, especially in movies, is a demonstrated risk factor for adolescent alcohol use. This paper examines processes underlying this association and whether parenting mitigates such harms. A mediational model of parental restriction of mature media (W1), alcohol content exposure (W2), alcohol expectancies, peer norms (W3), and alcohol outcomes (W4) was tested using annual assessments from a study of adolescent drinking (N = 879; 52% female; 21% Non-White; 12% Hispanic). When restrictions are not in place, adolescents report greater exposure to alcohol content, leading to higher perceived peer drinking. Parental monitoring did not buffer the link between exposure and peer norms. Parental media restriction and perceptions about peers comprise mechanisms by which alcohol-saturated media influences youth drinking.

Profiles of Parenting in the Digital Age: Associations With Adolescent Alcohol and Marijuana Use

OBJECTIVE

This study assessed parental communication and behavior related to children's Internet and social media usage to delineate profiles of parenting regarding these newer forms of media and associated those profiles with youth alcohol and marijuana use.

METHOD

Using data from 748 adolescents (mean age = 15.8, 52% female, 25% non-White) and their parents, latent class analysis was performed to identify classes based on items concerning device ownership, monitoring, and communication of online activities. The associations between class membership and ever use of alcohol and marijuana were then tested, controlling for screen time, general parenting, substance availability, and deviance.

RESULTS

We identified five classes: high media parenting (23%), low media parenting (20%), moderate media parenting with limited device access (11%), moderate media parenting with high device access (25%), and low monitoring but high communication about online activities (21%). Probability of class membership was differentially associated with contemporaneous and 1-year prospective alcohol and marijuana use. The low-device-access class had the highest percentage of abstainers at both time points. The lowest rate of abstaining was associated with membership in the high-device-access class but moderate levels of monitoring. Membership in the low media parenting class was associated with use of both substances.

CONCLUSIONS

This study provides a novel exploration of media parenting, an important construct in the context of increased access to personalized media devices that allow for streaming of mature media content related to substance use.

E-cigarette use susceptibility among youth in Mexico: The roles of remote acculturation, parenting behaviors, and internet use frequency

INTRODUCTION

Adolescent electronic cigarette (e-cigarette) use is increasing worldwide, raising concerns about its impact on youth development. Remote acculturation may influence the e-cigarette use cognitions of youth in Mexico by influencing their media use, thereby contributing to their e-cigarette use susceptibility. This study examined whether remote acculturation was associated with youth internet use frequency, and whether youth internet use frequency, in turn, was associated with youth e-cigarette use susceptibility. Because parenting behaviors can relate with lower tobacco and media use (e.g., internet use), this study also examined the associations of parental media restrictions and mother's parenting practices with youth internet use frequency and e-cigarette use susceptibility.

METHODS

Data came from a school-based survey with middle school students in Mexico who had never tried e-cigarettes (N = 6004; 52.6% female; Mage = 13.07 years). Students completed measures of remote acculturation, parental media restrictions, mother's parenting practices, internet use, and e-cigarette use susceptibility.

RESULTS

Structural equation analyses suggest that U.S. American cultural orientation may increase youth e-cigarette use risk by way of higher youth internet use. Mexican cultural orientation and parental media restrictions may reduce youth e-cigarette use risk by way of lower youth internet use.

CONCLUSIONS

Preventive interventions to reduce Mexican youths' intention to try e-cigarettes could benefit from efforts to reduce youth internet use and from media literacy interventions that inform parents and youth about the influence of internet use on youth e-cigarette use.

Why are Spanish Adolescents Binge Drinkers? Focus Group with Adolescents and Parents

Binge drinking in adolescents is a worldwide public healthcare problem. The aim of this study was to explore the perceptions about determinants of binge drinking in Spanish adolescents from the perspective of adolescents and parents. A qualitative study using fourteen semi-structured focus groups of adolescents was conducted during the 2014/2015 school year (n = 94), and four with parents (n = 19), based on the I-Change Model for health behaviour acquisition. Students had a low level of knowledge and risk perception and limited self-efficacy. Girls reported more parental control, and when they get drunk, society perceives them worse. Adolescents suggested focus preventive actions to improve self-efficacy and self-esteem. Parents were permissive about alcohol drinking but rejected binge drinking. They offered alcohol to their children, mainly during celebrations. A permissive family environment, lack of control by parents, adolescents’ low-risk perception, low self-esteem and self-efficacy, as well as the increase of binge drinking in girls as part of the reduction of the gender gap, emerge as risk factors for binge drinking. Future health programmes aimed at reducing binge drinking should focus on enhancing motivational factors, self-esteem, and self-efficacy in adolescents; supervision and parental control; as well as pre-motivational factors by increasing knowledge and risk awareness, considering gender differences.

Remote Acculturation and Cigarette Smoking Susceptibility among Youth in Mexico

Many adolescents in majority world countries emulate U.S. American culture, which can influence their development. Globalization allows adolescents from majority world countries to learn about U.S. American culture through mass media and the exchange of information via the internet and other forms of communication. As such, youth in Mexico may experience remote acculturation, which can influence their smoking behaviors. We developed and tested a measure of remote acculturation (i.e., orientation to U.S. American and Mexican culture) among adolescents in Mexico and examined the association of remote acculturation with adolescents' smoking-related cognitions. Data came from a school-based survey of 5492 never-smoker, urban adolescents (51% female, M age = 14.07 years). Confirmatory factor analyses supported two latent factors-one for U.S. American and another for Mexican cultural orientation. Structural equation models revealed that stronger Mexican cultural orientation was associated with lower positive smoking-related attitudes, which were related with lower smoking susceptibility. Consistent with research on acculturation among U.S. Hispanic youth, findings indicate that stronger orientation toward U.S. culture may put adolescents in Mexico at risk for cigarette smoking, while greater orientation toward Mexican culture may prevent youth smoking in Mexico. We discuss directions for future research and policymaking strategies to prevent youth smoking in Mexico.

Exposure to tobacco in video games and smoking among gamers in Argentina

BACKGROUND

Our objective was to assess whether exposure to tobacco in video games is associated with smoking among adolescent gamers from Argentina.

METHODS

Cross-sectional data were analysed from students in public and private middle schools in Argentina. Tobacco content in video games was estimated using previously validated methods and adolescents' tobacco exposure was assessed by multiplying tobacco content in the top three video games they play by the hours played per day. The primary outcome was current smoking. Multilevel logistic regression models adjusted for clustering within schools, regressing current smoking on tobacco exposure in video games (ie, none, low, high) after controlling for age, sex, parental education, parenting style, parental rules about the use of video games, rebelliousness, sensation seeking and 'technophilia'.

RESULTS

Of the 3114 students who participated, 92% of boys (1685/1802) and 56% of girls (737/1312) played video games and were included in the analytical sample. The prevalence of smoking was 13.8% among boys and 22.0% among girls; 74.5% of boys played video games more than 1 hour per day compared with 47.7% of girls. High exposure to tobacco content in video games compared with no exposure was independently associated with current smoking among girls (OR 1.78; 95% CI 1.02 to 3.09) but not among boys (OR 0.98; 95% CI 0.64 to 1.51).

CONCLUSIONS

Greater exposure to tobacco content in video games was associated with higher likelihood of smoking among Argentine girls who play video games, suggesting the need for policies that limit these exposures.

Smoking susceptibility as a predictive measure of cigarette and e-cigarette use among early adolescents

OBJECTIVE

To assess the validity of a standard measure of smoking susceptibility for predicting cigarette and e-cigarette use in a sample of early adolescents in Argentina and Mexico.

MATERIALS AND METHODS

A school-based longitudinal survey was conducted in 2014-16 among secondary students. We analyzed students who were never smokers of regular cigarettes or e-cigarettes at baseline and who completed both surveys. The main independent variable was smoking susceptibility. Multilevel logistic regression models were used, adjusting for sociodemographic and personal variables, social network use of cigarettes and exposure to advertising.

RESULTS

In the adjusted analysis, smoking susceptibility independently predicted cigarette initiation (Argentina: AOR 2.28; 95%CI 1.66-3.14; Mexico: AOR 2.07; 95%CI 1.74-2.45) and current smoking (Argentina: AOR 3.61; 95%CI 2.48-5.24; Mexico: AOR 1.69; 95%CI 1.29-2.22); however, it only predicted e-cigarette initiation in Mexico (Mexico: AOR 1.29; 95%CI 1.02-1.63).

CONCLUSIONS

Smoking susceptibility was a valid measure to predict future cigarette smoking in this sample.

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.

Demographic, physical and mental health assessments in the adolescent brain and cognitive development study: Rationale and description

The Adolescent Brain and Cognitive Development (ABCD) Study incorporates a comprehensive range of measures assessing predictors and outcomes related to both mental and physical health across childhood and adolescence. The workgroup developed a battery that would assess a comprehensive range of domains that address study aims while minimizing participant and family burden. We review the major considerations that went into deciding what constructs to cover in the demographics, physical health and mental health domains, as well as the process of selecting measures, piloting and refining the originally proposed battery. We present a description of the baseline battery, as well as the six-month interim assessments and the one-year follow-up assessments. This battery includes assessments from the perspectives of both the parent and the target youth, as well as teacher reports. This battery will provide a foundational baseline assessment of the youth's current function so as to permit characterization of stability and change in key domains over time. The findings from this battery will also be utilized to identify both resilience markers that predict healthy development and risk factors for later adverse outcomes in physical health, mental health, and substance use and abuse.

Smoking in Movies and Adolescent Smoking Initiation: A Longitudinal Study among Argentinian Adolescents

OBJECTIVE

To assess whether exposure to movie smoking is associated with cigarette smoking among Argentinian adolescents.

STUDY DESIGN

A school-based longitudinal study involving 33 secondary schools in Argentina was performed. The sample included 2502 never smokers (average age at entry = 12.5 years), 1700 (67.9%) of whom completed follow-up surveys 17 months later. Exposure to the top 100 highest-grossing films for each year between 2009 and 2013 was assessed by content-coding films for tobacco and then by asking adolescents whether they had seen each of 50 titles, randomly selected from the larger pool, then parsing exposure into tertiles. Logistic regression models estimated aOR for the following transitions: nonsusceptible to susceptible never smoker, never smoker to ever smoker, and never smoker to current smoking (last 30 days).

RESULTS

At follow-up, 34.4% of nonsusceptible never smokers became susceptible, 24.1% reported having tried smoking, and 9.4% were current smokers. Most exposure to movie smoking was from US-produced films (average 60.3 minutes compared with only 3.4 minutes from Argentine films). Greater exposure to smoking in movies was significantly associated with increased odds of becoming susceptible (aOR_{first vs third tertile} 1.77, 95% CI 1.30-2.41), of trying smoking (aOR_{first vs third tertile} 1.54, 1.14-2.08), and marginally associated with current smoking (AOR_{first vs third tertile} 1.54, 0.99-2.40). Exposure to smoking in US- or Argentine-produced films had similar associations.

CONCLUSION

In Argentina, exposure to smoking in the movies predicted future smoking transitions among early adolescents, with most exposure coming from viewing US movies.

PREVALENCE AND PREDICTORS OF E-CIGARETTE TRIAL AMONG ADOLESCENTS IN ARGENTINA

Introduction

Over the last few years, the increasing use of electronic cigarettes has become a new public health problem. Since 2011, Argentina has had a complete ban on marketing and sale of e-cigarettes. However, e-cigarettes are marketed online and can be easily bought in stores. We conducted a longitudinal study to evaluate the determinants of e-cigarette trial among Argentinean early adolescents.

Methods

A school-based longitudinal study was conducted in 2014-15, in 3 large cities in Argentina. Among students who reported never smoking an e-cigarette at baseline, we assessed demographics, media use, sensation seeking, smoking behavior, network member smoking, use of other substances, and perception of e-cigarette risk as potential risk factors for e-cigarette trial at follow up (mean between-wave interval 17.1 months) using multilevel logistic regression models with random intercepts for schools.

Results

E-cigarette trial prevalence increased from baseline (1.8%; n=57) to follow up (7.1%; n=139). Independent predictors of e-cigarette use at follow up included: higher sensation seeking (OR: 1.49 95% CI 1.21-1.84); being a current smoker (OR: 2.58 95% CI 1.38-4.83); having close friends that smoke cigarettes (OR: 1.93 95% CI 1.25-2.99) and being highly exposed to tobacco product ads online (OR: 1.87 95% CI 1.04-3.36). Attending a public school was the only protective factor (OR: 0.40 95% CI 0.22-0.73).

Conclusion

In Argentina, illicit trial of e-cigarettes among early adolescents is low but appears to be rapidly increasing. Identifying students at risk could help identify policies and programs to prevent increasing use in this population.