Proximal and distal social influence on alcohol consumption and marijuana use among middle school adolescents

School-Level Longitudinal Predictors of Alcohol, Cigarette, and Marijuana Use

This study analyzed measures aggregated at the school level to identify key predictors of drinking alcohol, binge drinking, smoking cigarettes, and using marijuana. Using data collected from 6th through 12th grade students between 2011 and 2015, we identify school-level variables that predict school-level prevalence in the subsequent year. Data included prior year assessments of: (1) school-wide prevalence, (2) perceived ease of access to drugs, (3) perceived adult disapproval of drug use, (4) perceived peer disapproval of drug use, and (5) perceived prevalence of drug use. We regressed grade-level behaviors on predictor variables from the previous school year. In middle schools, prior grade prevalence and prior grade perceived norms were significant predictors of subsequent grade prevalence. For high schools, prior year prevalence, aggregated peer norms, and perceived ease of access predicted subsequent use. These analyses provide evidence that a school's culture is predictive of changes in prevalence over time.

Sexual Identity Disclosure and Alcohol Experiences Among LGBTQ+ Adolescents

Sexual and gender minority youth (SGMY) report greater alcohol use in comparison to their heterosexual counterparts. Prior research has found that elevated alcohol use among SGMY can be explained by minority stress experiences. Sexual identity outness may be another factor that drives alcohol use among SGMY, given that outness is associated with alcohol use among older sexual and gender minority samples. We examined how patterns of sexual identity outness were associated with lifetime alcohol use, past-30-day alcohol use, and past-30-day heavy episodic drinking. Data were drawn from the LGBTQ National Teen Survey (N = 8884). Participants were SGMY aged 13 to 17 (mean age = 15.59) years living in the US. Latent class analysis was used to identify sexual identity outness patterns. Multinomial regressions were used to examine the probability of class membership by alcohol use. Six outness classes were identified: out to all but teachers (n = 1033), out to siblings and peers (n = 1808), out to siblings and LGBTQ+ peers (n = 1707), out to LGBTQ+ peers (n = 1376), mostly not out (n = 1653), and very much not out (n = 1307). SGMY in classes characterized by greater outness to peers, friends, and family had greater odds of lifetime alcohol use compared with SGMY in classes characterized by lower outness. These findings suggest that SGMY with greater sexual identity outness may be a target for alcohol use prevention programming. Differences in sexual identity outness may be explained by minority stress factors.

Knowledge, Attitudes, and Subjective Norms Associated with COVID-19 Vaccination among Pregnant Women in Kenya: An Online Cross-Sectional Pilot Study Using WhatsApp

COVID-19 vaccination during pregnancy has been recommended, but the perceptions related to uptake remain unexplored. This pilot study aimed to explore how perceptions influence COVID-19 vaccine uptake among a sample of 115 pregnant women in Kenya, recruited via WhatsApp. Data were collected using an adapted online questionnaire between May and October 2022. Logistic analyses assessed the relationship between COVID-19 vaccination uptake and the Theory of Reasoned Action (TRA) constructs: attitudes and subjective norms. COVID-19 vaccination coverage was 73%, with vaccine hesitancy estimated at 41.4% among the unvaccinated group. Most participants had completed college education and had good knowledge of COVID-19 vaccines. There was no significant effect of enrollment in WhatsApp pregnancy groups on attitudes toward COVID-19 vaccination. Pregnant women were concerned about vaccine effectiveness (31.1%), and almost one-half (47.3%) were discouraged from receiving COVID-19 vaccines. Positive attitudes towards vaccination were associated with COVID-19 vaccination (aOR 2.81; 95% CI 1.12-7.04; p = 0.027), but no significant relationship was found between COVID-19 vaccination and strong subjective norms (influences to get COVID-19 vaccines). Our findings suggest that strategies to improve vaccination should consider targeting attitudes and proximal social networks (friends/family) to facilitate vaccination decision-making. WhatsApp can be used for research distribution and enhance the dissemination of accurate information.

Adolescents' perceptions of alcohol portrayals in the media and their impact on cognitions and behaviors

OBJECTIVE

Exposure to alcohol in the media is pervasive and may influence adolescents' perceptions and use of alcohol. The purpose of this study was to better understand how adolescents perceive alcohol-related content in both entertainment and social media, with a focus on the valence of portrayals (i.e., positive, negative) and impacts on cognitions and behaviors.

METHOD

Participants were 40 high school students (60% female). Nine focus groups were conducted via videoconferencing, stratified by grade (9th/10th, 11th/12th) and gender. Transcripts were analyzed via template-style thematic analyses to identify themes.

RESULTS

Six themes were developed, including (a) some portrayals of alcohol may increase likelihood of using alcohol, (b) some portrayals of alcohol in the media can discourage drinking, (c) sometimes truly negative consequences of alcohol are portrayed positively or downplayed, (d) media portrayals of alcohol are perceived to be based in reality but are at times exaggerated, (e) adolescent and adult alcohol use is portrayed differently in entertainment media, and (f) the extent to which adolescents are influenced by the media may depend on their preexisting attitudes, beliefs, and education.

CONCLUSIONS

Adolescents have awareness of media portrayals of alcohol, both positive and negative, and their associated impacts. Findings highlight the need for much more work to understand the conditions under which, and for whom, exposure to different types of positive portrayals of alcohol in the media translate into positive expectancies about alcohol or drinking motives. Such work may ultimately inform intervention targets to reduce early initiation and/or risky drinking among adolescents. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Awareness of peers in recovery and of a campus collegiate recovery community at a university in the southeastern United States

Objective: Little is known about the extent of student awareness about collegiate recovery communities (CRCs) and of peers in recovery. Participants: A convenience sample of 237 undergraduate students from a diverse major at a private university participated in an anonymous online survey in Fall 2019. Methods: Participants reported whether they knew about the local CRC, whether they knew a peer in recovery, sociodemographic characteristics, and other information. Multivariable modified Poisson regression models were fitted to estimate correlates of awareness of the CRC and of peers in recovery. Results: Overall, 34% were aware of the CRC and 39% knew a peer in recovery. The latter was associated with being a member of Greek life, a junior or senior, using substances regularly, and personally being in recovery. Conclusions: Future research should explore ways to increase awareness of CRCs and assess the role of connections between students in recovery and peers across campus.

Investigating the Relative Influence of Romantic Sex Partners and Close Friends on Adolescent Alcohol and Marijuana Use

A large body of research has identified peer exposure as a key factor driving adolescent substance use. However, findings on the role of sex partners are less robust and mixed. This study aims to fill this gap by examining the independent contribution of close friends' and sex partners' alcohol and marijuana use on adolescents' use of these substances. A secondary data analysis of social network data collected in 2000-2002 from a household sample of African American youth (14-19 years old) in the Bayview and Hunter's Point neighborhoods of San Francisco was conducted. Index participants and their nominated close friends and romantic sex partners (N = 104 triads) self-reported recent alcohol and marijuana use (defined as any use in the past 3 months). Generalized estimated equations were used to estimate the independent association between adolescent's recent substance use and their friend's and sex partner's use. Adolescents with a marijuana-using romantic sex partner had a nearly six-fold higher odds of using marijuana compared to adolescents with a non-using partner, controlling for close friend's marijuana use and other confounders [OR:5.69, 95%CI: 1.94, 16.7]; no association with close friend's marijuana use was found. A similar pattern was observed for alcohol use. Adolescents with an alcohol-using romantic sex partner had increased odds of using alcohol compared to adolescents with a non-using partner, controlling for close friend's alcohol use and other confounders [OR:2.40, 95%CI: 1.02, 5.63]; no association with close friend's alcohol use was found. Romantic sex partners may play a unique and significant role in adolescent substance use. Peer-focused interventions may be more effective if they consider romantic sex partners. Future research should consider the role of romantic sex partners in changing social context related to substance use from adolescence to young adulthood.

Role of alcohol media literacy in alcohol use among children and adolescents: a systematic review

Enhancing alcohol media literacy (AML) is a critical strategy to attenuate negative effects of alcohol-related media messages. We aimed to systematically review previous studies on AML in children and adolescents. Through database and hand searches, we identified four non-experimental and 13 experimental studies. From the 17 studies, we extracted data on theoretical framework, AML measures, intervention contents and main findings. Our review revealed the following. First, nine and four studies used a single theory and at least two theories, respectively. The most frequently used theory was the Message Interpretation Process model. Second, 13 studies assessed AML using participant self-reporting or evaluators’ ratings of participant performance, but no study reported validities of AML measures. Eight studies assessed tobacco or general media literacy as well as AML. Third, all experimental studies used three to five media literacy core concepts proposed by the Center for Media Literacy in AML interventions. Finally, all non-experimental studies found strong cross-sectional associations between higher AML and improved drinking outcomes; all experimental studies found strong intervention effects, such as an increase in AML or improvement in drinking outcomes. In addition, intervention effects differed across participants’ gender and drinking experiences. Given our review, health professionals should implement strategies to enhance children and adolescents’ AML. Future research should investigate (i) causal inferences in non-experimental studies, (ii) long-term intervention effects in experimental studies and (iii) differences in intervention effects across participants’ characteristics, while using solid theoretical frameworks and multidimensional AML concepts.

A Longitudinal Study of Alcohol and Cannabis Use in Young Adulthood: Exploring Racial and Ethnic Differences in the Effects of Peer and Parental Influences From Middle Adolescence

OBJECTIVE

This study assessed how changes from middle adolescence to young adulthood in peer and parental influences relate to frequency of alcohol and cannabis use in young adulthood and evaluated the differences between three racial/ethnic groups.

METHOD

The analytic sample (n = 2,808; 52.9% female; 54% Hispanic, 22.9% White, 23.1% Asian/Pacific Islander) was derived from a longitudinal cohort initially recruited from 16 middle schools in Southern California who completed annual surveys. Data were collected across six waves beginning in Spring 2013 (mean age = 16.2) through Spring 2019 (mean age = 21.6).

RESULTS

Multigroup latent growth models revealed consistent increases during adolescence and young adulthood in perceived peer and parental approval of alcohol and cannabis and in the amount of time spent around peers who used these substances. After we controlled for prior use, these increases related to alcohol and cannabis use at age 21, with few exceptions. The time spent around peers most strongly influenced later cannabis use for Hispanic young adults, whereas the influence of peer approval on later alcohol and cannabis use, and parental approval on later alcohol use, was strongest among White young adults.

CONCLUSIONS

The frequency of alcohol and cannabis use in young adulthood was shaped, in part, from increases in direct and indirect peer influence and perceived parental approval of substance use across two important developmental periods. The findings highlight the importance of early and sustained intervention efforts targeting these social influences, especially among White adolescents, which may potentially decrease alcohol and cannabis use as youth enter young adulthood.

Race Differences in Opioid Misuse and Adolescent Suicidality

Purpose

The rise of the opioid epidemic coincided with the increased risk of suicide as the leading causes of death among adolescents in the United States. Past research has linked non-medical prescription opioid use (NMPOU) with adolescent suicide. Less focus has been placed on race and ethnic differences among adolescents impacted by the opioid epidemic. This study examined the relationship of adolescent NMPOU and suicidality, stratified by race.

Method

The 2016 National Survey on Drug Use and Health (NSDUH) was used for this study. Weighted multivariate logistic regression analyses were conducted on a sample of 11,489 adolescent respondents to examine the effect of past-year NMPOU with the odds for serious thoughts of suicide, having a suicide plan, and making a suicide attempt.

Results

Findings indicated a higher prevalence of suicidality among adolescents who engaged in NMPOU compared to non-users. Adolescent opioid misuse was associated with 68% higher odds for having a suicide plan in the past year (OR = 1.68, 95% CI: [1.07, 2.63], p < 0.05). Interaction analysis found that among Asian adolescents, NMPOU was associated with higher odds for having a suicide plan compared to other race groups (OR=1.53, 95% CI: [1.04, 2.23], p < 0.05).

Discussion

Results indicated that adolescent opioid misuse is a risk factor for suicide, and Asians compared to other race groups were at greater risk. Social workers can serve as a nexus point in effectively engaging at-risk adolescents in substance use and mental health prevention and recovery services.

Exposure to "Vaccination Selfies" Relate to Readers' Vaccination Intention: The Moderating Role of Partisan Media Use and the Mediating Role of Affective Responses

As vaccines for COVID-19 become accessible to the U.S. public, vaccinated individuals often post "vaccination selfies" on social media to encourage unvaccinated others to be inoculated. This study explores the relationship between exposure to these vaccination posts and post readers' vaccination intention. Drawn upon the functional affect theories, the authors proposed integral affective responses to the vaccination posts to explain readers' vaccination intention. Social media users' partisan media use was proposed to explain readers' different affective responses. Results from a cross-sectional survey (N = 343) showed that only exposure to proximal others' (e.g., friends), not distal others' (e.g., celebrities), vaccination posts was significantly associated with vaccination intention through positive affective responses. Conservative media use enhanced readers' negative affective response to vaccination posts whereas liberal media use was associated with positive affective responses. The findings highlighted the importance of social norms and positive affection appeals in pro-vaccination campaigns.

A Qualitative Analysis of Beliefs About Sexual Consent Among High School Students

Examining how adolescents understand the concept of sexual consent, and expect to garner or confer consent in sexual encounters, can contribute to the design of age- and developmentally appropriate prevention programs that promote healthy adolescent dating and sexual relationships. The current qualitative study utilized semi-structured in-depth interviews (N = 33) to explore perceptions of sexual consent among high school students (ages 14-18). Thematic analysis identified three salient themes pertaining to (a) the definition of consent as indicating a verbal "yes" to engage in sexual activity, (b) beliefs that an array of verbal and nonverbal strategies would be utilized to garner or convey consent in actual sexual encounters, and (c) expectations that consent would be communicated differently following an initial sexual encounter. Specifically, whereas consent was defined as a verbal provision of affirmative consent, both male and female adolescents believed girls typically conveyed consent nonverbally in sexual encounters. Adolescent girls indicated that they would convey sexual refusal through nonverbal cues, whereas adolescent boys reported they would proceed with sexual activity until they heard the verbal expression of "no." Regardless of gender, participants shared the perception that adolescents who previously engaged in sexual activity can expect that sexual activity will happen again without the need for verbal consent, particularly within established relationships. These findings highlight important discrepancies in adolescents' definition of sexual consent-primarily through verbal consent-and how they behaviorally indicated sexual consent and sexual refusal-primarily through nonverbal actions.

Early and Late Adolescent Factors that Predict Co-use of Cannabis with Alcohol and Tobacco in Young Adulthood

The changing legal landscape of cannabis in the USA has coincided with changes in how cannabis is used, including its co-use with other substances. This study analyzed 10 years of data from a diverse cohort of youth (N = 2429; 54% Hispanic, 16% Asian, 16% white, 3% black, 10% multiracial) to examine predictors in early and late adolescence of co-use of alcohol with cannabis (AC) and tobacco with cannabis (TC) at age 21. Two forms of co-use were examined: concurrent (use of both substances in past month) and sequential (use of one substance right after the other). Analyses focused on four predictor domains: individual (e.g., resistance self-efficacy), peer (e.g., time spent around peers who use), family (e.g., sibling use), and neighborhood (i.e., perceived alcohol and drug problems in neighborhood). For each co-use combination (AC or TC), we estimated parallel process piecewise latent growth models in a structural equation modeling framework using Mplus v8. The final AC and TC co-use models included all predictor variables from the four domains. Increases in positive expectancies and time spent around peers who use AC, as well as steeper decreases in resistance self-efficacy, were all related to a greater likelihood of AC co-use in young adulthood. Increases in sibling TC use and time spent around peers who use TC, as well as steeper decreases in resistance self-efficacy, were all related to a greater likelihood of TC co-use in young adulthood. Overall, findings highlight the importance of addressing peer influence in prevention programming during both early and late adolescence.

Social Learning and Addiction

Social learning theory, as originally proposed by Albert Bandura, followed 2000 years of intellectual inquiry into the determinants of human behavior. Reciprocal determinism is a central component of this theory and proposes that human behavior is determined by functional relationships between (1) personal factors, (2) the external environment, and (3) the behavior itself. Using this model, drug addiction can be viewed as resulting from the functional relationships between an individual's personal characteristics, social environment, and drug-centric behaviors. In other words, addiction can be viewed as a chronically evolving biopsychosocial disorder, encompassing dimensions that are both internal and external to the individual. Effective treatment interventions should thus target all nodes of the model and the functional relationships between them, and they must constantly evolve with the progression of the disorder. An argument is thus constructed that emphasizes the need for an organized structure of metacontingencies, operating within an individual's social environment, that targets the functional relationships between the factors that drive drug use. Optimally, these metacontingencies would operate within socially connected individuals who have the power to control the functional relationships that influence drug use, the vested interest to monitor individual and collective outcomes, the skills to determine what moment-to-moment decisions are needed to influence behavioral change, and the relative permanence necessary to carry through with the implementation of new strategies to produce outcomes that are cumulatively significant.

The role of school characteristics in pre-legalization cannabis use change among Canadian youth: implications for policy and harm reduction

Reducing youth cannabis use in Canada is a public health priority with schools of interest as a potential modifier of behavior and as a venue for prevention programming. This work aimed to provide a basis for future policy and programming by evaluating pre-legalization cannabis use change patterns in schools and the impact of school characteristics on these patterns. Average rates of cannabis use behavior change (initiation, escalation, reduction, cessation) were collected from 88 high schools located in Ontario and Alberta, Canada participating in the COMPASS prospective cohort study. There was little variability in cannabis use behaviors between schools with intra-class correlation coefficients lowest for cessation (0.02) and escalation (0.02) followed by initiation (0.03) and reduction (0.05). Modest differences were found based on school province, urbanicity and student-peer use. Cannabis ease of access rates had no significant effect. Fewer than half the schools reported offering school drug use prevention programs; these were not significantly associated with student cannabis use behaviors. In conclusion, current school-based cannabis prevention efforts do not appear sufficiently effective. Comprehensive implementation of universal prevention programs may reduce cannabis harms. Some factors (urbanicity, peer use rates) may indicate which schools to prioritize.

Qualitative exploration of the intersection between social influences and cultural norms in relation to the development of alcohol use behaviour during adolescence

OBJECTIVES

Few contemporary studies have examined peer and social drivers of alcohol use during mid-adolescence. We sought to explore young people's perspectives on socio-cultural influences relating to alcohol use behaviour during this period.

DESIGN

Qualitative research study.

METHODS

Semi-structured one-to-one (n=25), paired (n=4) or triad (n=1) interviews and one focus group (n=6) were conducted with 30 young people aged 14 to 15 (13 males, 17 females) recruited from 4 schools, and 12 participants (aged 14 to 18, 8 males, 4 females) recruited from two youth groups in an urban centre in the West of England. Nineteen participants abstained from alcohol use, 9 were occasional or moderate drinkers and 14 drank alcohol more regularly. Interviews were audio-recorded, transcribed verbatim and analysed thematically using NVivo V.10, through a lens of social influence and social norms theories.

RESULTS

Alcohol consumption was associated with being cool, mature and popular, while enabling escape from reality and boosting confidence and enjoyment. Positive expectancies, alongside opportunity, contributed to motivating initiation, but social influences were paramount, with participants describing a need to 'fit in' with friends to avoid social exclusion. Such influences positioned drinking at parties as a normative social practice, providing opportunities for social learning and the strengthening of peer norms. Social media presented young people with positive alcohol-associated depictions of social status, enjoyment and maturity. This intersection of influences and norms generated a pressurised environment and a sense of unease around resisting pressures, which could elicit stigmatising insults.

CONCLUSIONS

Cultural norms, social influences and social media intersect to create a pressurised environment around alcohol use during mid-adolescence, driving the escalation in the prevalence of excessive consumption at this stage. New interventions need to address normative influences to enable the prevention of excessive alcohol use during adolescence.

Alcohol Use among Latinx Early Adolescents: Exploring the Role of the Family

The present study describes results of a randomized three-group repeated measures study that examined whether augmenting a culturally-based parent education program (Familias) can strengthen the effects of a youth intervention (kiR) in reducing rates of alcohol consumption among Latinx adolescents. A stratified random sample of 462 Latinx early adolescents from a Southwestern city participated in this study. Ordinary Least Squares regression results show that receiving the parental and youth curricula components and two other family practices were significantly associated with lower rates of alcohol consumption at Wave 2. Findings support the notion that prevention efforts that include a culturally grounded parent component could be a more effective strategy to help Latinx youth refrain from alcohol use than youth-only programs.

Long-term Associations Between Substance Use-Related Media Exposure, Descriptive Norms, and Alcohol Use from Adolescence to Young Adulthood

Adolescents and young adults in the United States are constantly exposed to substance-related media and advertising content. The current study seeks to explore, developmentally, how exposure to substance-related media content influences both normative beliefs about peer alcohol use and individual alcohol use. Youth (N = 4'840; 50.6% female) were followed for ten years from age 12 to 22. Auto-regressive latent trajectory with structured residual (ALT-SR) models were used to explore within-person reciprocal associations between substance-related media content, descriptive norms, and alcohol use. Results indicated that' across adolescence and young adulthood, exposure to substance-related media content was associated with increased alcohol use via perceived alcohol norms. The pathway from media exposure to alcohol use was mediated by increased perceived norms for adolescents only. With screen time increasing over the last decade, it is important to invest resources into real-time interventions that address substance-related social media content as it relates to misperceived norms and to begin these interventions in early adolescence.

Drinking to keep pace: A study of the moderating influence of extraversion on alcohol consumption similarity in drinking buddy dyads

Heavy drinking in college remains a concerning issue due to its association with both health and social risks. While modelling contributes to college students' alcohol use, little work has identified who might be most susceptible to modelling effects. Peterson, Morey, and Higgins (2005) found males high in extraversion were more susceptible than others to matching strangers' drinking levels in a lab-based social drinking context. We sought to replicate and extend these findings by examining the impact of extraversion on social matching of alcohol consumption levels of a drinking buddy in college students' real lives. First, a significant relationship between buddy and target drinking levels was predicted in dyadic drinking situations. Additionally, we hypothesized that target extraversion would positively moderate this buddy- target drinking levels relationship. Data from 149 college student targets (74% F) and their same-sex drinking buddy were collected through online questionnaires examining targets' extraversion levels, and the drinking levels and social drinking context of both dyad members through a 30-day Timeline Followback measure. Linear mixed-effects modelling confirmed the study's first social matching hypothesis, while also revealing that target extraversion positively moderated the relationship between buddy and target daily drinking levels in dyadic drinking contexts. Findings extend those of Peterson et al. (2005) to a real-world (vs. lab-based) context, modelling of a buddy's (vs. stranger's) drinking levels, and a sample including women (vs. all-male). Results provide novel information on extraversion's contributions to modelling of alcohol use that may guide useful modifications to personality-based interventions for reducing college student heavy drinking.

Sensation seeking to marijuana use: Exploring the mediating roles of risk appraisal and social norms

While studies have shown a robust association between sensation seeking (SS) and adolescent marijuana use, comparatively little is known about the mechanisms that potentially account for this association. The current study tests a theoretical model linking SS to marijuana use through risk appraisal and normative influences (i.e., perceived behavior and attitudes of others). Utilizing a nationally representative, cross-sectional sample of high school seniors (N = 2117), the current study finds risk appraisal and normative influences mediate the relationship between SS and marijuana use. Furthermore, perceptions of risk appear to be strongly influenced by proximal peer norms. These results indicate risk appraisal and normative processes may be key explanatory mechanisms in the association between SS and adolescent marijuana use. Theoretical and policy implications for this model are discussed.

Dyadic and Group-Level Positive Friendship Characteristics and Susceptibility to Perceived Delinquent Peer Substance Use

Peer relations researchers have suggested that dyadic and peer group relationship characteristics may interact with each other to affect behavior. Building on prior work that has pitted the relative effects of dyadic and peer group relationship characteristics on susceptibility to peer influence, the present study sought to integrate dyadic and group characteristics into a moderational model by testing whether friendship quality and peer group identification together exacerbate risk for conforming to peer norms for substance use. This longitudinal study included 387 early adolescents assessed annually for 4 years. Participants completed measures of perceived peer delinquency, friendship quality, peer group identification, and substance use frequency. Results indicated that perceived peer delinquency had the strongest association with substance use for adolescents characterized by high friendship quality and high peer group identification. These findings highlight the importance of considering the joint effects of multiple peer relationship characteristics on susceptibility to peer influence.

Declining alcohol consumption among adolescents and schools in Stockholm, 2010-2016

Aims:

The principle aim of this study was to investigate changes in alcohol consumption among adolescents in Stockholm from 2010 to 2016. A further aim was to investigate whether there are divergent or similar trends in alcohol consumption among elementary schools in Stockholm from 2010 to 2016 and, if there are diverging trends, to examine how the differences might be explained.

Methods:

Data were analysed using multilevel mixed effects linear regression, in which individual students represented one level and schools the second level.

Data:

Student-level data were derived from the Stockholm School Survey for the years 2010, 2012, 2014 and 2016 (n = 15481). School-level data (n = 132) were derived from registries of the Swedish National Agency for Education.

Results:

The results showed that there was an almost 45% decline in total alcohol consumption among ninth-grade students in Stockholm between 2010 and 2016. The decline was similar among all analysed consumption groups. Two factors were found to statistically explain some of the general decline: more restrictive parental attitudes towards alcohol and, more importantly, decreasing alcohol consumption among the students’ peers. The downward trends among schools between 2010 and 2016 were universal but not identical, but when parental attitudes towards alcohol and peers’ alcohol behaviour were controlled for, the diverging school trends in alcohol consumption were considerably more equal.

Conclusions:

School constitutes a social context for the student of which both parents and peers are important parts, and the diverging changes may be due to the norms and behaviours, influenced by parents and peers, characterising these schools.

Adolescent betel nut use in Guam: beliefs, attitudes and social norms

Betel (areca) nut is an addictive substance chewed with or without tobacco widely in Asia and the Pacific, including the U.S.-affiliated Pacific Islands (USPI). Betel nut use has been found to cause oral cancer. Research suggests that most betel nut use initiation occurs in adolescence. However, very little is currently known about the etiology of adolescent betel nut use. The present study reports findings of a formative, qualitative research conducted to understand the attitudinal and social factors associated with adolescent betel nut use in USAPI. The objective was to develop a theoretical framework of adolescent betel nut etiology that would guide the development of a prevention program. Semi-structured interviews were conducted with 20 adolescent betel nut users (M age = 14.5; SD = 2.2) from Guam. Findings suggested a framework of adolescent betel nut etiology in which intrapersonal, social, and environmental factors influence betel nut use behavior. The framework is consistent with ecological frameworks of adolescent substance use in which proximal personal and social influences on adolescent substance use occur within the context of a wider socio-cultural context conducive to adolescent substance use. Specifically, we found that beliefs such as betel nut tastes good and induces relaxation represent some of the betel nut use motives; parental permissiveness and peer and sibling use encourage betel nut use; and cultural acceptance and easy accessibility to betel nuts provide an environmental context conducive to betel nut use. Findings are discussed in the context of developing an adolescent betel nut use prevention program.

Relative influence of perceived peer and family substance use on adolescent alcohol, cigarette, and marijuana use across middle and high school

PURPOSE

Substance use by peers and family may affect adolescent substance use, yet the relative influence may shift during adolescence as youth differentiate themselves from family and more closely affiliate with peers. This study examined trends in concordance of adolescent cigarette, alcohol and marijuana use and corresponding perceived use by friends and family members during middle and high school.

METHODS

Data are from a longitudinal cohort of 12,038 youth who completed up to five surveys during grades 6-12. At each wave, adolescents reported past month use of cigarettes, alcohol and marijuana, as well as perceived use by their best friend, older sibling and most important adult figure. For each substance, we used time-varying effect models to estimate how associations between adolescent use and perceived use varied across grade.

RESULTS

For all substances, concordance with best friend use was positive and stronger than concordance with older sibling or adult use at all grades. Concordance with both best friend and older sibling use of all substances was pronounced in 6th grade. Concordance peaked again during mid-high school for smoking (best friend, older sibling) and marijuana (best friend). Concordance with adult marijuana use peaked in middle school, yet associations with adult alcohol and cigarette use were relatively stable.

CONCLUSIONS

Substance use prevention efforts that seek to counter peer normative pressures should begin prior to middle school and span high school. Such efforts should address the role of peer and family environments, as both were found to be relevant during middle and high school.

Clusters of alcohol and drug use and other health-risk behaviors among Thai secondary school students: a latent class analysis

Background

Alcohol and drug use and other health-risk behaviors tend to cluster together among adolescents and contribute a large amount of harm to both themselves and to others. This paper aims to characterize secondary school students based on their clusters of health-risk behaviors and identify factors determining class membership to these behavior-clusters.

Methods

Data from a national school survey was used to identify clusters of alcohol and drug use and other health-risk behaviors among secondary school students aged 12–15 years using a latent class regression model. A multinomial logistic regression model was used to identify predictors of the cluster membership.

Results

A total of 25,566 students were included in the analysis, of which 88% were classified as having low-risk behaviors reporting only moderate alcohol use; 11% as having moderate-risk behaviors, such as driving under the influence of alcohol, fighting, carrying a weapon, and alcohol and tobacco use; and 0.6% as having high-risk behaviors, such as use of illicit drugs, particularly kratom and cannabis. Males, older students, those with a poor school performance, not living with parents, drug use by family members and peers, and having a low level of perceived disdain from their friends if they used drugs were significant risk factors for being in the moderate- and high-risk behavior classes.

Conclusions

Alcohol, tobacco and drug use, as well as other health-risk behaviors such as fighting, are clustered in Thai secondary school students. This result highlights the importance of comprehensive prevention and education strategies, particularly for moderate to high-risk groups.

Role of social normative beliefs as a moderating factor in smoking intention among adolescent girls in Korea

In this study, we investigated the relationship between risk-taking tendency and smoking intention as moderated by social normative beliefs among Korean female adolescents. A cross-sectional study was conducted with 274 female adolescents in middle school. Multiple regression and simple slope analyses were employed to test the moderating effects of social normative beliefs regarding smoking on the relationship between risk-taking tendency and smoking intention. Results determined that risk-taking tendency, social normative beliefs regarding smoking, and their interaction were significant factors influencing smoking intention among adolescents. Risk-taking tendency was associated with greater smoking intention among adolescents, with higher than average social normative beliefs regarding smoking. However, risk-taking tendency was not significantly associated with smoking intention for adolescents with lower than average social normative beliefs regarding smoking. In conclusion, social normative beliefs regarding smoking moderated the relationship between risk-taking intention and smoking intention among Korean female adolescents. Unique sociocultural perceptions about smoking behaviors of adolescents need to be reflected in smoking-prevention and -cessation programs.

Understanding Educational and Psychosocial Factors Associated with Alcohol Use among Adolescents in Denmark; Implications for Health Literacy Interventions

Background. Alcohol misuse is a global public health priority, with a variation in prevalence and impact between countries. Alcohol misuse in adolescence is associated with adverse psychological, social and physical health. Adolescents in Denmark have higher alcohol consumption and problematic alcohol use than adolescents in other European countries. Associations between social determinants of health (SDH), psycho-social factors and alcohol consumption are complex and influenced by national context and cultures. This study explored these associations in Danish adolescents. Method. The European School Survey Project on Alcohol and Other Drugs (ESPAD) survey collects data on alcohol and substance use among 15⁻16-year-old European students. Data contributed by Danish students to the 2011 survey were analyzed. The outcomes of interest were alcohol consumption (any, intoxication and problematic). Health literacy was not directly measured, so self-described educational performance and knowledge about alcohol were used as proxies for health literacy. Exploratory factors thus included socio-demographic, health literacy-related (knowledge about alcohol, educational performance) and psycho-social factors, as well as expectancies of the effect of alcohol (both positive and negative) and self-reported health. Univariate and multivariate logistic regression analyses were undertaken. Results. Of the 2768 adolescents who participated in the survey, 2026 (80%) consumed alcohol during the last 30 days, 978 (38%) were intoxicated at least once during the last 30 days, and 1050 (41%) experienced at least one problem because of alcohol use during the last 12 months. Multivariable analysis showed that the factors associated with higher alcohol intake were gender, poor relationships with parents, expectancies of the impact of alcohol (both positive and negative), and the influence of peers and their alcohol use. Higher school performance was related to lower alcohol consumption. Low socio-demographic status was not associated with higher alcohol consumption. Conclusions. This study confirmed the high levels of alcohol intake, intoxication, and problem drinking amongst the Danish students in the survey and the complexity of the socio-demographic, psychosocial, health literacy-related, and environmental factors associated with alcohol behaviours. Approaches to addressing the issue of alcohol use in Danish adolescents will need to be multi-factorial, including supporting students to develop alcohol-related health literacy skills to enable them to make informed choices.

When and How Do Brief Alcohol Interventions in Primary Care Reduce Alcohol Use and Alcohol-Related Consequences among Adolescents?

OBJECTIVE

To systematically describe when and how brief alcohol interventions delivered to adolescents in primary care settings reduce alcohol use and alcohol-related consequences among adolescents, using realist review methodology.

STUDY DESIGN

Eleven electronic databases, gray literature, and reference screening were searched up to June 2016; 11 brief interventions published in 13 studies met inclusion criteria. Intervention design components (delivery context and intervention mechanisms) underlying brief alcohol interventions for adolescents were extracted and linked to alcohol use and related consequences.

RESULTS

Brief interventions had either an indicated context of delivery (provided to adolescent patients with low-to-moderate risk for alcohol problems) or universal context of delivery (provided to general adolescent patient population). Interventions that used motivational interviewing in an indicated delivery context had 2 potential mechanisms-eliciting and strengthening motivation to change and providing direction through interpretation. These interventions resulted in clinically significant reductions in alcohol use and associated consequences. Peer risk also was identified among universal and indicated brief interventions as a potential mechanism for changing alcohol-related outcomes among adolescents who received the intervention. None of the studies tested the processes by which interventions were expected to work.

CONCLUSIONS

The current evidence base suggests that both indicated and universal delivery of brief alcohol interventions to adolescents in primary care settings can result in clinically important changes in alcohol-related outcomes. Studies that test brief intervention processes are now necessary to better understand how brief interventions work with adolescents in primary care settings.

Use of alcohol, tobacco and illicit drugs among ethnic Norwegian and ethnic minority adolescents in Hordaland county, Norway: the youth@hordaland-survey

OBJECTIVE

To describe potential differences in unhealthy behaviours among ethnic Norwegian adolescents and minority adolescents from countries within the European Union, European Economic Area or US (EU/EEA countries) and adolescents from non-EU/EEA countries. Specifically, we aimed to investigate ethnic differences in use of alcohol, tobacco and illicit drugs, and potential confounding due to socio-demographic characteristics.

DESIGN

Cross-sectional population-based study of adolescents aged 16-19 (N = 10,122), with self-reported ethnicity as grouping variable, and self-reported use of alcohol, tobacco and illicit drugs as dependent variables.

RESULTS

We found that minority adolescents from EU/EEA and non-EU/EEA countries differed from ethnic Norwegian adolescents on important indicators of unhealthy behaviours. Compared to Norwegian adolescents, adolescents from EU/EEA were more likely to report having tried to smoke, to be a daily smoker and to ever having tried an illicit drug (adjusted odds ratio (OR) ranging from 2.01 to 3.74). They were, however, less likely to have tried snus (a form of smokeless tobacco; adjusted OR 0.64; confidence interval (CI) 95% 0.43-0.97) and to report daily snus use (adjusted OR 0.31; CI95% 0.15-0.67). There were no differences in having tried alcohol. Non-EU/EEA adolescents were less likely to have ever tried alcohol (OR 0.24; CI95% 0.18-0.31), snus (OR 0.47; CI95% 0.34-0.65) and to smoke (0.68; CI95% 0.52-0.91), and less likely to report daily snus use (OR 0.36; CI95% 0.21-0.62) compared to Norwegian adolescents. There were no differences with regard to having tried illicit drugs and reporting being a daily smoker. All differences observed were robust to adjustment for age, gender and family socio-economic status.

CONCLUSION

The presents study identified important differences in unhealthy behaviours across different ethnic groups in Norway. The differences in the prevalence of unhealthy behaviours among ethnic minorities are still relevant in a public health perspective, and potential mechanisms should be investigated further.

Association between Australian adolescent alcohol use and alcohol use risk and protective factors in 2011 and 2014

INTRODUCTION AND AIMS

Changes in risk and protective factors of adolescent alcohol use may be contributing to the recent decline in Australian adolescents alcohol use. The study aimed to determine the: (i) prevalence of alcohol use, risk and protective factors in 2011 and 2014; and (ii) association between alcohol use and risk and protective factors in 2011 and 2014.

DESIGN AND METHODS

A repeat cross-sectional study was conducted. Grade 9-10 (aged 15-17 years) students from 32 Australian secondary schools were sampled in 2011 and 2014. A self-report survey collected data regarding alcohol use (ever, recent, 'binge drinking'), risk factors (e.g. alcohol use/permissive attitude to alcohol by friends/siblings/parents) and protective factors (e.g. self-efficacy; school/home/community support; peer caring relationships). Descriptive statistics were used to determine differences in alcohol use, risk and protective factors between 2011 and 2014. Adjusted multivariable logistic regression analyses examined associations between alcohol use, risk and protective factors separately in 2011 and 2014 (six models).

RESULTS

Fewer adolescents reported alcohol use in 2014 compared with 2011 (ever: 56.6% vs. 67.9%, recent: 17.3% vs. 21.2%, 'binge drinking': 20.0% vs. 23.5%; 2011: n = 4366; 2014: n = 5199). Significant differences between 2014 and 2011 were found for some risk (five lower; one higher) and protective factors (four lower). Risk factors that were significantly lower in 2014 compared to 2011 were amongst variables with the strongest associations with alcohol use.

DISCUSSION AND CONCLUSIONS

The strength of associations with alcohol use, and decrease in the prevalence of certain risk factors in 2014 compared to 2011, suggests such factors may be contributing to the decline in adolescent alcohol use.

Neighborhood or School? Influences on Alcohol Consumption and Heavy Episodic Drinking Among Urban Adolescents

Little is known about the relative influences of neighborhood and school on the alcohol socialization process. Survey data from the Young in Oslo Study (N = 10,038, mean age 17.1 years, 52% girls) were used to investigate the details of such influences, using cross-classified multilevel models. School and neighborhood contexts were equally important for ordinary alcohol use; however, neighborhood influences were mainly explained by individual and family factors, whereas peer-based sociocultural processes played a key role in explaining school effects. Neither context had much impact on heavy episodic drinking. The study suggests that "privileged" youth may be at risk of high alcohol consumption. Parental influences and peer-based sociocultural aspects of the school milieu should be considered in prevention efforts.

Risk Factors for Youth E-Cigarette "Vape Trick" Behavior

PURPOSE

Some adolescent users of e-cigarettes and other electronic vaping products (EVPs) report performing "vape tricks" (exhaling aerosol to make shapes). However, little is known about this behavior. We examined the frequency of performing and watching vape tricks and the characteristics of those most likely to perform vape tricks among a sample of adolescent EVP users.

METHODS

We used social media ads to recruit a national convenience sample of U.S. adolescents (n = 1,729) to participate in an online survey in September 2016. Inclusion criteria required participants to be aged 15-17 years and to have used EVPs at least once in the past 30 days.

RESULTS

The majority of EVP-using adolescents reported trying (77.8%) and watching vape tricks in person (83.7%) or online (74.0%). Risk factors for performing tricks included using advanced vaping devices, vaping every day, white race, moderate levels of seeing and sharing vaping information on social media, and believing that EVP use is more normative among peers. Likelihood of trying vape tricks decreased as beliefs about the harmfulness of EVPs increased.

CONCLUSIONS

Vape tricks pose a potential threat to adolescent health if they encourage nonusers to initiate or current EVP users to use more frequently or switch to advanced devices that produce more harmful chemical emissions. Further research should examine the possible health effects of performing vape tricks, and future public health campaigns should be informed by an understanding of the appeal of this activity for adolescents.

Examining a Partial Biopsychosocial Model for Monthly Alcohol, Tobacco, and Marijuana Use Among Adolescents

Alcohol, tobacco, and marijuana are commonly used substances among adolescents. In the context of the Biopsychosocial Model (BPSM), this study investigated the relationships between psychological and normative factors associated with adolescent alcohol, tobacco, and marijuana use. Data were analyzed from 1053 middle and high school students. Structural equation modeling was used to examine the relationships between BPSM constructs. Results indicate that latent constructs of the BPSM are significant antecedent factors to alcohol, tobacco, and marijuana use; however, the relationships between study constructs were inconsistent with those theorized by BPSM. Findings support the importance of theory testing for complex models applied to new topics and new populations.

The effects of social contact on cocaine intake in female rats

BACKGROUND

Studies conducted in male rats report that social contact can either facilitate or inhibit drug intake depending on the behavior of social partners. The purpose of the present study was to: (1) examine the effects of social contact on cocaine intake in female rats, (2) examine the behavioral mechanisms by which social contact influences cocaine intake, and (3) examine whether the estrous cycle moderates the effects of social contact on cocaine intake.

METHODS

Female rats were assigned to either isolated or pair-housed conditions in which a social partner either had access to cocaine (cocaine partner) or did not have access to cocaine (abstinent partner). Pair-housed rats were tested in custom-built operant conditioning chambers that allowed both rats to be tested simultaneously in the same chamber.

RESULTS

Rats housed with a cocaine partner self-administered more cocaine than isolated rats and rats housed with an abstinent partner. A behavioral economic analysis indicated that these differences were driven by a greater intensity of cocaine demand (i.e., greater intake at lower unit prices) in rats housed with a cocaine partner. Multivariate modeling revealed that the estrous cycle did not moderate the effects of social contact on cocaine intake.

CONCLUSIONS

These findings indicate that: (1) social contact influences cocaine self-administration in females in a manner similar to that reported in males, (2) these effects are due to differences in the effects of social contact on the intensity of cocaine demand, and (3) these effects are consistent across all phases of the estrous cycle.

Misperception and accurate perception of close friend substance use in early adolescence: Developmental and intervention implications

Misperceptions of peer substance use (SU) are believed to be a robust correlate of adolescent SU; however, perceived peer SU is biased in the direction of an adolescent's own SU raising questions about the validity of perceived peer SU (social norms; Henry, Kobus, & Schoeny, 2011). In addition, social norm theories emphasize inaccurate perceptions of peer SU while other theories emphasize actual peer behavior and selection of friends as motivators of adolescent SU. Furthermore, no theories consider the role of accurate perceptions, suggesting the need to more carefully consider the coevolution of perceived peer norms, actual peer behavior, and adolescent SU. To do this, we modeled the latent structure of accurate and inaccurate perceptions of peer SU while including an adolescent's own SU using latent class analysis and tested the natural evolution of the classes using latent transition analysis. The design included 3 annual assessments of peer and perceptions of peer SU and 6 assessments of adolescent SU (N = 765; age = 10-13 at Wave 1; female = 53%). Latent class analysis findings largely replicated Henry et al. (2011), suggesting that misperceptions of peer SU were biased by an adolescent's own SU. We also found 3 distinct pathways to a high risk class that predicted high levels of later adolescent SU, 2 in which adolescent and perceived peer SU preceded peer SU (age = 10-12 and 12-14) and another in which peer SU preceded adolescent SU and perceptions of peer SU (age = 12-14). Implications for peer influence theories are discussed. (PsycINFO Database Record

Multivariate family factors in lifetime and current marijuana use among American Indian and white adolescents residing on or near reservations

BACKGROUND

Rates of marijuana use are consistently high among reservation-based American Indian adolescents. The roles of family are unique in this ethnic group and can serve as sources of both risk and protection for substance use.

PURPOSE

To assess the relationships between distal and proximal family factors and lifetime and current marijuana use among American Indian and white middle and high school students who attend the same schools on or near reservations.

METHODS

In-school surveys were administered to 3380 American Indian and 1562 white students from 35 middle schools and 17 high schools regarding levels of marijuana use and family characteristics. Three logistic regression models (Control, Control+Distal; Control+Distral+Proximal) estimated effects of multiple family variables on lifetime and current marijuana use.

RESULTS

Strong effects were found for family structure, parental monitoring, family conflict, and family sanctions against marijuana use. Weaker effects were found for family participation in school events, and no relationship was found for family communication about marijuana. Anumber of similar results were found across ethnicity and middle and high school students.

CONCLUSIONS

Family variables exert strong and largely consistent effects across reservation-based American Indian and white youth on lifetime and current marijuana use. Interventions that include a broad range of targeted family components may serve to both limit uptake and forestall increases in adolescent marijuana use in these two groups.

Psychosocial Factors Associated With Smoking Intention in Korean Male Middle School Students

This study examined psychosocial factors influencing smoking intention in Korean male middle school students. We used a descriptive cross-sectional design, based on the biopsychosocial model, to analyze data from 309 male adolescents aged 14–16 years in middle school. Of the psychological factors examined, stress and risk-taking tendency were significantly associated with smoking intention. Of the social factors examined, social normative beliefs, close friends’ and siblings’ smoking, and low socioeconomic status were significant factors in smoking intention. The explanatory power of these variables in the predictive model was 23.1%. In conclusion, the unique psychological and social characteristics of adolescents should be reflected in interventions for smoking prevention.

Alcohol attitudes, motives, norms, and personality traits longitudinally classify nondrinkers, moderate drinkers, and binge drinkers using discriminant function analysis

INTRODUCTION

Binge drinking is commonly defined in the literature as consuming at least 5 drinks for males and 4 drinks for females. These quantities correspond to approximately a blood alcohol concentration of 0.08%, the level of intoxication making it illegal to drive in the United States.

METHODS

The study scrutinized the longitudinal classification of three drinker types using male (n=155) and female (n=351) college students. Measures of personality (sensation seeking, extraversion, agreeableness, conscientiousness, neuroticism, and openness), alcohol attitudes, alcohol motivations (social, coping, enhancement, and conformity), and alcohol social norms (typical students, friends, closest friends, and parents) were administered at Time 1. Drinker type (nondrinkers, moderate drinkers, or binge drinkers) was assessed one month later.

RESULTS

Discriminant function analyses revealed that the set of measures statistically distinguished among the three drinker types. The first function was significant and yielded high loadings for attitudes, social motives, enhancement motives, coping motives, closest friend norms, and friend norms for both genders. Model classification accuracy was 73% for the male and 67% female samples. Multivariate analysis of variance (MANOVA) compared mean differences in a 2 (gender: males or females)×3 (drinker type: nondrinkers, moderate drinkers, or binge drinkers) design. Measures systematically differing across all pairwise comparisons of the three drinker types, starting from the strongest effect (eta-squared), were as follows: alcohol attitudes, social motives, enhancement motives, closest friend norms, friend norms, coping motives, sensation seeking, and extraversion.

CONCLUSIONS

Attitude, motivation, and norm variables tended to be more important than personality in distinguishing drinker types. Considering the malleability of attitudes and belief motivations, the risk variables of alcohol attitudes, social motives, and enhancement motives identified in this research warrant consideration in prevention and campaign efforts targeting problematic drinking.

Substance use capital: Social resources enhancing youth substance use

BACKGROUND

Social capital is described as a protective factor against youth substance use, but it may also be associated with behaviours that do not enhance health. The present study hypothesized that 'substance use capital', i.e. resources favourable to substance use, is a risk factor for substance use and misuse.

METHODS

We used baseline data from the ongoing Cohort Study on Substance Use Risk Factors (C-SURF) that included a representative sample of young Swiss men (n=5623). Substance use (alcohol, cannabis, 15 illicit drugs, lifetime use, hazardous use and dependence), substance use capital (parental and peer attitudes towards substance use, parental and peer drug use, perceived norms of substance use) and aspects of social capital (relationships with parents and peers) were assessed. Logistic regressions were used to examine the associations between substance-related resources and social resources, and substance use.

RESULTS

Results showed that substance-related resources were associated with an increased risk of substance use (OR between 1.25 and 4.67), whereas social resources' associations with substance use were commonly protective but weaker than substance-related resources. Thus, a drug-friendly environment facilitated substance use and misuse. Moreover, the results showed that peer environments were more drug-friendly than familial environments.

CONCLUSION

In conclusion, this study highlighted a concept of 'substance use capital', which may be useful for advancing both theoretical and applied knowledge of substance use. Indeed, substance use is not only associated with a lack of social resources, but also with specific drug-friendly social resources coming from environment and background.

The effects of sex, estrous cycle, and social contact on cocaine and heroin self-administration in rats

RATIONALE

Preclinical studies indicate that gonadal hormones are important determinants of drug self-administration. To date, little is known about the influence of sex and estrous cycle on drug self-administration in ecologically relevant social contexts.

OBJECTIVE

The objective of this study was to examine the role of sex and estrous cycle in a rat model during cocaine and heroin self-administration with male-female and female-female social dyads.

METHODS

Male and female virgin rats were trained to self-administer cocaine and heroin in operant conditioning chambers that permitted two rats to self-administer concurrently, but prevented physical contact. Experiment 1 examined cocaine self-administration on a progressive ratio schedule in male-female dyads. Experiments 2 and 3 examined heroin self-administration on a fixed ratio schedule in male-female dyads at constant and varying doses, respectively. Experiment 4 examined heroin self-administration in female-female dyads on a fixed ratio schedule.

RESULTS

Cocaine-maintained breakpoints increased by ∼17 % in females during estrus, but remained consistent in males. Heroin self-administration decreased by ∼70 % during proestrus in females whether they were isolated, housed with males, or housed with females. Heroin self-administration was lower in males than females under some conditions and was not consistently associated with the responding of females.

CONCLUSIONS

Cocaine and heroin self-administration is influenced by the estrous cycle in females when in the presence of a male partner. As a novel finding, these data illustrate that heroin self-administration is reduced in females during proestrus regardless of the social context tested. Finally, these data suggest that drug self-administration in males is only minimally influenced by the hormonal status of a female partner.

Social Anxiety and Cannabis-Related Impairment: The Synergistic Influences of Peer and Parent Descriptive and Injunctive Normative Perceptions

OBJECTIVES

Cannabis users, especially socially anxious cannabis users, are influenced by perceptions of other's use. The present study tested whether social anxiety interacted with perceptions about peer and parent beliefs to predict cannabis-related problems.

METHODS

Participants were 148 (36.5% female, 60.1% non-Hispanic Caucasian) current cannabis users aged 18-36 (M = 21.01, SD = 3.09) who completed measures of perceived descriptive and injunctive norms, social anxiety, and cannabis use behaviors. Hierarchical multiple regressions were employed to investigate the predictive value of the social anxiety X parent injunctive norms X peer norms interaction terms on cannabis use behaviors.

RESULTS

Higher social anxiety was associated with more cannabis problems. A three-way interaction emerged between social anxiety, parent injunctive norms, and peer descriptive norms, with respect to cannabis problems. Social anxiety was positively related to more cannabis problems when parent injunctive norms were high (i.e., perceived approval) and peer descriptive norms were low. Results further showed that social anxiety was positively related to more cannabis problems regardless of parent injunctive norms.

CONCLUSIONS

The present work suggests that it may be important to account for parent influences when addressing normative perceptions among young adult cannabis users. Additional research is needed to determine whether interventions incorporating feedback regarding parent norms impacts cannabis use frequency and problems.

A critique of cannabis legalization proposals in Canada

An editorial in this issue describes a cannabis policy framework document issued by a major Canadian research centre, calling for legalization of non-medical use under strict controls to prevent increase in use, especially by adolescents and young adults who are most vulnerable to adverse effects of cannabis. It claims that such a system would eliminate the severe personal, social and monetary costs of prohibition, diminish the illicit market, and provide more humane management of cannabis use disorders. It claims that experience with regulation of alcohol and tobacco will enable a system based on public health principles to control access of youth to cannabis without the harm caused by prohibition. The present critique argues that the claims made against decriminalization and for legalization are unsupported, or even contradicted, by solid evidence. Early experience in other jurisdictions suggests that legalization increases use by adolescents and its attendant harms. Regulation of alcohol use does not provide a good model for cannabis controls because there is widespread alcohol use and harm among adolescents and young adults. Government monopolies of alcohol sale have been used primarily as sources of revenue rather than for guarding public health, and no reason has been offered to believe they would act differently with respect to cannabis. Good policy decisions require extensive unbiased information about the individual and social benefits and costs of both drug use and proposed control measures, and value judgments about the benefit/harm balance of each option. Important parts of the necessary knowledge about cannabis are not yet available, so that the value judgments are not yet possible. Therefore, a better case can be made for eliminating some of the harms of prohibition by decriminalization of cannabis possession and deferring decision about legalization until the necessary knowledge has been acquired.

Social Goals and Grade as Moderators of Social Normative Influences on Adolescent Alcohol Use

BACKGROUND

The literature distinguishes 2 types of social normative influences on adolescent alcohol use, descriptive norms (perceived peer alcohol use) and injunctive norms (perceived approval of drinking). Although theoretical formulations suggest variability in the salience and influence of descriptive and injunctive norms, little is understood regarding for whom and when social norms influence adolescent drinking. Strong agentic and communal social goals were hypothesized to moderate the influence of descriptive and injunctive norms on early adolescent alcohol use, respectively. Developmental changes were also expected, such that these moderating effects were expected to get stronger at later grades.

METHODS

This longitudinal study included 387 adolescents and 4 annual assessments (spanning 6th to 10th grade). Participants completed questionnaire measures of social goals, social norms, and alcohol use at each wave.

RESULTS

Multilevel logistic regressions were used to test prospective associations. As hypothesized, descriptive norms predicted increases in the probability of alcohol use for adolescents with strong agentic goals, but only in later grades. Injunctive norms were associated with increases in the probability of drinking for adolescents with low communal goals at earlier grades, whereas injunctive norms were associated with an increased probability of drinking for adolescents with either low or high communal goals at later grades. Although not hypothesized, descriptive norms predicted increases in the probability of drinking for adolescents high in communal goals in earlier grades, whereas descriptive norms predicted drinking for adolescents characterized by low communal goals in later grades.

CONCLUSIONS

The current study highlights the importance of social goals when considering social normative influences on alcohol use in early and middle adolescence. These findings have implications for whom and when normative feedback interventions might be most effective during this developmental period.

Cannabis use in children with individualized risk profiles: Predicting the effect of universal prevention intervention

AIM

To study the effect of a universal prevention intervention targeting cannabis use in individual children with different risk profiles.

METHODS

A school-based randomized controlled prevention trial was conducted over a period of 33 months (n=1874 sixth-graders, baseline mean age 11.82). We used a two-level random intercept logistic model for panel data to predict the probabilities of cannabis use for each child. Specifically, we used eight risk/protective factors to characterize each child and then predicted two probabilities of cannabis use for each child if the child had the intervention or not. Using the two probabilities, we calculated the absolute and relative effect of the intervention for each child. According to the two probabilities, we also divided the sample into a low-risk group (the quarter of the children with the lowest probabilities), a moderate-risk group, and a high-risk group (the quarter of the children with the highest probabilities) and showed the average effect of the intervention on these groups.

RESULTS

The differences between the intervention group and the control group were statistically significant in each risk group. The average predicted probabilities of cannabis use for a child from the low-risk group were 4.3% if the child had the intervention and 6.53% if no intervention was provided. The corresponding probabilities for a child from the moderate-risk group were 10.91% and 15.34% and for a child from the high-risk group 25.51% and 32.61%. School grades, thoughts of hurting oneself, and breaking the rules were the three most important factors distinguishing high-risk and low-risk children.

CONCLUSIONS

We predicted the effect of the intervention on individual children, characterized by their risk/protective factors. The predicted absolute effect and relative effect of any intervention for any selected risk/protective profile of a given child may be utilized in both prevention practice and research.

Social networks and substance use among at-risk emerging adults living in disadvantaged urban areas in the southern United States: a cross-sectional naturalistic study

BACKGROUND AND AIMS

Substance use and risk-taking are common during emerging adulthood, a transitional period when peer influences often increase and family influences decrease. Investigating relationships between social network features and substance use can inform community-based prevention programs. This study investigated whether substance use among emerging adults living in disadvantaged urban areas was influenced by peer and family social network messages that variously encouraged and discouraged substance use.

DESIGN

Cross-sectional, naturalistic field study.

SETTING AND PARTICIPANTS

Lower-income neighborhoods in Birmingham, Alabama, USA with 344 participants (110 males, 234 females, ages 15-25 years; mean = 18.86 years), recruited via respondent-driven sampling.

MEASUREMENTS

During structured interviews conducted in community locations, the Alcohol, Smoking and Substance Involvement Screening Test assessed substance use and related problems. Predictor variables were network characteristics, including presence of substance-using peers, messages from friends and family members about substance use and network sources for health information.

FINDINGS

Higher substance involvement was associated with friend and family encouragement of use and having close peer network members who used substances (Ps < 0.001). Peer discouragement of substance use was associated with reduced risk (b = - 1.46, P < 0.05), whereas family discouragement had no protective association.

CONCLUSIONS

Social networks appear to be important in both promoting and preventing substance use in disadvantaged young adults in the United States.

Animal models of social contact and drug self-administration

Social learning theories of drug abuse propose that individuals imitate drug use behaviors modeled by social peers, and that these behaviors are selectively reinforced and/or punished depending on group norms. Historically, animal models of social influence have focused on distal factors (i.e., those factors outside the drug-taking context) in drug self-administration studies. Recently, several investigators have developed novel models, or significantly modified existing models, to examine the role of proximal factors (i.e., those factors that are immediately present at the time of drug taking) on measures of drug self-administration. Studies using these newer models have revealed several important conclusions regarding the effects of social learning on drug abuse: 1) the presence of a social partner influences drug self-administration, 2) the behavior of a social partner determines whether social contact will increase or decrease drug intake, and 3) social partners can model and imitate specific patterns of drug self-administration. These findings are congruent with those obtained in the human laboratory, providing support for the cross-species generality and validity of these preclinical models. This mini-review describes in detail some of the preclinical animal models used to study social contact and drug self-administration to guide future research on social learning and drug abuse.