Saturation of tobacco smoking models and risk of alcohol and tobacco use among adolescents

Cumulative Exposure to Neighborhood Conditions and Substance Use Initiation among Low-Income Latinx and African American Adolescents

PURPOSE

While previous research underscores the important role that neighborhood contexts play for child and adolescent health and well-being, how these neighborhood contexts influence substance use initiation among adolescents from low-income and ethnic minority families has been understudied.

METHODS

This study is a secondary analysis of data from the Denver Child Study a retrospective survey that uses a natural experiment aimed at assessing neighborhood effects on developmental outcomes of Latinx and African American adolescents (N = 736). Cox cause-specific hazards models were estimated to test: (1) the effects of cumulative exposure to neighborhood social disorder, neighborhood violent and property crime rates, and neighborhood social capital during preadolescence (ages 8-11) on the likelihood of initiating alcohol, cigarette, and marijuana use during adolescence (ages 12-18), after controlling for youth, caregiver, and household factors; and (2) whether the effects of these cumulative neighborhood factors vary by Latinx and African American ethnicity.

RESULTS

5.6% of adolescents in this study initiated cigarette use, 5.4% initiated alcohol use and 5.2% used marijuana for the first time during adolescence. The results indicate that exposure to neighborhood social disorder during preadolescence is a significant risk factor, especially for the initiation of cigarette use (HR = 1.36, 95% CI = 1.062-1.745, p = 0.015) particularly among Latinx adolescents (HR = 1.42, 95% CI = 1.031-1.966, p = 0.032).

CONCLUSIONS

The findings suggest the need for further research on the relationship between exposure to neighborhood social disorder and adolescent substance use initiation in order to develop and implement community-based prevention and intervention programs to reduce substance use initiation and facilitate healthy adolescent development.

Influence of parental smoking on the use of alcohol and illicit drugs among adolescents

OBJECTIVE

To evaluate the association between parental smoking and the use of alcohol and illicit drugs among adolescent children.

METHODS

A cross-sectional study with 6,264 adolescents (59.7% female) aged between 14 and 19 years. To establish the sample, we used two-stage cluster random sampling. The data on parental smoking and use of cigarettes, alcohol and illicit drugs among adolescents were collected using a questionnaire.

RESULTS

Smoking adolescents were more prone to use alcohol (odds ratio - OR: 10.35; 95%CI: 7.85-13.65) and illicit drugs (OR: 11.75; 95%CI: 9.04-15.26) than non-smokers (p<0.001). Adolescents with at least one parent (OR: 1.4; 95%CI: 1.13-1.89) or both parents smoking (OR: 1.6; 95%CI: 1.01-2.67) were more likely to smoke when compared to those having no parents smoking. The adjusted analysis limited to non-smoking adolescents showed a positive association (p<0.05) between parental tobacco use and the use of alcohol (OR: 1.4; 95%CI: 1.23-1.62) and illicit drugs (OR: 1.6; 95%CI: 1.24-2.13), irrespective of age, sex, maternal schooling and place of residence.

CONCLUSION

Parental smoking was associated with the use of alcohol and other illicit drugs by adolescents, even among nonsmokers.

Prevalence and determinants of cigarette smoking among college students: a cross-sectional study in Douala, Cameroon

Background

Tobacco is the most important avoidable risk for non communicable diseases. While tobacco consumption is stable or declining in developed countries, it is increasing in the developing world with a rate of 3.4 % per annum. The objective of this study was to estimate the prevalence and factors associated with cigarette smoking among college students.

Methods

A cross-sectional study was conducted from December 2012 to April 2013 in secondary schools in Douala, Cameroon. A self-administered questionnaire was used to collect sociodemographic data, smoking behavior and peer smoking among college students. Logistic regression analyses was employed to identify factors associated with cigarette smoking.

Results

Of a total of 2623 students included, 1579 (60.2 %) were female. The mean age of participants was 19.2 ± 2.53 years. The prevalence of current smoking was 11.2 % [95 % confidence interval (CI) 10 – 12], with 20 % in males and 5.3 % in females. Cigarette smoking was with significantly associated with friends smoking [Odds ratio (OR) 6.66; 95 % CI 4.69 – 9.45)], male gender (OR 3.61; 95 % CI 2.52 – 5.16), increase in age (OR 1.10; 1.03 – 1.17), parental smoking 1.69 (1.04 – 2.76), and attending general education (OR 1.85; 1.23 – 2.78).

Conclusions

Cigarette smoking constitutes a significant health hazard in college students in Douala. Youth population and especially male students should be continuously targeted by preventive measures and sensitization campaigns against tobacco use. Parents should be aware on the influence of their smoking behavior on initiation of smoking in their children and should be encouraged to quit smoking.

The effect of general and drug-specific family environments on comorbid and drug-specific problem behavior: a longitudinal examination

Previous research has shown that the development of alcohol and tobacco dependence is linked and that both are influenced by environmental and intrapersonal factors, many of which likely interact over the life course. The present study examines the effects of general and alcohol- and tobacco-specific environmental influences in the family of origin (ages 10-18) and family of cohabitation (ages 27-30) on problem behavior and alcohol- and tobacco-specific outcomes at age 33. General environmental factors include family management, conflict, bonding, and involvement. Alcohol environment includes parental alcohol use, parents' attitudes toward alcohol, and children's involvement in family drinking. Tobacco-specific environment is assessed analogously. Additionally, analyses include the effects of childhood behavioral disinhibition, initial behavior problems, and age 18 substance use. Analyses were based on 469 participants drawn from the Seattle Social Development Project (SSDP) sample. Results indicated that (a) environmental factors within the family of origin and the family of cohabitation are both important predictors of problem behavior at age 33; (b) family of cohabitation influences partially mediate the effects of family of origin environments; (c) considerable continuity exists between adolescent and adult general and tobacco (but not alcohol) environments; age 18 alcohol and tobacco use partially mediates these relationships; and (d) childhood behavioral disinhibition contributed to age 33 outcomes, over and above the effects of family of cohabitation mediators. Implications for preventive interventions are discussed.

The association between alcohol and tobacco use among elementary and high school students in Crete, Greece

Background

Tobacco and alcohol use during adolescence have potential long term health consequences and a possibility of future addiction.

Methods

This cross sectional study took place in 2007 among a convenience sample of 981 adolescents from public elementary and high schools in Eastern Crete, Greece. Following parental consent, an anonymous structured questionnaire including information on personal and family use of alcohol and tobacco was distributed.

Results

Among the entire study population, cigarette experimentation was found to be associated with current alcohol use, with an Adjusted Odds Ratio (aOR) of 38.8; (95%C.I: 5.33-58.2) and with having a smoker in the immediate family (aOR 10.3; 95%C.I: 3.14-34.0). Among the subset of elementary school children, cigarette smoking was strongly associated with current alcohol use aOR 9.7; (95%C.I: 2.12-44.3), while the association between smoking experimentation and sibling and parental alcohol use was statistically significant within the entire population (however not among elementary students) with an aOR of 2.76 (95%C.I: 1.24-6.15) and aOR 3.66, (95%C.I: 1.97-6.81) respectively. The elementary child’s gender was not found to be associated with cigarette experimentation among this study population.

Conclusions

Strong associations were found between alcohol use and tobacco experimentation. The potential parental influence on consequent adolescent tobacco and alcohol use was also noted. Potential community based interventions, if launched in Greece, should take the role of the Greek family into account.

Smoking among adolescents in Northern Greece: a large cross-sectional study about risk and preventive factors

Background

The aim of the present study was to investigate epidemiological data about cigarette smoking in relation with risk and preventive factors among Greek adolescents.

Methods

We randomly selected 10% of the whole number of schools in Northern Greece (133 schools, 18,904 participants were included). Two anonymous questionnaires (smoker's and non-smoker's) were both distributed to all students so they selected and filled in only one. A parental signed informed consent was obtained using an informative leaflet about adolescent smoking.

Results

The main findings of the study were: a) 14.2% of the adolescents (mean age+/−SD: 15.3+/−1.7 years) reported regular smoking (24.1% in the age group 16–18 years), b) 84.2% of the current smokers reported daily use, c) students who live in urban and semirural areas smoke more frequently than those in rural areas, d) students in technically oriented schools smoke twice as frequent compared to those in general education, e) risk factors for smoking: male gender, low educational level of parents, friends who smoke (OR: 10.01, 95%CI: 8.53-11.74, p<0.001), frequent visits to internet cafes (OR:1.53, 95%CI: 1.35-1.74, p<0.001), parents, siblings (OR:2.24, 95%CI: 1.99-2.51, p<0.001) and favorite artist (OR:1.18, 95%CI: 1.04-1.33, p=0.009) who smoke, f) protective factors against smoking: participation in sports (OR:0.59, 95%CI: 0.53-0.67, p<0.001), watching television (OR:0.74, 95%CI 0.66-0.84, p<0.001) and influence by health warning messages on cigarette packets (OR:0.42, 95%CI: 0.37, 0.48, p<0.001).

Conclusions

Even though prevalence of cigarette smoking is not too high among Greek adolescents, frequency of everyday cigarette use is alarming. We identified many social and lifestyle risk and preventive factors that should be incorporated in a national smoking prevention program among Greek adolescents.

Developmental momentum toward substance dependence: natural histories and pliability of risk factors in youth experiencing chronic stress

BACKGROUND

Mitigation of substance use (SU) disorder (SUD) risk factors is a common goal of prevention. Research has clarified much about risk factors including their prediction of SU/SUD, associations with other etiological variables and mediation of SU outcomes. Greater understanding of the emergence of risk factors themselves may improve prevention. For example, in lieu of experimental data, the level of resistance to change of a risk factor (its pliability) could inform "dosage" of intervention needed to reduce the risk.

METHODS

Two attributes of 22 previously-documented predictors of SU/SUD were quantified: natural history (average age-related trend) and pliability (quantified using correlations between intercepts and growth parameters of hierarchical linear modeling trajectories). The longitudinal sample of 1147 8- through 16-year-olds were recruited from a northeastern summer camp for youth experiencing chronic stress due to one or more stressors (X¯=2.2stressors, SD=1.41) which typically last at least one year. Half were male, 69.3% were European-American, 8.5% were African-American, and the remaining were small proportions each of other or mixed races/ethnicities.

RESULTS

Average trajectories of 21 predictors correspond to increasing SUD risk with age. Predictor pliability varied greatly, ranging from extremely high for School Commitment to extremely low for Peer Pressure Susceptibility.

CONCLUSIONS

Results suggest different intervention strategies may be needed to manage risk factors over the long-term. To illustrate, maintaining a high school commitment appears to require boosters whereas reducing peer pressure susceptibility appears to require high initial "dosage" with less need for boosters.

Trends in cigarette use behaviors among adolescents by region in Korea

Objectives

Understanding recent trends in cigarette smoking among adolescents is important in order to develop strategies to prevent cigarette smoking. The aim of this study was to compare recent trends in cigarette smoking for adolescents living in rural areas, small towns and metropolitan cities in Korea.

Methods

The raw data from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) from 2005 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Logistic regression models were used to evaluate significant linear time trends in cigarette smoking. The indicators of cigarette use behaviors were 'current smoking rate', 'frequent smoking rate', 'heavy smoking rate' and 'smoking experience rate before 13 years of age'. All analyses were conducted according to gender.

Results

Statistically significant increasing trends in current smoking rate and frequent smoking rate were observed and borderline significant increasing trends in heavy smoking rate were shown among rural boys. Among metropolitan city boys, statistically significant increasing trends were also seen for frequent smoking. Statistically significant decreasing trends in current smoking rate were observed among small town and metropolitan city girls. Smoking experience rate before 13 years of age for rural girls decreased significantly.

Conclusions

Cigarette smoking prevalence among adolescents in the rural areas has increased in the last five years especially among boys. Our findings suggest that anti-tobacco program for adolescents should be conducted primarily for those in rural areas.

Tobacco retailer density surrounding schools and youth smoking behaviour: a multi-level analysis

BACKGROUND

Youth smoking prevention should be a public health priority. It is not only vital to prevent youth from smoking but also to prevent non-smoking youth from becoming susceptible to smoking. Past research has examined factors associated with youth's susceptibility to become a future smoker, but research has yet to examine tobacco retailer density and susceptibility to smoking among never smokers. The objectives of this study are to examine how tobacco retailer density surrounding schools and social smoking influences are associated with smoking susceptibility among youth of never smokers, and occasional and daily smoking among youth of current smokers.

METHODS

Data were collected in 2005-2006 from grade 9 to 12 students attending 76 secondary schools in Ontario, Canada, as part of the SHAPES-On study. A series of multi-level logistic regression analyses were performed to understand how student- and school-level factors are associated with three smoking behaviour outcomes: smoking susceptibility among never smokers, occasional smoking, and daily smoking.

RESULTS

The number of tobacco retailers surrounding a school was found to be associated with the likelihood of a never smoker being susceptible to future smoking (OR 1.03, 95CI% 1.01, 1.05). We also identified that being surrounded by smoking social influences, specifically family and close friends, can substantially increase the likelihood that never smokers are at risk for future smoking or that youth are already occasional or daily smokers.

CONCLUSIONS

We identified that the number of tobacco retailers surrounding a school was associated with an increased odds of being susceptible to future smoking among male never smokers. Smoking social models surrounding youth also appears to have an important impact on their smoking behaviour regardless of their smoking status. It is important for youth smoking prevention programs to begin early, interrupt youths' susceptibility to future smoking, and focus on subgroups that are at higher risk of smoking. The government should consider the impact of tobacco retailer density on youth smoking behaviour, and be cautious when granting licenses for establishments to sell tobacco products.

Tobacco use among adolescent students and the influence of role models

Background:

Seventy per cent of premature deaths among adults are due to behavioral patterns that emerge in adolescence, including smoking.

Objective:

The objective was to study the prevalence of tobacco use among adolescent students in South Delhi and its epidemiological correlates.

Materials and Methods:

This was a cross-sectional study.

Setting:

Three schools and two colleges of South Delhi were chosen. There were 550 adolescent students aged 14-19.

Statistical Analysis:

Statistical analysis was done using proportions, the chi-square test, and multivariate logistic regression.

Results:

A total of 88 (16.0%) students reported having ever tried cigarette or bidi smoking. The prevalence of current smoking was 7.1%. Exactly 10% (55) of the students reported having ever used smokeless forms of tobacco. The prevalence of tobacco use overall was found to be 20.9%, and was significantly higher (P=0.016) among the males than the females. Tobacco use was found to be significantly associated with having seen a brother/sister smoke (OR 5.15), best friend smoke (OR 2.92), and belonging to a nuclear family (OR 1.96).

Conclusions:

Tobacco use is still an important risk behavior among adolescent students. This study found a strong association of tobacco use by the adolescents with their having seen various role models ever smoking.

Patterns of smoking and its association with psychosocial work conditions among blue-collar and service employees of hospitality venues in Shenyang, PR China

Background

To characterize the smoking patterns of hospitality employees in blue-collar and service occupations, and to examine its relations with psychosocial work conditions.

Methods

The Shenyang Hospitality Industry Employees Survey-a face-to-face cross-sectional study of representative hospitality industry employees-was conducted between March and July 2008. A total of 4,213 workers were selected using stratified random cluster sampling designs, and final analyses were performed on 2,508 blue-collar and service subjects. Multilevel-logistic regression models were used to estimate the contribution of psychosocial work conditions to smoking status.

Results

Blue-collar and service employees smoked at a rate 1.4 times that of the general population (49.4% vs. 35.8%), more particularly for females (12.9% vs. 3.08%). Strain jobs had significantly higher odds ratio of daily smoking (OR 2.09, 95%CI: 1.28-3.41) compared to the relaxed category. The passive jobs (OR 2.01, 95%CI 1.27 to 3.17), highest job demands (OR 1.72, 95%CI: 1.13-2.61), and lowest job control (OR 2.56, 95%CI: 1.57-4.16) were also associated with a significantly higher daily smoking ratio. The negative relationship between job stability and smoking behavior was slightly stronger among daily than occasional smokers. However, neither job strain nor any of its components was found to be significantly associated with occasional smoking.

Conclusions

Smoking in hospitality blue-collar and service employees is certainly a major occupational health problem in Shenyang. This evidence also suggests an association between psychosocial-work conditions and smoking status, and implies that more intervention studies where changes in work environment are carried out in combination with health promotion interventions should be performed.

Perceived exposure to substance use and risk-taking behavior in early adolescence: cross-sectional study

AIM

To examine the relation between perceived exposure to parents, siblings, and peers' substance use and self-reported substance consumption among early adolescents in Primorsko-goranska county, Croatia, and between perceived exposure to substance use and risk-taking behaviors such as going out late at night, gathering at secluded places, skipping school, and gambling.

METHOD

A self-reported cross-sectional survey was conducted in 2007 among 2219 eight-grade (14-year old) pupils in elementary schools in Primorsko-goranska county. Exposure to substance use in their immediate social environment, self-reported consumption of cigarettes, alcohol, inhalants, and marihuana, ways of spending free time, and family and peer relationships were assessed.

RESULTS

There was a significant association between perceived exposure to substance use and self-reported consumption of cigarettes, alcohol, inhalants, and marihuana in both sexes (P < 0.001). Pupils whose parents, siblings, and peers used substances significantly more often developed the same behavioral patterns. Level of exposure to substance use in the immediate social environment had the strongest effect on experimenting with smoking among girls (from 26.6% in low exposure to 76.2% in high exposure group) and among boys (from 15.8% in low exposure to 69.4% in high exposure); on regular everyday smoking among girls (from 4.4% in low exposure to 45% in high exposure group) and among boys (from 2.7% in low exposure to 36.7% in high exposure group); on hard liquor consumption among girls (from 25.1% in low exposure to 79.5% in high exposure group) and among boys (from 28.1% in low exposure to 78.4% in high exposure group), as well as on binge drinking among girls (from 10.9% in low exposure to 56.6% in high exposure group) and among boys (from 15.5% in low exposure to 62.4% in high exposure group). Girls and boys exposed to substance use engaged more often in risk-taking and potentially delinquent behaviors (F(2, 1180) = 166 502; P < 0.001, two-way ANOVA).

CONCLUSION

High exposure to substance use in immediate social environment and its great impact on substance use among early adolescents indicate that there is a need for the introduction of preventive programs that would reduce inappropriate behavior among adolescents' social models.

Parental and peer influences on teen smoking: Are White and Black families different?

INTRODUCTION

The health risks associated with smoking disproportionately burden Blacks, and Black adults are more likely to smoke than are White adults. Most adult smokers have their first smoking experience as teenagers; however, rates of smoking initiation during adolescence remain lower among Black compared with White youth.

METHODS

The level and impact of family and peer risk and protective factors on adolescent smoking across both groups were modeled prospectively from 8th to 10th grade in a sample of 331 (Black n = 162, White n = 168) families using data from self-administered computer-assisted questionnaires. Predictors included parent smoking, guidelines against substance use, monitoring, consistent discipline, attachment to parents, and association with deviant peers.

RESULTS

Mean-level differences indicated greater risk for Black teens in some cases and higher protection in others. Multiple-group structural equation modeling indicated no race differences. Several factors affected both groups: (a) parenting factors reduced association with deviant peers, (b) association with deviant peers increased the risk of smoking in the 10th grade, and (c) teens were more likely to smoke if their parents smoked.

DISCUSSION

Reduced smoking among Black teens compared with White teens may be due to the protection of clear parental guidelines about substance use and clearly stated consequences for failure to observe those guidelines.

Home-based sourcing of tobacco among adolescents

OBJECTIVE

To study home-based sources of tobacco and associated family factors among Finnish adolescents.

METHODS

Nationwide surveys (1999, 2003, 2007) of 14-16-year-old daily (n=2355), occasional (n=708), and experimental (n=2763) smokers. The main outcome measure was home-based sourcing of tobacco (parents, siblings, taking from home) during the past month. Logistic regression was used for statistical analysis.

RESULTS

Home-based sources were used by 44% of daily, 11% of occasional, and 9% of experimental smokers; other social sources by 93%, 65%, and 51%; and commercial sources by 70%, 28%, and 10% respectively. Among daily smokers, home sources meant siblings (24%), parents (19%), and taking from home (19%). Parental smoking and absence of a home-smoking ban increased home-based sourcing. The odds ratio (OR) for obtaining tobacco from any home-based source was 6.96 (95% CI: 3.75-12.91) and from parents 7.44 (2.68-20.65) when both parents smoked versus nonsmoking parents. In the absence of a home-smoking ban, corresponding ORs were 2.21 (1.28-3.81) and 21.33 (2.84-60.30) versus those reporting having a ban. Obtaining tobacco from parents was more common in single-parent/reconstituted families than in families with two biological parents.

CONCLUSIONS

Parents should be provided with guidance about the consequences of home-based sourcing in the persistence of children's smoking habit.

Peer and role model influences for cigarette smoking in a young adult military population

Previous research has shown that 8% to 10% of nonsmokers initiated smoking during their first year of military service despite a period of forced abstinence during boot camp. To our knowledge, no studies have looked at the influence of peers and role models on the initiation of smoking among U.S. Air Force personnel who recently completed boot camp. This cross-sectional study examined the role of perceived peer norms, roommate influence, role model influence, perceived norms of all active duty personnel, and depressive symptoms in the initiation and reinitiation of smoking among 2,962 Air Force technical training students. Previous nonsmokers were more likely to initiate smoking if they perceived that the majority of their classmates smoked (OR = 1.67, 95% CI[1.05-2.67]) and if they reported that their military training leader or classroom instructor used tobacco products (OR = 1.69, 95% CI[1.12-2.56]). Additionally, previous nonsmokers were more likely to initiate smoking if their roommate smoked (OR = 1.67, 95% CI[1.09-2.56]). Similar results were seen with previous smokers who perceived that the majority of their classmates smoked (OR = 1.63, 95% CI[1.03-2.58]) and if they reported that their military training leader or classroom instructor used tobacco products (OR = 1.95, 95% CI[1.29-2.94]). Our study suggests that military role models who use tobacco, peer smoking behavior, and perceived smoking norms increase the likelihood of smoking initiation among newly enlisted military personnel who have recently undergone a period of forced abstinence.

NEIGHBORHOOD NORMS AND SUBSTANCE USE AMONG TEENS

This paper uses new data from the Los Angeles Family and Neighborhood Survey (L.A. FANS) to examine how neighborhood norms shape teenagers' substance use. Specifically, it takes advantage of clustered data at the neighborhood level to relate adult neighbors' attitudes and behavior with respect to smoking, drinking, and drugs, which we treat as norms, to teenagers' own smoking, drinking, and drug use. We use hierarchical linear models to account for parents' attitudes and behavior and other characteristics of individuals and families. We also investigate how the association between neighborhood norms and teen behavior depends on: (1) the strength of norms, as measured by consensus in neighbors' attitudes and conformity in their behavior; (2) the willingness and ability of neighbors to enforce norms, for instance, by monitoring teens' activities; and (3) the degree to which teens are exposed to their neighbors. We find little association between neighborhood norms and teen substance use, regardless of how we condition the relationship. We discuss possible theoretical and methodological explanations for this finding.

Intergenerational exchange and perinatal risks: a note on interpretation of generational recurrence risks

Population-based data that cover reproductive health outcomes across two complete generations have recently become available in the Nordic countries. Such data enable estimation of recurrence risks from one generation to the next of different conditions such as birth defects or pre-eclampsia. Risks related to a singleton pregnancy involve the contribution of three individuals: the mother, the father and the fetus. A paternal contribution is mainly through the father's contribution of half of the alleles of the fetus. A maternal contribution may occur in three fundamentally different ways. First, the mother provides half of the genomic alleles to the fetus, with contribution of paternal alleles completing the whole genome. Second, the mother provides the fetal environment and possible susceptibility to complications during pregnancy which she may have inherited from her mother. Finally, she provides the fetal mitochondria. Because of these different contributions, recurrence from mother to offspring is fundamentally different from recurrence from father to offspring. How recurrence risks reflect and shape the underlying contributions to overall perinatal risk is illustrated through a review of published data from Norway on gestational age, pre-eclampsia and birth defects.

Longitudinal modeling of genetic and environmental influences on self-reported availability of psychoactive substances: alcohol, cigarettes, marijuana, cocaine and stimulants

BACKGROUND

Although an obvious environmental factor influencing drug use, the sources of individual differences in drug availability (DA) are unknown.

METHOD

This report is based on 1788 adult males from the Mid-Atlantic Twin Registry who participated in a structured telephone interview that included retrospective assessments of DA (cigarette, alcohol, marijuana, cocaine and stimulants) between ages 8 and 25. We fitted a biometric dual change score (DCS) model, adapted for ordinal data, to model latent growth and estimate the genetic and environmental components of variance over time.

RESULTS

DA, despite being considered an environmental risk factor, is under both genetic and environmental control. For cigarette, alcohol, marijuana and cocaine availability, there was an overall increase in additive genetic variance and a decline in shared environmental variance over time. Non-shared environmental variance remained steady. Stimulant availability did not follow this pattern. Instead, there was an upswing in shared environmental effects with increasing age.

CONCLUSION

We have modeled the genetic and environmental architecture of changes in DA across adolescence. The rise in additive genetic variance over time coincides with acceleration in the expression of individual differences, probably brought on by an increase in personal freedom and a reduction in social constraints. Understanding the etiology of DA is likely to reveal key components, acting directly or indirectly, in the pathway(s) leading to drug initiation, abuse and dependence.

Social influences and self-efficacy as predictors of youth smoking initiation and cessation: a 3-year longitudinal study of vocational high school students in Taiwan

AIMS

This 3-year longitudinal study examined changes in patterns of risk factors and protective factors of smoking initiation and cessation among vocational high school students in Taipei, Taiwan.

DESIGN AND SETTING

In 2000, a total of 2151 10th grade students from 16 vocational high schools were assessed and followed up in the 11th and 12th grades. Self-administered questionnaires were collected in each year to assess the pattern of changes in smoking behaviors, and risk and protective factors.

FINDINGS

Of the 1654 non-smokers in the 10th grade, 227 students initiated smoking by the 12th grade. Higher risk factors such as peer smoking, peers offering cigarettes, alcohol use and lower protective factors, such as refusal self-efficacy, antismoking attitude and belief in the 10th grade predicted youth initiation by grade 12. Increases in risk factors and decreases in protective factors during the years from 10th to 12th grades were associated significantly with youth smoking initiation. Of the 494 smokers in the 10th grade, 76 students quit smoking by the 12th grade. Lower risk factors and higher protective factors in 10th grade smokers predict youth smoking cessation by grade 12. Decreases in risk factors and increases in protective factors were associated significantly with youth smoking cessation.

CONCLUSIONS

The risk factors (i.e. social influences) and protective factors (i.e. self-efficacy) examined in this study predict both youth smoking initiation and youth smoking cessation.

Gender differences in predictors of drinking behavior in adolescents

This study explored the differences in the risk factors associated with alcohol use, problem drinking, and related consequences between male and female high school students in eastern Taiwan. A total of 771 10th grade students, including 327 boys (42.4%) and 444 girls (57.6%), from four randomly selected high schools in eastern Taiwan were included in the survey. Multiple logistic regression analyses were performed. In conclusion, paternal drinking was found to be an important factor for the development of alcohol use in adolescent boys but had less impact on girls when compared with maternal drinking. Peer norms and peer relationships had greater effects on drinking behavior in female than in male adolescents. Alcohol use appeared to be much more closely related to family relationships in female than in male adolescents. In adolescent boys, deviant self-image was the real factor causing problem drinking. Therefore, preventive intervention for boys should focus on managing psychological distress and strengthening positive self-image, while correcting peer drinking norms, learning of drinking refusal self-efficacy, establishing friendships without drinking, and positive parent-child communication should be enhanced for girls.