The interplay of friendship networks and social networking sites: longitudinal analysis of selection and influence effects on adolescent smoking and alcohol use

Associations between frequency of exposure to peer-generated alcohol-related posts and alcohol use within a social network of college students

Peer alcohol use, commonly assessed via perceptions of how many drinks peers consume, is a robust predictor of college drinking. These perceptions are formed by in-person exposure to peer drinking but also may be affected by seeing alcohol-related content (ARC) shared on peer social media accounts. Most research assesses exposure by asking about the frequency of ARC sharing by a whole friend group, potentially missing influences from specific friends. Social network methods collect information about specific friends and their behavior but few studies have used these methods to examine the effects of ARC on drinking, nor have they examined potential moderators of this relationship. The purpose of this study was to examine whether perceived frequency of exposure to ARC shared by social network members on social media is associated with participant alcohol use after controlling for network members' self-reported alcohol use, and if participant gender and relationship qualities with network members moderate this association. Participants were 994 college students (Mage = 21.17, SD = 0.47; 61.8 % female; 55.4 % White; 12.3 % Hispanic) who completed a web-based survey. Due to the social network design, network autocorrelation analyses were conducted, which revealed that greater perceived frequency of exposure to network member ARC was significantly associated with higher alcohol quantity above and beyond network members' alcohol use. Peer ARC had a unique association with drinking behavior independent of in-person peer alcohol use, although the cross-sectional design precludes making causal inferences. Clinicians delivering alcohol interventions to college students may wish to discuss exposure to ARC as another important source of peer influence and how media literacy may help reduce the effects.

Socio-economic inequalities in smoking and drinking in adolescence: Assessment of social network dynamics

AIMS

We investigated whether (1) adolescents selected friends with a similar socio-economic status (SES), (2) smoking and alcohol consumption spread in networks and (3) the exclusion of non-smokers or non-drinkers differed between SES groups.

DESIGN

This was a longitudinal study using stochastic actor-oriented models to analyze complete social network data over three waves.

SETTING

Eight Hungarian secondary schools with socio-economically diverse classes took part.

PARTICIPANTS

This study comprised 232 adolescents aged between 14 and 15 years in the first wave.

MEASUREMENTS

Self-reported smoking behavior, alcohol consumption behavior and friendship ties were measured. SES was measured based upon entitlement to an income-tested regular child protection benefit.

FINDINGS

Non-low-SES adolescents were most likely to form friendships with peers from their own SES group [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.02-1.11]. Adolescents adjusted their smoking behavior (OR = 24.05, 95% CI = 1.27-454.86) but not their alcohol consumption (OR = 1.65, 95% CI = 0.62-4.39) to follow the behavior of their friends. Smokers did not differ from non-smokers in the likelihood of receiving a friendship nomination (OR = 0.98, 95% CI = 0.87-1.10), regardless of their SES. Alcohol consumers received significantly more friendship nominations than non-consumers (OR = 1.16, 95% CI = 1.01-1.33), but this association was not significantly different according to SES.

CONCLUSIONS

Hungarian adolescents appear to prefer friendships within their own socio-economic status group, and smoking and alcohol consumption spread within those friendship networks. Socio-economic groups do not differ in the extent to which they encourage smoking or alcohol consumption.

Following social media influencers who share alcohol-related content is associated with college drinking

INTRODUCTION

Frequent exposure to peer-shared alcohol-related content (ARC) on social media is associated with greater alcohol consumption and related consequences among undergraduates. Social media influencers also share ARC; yet, the effect of exposure to influencer-shared ARC on alcohol outcomes has not been examined. The current study examined whether following influencers who share ARC and the frequency of sharing were associated with alcohol outcomes, and associations between influencer type (e.g., actors) and alcohol outcomes.

METHODS

Undergraduates (N = 528) from two universities in the United States completed an online survey assessing demographics, social media use, alcohol use and related consequences. They listed up to five influencers they followed and viewed the most content from. A series of linear regression models were conducted.

RESULTS

Having a larger proportion of influencers sharing ARC was associated with greater quantity, frequency and peak drinks, but not consequences. Frequency of influencers sharing ARC was associated with greater quantity and peak drinks, but not frequency or consequences. Findings remained significant, even after controlling for peer ARC. Actor ARC, everyday person ARC and 'other' type influencer ARC were associated with several alcohol outcomes.

DISCUSSION AND CONCLUSIONS

This study added to the literature by examining how following influencers who share ARC, and sharing frequency, were associated with drinking outcomes over and above exposure to peer ARC. It also examined whether ARC content from specific types of influencers was associated with alcohol outcomes. Findings highlight that the source of ARC is relevant when studying the effects of ARC exposure on college drinking.

Adolescents' Drinking Behavior Off- and Online: Disentangling Exposure Effects and Selective Exposure in Networked Communication Structures

This article applies a network approach to better understand the often-demonstrated link between adolescents' drinking behavior and their exposure to alcohol-related content on social media. Focusing on social dynamics among adolescents and their peers, we investigate the causes and consequences of exposure to individual peers who share alcohol-related content online. Drawing on social network literature and the perspective of networked communication online, we distinguish between exposure effects and selective exposure as the two core dynamics that can explain the association between drinking behavior and exposure to alcohol-related content online. Based on a two-wave network survey among adolescents aged 14 to 17 (n = 277), we applied a longitudinal network analysis to test both dynamics simultaneously. The findings indicate no exposure effects but robust evidence for selective exposure. This means that drinking adolescents are more likely to become exposed to peers who post alcohol-related content. The stochastic actor-oriented model hereby controls for rivaling explanations, such as the tendency to be exposed to friends, classmates, and peers of the same gender. In addition to these empirical findings, we discuss the value of the network approach, outlining the implications for future research and prevention strategies.

Using social network methodology to examine the effects of exposure to alcohol-related social media content on alcohol use: A critical review

Peer social influence is a robust predictor of problematic drinking among young adults and adolescents; it is typically assessed by collecting nonspecific social network information (i.e., behaviors of peers globally) or specific social network information (i.e., behaviors of named friends). Socialization happens both in-person and online through social media. Exposure to alcohol-related social media content is consistently related to alcohol consumption in cross-sectional and longitudinal studies alike. Previous research has often not focused on who specifically is sharing the alcohol-related social media content with most examining effects of exposure to content posted by nonspecific network members (e.g., peers, friends) and individual alcohol consumption. The purpose of the current critical review is to describe how exposure to alcohol-related social media content is commonly measured and how including a specific social network assessment may explain more variance in alcohol use. The review found inconsistencies in the reference groups used when assessing frequency of exposure and found that specific modalities of content exposure were often not assessed. Of the 30 published studies reviewed, 15 used cross-sectional designs, which is regrettable considering that the composition of adolescent and young adult peer groups have been found to change over time possibly affecting the content viewed. Understanding factors which affect the relationship between exposure to alcohol-related social media content and individual alcohol use has implications for tailoring drinking interventions to address the unique social influence of social media content. Gaps in the literature are summarized and future directions for research are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The dynamics of adolescents’ pubertal maturation, depressive symptoms and friendship networks: stochastic actor-oriented model

This study aimed to examine whether adolescents select friends based on their friends’ levels of depressive symptoms, and to determine whether the potential homophily phenomenon for depressive symptoms is attenuated after considering pubertal maturation and gender. Data were from the first three waves of the Taiwan Youth Project, a longitudinal study that annually surveys 7th graders from 40 junior high schools. Participants were asked at each wave to fill out a survey including depressive symptoms, pubertal maturation, and to name three best friends in school. Stochastic actor-oriented models were built to explore the dynamic changes in friendship networks by estimating the probability of the friendship connections and behavioral changes depending on the individual’s current network position and behavioral status. We used a sample of 2,336 adolescents. From 8 to 9th grade, adolescents tended to select friends who were similar in terms of their levels of depressive symptoms (B = 0.358, SE = 0.131, p < .001), without adjusting for gender and pubertal maturation. This homophily effect based on depressive symptoms became non-significant when pubertal maturation was included. Adolescents’ depressive symptoms did not further influence their friends’ depression levels, after controlling for pubertal maturation and gender. Future studies should further examine the mechanisms and group dynamics within clusters of adolescents who are depressed. Providing a supportive environment and tools is warranted to help adolescents cope with negative emotions within their peer group.

The association between social network members sharing alcohol-related social media content and alcohol outcomes among college student drinkers

BACKGROUND

College-aged young adults (e.g., 18 to 29-year-olds) use social media more than any other age group. An emerging body of literature shows that higher exposure to alcohol-related social media content is associated with greater alcohol consumption among college students. However, most studies assess exposure to peer drinking on social media using global measures, rather than measuring the exposure to alcohol-related posts of identified specific close peers. We examined whether having a higher proportion of important peers (i.e., social network members) who post alcohol-related social media content is associated with greater alcohol consumption and alcohol-related consequences. We also investigated the extent to which the qualities of network members who share alcohol-related content are associated with participants' alcohol outcomes.

METHODS

Participants were 130 college students (86.2% female, 56.9% White) with an average age of 23.39 years (SD = 5.63) who had consumed at least one alcoholic drink in the past week. Participants completed measures of their social media use, alcohol consumption, alcohol-related consequences, and characteristics of important peers in their social network, including their alcohol-related social media posting.

RESULTS

Having a higher proportion of social network members who post alcohol-related social media content was positively related to participants' drinks per week and peak number of drinks. Higher network proportions of drinking buddies posting alcohol-related content were also associated with a greater frequency of alcohol use. Having a higher proportion of friends who post alcohol content and from whom the participants seek advice was linked to more alcohol-related consequences.

CONCLUSIONS

Having more important peers who post alcohol-related content on social media is associated with alcohol outcomes among college students. Harm-reduction focused alcohol interventions delivered on college campuses that incorporate information about the influence of viewing and sharing alcohol-related content could help to reduce alcohol consumption and alcohol-related consequences among students.

Analyzing Twitter Chatter About Tobacco Use Within Intoxication-related Contexts of Alcohol Use: "Can Someone Tell Me Why Nicotine is So Fire When You're Drunk?"

INTRODUCTION

Alcohol and tobacco are commonly used together. Social influences within online social networking platforms contribute to youth and young adult substance use behaviors. This study used a sample of alcohol- and tobacco-related tweets to evaluate: (1) sentiment toward co-use of alcohol and tobacco, (2) increased susceptibility to tobacco use when consuming alcohol, and (3) the role of alcohol in contributing to a failed attempt to quit tobacco use.

METHODS

Data were collected from the Twitter API from January 1, 2019 through December 31, 2019 using tobacco-related keywords (e.g., vape, ecig, smoking, juul*) and alcohol-related filters (e.g., drunk, blackout*). A total of 78,235 tweets were collected, from which a random subsample (n = 1,564) was drawn for coding. Cohen's Kappa values ranged from 0.66 to 0.99.

RESULTS

Most tweets were pro co-use of alcohol and tobacco (75%). One of every ten tweets reported increased susceptibility to tobacco use when intoxicated. Non-regular tobacco users reported cravings for and tobacco use when consuming alcohol despite disliking tobacco use factors such as the taste, smell, and/or negative health effects. Regular tobacco users reported using markedly higher quantities of tobacco when intoxicated. Individuals discussed the role of alcohol undermining tobacco cessation attempts less often (2.0%), though some who had quit smoking for prolonged periods of time reported reinitiating tobacco use during acute intoxication episodes.

CONCLUSIONS

Tobacco cessation interventions may benefit from including alcohol-focused components designed to educate participants about the association between increased susceptibility to tobacco use when consuming alcohol and the role of alcohol in undermining tobacco cessation attempts.

IMPLICATIONS

Sentiment toward co-use of alcohol and tobacco on Twitter is largely positive. Individuals reported regret about using tobacco, or using more than intended, when intoxicated. Those who had quit smoking or vaping for prolonged periods of time reported reinitiating tobacco use when consuming alcohol. While social media-based tobacco cessation interventions like the Truth Initiative's "Ditch the Juul" campaign demonstrate potential to change tobacco use behaviors, these campaigns may benefit from including alcohol-focused components designed to educate participants about the association between increased susceptibility to tobacco use when consuming alcohol and the role of alcohol in undermining tobacco cessation attempts.

Understanding the Roles of Sport and Alcohol Use in Adolescence on Physical and Sexual Intimate Partner Violence Perpetration in Young Adulthood: Findings From a Sex-Stratified Multilevel Analysis

Adolescent peer groups shape beliefs that dictate behavioral norms, including intimate partner violence (IPV) perpetration behaviors, with lasting influence into adulthood. This study examines the role of sport engagement and alcohol use in adolescence on perpetration of physical and sexual IPV in young adulthood. A secondary data analysis was conducted with data from 3411 male and 4318 female participants in the National Longitudinal Study of Adolescent to Adult Health study. Sports and other school activity participation, as well as alcohol use, were measured in middle and high school students. Intimate partner violence perpetration was measured six years later with items from the revised Conflict Tactics Scales. Sex-stratified logistic cross-classified multilevel analyses indicate that, for males, participation in football in adolescence was associated with higher odds of IPV perpetration in young adulthood (aOR:1.26, p = .01). For males and females, non-engagement in any school activities in adolescence was associated with higher odds of IPV perpetration in young adulthood (male aOR: 1.52, p < .01; female aOR: 1.19, p = .04). Alcohol use in adolescence was also associated with higher odds of IPV perpetration in young adulthood for both males and females, even when low level drinking (1-2 drinks in the past 12 months) was reported (male aOR: 1.40, p < .01; female aOR: 1.38, p < .01). Random-effect estimates indicate small but significant contributions of adolescent peer, school, and neighborhood contexts on IPV perpetration in young adulthood for both boys and girls. These findings highlight that football engagement among boys, and alcohol use among boys and girls, are linked to longer-term risk for IPV perpetration, but engagement in other sports and school activities appear to serve as protective factors. These findings, taken with those regarding social context effects, suggest that positive social environment and networks in adolescence, inclusive of those offered in some sports, can be useful platforms for IPV prevention efforts.

Non-monetary incentives for tobacco prevention among youth in Indonesia

We provide evidence on the effectiveness of a school-based program that uses a non-monetary penalty and regular monitoring to prevent risky behavior among adolescents in Indonesia. The field experiment invited students to sign a pledge to abstain from tobacco use and a similar pledge for parents to monitor their children. To test group incentives, a subset of treated schools also competed against each other for the highest tobacco abstinence rates. We find that the individual pledge increases biochemically verified tobacco abstinence by 5 percentage points. This effect is sustained 3 months after the program ended. School competition has no additional impact on tobacco abstinence. Our findings highlight the effectiveness of non-monetary incentives to curb risky behaviors among adolescents who face limited self-control and peer pressure.

Uso excessivo de redes sociais por estudantes de ensino médio do sul do Brasil

Resumo Objetivo: Avaliar a prevalência do uso excessivo de redes sociais e identificar os seus fatores associados em estudantes do ensino médio do Sul do Brasil. Métodos: Trata-se de um estudo transversal de base populacional. Foram elegíveis para esta pesquisa todos os estudantes que estavam cursando o ensino médio no Instituto Federal do Rio Grande do Sul, campus Rio Grande, no 2º semestre de 2019. No total, 513 alunos participaram do estudo. A variável dependente deste estudo foi o uso excessivo de redes sociais, definido como mais de cinco horas por dia. Foram realizadas análises descritivas e bivariadas e, para verificar as associações, foi utilizada a regressão de Poisson, com ajuste robusto da variância. Resultados: A prevalência de estudantes que relataram uso excessivo de redes sociais foi de 35,9%. Os grupos mais suscetíveis a usar excessivamente as redes sociais foram: sexo feminino, cor de pele preta/parda e faixa etária entre 18 e 20 anos. Houve associação entre uso excessivo de redes sociais com tabagismo, risco de depressão, ansiedade e estresse, risco elevado de suicídio e uso de drogas. Conclusões: Mais de um terço dos estudantes usava em excesso as redes sociais. Esse comportamento esteve associado com desfechos negativos em saúde.

Alcohol and Cancer: Existing Knowledge and Evidence Gaps across the Cancer Continuum

Alcoholic beverages are carcinogenic to humans. Globally, an estimated 4.1% of new cancer cases in 2020 were attributable to alcoholic beverages. However, the full cancer burden due to alcohol is uncertain because for many cancer (sub)types, associations remain inconclusive. Additionally, associations of consumption with therapeutic response, disease progression, and long-term cancer outcomes are not fully understood, public awareness of the alcohol-cancer link is low, and the interrelationships of alcohol control regulations and cancer risk are unclear. In December 2020, the U.S. NCI convened a workshop and public webinar that brought together a panel of scientific experts to review what is known about and identify knowledge gaps regarding alcohol and cancer. Examples of gaps identified include: (i) associations of alcohol consumption patterns across the life course with cancer risk; (ii) alcohol's systemic carcinogenic effects; (iii) alcohol's influence on treatment efficacy, patient-reported outcomes, and long-term prognosis; (iv) communication strategies to increase awareness of the alcohol-cancer link; and (v) the impact of alcohol control policies to reduce consumption on cancer incidence and mortality. Interdisciplinary research and implementation efforts are needed to increase relevant knowledge, and to develop effective interventions focused on improving awareness, and reducing harmful consumption to decrease the alcohol-related cancer burden.

Excessive use of social media by high school students in southern Brazil

Objective:

To assess the prevalence of excessive use of social media and associated factors, as well as possible health consequences in high school students in southern Brazil.

Methods:

This is a population-based cross-sectional study, conducted with high school students in the city of Rio Grande, RS. All students who were attending high school at the Federal Institute of Rio Grande do Sul, campus Rio Grande, were eligible for this research in the second semester of 2019. In total, 513 students participated in the study. The dependent variable was excessive use of social media, defined as more than five hours per day. Descriptive and bivariate analyses were carried out and the Poisson regression was used to verify associations, with robust adjustment of variance.

Results:

The prevalence of students who reported excessive use of social media was 35.9%. The groups that were most susceptible to excessive use of social media had the following profile: female, black/brown skin, aged between 18 and 20 years old, attending the first year of high school. Excessive use of social media was shown to be associated with smoking, risk of depression, anxiety and stress, high risk of suicide and drug use.

Conclusions:

More than a third of students used social media excessively. This behavior was associated with negative health outcomes.

Agent-Based Models for Assessing Complex Statistical Models: An Example Evaluating Selection and Social Influence Estimates from SIENA

Although agent-based models (ABMs) have been increasingly accepted in social sciences as a valid tool to formalize theory, propose mechanisms able to recreate regularities, and guide empirical research, we are not aware of any research using ABMs to assess the robustness of our statistical methods. We argue that ABMs can be extremely helpful to assess models when the phenomena under study are complex. As an example, we create an ABM to evaluate the estimation of selection and influence effects by SIENA, a stochastic actor-oriented model proposed by Tom A. B. Snijders and colleagues. It is a prominent network analysis method that has gained popularity during the last 10 years and been applied to estimate selection and influence for a broad range of behaviors and traits such as substance use, delinquency, violence, health, and educational attainment. However, we know little about the conditions for which this method is reliable or the particular biases it might have. The results from our analysis show that selection and influence are estimated by SIENA asymmetrically and that, with very simple assumptions, we can generate data where selection estimates are highly sensitive to misspecification, suggesting caution when interpreting SIENA analyses.

Smoking cessation among adolescents in Europe: The role of school policy and programmes

INTRODUCTION

European estimates of adolescent smoking cessation are lacking and studies on the role of schools in quit behaviour are scarce. We aimed to describe smoking cessation attempts and success among adolescents in Europe and explored the association with school policy and programmes.

METHODS

We used cross-sectional data from the 2013 and 2016-2017 surveys of the European SILNE and SILNE-R projects. We included 4,509 12-19-year-old current or ex-smokers in 67 secondary schools in seven countries (Belgium, Germany, Finland, Ireland, Italy, the Netherlands, and Portugal). School staff reported strength of smoke-free school policies (SFSPs), proportion of grades in which anti-tobacco education was offered, and whether the school offered any form of cessation support programme. Multilevel logistic regression analysis determined school-level variation and the association of school-level and individual-level variables with self-reported and self-defined quit attempts and quit success.

RESULTS

Over three quarters (77.3%) of students reported a quit attempt and half of them (50.1%) reported quit success. Prevalence rates of quit success and quit attempts, showed relatively small variations between schools within countries. Associations of smoke-free school policy, tobacco educational programmes and cessation programmes with quit attempts and quit success could not be demonstrated with statistical significance. Quit attempts and quit success were inversely associated with alcohol use, parental smoking, and friend smoking.

CONCLUSION

This study demonstrates that adolescence is an important time to encourage quitting and to support quit attempts. We did not find evidence for a contribution of school policies and programmes to quit behaviour of adolescent smokers.

A Mobile Peer Intervention for Preventing Mental Health and Substance Use Problems in Adolescents: Protocol for a Randomized Controlled Trial (The Mind Your Mate Study)

Background

Anxiety, mood, and substance use disorders have significant social and economic impacts, which are largely attributable to their early age of onset and chronic disabling course. Therefore, it is critical to intervene early to prevent chronic and debilitating trajectories.

Objective

This paper describes the study protocol of a CONSORT (Consolidated Standards of Reporting Trials)-compliant randomized controlled trial for evaluating the effectiveness of the Mind your Mate program, a mobile health (mHealth) peer intervention that aims to prevent mental health (focusing on anxiety and depression) and substance use problems in adolescents.

Methods

Participants will consist of approximately 840 year 9 or year 10 students (60 students per grade per school) from 14 New South Wales high schools in Sydney, Australia. Schools will be recruited from a random selection of independent and public schools across the New South Wales Greater Sydney Area by using publicly available contact details. The intervention will consist of 1 introductory classroom lesson and a downloadable mobile app that will be available for use for 12 months. Schools will be randomly allocated to receive either the mHealth peer intervention or a waitlist control (health education as usual). All students will be given web-based self-assessments at baseline and at 6- and 12-month follow-ups. The primary outcomes of the trial will be the self-reported use of alcohol and drugs, anxiety and depression symptoms, knowledge about mental health and substance use, motives for not drinking, and willingness to seek help. Secondary outcomes will include positive well-being, the quality of life, and the impact of the COVID-19 pandemic. Analyses will be conducted using mixed-effects linear regression analyses for normally distributed data and mixed-effects logistic regression analyses for categorical data.

Results

The Mind your Mate study was funded by an Australian Rotary Health Bruce Edwards Postdoctoral Research Fellowship from 2019 to 2022. Some of the development costs for the Mind your Mate intervention came from a seed funding grant from the Brain and Mind Centre of the University of Sydney. The enrollment of schools began in July 2020; 12 of 14 schools were enrolled at the time of submission. Baseline assessments are currently underway, and the first results are expected to be submitted for publication in 2022.

Conclusions

The Mind your Mate study will generate vital new knowledge about the effectiveness of a peer support prevention strategy in real-world settings for the most common mental disorders in youth. If effective, this intervention will constitute a scalable, low-cost prevention strategy that has significant potential to reduce the impact of mental and substance use disorders.

Trial Registration

Australian New Zealand Clinical Trials Registry ACTRN12620000753954; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379738&isReview=true

International Registered Report Identifier (IRRID)

DERR1-10.2196/26796

[Changes in tobacco and alcoholic beverage consumption among adolescents from Curitiba in the State of Paraná: a longitudinal study]

The scope of this study was to verify alterations in cigarette and alcohol consumption in a sample of adolescents from the state education system of the city of Curitiba in the State of Paraná between 2015 and 2017. It involved a longitudinal prospective cohort study conducted with 799 adolescents (11 to 15 years of age) between 2015 and 2017. The Youth Risk Behavior Surveillance System (YRBS) questionnaire evaluated mild and excessive alcohol and tobacco consumption. Modifications of alcohol and tobacco consumption were evaluated through Generalizable Estimating Equation (GEE) models with Poisson distribution to obtain Incidence Risk Ratios (IRR) with 95% confidence intervals (95%CI). The "time" variable was treated as an independent variable along with other possible predictors (gender, age bracket, nutritional status, socioeconomic level, head of household education, physical activity and screen time). Tobacco consumption (IRR= 1,32, 95%CI = 1,02; 1,71), mild (IRR= 1,32, 95%CI = 1,13; 1,53) and excessive (IRR= 1,21, 95%CI = 1,04; 1,40) alcohol consumption increased between 2015 and 2017. This study indicates that adolescents participating in this research are modifying their behaviors towards a less healthy lifestyle.

FACTORS ASSOCIATED TO ALCOHOL USE BY ADOLESCENTS

ABSTRACT Objective to analyze the association between alcohol use by adolescents and environmental, family and social relations factors. Method and epidemiological study, of the cross-sectional cohort type, with a sample consisting of 303 students from the Brazilian 9thgrade of elementary level of public and private schools in Divinópolis, Minas Gerais, Brazil. Data was collected through the replication of the “General Information” and “Use of Alcohol” modules from the National Survey of School Health - 2015. The answer variable was alcohol consumption in life, associating it with explanatory variables related to: living with parents, maternal schooling, administrative dependency of the school, alcohol use by friends, and future perspectives. Univariate and multivariate analyses were used using Pearson's chi-square tests and Poisson's model for robust variances. Results an association was found in the multivariate analysis between consumption of beverages and intending to study only until high school or technical school (p=0.007), continuing to study and work (p=0.003), not living with parents (p=0.010), and having friends who make use alcohol (p=0.009). Conclusion social relationships were the most relevant factor for alcohol consumption by adolescents, mainly influenced by friends who use it and by the interpersonal relationships established by them.

Finding and Keeping Friends in College and Their Influence on Alcohol Use: A Network Analysis

OBJECTIVE

We investigate how alcohol use and friendship co-evolve during students' transition to university. We discern effects of peer influence from friend selection based on alcohol use, whether such effects vary in strength across the school year, and whether alcohol has different effects on friendship formation versus friendship maintenance.

METHOD

We gathered data on friendships, alcohol use, and binge drinking from 300 residence hall students (71% female) at a large, public U.S. university. Surveys were conducted at four time points during the 2015-2016 academic year. We used a stochastic actor-oriented model to test whether alcohol use was influenced by one's friends, while simultaneously testing for friend selection based on alcohol use and related network processes.

RESULTS

Students were 7.0 times more likely to drink alcohol weekly if all versus none of their friends drank weekly and 6.8 times more likely to binge drink when all versus none of their friends engaged in binge drinking, after we controlled for friend selection. Alcohol use differentially affected friendship creation and maintenance in a complex manner: (a) weekly drinkers were more likely to form new friendships and dissolve existing friendships than nondrinkers and (b) similarity on drinking fostered new friendships but had no effect on friendship persistence.

CONCLUSIONS

Friends influence one another's weekly drinking and binge drinking, whereas conversely, alcohol use contributes to both friendship formation and friendship instability.

Finding and Keeping Friends in College and Their Influence on Alcohol Use: A Network Analysis

OBJECTIVE

We investigate how alcohol use and friendship co-evolve during students' transition to university. We discern effects of peer influence from friend selection based on alcohol use, whether such effects vary in strength across the school year, and whether alcohol has different effects on friendship formation versus friendship maintenance.

METHOD

We gathered data on friendships, alcohol use, and binge drinking from 300 residence hall students (71% female) at a large, public U.S. university. Surveys were conducted at four time points during the 2015-2016 academic year. We used a stochastic actor-oriented model to test whether alcohol use was influenced by one's friends, while simultaneously testing for friend selection based on alcohol use and related network processes.

RESULTS

Students were 7.0 times more likely to drink alcohol weekly if all versus none of their friends drank weekly and 6.8 times more likely to binge drink when all versus none of their friends engaged in binge drinking, after we controlled for friend selection. Alcohol use differentially affected friendship creation and maintenance in a complex manner: (a) weekly drinkers were more likely to form new friendships and dissolve existing friendships than nondrinkers and (b) similarity on drinking fostered new friendships but had no effect on friendship persistence.

CONCLUSIONS

Friends influence one another's weekly drinking and binge drinking, whereas conversely, alcohol use contributes to both friendship formation and friendship instability.

Public Response to a Social Media Tobacco Prevention Campaign: Content Analysis

Background

Prior research suggests that social media–based public health campaigns are often targeted by countercampaigns.

Objective

Using reactance theory as the theoretical framework, this research characterizes the nature of public response to tobacco prevention messages disseminated via a social media–based campaign. We also examine whether agreement with the prevention messages is associated with comment tone and nature of the contribution to the overall discussion.

Methods

User comments to tobacco prevention messages, posted between April 19, 2017 and July 12, 2017, were extracted from Twitter, Facebook, and Instagram. Two coders categorized comments in terms of tone, agreement with message, nature of contribution, mentions of government agency and regulation, promotional or spam comments, and format of comment. Chi-square analyses tested associations between agreement with the message and tone of the public response and the nature of contributions to the discussions.

Results

Of the 1242 comments received (Twitter: n=1004; Facebook: n=176; Instagram: n=62), many comments used a negative tone (42.75%) and disagreed with the health messages (39.77%), while the majority made healthy contributions to the discussions (84.38%). Only 0.56% of messages mentioned government agencies, and only 0.48% of the comments were antiregulation. Comments employing a positive tone (84.13%) or making healthy contributions (69.11%) were more likely to agree with the campaign messages (P=0.01). Comments employing a negative tone (71.25%) or making toxic contributions (36.26%) generally disagreed with the messages (P=0.01).

Conclusions

The majority of user comments in response to a tobacco prevention campaign made healthy contributions. Our findings encourage the use of social media to promote dialogue about controversial health topics such as smoking. However, toxicity was characteristic of comments that disagreed with the health messages. Managing negative and toxic comments on social media is a crucial issue for social media–based tobacco prevention campaigns to consider.

Puff or pass: do social media and social interactions influence smoking behaviour of university students? A cross-sectional mixed methods study from Dhaka, Bangladesh

OBJECTIVE

To determine whether the odds of being a smoker differ based on social media use and social interactions among urban university students in Bangladesh.

HYPOTHESIS

Social media use and social interactions influence the smoking behaviour of Bangladeshi university students, particularly in starting and maintaining cigarette smoking.

DESIGN AND SETTING

A cross-sectional study using mixed methods on 600 student smokers and non-smokers recruited from two public and two private universities in Dhaka, Bangladesh, a lower middle-income country with limited resources. Exclusion criteria were those who did not use any form of social media and PhD students.

RESULTS

Odds of smoking were significantly higher for those who socialised more than 4 hours/day (p<0.05; OR 1.75; 95% CI 1.12 to 2.75) and typically at night (p<0.05; OR 2.80; 95% CI 1.95 to 4.00). Odds of smoking were also higher for those who liked (p<0.05; OR 4.85; 95% CI 3.32 to 7.11), shared (p<0.05; OR 20.50; 95% CI 13.02 to 32.26) and followed (p<0.05; OR 2.88; 95% CI 1.36 to 6.11) tobacco-related content on social media. Qualitative analysis resulted in emergent themes of smokers imitating tobacco-related photos or videos seen on social media and peers as an influence for smoking initiation.

CONCLUSION

This study suggests social media and social interactions may influence smoking behaviour in university students in Dhaka, Bangladesh. Future research should continue to investigate the roles social media and social interaction have on smoking in order to explore social media-based smoking cessation interventions or dissemination of smoking health hazards through social media.

A review of psychosocial factors linked to adolescent substance use

PURPOSE

Informed by ecological theories and models of influence, this review discusses various psychosocial risk and protective factors that contribute to adolescent substance use behavior. Given typical patterns of substance use initiation during this developmental period, an emphasis is placed on alcohol, cigarette, and marijuana use.

FINDINGS

Consistent with bioecological theories, peers and parents tend to have the strongest effect on adolescent substance use behavior. Influences can be both direct, such as offers and availability to use substances, as well as indirect influences, such as the perception of substance use approval. Schools and neighborhoods also contribute to adolescent substance use behavior, but this effect is often less direct. Moreover, the effect of neighborhoods on adolescent behavior reflects both structural components (e.g., neighborhood racial composition, teacher-student ratios) in addition to social process (e.g., neighborhood social cohesion, school connectedness). A review of parallel studies conducted with animals is also provided.

SUMMARY

Adolescent substance use behavior does not occur in a vacuum. Investigations must encompass the relevant social ecologies that affect adolescent behavior, including family, peer, school, and neighborhood contexts to provide a more complete understanding of substance use etiology.

Perceived Social Acceptability and Longitudinal Trends in Adolescent Cigarette Smoking

The current study uses methods from social network analysis to predict longitudinal trends in adolescent cigarette smoking based on perceived social acceptability from friends, in addition to typical measures of peer influence (e.g., self-reported cigarette use of friends). By concurrently investigating the role of perceived social acceptability of smoking and peer influence, the current study offers new insight into the mechanisms through which peers influence adolescent smoking. Two waves of data from five high schools within one US school district (n = 1563) were used. Stochastic actor-based models simultaneously estimated changes in smoking predicted by perceived social acceptability and peer influence. Findings demonstrate that adolescents with higher perceived social acceptability of cigarette use increased cigarette smoking over time. Conversely, support for peer influence on smoking was not found after controlling for the effects of perceived social acceptability. The results suggest that perceived social acceptability regarding cigarette smoking rather than self-report of cigarette use among friends is predictive of future smoking behavior. Consequently, the findings highlight the need for prevention efforts to take into account the multifaceted dynamics between adolescent smoking and friendships. Programs that address peer influence alone, without considering peer mechanisms such as perceived social acceptability, are at risk of ignoring critical avenues for prevention.

JUUL on Twitter: Analyzing Tweets About Use of a New Nicotine Delivery System

BACKGROUND

Initial reports suggest that JUUL, a popular e-cigarette, is being used in schools and other locations in which cigarette smoking is illegal or discouraged. However, there is little scholarly research documenting this. We aimed to make a systematic analysis of JUUL use themes and sentiment on Twitter.

METHODS

Data were collected from Twitter's Filtered Streams Application Programming Interface from April 12, 2018 to May 10, 2018. This yielded 67,934 tweets, from which a random sample of 2% was selected for coding. The final dataset included 1209 tweets. Inter-rater reliability ranged κ = 0.64-0.85.

RESULTS

The majority (71.5%) of tweets expressed positive sentiment toward JUUL. JUUL use in places where cigarette smoking is illegal or discouraged appeared in 111 tweets (9.2%); approximately one-third of these tweets referring to using the device in school. Nearly 20% of tweets mentioned using the device at home and/or directly in front of responsible adults.

CONCLUSIONS

This study confirms anecdotal reports of JUUL use in places where cigarette smoking is illegal or discouraged. Positive sentiment about use of JUUL suggests that the product is being normalized among young people. It may be valuable for educators to discuss the addictive nature of nicotine delivered through JUUL with younger populations.

Social media use and risky behaviors in adolescents: A meta-analysis

INTRODUCTION

This systematic review and meta-analysis examined the associations between social media use and risky behaviors during adolescence, and evaluated study characteristics (e.g., sample age, type of social media platform assessed) that may moderate these relationships.

METHODS

A comprehensive search strategy identified relevant studies from PsycInfo, PubMed, Google Scholar, and Proquest Dissertations and Theses Global.

RESULTS

The final sample included 27 independent cross-sectional studies with a total of 67,407 adolescents (M_age = 15.5, range: 12.6-18.0 years; 51.7% girls; 57.2% White). Results from random effects models indicated that there were positive, small-to-medium correlations between social media use and engagement in risky behaviors generally (r = 0.21, 95% CI = 0.16-0.25), substance use (r = 0.19, 95% CI = 0.12-0.26), and risky sexual behaviors (r = 0.21, 95% CI = 0.15-0.28). There were an insufficient number of independent samples available to conduct a random effect models for violence-related behaviors (k = 3). Moderator analyses suggested that studies assessing solely early social media platforms (e.g., Facebook/MySpace only) in relation to substance use had smaller effect sizes than substance use studies assessing a broader range of contemporary social media platforms. In addition, younger samples had larger effect sizes for studies focused on social media use and risky sexual behaviors.

CONCLUSIONS

The positive links identified between social media and risky behaviors during adolescence in this meta-analysis suggest that developmental theories of risk taking would benefit from incorporating the social media context. Longitudinal studies are needed to clarify directionality and make more specific practice and policy recommendations so that social media is a safe place in which adolescents can thrive.

Peer social network processes and adolescent health behaviors: A systematic review

Research has highlighted the importance of peers for determining health behaviors in adolescents, yet these behaviors have typically been investigated in isolation. We need to understand common network processes operating across health behaviors collectively, in order to discern how social network processes impact health behaviors. Thus, this systematic review of studies investigated adolescent peer social networks and health behaviors. A search of six databases (CINAHL, Education Resources Information Centre, Embase, International Bibliography of the Social Sciences, Medline and PsycINFO) identified 55 eligible studies. The mean age of the participants was 15.1 years (range 13-18; 51.1% female). Study samples ranged from 143 to 20,745 participants. Studies investigated drinking (31%), smoking (22%), both drinking and smoking (13%) substance use (18%), physical activity (9%) and diet or weight management (7%). Study design was largely longitudinal (n = 41, 73%) and cross-sectional (n = 14, 25%). All studies were set in school and all but one study focused on school-based friendship networks. The Newcastle-Ottawa Scale was used to assess risk of bias: studies were assessed as good (51%), fair (16%) or poor (33%). The synthesis of results revolved around two network behavior patterns: 1) health behavior similarity within a social network, driven by homophilic social selection and/or social influence, and 2) popularity: health behavior engagement in relation to changes in social status; or network popularity predicting health behaviors. Adolescents in denser networks had statistically significant lower levels of harmful behavior (n = 2/2, 100%). Findings suggest that social network processes are important factors in adolescent health behaviors.

Parents modelling, peer influence and peer selection impact on adolescent smoking behavior: A longitudinal study in two age cohorts

Understanding the key factors that influence smoking behavior, especially during adolescence, has a meaningful impact on public health. This study examined the impact of parent modelling, peer influence and peer selection on adolescent smoking behavior in two Portuguese cohorts followed for three years. A questionnaire was delivered in classes and schools randomly selected, three times, one per year (cohort1: time1-7th, time2-8th, time3-9th; cohort2: time1-10th, time2-11th, time3-12th graders). The sample included a total of 656 students (402 younger [time1 Mage = 13.17, SD = 0.53, 63.7% girls;] and 254 older [time 1 Mage = 16.20, SD = 0.53, 65% girls]). Longitudinal data were examined through an autoregressive cross-lagged model (ARCL). The model explained 35% of the variance in smoking behavior at T3 for the global sample (4% for the younger and 58% for the older). Over time, in both cohorts, the percentage of never smokers decreased sharply and the percentage of regular smokers increased rapidly. We observed that participants in the older cohort had higher chances of smoking if their parents smoked. Nevertheless, we did not find a parental modelling effect in the longitudinal model. Peer influence and peer selection influenced smoking behavior. However, peer selection influenced the youngest group, both processes influenced the middle age group, and only peer influence influenced the oldest. Best friend and friends had a stronger impact on the younger while friends and same grade students had a stronger impact on the older. Prevention programs should regard these differences of interpersonal influences through adolescent development and specific strategies for different age groups should be considered.

Selection and Socialization Influences on Adolescent Alcohol Use: The Individual and Joint Contexts of Neighborhood Disadvantage and Population Density

Background: Neighborhood disadvantage (ND) and population density (PD) are two community characteristics contextualizing friends' influence on adolescent alcohol use. However, these community characteristics are rarely examined for potential joint contributions, although it is possible that the way friends are selected or influence alcohol use are shaped by both ND and PD. In addition, prior studies examining ND or PD contexts on friend influence rarely discern between socialization and selection. Objectives: The current study examined how selection and socialization influences on adolescent alcohol use are shaped by unique and joint contexts of ND and PD. Methods: Adolescents from Waves I and II of the National Longitudinal Study of Adolescent and Adult Health (Add Health) were included in three models assessing friends' socialization of alcohol us initiation and binge drinking, and selection of drinking friends. ND and PD were tested for mediation and moderation individually and jointly. Results: Results indicated that socialization of drinking initiation was stronger in high ND contexts, and that continued binge drinking was stronger in low ND contexts. PD indirectly influenced socialization of initiation and binge drinking maintenance via a negative association with number of drinking friends. PD and ND jointly influenced the association between initial binge drinking and next-year selection of drinking friends, such that selection was stronger within areas related to lower levels of drinking friends. Conclusions/Importance: Current results indicate that PD and ND shape friends' influence on alcohol use in unique ways. These must be accounted for to better understand bidirectional effects of friend influence.

Social Norms and Smoking Risk in iTaukei Fijian Adolescent Women

OBJECTIVE

To investigate the association of a variety of social smoking exposures with cigarette smoking among iTaukei adolescent women in Fiji.

METHODS

Self-report data were collected in a representative sample of school-going iTaukei adolescent women (n=523). We fitted logistic regression models of current cigarette smoking with school, peer, media, and other social exposures to smoking as predictors.

RESULTS

Current cigarette smoking was associated with exposure to close friend, peer, and routine social smoking as well as higher prevalence of school peer smoking, but not parent tobacco use and media smoking exposures-in our fully adjusted model.

CONCLUSIONS

Peer and school-based smoking exposures may increase cigarette smoking risk in school-going iTaukei adolescent women and may be strategic interventional targets to augment existing preventive approaches.

The Paradoxical Outcomes of Observing Others' Exercise Behavior on Social Network Sites: Friends' Exercise Posts, Exercise Attitudes, and Weight Concern

This study examined the implications of observing others' exercise behavior on social network sites (SNSs). Social cognitive theory and social comparison theory were used to make predictions about the conditions under which individuals' (N = 232) exposure to exercise-related SNS posts from others in their social network were related to their weight concerns and exercise attitudes. The results revealed a paradox in which observing others' exercise posts was associated with both adaptive and maladaptive responses. The number of exercise-related SNS posts received from members of respondents' social networks was associated with greater weight concern, and this relationship was stronger among respondents who viewed exercise-related posts from network members who were similar to respondents. Yet, among respondents who had a tendency to make appearance-related upward social comparisons, the number of others' exercise-related SNS posts received was associated with pro-exercise attitudes.

The effect of parental drinking on alcohol use in young adults: the mediating role of parental monitoring and peer deviance

BACKGROUND AND AIMS

Evidence demonstrating an association between parental alcohol use and offspring alcohol use from robust prospective studies is lacking. We tested the direct and indirect associations between parental and young adult alcohol use via early alcohol initiation, parental monitoring and associating with deviant peers.

DESIGN

Prospective birth cohort study. Path analysis was used to assess the possible association between parental alcohol use (assessed at 12 years) and alcohol use in young adults (assessed at 18 years) via potential mediators (assessed at 14 and 15.5 years, respectively).

SETTING

South West England.

PARTICIPANTS

Data were available on 3785 adolescents and their parents from the Avon Longitudinal Study of Parents and Children.

MEASUREMENTS

The continuous Alcohol Use Disorders Identification Test (AUDIT) score was used as the primary outcome measure. Maternal alcohol use was defined as light (< 4 units on any day), moderate (≥ 4 units on 1-3 days) and high-risk (≥ 4 units on ≥ 4 days in 1 week). Partner alcohol use was also defined as light, moderate and high risk. Socio-economic variables were included as covariates.

FINDINGS

There was strong evidence of a total effect from maternal alcohol use to young adult alcohol use [moderate: b = 1.07, 95% confidence interval (CI) = 0.64, 1.49, P < 0.001; high risk: b = 1.71, 95% CI = 1.07, 2.35, P < 0.001]. The majority of this association was explained through early alcohol initiation (moderate: b = 0.14, 95% CI = 0.04, 0.25, P = 0.01; high risk: b = 0.24, 95% CI = 0.07, 0.40, P < 0.01) and early alcohol initiation/associating with deviant peers (moderate: b = 0.06, 95% CI = 0.02, 0.10, P < 0.01; high risk: b = 0.10, 95% CI = 0.03, 0.16, P < 0.01). There was strong evidence of a remaining direct effect (moderate: b = 0.81, 95% CI = 0.39, 1.22, P < 0.001; high risk: b = 1.28, 95% CI = 0.65, 1.91, P < 0.001). A similar pattern of results was evident for partner alcohol use.

CONCLUSIONS

Young adults whose parents have moderate or high-risk alcohol consumption are more likely to consume alcohol than those with parents with lower alcohol consumption. This association appears to be partly accounted for by earlier alcohol use initiation and higher prevalence of association with deviant peers.

Talking about tobacco on Twitter is associated with tobacco product use

Tobacco-related content appears on social media in the form of advertising and messages by individuals. However, little is known about associations between posting social media messages and tobacco product use among adolescents and young adults. Self-reports of tobacco product use were obtained from the Children's Health Study of young adults in Southern California. Among the 1486 respondents in the most recent wave of the cohort (2016-2017), 284 provided tobacco product use data and their Twitter user names to access publicly available Twitter account data (mean age = 20.1 yrs. (SD = 0.6), 54% female, 49% Hispanic). We obtained the tweets that those respondents posted on Twitter, searched the tweets for 14 nicotine- and tobacco-related keywords, and coded these statements as positive or negative/neutral. Logistic regression analyses were conducted to determine whether respondents who posted positive tobacco-related tweets were more likely to report tobacco product use, relative to those who did not post any positive tobacco-related tweets. Respondents who posted any positive messages about tobacco had significantly higher odds of reporting past month use of cigarettes (OR = 3.15, 95% CI = 1.36, 7.30) and any tobacco product (OR = 2.41, 95% CI = 1.16, 5.01), relative to respondents who did not post about tobacco. This is the first study to establish an empirical link between adolescents' and young adults' tobacco-related Twitter activity and their tobacco product use. Health communications about the risks of tobacco use could target adolescents who post positive messages about tobacco products on Twitter.

Social relations and life satisfaction: the role of friends

Social capital is defined as the individual’s pool of social resources found in his/her personal network. A recent study on Italians living as couples has shown that friendship relationships, beyond those within an individual’s family, are an important source of support. Here, we used data from Aspects of Daily Life, the Italian National Statistical Institute’s 2012 multipurpose survey, to analyze the relation between friendship ties and life satisfaction. Our results show that friendship, in terms of intensity (measured by the frequency with which individuals see their friends) and quality (measured by the satisfaction with friendship relationships), is positively associated to life satisfaction.

Who is watching user-generated alcohol posts on social media?

AIM

To examine students' exposure to user-generated alcohol content on social media, and identify characteristics (i.e. demographics, personality traits, alcohol use, alcohol-related cognitions, and social media factors) associated with monthly or more frequent exposure.

METHOD

College/university students (N=11,236) in Bergen, Norway, completed a web-survey measuring exposure to alcohol on social media - both frequency and interpretations of alcohol content. The survey included questions regarding demographics, personality, alcohol-related cognitions, and general use of social media and alcohol. Binary logistic regressions were run to identify characteristics associated with monthly or more frequent exposure to alcohol-related posts on social media.

RESULTS

A total of 96.7% had been exposed to alcohol-related posts, exposure to posts with a positive valence of alcohol were more frequently reported than exposure to content with a negative valence of alcohol. Reports of monthly or more frequent exposure to alcohol on social media were associated with a range of characteristics, among these younger age, being native Norwegian, lower extroversion and higher agreeableness and self-monitoring scores, higher alcohol use, stronger descriptive norms for alcohol use among online-friends, and more frequent logins to social media.

CONCLUSIONS

Students' potential inflated alcohol norms (originating from social media) should be addressed. The results suggest that exposure may be determined by high alcohol use and membership in demographical groups associated with high alcohol use, an increased attentiveness towards others' behavior, and excessive social media use. Future studies investigating the relationship between alcohol exposure on social media and later alcohol use should control for such factors.

Feasibility of e-Health Interventions on Smoking Cessation among Vietnamese Active Internet Users

Introduction: Although e-health interventions are widely implemented as a supportive measure to smoking cessation, there is a lack of evidence in the feasibility of its application among Vietnamese youths, which is considered to be one of the most frequent internet using populations. This study assessed the quitting attempts among smokers and their preference and willingness to pay for smartphone-based cessation supporting applications in a sample of active internet users approached. Methods: A total of 1082 participants were recruited for the online-based survey from August to October 2015 in Vietnam. Information on sociodemographic characteristics, health information seeking behaviors on the internet, smoking status, quitting attempts and willingness to pay for smartphone-based cessation supporting applications were collected. Multivariate logistic regression was used to determine the associated factors with current smoking and willingness to pay for the smoking cessation application. Results: About 11% of participants were current smokers while 73.4% had attempted to quit smoking. Only 26.8% of the individuals indicated that they were willing to utilize a smartphone application to assist them in quitting. Participants who were male, had partners/spouse and lived at other places were more likely to smoke cigarette. Meanwhile, people who spent 50–70% of their online time to read health information were less likely to smoke. Results also show that living with family and never sharing health information on the internet were negatively associated with a participant’s willingness to pay for the smartphone application. Meanwhile, people who highly trusted health information were more likely to be willing to pay for the application. Conclusions: This prevalence of smoking and associated factors can provide potential indicators for creating several public health interventions in the new environment with the increasing development of information technology. This study implies that in order to expand the coverage of smoking cessation interventions, we recommend the integration of e-health interventions with clinical- or telephone-based conventional models by providing smartphone applications and information on the internet from reliable sources.

Systematic review of surveillance by social media platforms for illicit drug use

Background

The use of social media (SM) as a surveillance tool of global illicit drug use is limited. To address this limitation, a systematic review of literature focused on the ability of SM to better recognize illicit drug use trends was addressed.

Methods

A search was conducted in databases: PubMed, CINAHL via Ebsco, PsychINFO via Ebsco, Medline via Ebsco, ERIC, Cochrane Library, Science Direct, ABI/INFORM Complete and Communication and Mass Media Complete. Included studies were original research published in peer-reviewed journals between January 2005 and June 2015 that primarily focused on collecting data from SM platforms to track trends in illicit drug use. Excluded were studies focused on purchasing prescription drugs from illicit online pharmacies.

Results

Selected studies used a range of SM tools/applications, including message boards, Twitter and blog/forums/platform discussions. Limitations included relevance, a lack of standardized surveillance systems and a lack of efficient algorithms to isolate relevant items.

Conclusion

Illicit drug use is a worldwide problem, and the rise of global social networking sites has led to the evolution of a readily accessible surveillance tool. Systematic approaches need to be developed to efficiently extract and analyze illicit drug content from social networks to supplement effective prevention programs.

Disclosure and Exposure of Alcohol on Social Media and Later Alcohol Use: A Large-Scale Longitudinal Study

This article aims to investigate whether alcohol-related disclosure and exposure on social media can predict later alcohol use, and to identify covariates in these relationships. Data were collected by online surveys (two waves) among students in Bergen, Norway. The first survey was administered in fall 2015. The follow-up took place during fall 2016. A total of 5,217 students participated in both waves. The surveys included questions about demographics, personality, alcohol use, alcohol-related cognitions (e.g., attitudes and norms), social media use, and disclosure and exposure of alcohol on social media. Bivariate comparisons were conducted to assess differences in alcohol use between the frequent (i.e., monthly or more often) disclosure and exposure groups and low-frequent disclosure and exposure groups. Crude and adjusted linear regressions were employed to investigate if disclosure and exposure of alcohol could predict later alcohol use, when controlling for a range of covariates. Compared to the low-frequent disclosure and exposure groups, participants which frequently disclosed or were frequently exposed to alcohol-related content had higher alcohol use at baseline and 1 year later (p < 0.001), when no covariates were controlled for. Frequent disclosure of content reflecting positive aspects of alcohol predicted stable or slightly increased alcohol use at Time 2 (p < 0.01), even when all covariates (i.e., demographics, personality, alcohol use, alcohol-related cognitions, and social media use) were controlled for. In conclusion, frequent disclosure and/or exposure to alcohol-related content predicted alcohol use over time. Alcohol disclosure/exposure on social media could for the most part not predict later alcohol use when baseline alcohol use was controlled for. High alcohol use and alcohol disclosure/exposure on social media appear to be strongly intertwined, which hampers identification of directionality between alcohol use and disclosure/exposure. Disclosing content reflecting positive aspects of alcohol was the only independent variable that could predict further alcohol use when other factors, like baseline alcohol use, were held constant. This finding suggests that disclosure of alcohol content reflecting positive aspects of alcohol might have a self-enhancing effect on the sharers' further alcohol consumption, or that disclosing such content could indicate lenient alcohol-related cognitions not detected by the current measurements.

An application of the Continuous Opinions and Discrete Actions (CODA) model to adolescent smoking initiation

We investigated the impact of peers’ opinions on the smoking initiation process among adolescents. We applied the Continuous Opinions and Discrete Actions (CODA) model to study how social interactions change adolescents’ opinions and behaviors about smoking. Through agent-based modeling (ABM), we simulated a population of 2500 adolescents and compared smoking prevalence to data from 9 cohorts of adolescents in the National Survey on Drug Use and Health (NSDUH) from year 2001 till 2014. Our model adjusts well for NSDUH data according to pseudo R² values, which are at least 96%. Optimal parameter values indicate that adolescents exhibit imitator characteristics with regard to smoking opinions. The imitator characteristics suggests that teenagers tend to update their opinions consistently according to what others do, and these opinions later translate into smoking behaviors. As a result, peer influence from social networks plays a big role in the smoking initiation process and should be an important driver in policy formulation.

Friends' Alcohol-Related Social Networking Site Activity Predicts Escalations in Adolescent Drinking: Mediation by Peer Norms

PURPOSE

Adolescents' increased use of social networking sites (SNS) coincides with a developmental period of heightened risk for alcohol use initiation. However, little is known regarding associations between adolescents' SNS use and drinking initiation nor the mechanisms of this association. This study examined longitudinal associations among adolescents' exposure to friends' alcohol-related SNS postings, alcohol-favorable peer injunctive norms, and initiation of drinking behaviors.

METHODS

Participants were 658 high-school students who reported on posting of alcohol-related SNS content by self and friends, alcohol-related injunctive norms, and other developmental risk factors for alcohol use at two time points, 1 year apart. Participants also reported on initiation of three drinking behaviors: consuming a full drink, becoming drunk, and heavy episodic drinking (three or more drinks per occasion). Probit regression analyses were used to predict initiation of drinking behaviors from exposure to alcohol-related SNS content. Path analyses examined mediation of this association by peer injunctive norms.

RESULTS

Exposure to friends' alcohol-related SNS content predicted adolescents' initiation of drinking and heavy episodic drinking 1 year later, controlling for demographic and known developmental risk factors for alcohol use (i.e., parental monitoring and peer orientation). In addition, alcohol-favorable peer injunctive norms statistically mediated the relationship between alcohol-related SNS exposure and each drinking milestone.

CONCLUSIONS

Results suggest that social media plays a unique role in contributing to peer influence processes surrounding alcohol use and highlight the need for future investigative and preventive efforts to account for adolescents' changing social environments.

Reactions on Twitter to updated alcohol guidelines in the UK: a content analysis

OBJECTIVES

In January 2016, the 4 UK Chief Medical Officers released a public consultation regarding updated guidelines for low-risk alcohol consumption. This study aimed to assess responses to the updated guidelines using comments made on Twitter.

METHODS

Tweets containing the hashtag #alcoholguidelines made during 1 week following the announcement of the updated guidelines were retrieved using the Twitter Archiver tool. The source, sentiment and themes of the tweets were categorised using manual content analysis.

RESULTS

A total of 3061 tweets was retrieved. 6 sources were identified, the most prominent being members of the public. Of 821 tweets expressing sentiment specifically towards the guidelines, 80% expressed a negative sentiment. 11 themes were identified, 3 of which were broadly supportive of the guidelines, 7 broadly unsupportive and 1 neutral. Overall, more tweets were unsupportive (49%) than supportive (44%). While the most common theme overall was sharing information, the most common in tweets from members of the public encouraged alcohol consumption (15%) or expressed disagreement with the guidelines (14%), reflecting reactance, resistance and misunderstanding.

CONCLUSIONS

This descriptive analysis revealed a number of themes present in unsupportive comments towards the updated UK alcohol guidelines among a largely proalcohol community. An understanding of these may help to tailor effective communication of alcohol and health-related policies, and could inform a more dynamic approach to health communication via social media.

Popularity Breeds Contempt: The Evolution of Reputational Dislike Relations and Friendships in High School

In this study, we examined the dynamics of the perception of "dislike" ties (reputational dislike) among adolescents within the contexts of friendship, perceived popularity, substance use, and Facebook use. Survey data were collected from a longitudinal sample of 238 adolescents from the 11th and 12th grades in one California high school. We estimated stochastic actor-based network dynamic models, using reports of reputational dislike, friendships, and perceived popularity, to identify factors associated with the maintenance and generation reputational dislike ties. The results showed that high-status adolescents and more frequent Facebook users tended to become perceived as or stay disliked by their peers over time. There was a tendency for friendships to promote the creation and maintenance of reputational disliking but not vice versa. Adolescents tended to perceive others as disliked when their friends also perceived them as disliked. There was no evidence that either cigarette smoking or drinking alcohol affected reputational dislike dynamics. This study highlights the important role that the hierarchical peer system, online peer context, and friendships play in driving information diffusion of negative peer relations among adolescents.

Perceived norms and alcohol use among first-year college student-athletes' different types of friends

OBJECTIVE

To describe first-year college student-athletes' friendship contexts and test whether their perceptions of alcohol use and approval by different types of friends are associated with their own alcohol use.

PARTICIPANTS

First-year student-athletes (N = 2,622) from 47 colleges and universities participating in National Collegiate Athletic Association (NCAA) sports during February-March 2013.

METHODS

Student-athletes completed online surveys during the baseline assessment of an alcohol and other drug prevention program evaluation. Analyses tested whether perceptions of friends' alcohol use (descriptive norms) and perceptions of friends' approval of alcohol use (injunctive norms) predicted their alcohol use.

RESULTS

Both use and approval perceptions by upperclassmen, same-team, and most influential friends significantly predicted alcohol use. By contrast, only perceived use by first-year, nonteam, and less influential friends significantly predicted alcohol use.

CONCLUSIONS

Athletics departments' alcohol policies and prevention programming for first-year student-athletes should address the potential influence of different types of friends on alcohol use.

Investigating Sociodemographic Factors and HIV Risk Behaviors Associated With Social Networking Among Adolescents in Soweto, South Africa: A Cross-Sectional Survey

Background

Internet access via mobile phones and computers facilitates interaction and potential health communication among individuals through social networking. Many South African adolescents own mobile phones and can access social networks via apps.

Objective

We investigated sociodemographic factors and HIV risk behaviors of adolescent social networking users in Soweto, South Africa.

Methods

We conducted an interviewer-administered, cross-sectional survey of adolescents aged 14-19 years. Independent covariates of social networking were assessed by multivariate logistic regression analysis.

Results

Of 830 adolescents, 57% (475/830) were females and the median age was found to be 18 years (interquartile range 17-18). Social networking was used by 60% of adolescents (494/830); more than half, that is, 87% (396/494) accessed social networks through mobile phones and 56% (275/494) spent more than 4 hours per day using their mobile phones. Social networking was independently associated with mobile usage 2-4 hours (adjusted odds ratio [AOR]: 3.06, CI: 1.69-5.51) and more than 4 hours per day (AOR: 6.16, CI: 3.46-10.9) and one (AOR: 3.35, CI: 1.79-6.27) or more sexual partner(s) (AOR: 2.58, CI: 1.05-6.36).

Conclusions

Mobile phone–based social networking is prevalent among sexually active adolescents living in Soweto and may be used as an entry point for health promotion and initiation of low-cost adolescent health interventions.

Impact of Social Networking Sites on Children in Military Families

Youth in military families experience a relatively unique set of stressors that can put them at risk for numerous psychological and behavior problems. Thus, there is a need to identify potential mechanisms by which children can gain resiliency against these stressors. One potential mechanism that has yet to be empirically studied with military youth is social networking sites (SNSs). SNSs have gained significant popularity among society, especially youth. Given the significance of these communication tools in youths' lives, it is important to analyze how SNS use may affect military youth and their ability to cope with common military life stressors. The current review examines the potential positive and negative consequences associated with SNS use in coping with three common stressors of youth in military families: parent deployment, frequent relocation, and having a family member with a psychological or physical disability. By drawing from SNS and military literature, we predict that SNS use can be a positive tool for helping children in military families to cope with stressors. However, certain SNS behaviors can potentially result in more negative outcomes. Recommendations for future research are also discussed.