Patterns of alcohol use and the risk of drinking and driving among US high school students

Substance use Trajectories from Early Adolescence to Emerging Adulthood: A Comparison of Smoking, Binge Drinking, and Marijuana use

Over the past several years, there has been growing interest in identifying distinct developmental trajectories of substance use. Using data from the RAND Adolescent/Young Adult Panel Study (N = 6,527), we synthesize our prior findings on patterns of smoking, binge drinking, and marijuana use from early adolescence (age 13) to emerging adulthood (age 23). We also present new data on how these trajectory classes compare on key psychosocial and behavioral outcomes during emerging adulthood. For each type of substance use, we found two periods of vulnerability: early adolescence and the transition to emerging adulthood. As expected, early users were at relatively high risk for poor outcomes at age 23 compared to consistent low-level users and abstainers, even if they reduced their use during adolescence. However, youths who were not early users, but steadily increased their use over time, also tended to be at relatively high risk. Results suggest that multiple prevention approaches might be needed to successfully reach at-risk youths.

Attributes that differentiate children who sip alcohol from abstinent peers

Sipping alcohol during childhood may be a marker of differentiation as regards children's future risk of underage drinking; yet very little is known about alcohol use when it occurs among elementary school-aged children. The purpose of the present study is to examine alcohol sipping behavior in a sample of third-grade school children to learn whether sipping is associated with attributes that could increase children's likelihood of further underage drinking. We collected telephone interview data from 1,050 mothers and their third grade children (mean age 9.2 years; 48.2% male) residing in the Southeastern United States. The majority of mothers were White non-Hispanic (69.02%) or Black non-Hispanic (21.3%); most (85%) lived in households shared with fathers or other adult caretakers. We hypothesized that children who sip alcohol would score lower than abstinent peers on indicators of competence and score higher on indicators of exposure to alcohol-specific socialization by parents and peers. A multivariate model controlling for frequency of parent alcohol use and demographic covariates showed that children who had sipped alcohol were significantly less likely than abstinent peers to affirm indicators of competence and significantly more likely to affirm indicators of exposure to alcohol specific socialization by parents and by same age peers. These preliminary findings suggest that developmental attributes associated with risk of underage drinking begin to differentiate at least as young as middle childhood. Research is needed to test prospectively for continuity between alcohol risk attributes present in middle childhood and future alcohol use.

Regional differences associated with drinking and driving in Brazil

OBJECTIVE

To evaluate regional differences and similarities associated with drinking and driving (DUI) in the five Brazilian macro-regions.

METHOD

A roadside survey was conducted in the 27 Brazilian state capitals. A total of 3,398 drivers were randomly selected and given a structured interview and a breathalyzer test. To determine the predictors of positive blood alcohol concentration (BAC) in each region, a MANOVA was performed, and 3 groups were used as follows: 1) North and Northeast, 2) South and Midwest, and 3) Southeast. A Poisson robust regression model was performed to assess the variables associated with positive BAC in each group.

RESULTS

Of all surveyed drivers, 2,410 had consumed alcohol in the previous 12 months. Most were male, with a median age of 36. Leisure as the reason for travel was associated with positive BAC in all 3 groups. Low schooling, being older than 30, driving cars or motorcycles and having been given a breathalyzer test at least once in their lives predicted DUI in at least two different groups.

CONCLUSIONS

Factors , especially low schooling and leisure as a reason for travel, associated with drinking and driving were similar among regions, although certain region-specific features were observed. This information is important for aiming to reduce DUI in the country.

Traffic crashes and alcohol outlets in a Brazilian state capital

OBJECTIVE

Restricting alcohol outlets is being considered as a measure for preventing alcohol-related crashes. However, in many developing countries, alcohol availability is not regulated and its influence on motor vehicle traffic crashes is unknown. This study explores the association between traffic crashes and alcohol outlets in a Brazilian city.

METHOD

Data were geocoded and exploratory analysis was conducted using the kernel density estimator. Two generalized additive models (GAMs) were implemented to predict the factors associated with alcohol-related crashes.

RESULTS

For 78 percent of the 3840 traffic crashes where the driver was a victim, there was at least one bar located within a 300-m radius. The median distances between an outlet were 124.4 and 130.7 m for a non-alcohol- and alcohol-related crashes, respectively (P =.13). The GAMs did not make evident any significant association between the outlet locations and alcohol-related crashes: the presence of at least one outlet was associated with alcohol-related crashes with an odds ratio (OR) of 0.94 (95% confidence interval [CI] = 0.75-1.17). Alcohol crashes are more likely to be observed among males (OR = 1.58; 95% CI = 1.21-2.06), young drivers vs. those aged 50 years+ (OR = 3.4; 95% CI = 1.79-6.43), and crashes with fatalities (OR = 1.73; 95% CI = 0.98-3.04).

CONCLUSIONS

Density of alcohol outlets was high all over the city and both alcohol- and non-alcohol-related crashes occurred near an outlet. The study helps to better understand the relationship between alcohol availability and traffic crashes in a middle-income country where licensing/zoning is absent and suggests that measures for restricting the physical availability of alcohol are necessary, even though further studies are still needed.

High-risk driving behaviors among adolescent binge drinkers

BACKGROUND

Binge drinking is common among adolescents. Alcohol use, particularly binge drinking, has been associated with neurocognitive deficits and increased risk-taking behaviors, which may contribute to negative driving outcomes among adolescents even while sober.

OBJECTIVES

To examine potential differences in self-reported risky driving behaviors between adolescent binge drinkers and a matched sample of controls on measures of (1) compliance with graduated licensing laws, (2) high-risk driving behaviors, and (3) driving outcomes (i.e., crashes, traffic tickets).

METHODS

This study examined driving behaviors and outcomes in adolescent recent binge drinkers (n = 21) and demographically and driving history matched controls (n = 17) between the ages of 16-18 years.

RESULTS

Binge drinkers more frequently violated graduated licensing laws (e.g., driving late at night) and engaged in more "high-risk" driving behaviors, such as speeding and using a cell phone while driving. Binge drinkers had more traffic tickets, crashes, and "near crashes" than the control group. Speeding was the behavior most associated with crashes within the binge drinkers.

CONCLUSION

In this study, binge-drinking teens consistently engage in more dangerous driving behaviors and experience more frequent crashes and traffic tickets. They are also less compliant with preventative restrictions placed on youth while they are learning critical safe driving skills.

SCIENTIFIC SIGNIFICANCE

These findings highlight a need to examine the contribution of underlying traits (such as sensation seeking) and binge-related cognitive changes to these high-risk driving behaviors, which may assist researchers in establishing alternative prevention and policy efforts targeting this population.

Early onset of delinquency and the trajectory of alcohol-impaired driving among young males

Building upon the literature in developmental and life-course criminology, the present study assesses the possible association of age onset of delinquency with the trajectory of alcohol-impaired driving using data collected from the three waves of the Buffalo Longitudinal Survey of Young Men (BLSYM). It is argued that as a unique form of delinquency, alcohol-impaired driving among adolescents may be better understood in a broad context of adolescent delinquency involvement. The study adopts the general approach for the analysis of early onset of delinquency and criminal careers in developmental and life-course criminology and hypothesizes that early onset of delinquency is associated with a higher growth of alcohol-impaired driving over time among adolescents when age onsets of alcohol-impaired driving, drinking, and drug use are controlled. Our analysis with the HLM growth modeling method provides support for the hypothesis. Respondents who had an early start in delinquency were likely to have a faster growth of alcohol-impaired driving over the three waves of BLSYM, which implies that these respondents were likely to have a longer path of alcohol-impaired driving in their transition to adulthood. The implication of this finding is discussed.

Religiosity, Heavy Alcohol Use, and Vicarious Learning Networks Among Adolescents in the United States

Previous research has found that religiosity may protect against risky alcohol and drug use behaviors among adolescents, but the social mechanics underpinning the relationship are not well understood. This study examined the relationship between religiosity, heavy drinking, and social norms among U.S. adolescents aged 12 to 17 years, using the 2007 National Survey on Drug Use and Health ( n = 14,556). Based on a vicarious learning networks theoretical perspective, the effect of religiosity on heavy drinking behavior was hypothesized to be exerted indirectly through the norms of key reference groups in the social network (close friends and parents). Support was found for reference group norms as one underlying mechanism of the religiosity–alcohol relationship. Religiosity and nonpermissive drinking norms of parents, close friends, and peers maintained a strong protective association with adolescent heavy drinking. Supplementary analyses elaborated on the role of competing and complementary normative orientations among reference groups in the social network.

A descriptive analysis of the social context of drinking among first-time DUI offenders

OBJECTIVE

To understand the role of social context in contributing to the incidence of alcohol-impaired driving.

METHODS

Telephone interviews were conducted with 161 individuals who received a first-time DUI citation. They were predominantly white (70%), male (62%) and 21 to 45 years of age (62%). They were paid $25 for their participation. Questions were asked about their social network, the social context in which they typically drink, the specific location and circumstances where they were drinking at the time of their citation, risky driving behaviors, in the last month as well as the number of traffic tickets they received and crashes they have been involved in since they started to drive.

RESULTS

Two reliable social contexts of drinking were identified through principle components factors analysis: emotional pain and social facilitation. Analyses of variance showed that drinking in a context of emotional pain (eg, to deal with depression, stress) was related to drinking alone at this location and driving when they know they have had too much to drink. Drinking in a context of social facilitation (eg, with friends, to be sociable) was related to drinking more frequently and with others (versus alone) at this location. Social facilitation was also positively related to driving over the speed limit and running a red light/stop sign.

CONCLUSIONS

The social context of drinking is important for understanding the social network of drinking drivers, because most (86%) said that someone from their social network was with them at this drinking location. The need to understand how significant others influence the context of drinking as well as the likelihood of impaired driving is critical for program development. These results suggest that different types of interventions are needed for offenders depending on their social context of drinking.

Factors associated with alcohol and drug use among traffic crash victims in southern Brazil

OBJECTIVE

To investigate the prevalence of and factors associated with alcohol- or drug-related traffic crashes (TC) in a sample of TC victims who were admitted to the two emergency rooms of Porto Alegre in southern Brazil.

METHODS

A cross-sectional study with consecutive samples was used. Victims of non-fatal TCs (as drivers, passengers or pedestrians) who had presented at emergency rooms during the 45 days of data collection were selected. Subjects participated in a structured interview, were breathalyzed and underwent salivary drug testing. A multinomial logistic regression model was used to verify factors associated with alcohol or drug use.

RESULTS

Of the 609 victims who participated in the interview, 72% were male, and the median age was 29 years (interquartile range 23.0-40.0 years). The drivers were mostly men (p<0.001), with a higher binge drinking rate (p=0.003) and marijuana use (p=0.005) than seen in pedestrian and passengers. The prevalence of a positive blood alcohol concentration (BAC) ranged from 7.8% among the drivers to 9.2% among the pedestrians (p=0.861), and the cannabis prevalence was 13.3% among the drivers. The variables associated with an alcohol-related accident were binge drinking in the prior 12 months (OR 2.4; CI 95% 1.1-5.1) and coming from a party/bar (OR 8.7; CI 95% 2.8-26.7). Alcohol abuse or dependence increased by 5.2-fold the chance of another substance-related TC.

CONCLUSION

The large number of individuals found in TC-related emergency room visits in a short time frame is evidence of the Brazilian epidemic of TC. The data showed that alcohol abuse or dependence also increases the risk of intoxication by other drugs, and they point to alcohol and drug use as a major problem requiring specific TC-related public policies and law enforcement.

Delinquency and alcohol-impaired driving among young males: A longitudinal study

The present study assessed how the trajectory of delinquency affects the growth curve of alcohol-impaired driving using three-waves of data collected from the Buffalo Longitudinal Survey of Young Men (BLSYM). Using the structural equation modeling method, latent growth modeling was utilized to assess four age cohorts of sixteen, seventeen, eighteen, and nineteen years of age at the first wave. The data indicated that the growth rate of delinquency significantly and positively affects the growth rate of alcohol-impaired driving for the respondents who were sixteen at the first wave. The growth rate of drinking was also significantly and positively associated with the growth rate of alcohol-impaired driving for this age cohort. Although the growth rate of delinquency had no significant effect on the growth rate of alcohol-impaired driving for the age cohort which was seventeen at Wave 1, the growth rates of both drinking and drug use did affect for this age cohort. The data, however, showed that alcohol-impaired driving had a significant increase across the waves for the eighteen year old cohort, but there was no significant variation in the rate across respondents. Finally, for the nineteen year old cohort there was no significant increase in alcohol-impaired driving across the waves, and also no significant variation of the growth rate of alcohol-impaired driving across the respondents. These findings indicated that interventions focused on reducing delinquency, alcohol and drug use by sixteen and seventeen year old male adolescents will also reduce their alcohol-impaired driving.

Trends in alcohol-related traffic risk behaviors among college students

BACKGROUND

Alcohol-impaired driving is a major public health problem. National studies indicate that about 25% of college students have driven while intoxicated in the past month and an even greater percentage drive after drinking any alcohol and/or ride with an intoxicated driver. The purpose of this investigation was to examine the change in these various alcohol-related traffic risk behaviors as students progressed through their college experience.

METHODS

A cohort of 1,253 first-time first-year students attending a large, mid-Atlantic university were interviewed annually for 4 years. Repeated measures analyses were performed using generalized estimating equations to evaluate age-related changes in prevalence and frequency of each behavior (i.e., ages 19 to 22).

RESULTS

At age 19, 17%(wt) of students drove while intoxicated, 42%(wt) drove after drinking any alcohol, and 38%(wt) rode with an intoxicated driver. For all 3 driving behaviors, prevalence and frequency increased significantly at age 21. Males were more likely to engage in these behaviors than females. To understand the possible relationship of these behaviors to changes in drinking patterns, a post hoc analysis was conducted and revealed that while drinking frequency increased every year, frequency of drunkenness was stable for females, but increased for males.

CONCLUSIONS

Alcohol-related traffic risk behaviors are quite common among college students and take a significant upturn when students reach the age of 21. Prevention strategies targeted to the college population are needed to prevent serious consequences of these alcohol-related traffic risk behaviors.

Multiple trajectories of peer and parental influence and their association with the development of adolescent heavy drinking

This study used latent growth mixture modeling to identify discrete developmental patterns of heavy drinking, perceived parental disapproval of substance use, and association with peers who drink from early to late adolescence among a sample of 5,591 youth. We also examined associations among these trajectories to determine how the development of heavy drinking relates to the development of perceived parental disapproval of substance use and association with peer drinkers, both separately and jointly. We found that youth who perceived that their parents maintained consistently strong disapproval of substance use throughout adolescence were much more likely to abstain from heavy drinking during this period than were youth who reported that their parents’ disapproval for substance use either decreased or was maintained at only a moderate level. Furthermore, we found that across a variety of peer contexts—stable high association with drinking peers, stable low association, and increasing association—youth were at lowest risk for developing problematic patterns of heavy drinking when they perceived that their parents maintained strong disapproval of substance use throughout adolescence.

Social and behavioral characteristics of young adult drink/drivers adjusted for level of alcohol use

BACKGROUND

Alcohol consumption and drink/driving are positively correlated and many predictors of alcohol use also predict drink/driving. Past research has not fully distinguished the contributions of personal risk factors from the level of alcohol use in the prediction of drink/driving. As a result, the extent to which predictors are specific to drink/driving, versus due to a mutual association to alcohol use, is unclear.

METHODS

This study examined the unique and shared risk factors for drink/driving and alcohol use, and examined the attributable risk (AR) associated with predictors of drink/driving while adjusting for alcohol use. Study data were from a telephone survey of 3,480 Michigan-licensed young adults who were drinkers. Four groups of drink/drivers were formed based on the prior 12-month maximum severity of drink/driving: (1) never drink/driving; (2) driving at least once within an hour of 1 or 2 drinks; (3) driving within an hour of 3 or more drinks or while feeling the effects of alcohol; and (4) drinking while driving.

RESULTS

Lower perceived risk of drink/driving, greater social support for drinking and drink/driving, greater aggression and delinquency, more cigarette smoking, and more risky driving behaviors uniquely predicted drink/driving severity in models adjusted for alcohol use. The largest ARs were associated with social support for drinking and drink/driving and perceived risk of drink/driving.

CONCLUSIONS

These results confirm that alcohol use and drink/driving share risk factors, but also indicate that part of the variation in these factors is specific to drink/driving. Implications for interventions to reduce drink/driving are discussed.

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

AIMS

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

DESIGN

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

SETTING

The Atlantic provinces of Canada.

PARTICIPANTS

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

MEASUREMENTS

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

FINDINGS

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

CONCLUSIONS

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

Effectiveness of Brief Interventions After Alcohol-Related Vehicular Injury: A Randomized Controlled Trial

BACKGROUND

Because 40% of motor vehicle fatalities in the United States are alcohol-related, interventions delivered by trauma clinicians targeted to reduce drinking are of particular importance to public health. The objective of this study was to test the effectiveness of hospital-based brief intervention strategies to reduce alcohol consumption and other health-related outcomes in the year after an alcohol-related vehicular injury. Brief interventions are clinically based strategies including assessment and direct feedback about drinking alcohol, goal setting, behavioral modification techniques, and the use of a self-help manual.

METHODS

The study was a randomized controlled trial of two types of brief intervention with a 12-month follow-up. Participants with alcohol-related vehicular injury who were admitted to Level I trauma centers were eligible for enrollment. Enrolled participants were randomized to a control, simple advice, or brief counseling condition. Primary outcome variables were alcohol consumption (standard drinks/month, binges/month), adverse driving events (driving citations, traffic crashes), and changes in health status (hospital and emergency department admissions).

RESULTS

The study enrolled 187 participants at baseline and retained 100 across 12 months. Participants had a significant decrease in alcohol consumption and traffic citations at 12 months as compared with baseline. Mean standard drinks/month declined from 56.80 (SD 63.89) at baseline to 32.10 (SD 53.20) at 12 months. Mean binges/month declined from 5.79 (SD 6.98) at baseline to 3.21 (SD 6.17) at 12 months. There were no differences in alcohol consumption, adverse driving events, or health status by condition.

CONCLUSIONS

Whether the reductions in alcohol consumption and traffic citations were a result of the crash, hospitalization for injury, screening for alcohol use, or combination of these factors is difficult to determine. Further work is needed to understand the mechanisms involved in reductions of health-related outcomes and the role of brief intervention in this population.

Twelve-Month Prevalence and Changes in Driving After Drinking

Background

Methods

Results

Conclusions

Twelve-month prevalence and changes in driving after drinking: United States, 1991-1992 and 2001-2002

BACKGROUND

Drinking and driving has been identified as one of the most important contributors of motor vehicle fatalities. This paper addressed the existing gap in our public health knowledge regarding the current prevalence of driving after drinking and how this has changed over the past decade.

METHODS

Prevalence rates of drinking and driving in 2001-2002, and changes in those prevalence rates between 1991-1992 and 2001-2002 were examined in two large nationally representative surveys of the U.S. population.

RESULTS

Overall, the prevalence of driving after drinking was 2.9% in 2001-2002 representing approximately six million U.S. adults. This rate was about three quarters of the rate observed in 1991-1992 (3.7%), reflecting a 22% reduction. Generally, the male-female differentials in the rate of driving after drinking decreased over the past decade. However, the sex ratios increased substantially for under-aged youth over the past decade, reflecting the sharp decrease in prevalence of driving after drinking among 18-20-year-old women. Constant and emerging subgroups at high risk for drinking and driving included Whites, Native Americans, males, under-aged young adults and 21-25-year-olds.

CONCLUSIONS

The results of this study highlighted the need to continue to monitor prevalence and changes in driving after drinking. Results are discussed in the context of strengthening existing prevention and intervention efforts and developing new programs with the sociodemographic differentials observed in this study in mind.

Child and Adolescent Alcohol Use and Abuse

Alcohol abuse adversely affects the social, psychological, and physical health of children and adolescents. Therefore, it is imperative that youth receive the most reliable and valid assessment and methodologically proven interventions understood by research to date. Empirically supported child and adolescent assessment and interventions are described.

Ethnic differences in driving after drinking and riding with drinking drivers among adolescents

BACKGROUND

This study examined the relationship between ethnicity and driving after drinking (DD) and riding with drinking drivers (RWDD) while controlling for drinking patterns, driving practices, and background demographic characteristics including age and gender.

METHODS

Using random-digit dialing procedures, 1534 young adults ranging from 15- to 20-years of age(mean = 17.6) living in California were recruited to participate in a telephone survey. Latinos, African Americans, and Asian Americans were oversampled to allow cross-group comparisons.

RESULTS

Rates of DD were lower for females than for males and were also lower for African Americans and Asian Americans than for whites. However, after we controlled for drinking patterns and driving practices, the results showed Latinos at greater risk for DD than white adolescents. Compared with whites and males, Asian American and female adolescents were less likely to report RWDD. When drinking patterns and driving practices were taken into account, Latino adolescents were nearly twice as more likely to ride with drinking drivers than whites.

CONCLUSIONS

These findings indicate a greater need for directing prevention efforts to target Latino youth and youth at risk. Moreover, research aimed at elucidating the social and environmental factors involved in the low prevalence rates of DD and RWDD among Asian American youth may indicate possible protective factors to DD and RWDD operating within the Asian American community.

Why do they do it? A qualitative study of adolescent drinking and driving

Despite a decline in the prevalence of fatal traffic crashes involving adolescent drinking drivers in recent years, underage drinking and driving (DD) and riding with drinking drivers (RWDD) remain serious problems. This article reports the findings of a qualitative study investigating the influence of beliefs and expectancies on adolescents' decisions to participate in DD or RWDD. Forty-four adolescents, who in a previous survey admitted to having been involved in either DD or RWDD, were interviewed in 2000 about their experiences concerning either driving after drinking or getting into a car with a driver who had been drinking. Findings indicate that adolescent DD and RWDD are complex behaviors. Expectancies and control beliefs do not seem to influence the decision, whereas normative beliefs to some extent do. However, findings also indicate that increased enforcement of the laws may be helpful in preventing young people from getting involved in drinking and driving.

Alcohol availability as a predictor of youth drinking and driving: a hierarchical analysis of survey and archival data

BACKGROUND

Much attention has recently been directed toward developing preventive interventions to reduce drinking and driving through efforts to limit the numbers and locations of alcohol outlets at the community level. Although evaluations of these efforts have suggested linkages between alcohol outlets and problem outcomes, they have not addressed the linkage between outlets and drinking and driving among youth. The analysis reported here investigates the relationship between alcohol outlet densities and underage drinking and driving as self-reported on two telephone surveys conducted in California.

METHODS

These analyses were based on data obtained from two telephone surveys conducted by the Prevention Research Center and archival data collected by the California Department of Alcoholic Beverage Control and the US Census Bureau. The sample for the first survey consisted of 15- to 20-year-old adolescents and young adults contacted by telephone, using a random digit dialing of exchanges in the greater San Francisco Bay Area. A second set of survey data was similarly collected by a random sample of households throughout California, and the Bay Area subset was also used for this analysis.

RESULTS

At the individual level, older respondents were more likely to report drinking and driving and riding with drinking drivers, whereas females and Asians were less so. At the aggregate or city-level, alcohol outlet density, as measured by the number of on- and off-premises establishments licensed to sell alcohol, was associated with both drinking and driving and riding with drinking drivers. These effects were moderated by a number of individual level effects, with younger respondents and females more likely to be affected by outlet densities.

CONCLUSIONS

The findings here provide support for the implementation of policies targeting alcohol outlet density reductions. Areas with large numbers of such outlets provide ample opportunities to youth for alcohol purchases.

Correlations for perceived family environmental factors with substance use among adolescents in South Africa

Perceived family environmental factors were used to predict self-reported use of substances (drugs or alcohol) among adolescents in South Africa. 435 high school students (ages 15 to 19 years, M=17.2 yr., SD=1.34) answered a questionnaire which included questions on demographic variables, the Family Environmental Scale, and questions on substances used (drugs or alcohol). Logistic regression analysis indicated that scores on family conflict and low family moral-religious emphasis were significantly associated with drug use (57.9% of the variance was accounted for) and use of alcohol (62.3% of the variance was accounted for). Programmes for the reduction of substance use among adolescents should include activities designed to reduce family conflict and strengthen family moral-religious emphasis.

Illicit drug use, cigarette smoking and alcohol drinking behaviour among a sample of high school adolescents in the Pietersburg area of the Northern Province, South Africa

AIM

The aim of this study was to investigate the prevalence of illicit drug use, cigarette smoking and alcohol drinking behaviour among a sample of high-school adolescents in the Pietersburg area (Central Region) of the Northern Province, South Africa.

PARTICIPANTS

Participants in this study were 435 secondary-school adolescent students around the Pietersburg area (Central Region), in the Northern Province. Two hundred and forty-three (56%) participants were female and 192 (44%) were male. They were aged between 15 and 19 years, with the mean age of 17.25 years (S.D.=1.34). Their educational level ranged between standards 7 and 10 (Grades 9-12).

INSTRUMENTS

Participants' demographic variables were determined by use of a questionnaire which covered participants personal characteristics such as age and gender, as well as educational level. Illicit drug use, cigarette smoking, and alcohol drinking behaviour were also measured using the questionnaire.

RESULTS

Findings of this study indicate the prevalence rate of 19.8% for illicit drug use, 10.6% for cigarette smoking and 39.1% for alcohol consumption among the participants. Both drug use, cigarette smoking and alcohol consumption are associated more with males than with females. The majority of the drug users and cigarette smokers indicated that they do so when they are bored, tired or stressed up, or at parties; and most of those who drink alcohol indicated that they do so at parties, weekends, or any other time. The mean age for first drug use is 14.9 years (S.D.=1.77); 14.54 years (S.D.=1.80) for first cigarette smoking and 15.33 years (S.D.=1.91) for first alcohol consumption. Among those who drink alcohol, 24.1% and 14.1% experience unplanned drunkenness and irritability, respectively. Unplanned drunkenness is associated with males, while unplanned irritability (after drinking alcohol) is not associated with any gender.

CONCLUSION

Mental health workers and the law-enforcement agencies should take note of the above findings while planning preventive and therapeutic strategies for the reduction of drug use, cigarette smoking and alcohol use and abuse among adolescents in the area.

Attitudinal and normative predictors of alcohol use by older adolescents and young adults

A model of alcohol use based on the theory of planned behavior, expectancy theory, and the developmental literature on the influence of parents and peers was examined with 87 eleventh grade students, 105 college freshmen, and 107 college juniors. Specifically, the influence of attitudes about the positive and negative consequences of drinking, perceived parental and peer norms about alcohol consumption, and perceived control over drinking predicted self-reported alcohol use. The results suggest that, during adolescence, decisions to consume alcohol are rational, based on the consideration of the positive consequences of alcohol use and perceptions of control over drinking; however, the negative consequences of alcohol use are discounted. While perceived peer norms predicted alcohol consumption in all three age groups, the influence of perceived parental norms varied such that they predicted alcohol use only among the college juniors. Implications and avenues for future research are discussed.

Patterns and correlates of binge drinking trajectories from early adolescence to young adulthood

Latent growth mixture modeling was used to identify developmental trajectories (described in terms of demographics, exposure and resistance to a pro-drug environment, and deviant behavior) of binge drinking among 5,694 individuals who completed 6 surveys from ages 13 to 23 years: nonbingers (32%); moderate stables (37%), who had consistently low levels of bingeing; steady increasers (16%), who increased from the lowest to highest level of bingeing; adolescent bingers (9%), whose early rise in bingeing was followed by a decrease to a moderate level; and early highs (6%), who decreased from the highest level of bingeing to a moderate level. Results show considerable diversity in binge drinking patterns and the correlates of bingeing across trajectory classes.

Human factors in the causation of road traffic crashes

Road traffic crashes (RTCs) are responsible for a substantial fraction of morbidity and mortality and are responsible for more years of life lost than most of human diseases. In this review, we have tried to delineate behavioral factors that collectively represent the principal cause of three out of five RTCs and contribute to the causation of most of the remaining. Although sharp distinctions are not always possible, a classification of behavioral factors is both necessary and feasible. Thus, behavioral factors can be distinguished as (i) those that reduce capability on a long-term basis (inexperience, aging, disease and disability, alcoholism, drug abuse), (ii) those that reduce capability on a short-term basis (drowsiness, fatigue, acute alcohol intoxication, short term drug effects, binge eating, acute psychological stress, temporary distraction), (iii) those that promote risk taking behavior with long-term impact (overestimation of capabilities, macho attitude, habitual speeding, habitual disregard of traffic regulations, indecent driving behavior, non-use of seat belt or helmet, inappropriate sitting while driving, accident proneness) and (iv) those that promote risk taking behavior with short-term impact (moderate ethanol intake, psychotropic drugs, motor vehicle crime, suicidal behavior, compulsive acts). The classification aims to assist in the conceptualization of the problem that may also contribute to behavior modification-based efforts.

Civil liability, criminal law, and other policies and alcohol-related motor vehicle fatalities in the United States: 1984-1995

This study examines the associations between alcohol policies and motor vehicle fatality rates from 1984 to 1995 in the United States. State policies and state characteristics variables were merged with motor vehicle fatality rates over an 11 year period and analyzed using minimum logit chi-square method and fixed effects to create a quasi time-series analysis. Laws allowing individuals to sue bars for the drunken behavior of their patrons were the policies most strongly associated with lower minor and adult fatality rates. The mandatory first offense fine was associated with lower minor fatality rates but not adult fatality rates, while minor and adult rates fell after administrative per se license suspension and anti-consumption laws for all vehicle occupants. Many other public policies evaluated were not associated with lower fatality rates.

Prevalence of health risk behaviors among Asian American/Pacific Islander high school students

PURPOSE

[corrected] To compare the prevalence of selected risk behaviors among Asian American/Pacific Islander (AAPI) students and white, black, and Hispanic high school students in the United States.

METHODS

The national Youth Risk Behavior Survey conducted in 1991, 1993, 1995, and 1997 by the Centers for Disease Control and Prevention produced nationally representative samples of students in grades 9 through 12 in all 50 states and the District of Columbia. To generate a sufficient sample of AAPI students, data from these four surveys were combined into one dataset yielding a total sample size of 55, 734 students.

RESULTS

In the month preceding the survey, AAPI students were significantly less likely than black, Hispanic, or white students to have drunk alcohol or used marijuana. AAPI students also were significantly less likely than white, black, or Hispanic students to have had sexual intercourse; however, once sexually active, AAPI students were as likely as other racial or ethnic groups to have used alcohol or drugs at last intercourse or to have used a condom at last intercourse. AAPI students were significantly less likely than white, black, or Hispanic students to have carried a weapon or fought but were as likely as any of the other groups to have attempted suicide.

CONCLUSIONS

A substantial percentage of AAPI students engage in risk behaviors that can affect their current and future health. Prevention programs should address the risks faced by AAPI students using culturally sensitive strategies and materials. More studies are needed to understand the comparative prevalence of various risk behaviors among AAPI subgroups.

Cultural, social, and intrapersonal factors associated with substance use among alternative high school students

The purpose of this study was to identify cultural, social, and intrapersonal factors associated with tobacco, alcohol, and illicit drug use among students attending dropout prevention/recovery high schools. Four mutually exclusive categories of substance use were used as outcome measures, and religiosity, educational achievement, educational aspiration, family caring, others caring, self-esteem, optimism, coping, depression, loneliness, and self-efficacy were used as predictor variables. In the final multivariate model more family caring and loneliness were inversely associated with marijuana use; young age, more family caring, less coping ability, church attendance, and low educational aspirations were significantly associated with cocaine use. This study demonstrates the importance of health education and health promotion programs for students attending alternative high schools which include prevention of initiation, as well as treatment.

Changes in the alcohol consumption pattern among schoolchildren in Barcelona

Alcohol consumption is a major health problem in most developed countries. In Mediterranean countries, experimentation with alcoholic beverages typically occurs during the early adolescent years within the family context. In this study we analysed alcohol consumption and its determinants in a survey of a sample of schoolchildren in 1994. The results were compared to those obtained in a previous study in 1987. In 1994 a random, stratified sample of all 8th grade classrooms of a city, public, private or subsidised school was, obtained. Some 759 13 and 14 year old pupils responded to a self-administered questionnaire on health-related habits. Overall, there was a high awareness of alcohol in the environment, as 20.7% of the pupils reported their father was a regular or occasional drinker and 41.6% declared some of their friends were drinking. Compared with the results of the 1987 survey, there was a marked decline in the proportion of schoolchildren reporting alcohol consumption by their father or their siblings. Regarding the pupils' consumption, 66.7% of them had tried drinking alcohol in 1994, 54.7% declared they were allowed to drink in family celebrations, and 17.2% had experienced being drunk. Most of these indicators showed a significant decrease compared with the 1987 data, with the exception of drunken episodes where there appears to be no changes. The results suggest that there are some changes in the Spanish context, where regular drinking among adolescents may be declining.

Unsafe motor vehicle practices among substance-using college students

This study examines the relationship between substance use and behaviors that increase the risk for motor vehicle crashes and crash-related injuries. The investigation uses National College Health Risk Behavior Survey data collected in 1995 by the Centers for Disease Control and Prevention. These data are representative of 2- and 4-year undergraduate college students in private and public colleges and universities in the United States. Smokers, episodic heavy drinkers, marijuana users and users of illegal drugs in combination with alcohol were significantly more likely to drive after drinking alcohol and ride with a driver who had been drinking alcohol and significantly less likely to wear safety belts while driving or while riding in a car as a passenger. This study indicates that college students who are substance users are more likely to behave in a manner which increases their risk for motor vehicle crashes and motor vehicle crash injuries.

Drive-up liquor windows and convicted drunk drivers: a comparative analysis of place of purchase

This study examined alcohol purchase locations of convicted drunk drivers to determine the characteristics and arrest circumstances of offenders who bought alcohol at a drive-up liquor window compared with those who obtained alcohol elsewhere. Logistic regression analyses were used to assess the relationship between purchase location and the characteristics of 2,544 drunk drivers convicted in Santa Fe, NM, from 1986 to 1995. Analyses were performed to determine whether the place of purchase was related to arrest circumstances. The results revealed that drive-up windows were the preferred place of purchase of package liquor by offenders who bought the alcohol that they drank prior to arrest. The odds of being Hispanic (p < 0.0001), a high-risk problem drinker (p < 0.01), and drinking in the vehicle prior to arrest (p < 0.01) were significantly higher for drive-up window users than for offenders who purchased package liquor elsewhere. Based on these analyses, this study concludes that a statistically significant relationship exists between the use of drive-up windows and certain high-risk drinking behaviors. This increased use among vulnerable populations suggests that drive-up windows may facilitate alcohol misuse in these populations and thereby contribute to drunk driving.

Impairment of semantic and figural memory by acute ethanol: age-dependent effects

Alcohol drinking is prevalent among young adults in the U.S. Moreover, heavy drinking is acknowledged by a substantial percentage of young adults in both college and military subpopulations, despite the known cognitive demands associated with these endeavors and the cognitive impairments associated with alcohol usage. We assessed the acute effects of ethanol (0.6 g/kg) on the acquisition of both semantic and figural memory in a sample of young adults from 21 to 29 years of age using a repeated-measures, placebo-controlled experimental design. Ethanol significantly impaired memory acquisition in both domains. In addition, the effect of ethanol on three of the four memory measures assessed was dependent on the age of the subjects. Subjects in a young subgroup (21 to 24 years of age) were significantly more impaired in memory measures than those in the subgroup that was 25 to 29 years of age. These results indicate a divergence of the potency of ethanol against memory acquisition across a narrow age range in early adulthood. Whereas these data are preliminary, and should be generalized cautiously, they are also consistent with a growing literature using animal models that indicates that acute ethanol is a more potent antagonist of memory and memory-related hippocampal activity in adolescent animals compared with adults.

Drinking location and risk of alcohol-impaired driving among high school seniors

This study investigated environmental predictors of teenagers' alcohol-impaired driving, such as drinking location and alcohol source. Data for this study were part of the 15 Communities Mobilizing for Change on Alcohol Project. Relationships between drinking-driver status, alcohol source, drinking location, alcohol consumption, and individual demographics were determined for the full sample as well as for males and females separately, using mixed-model, logistic regression. Analyses were restricted to high school seniors who were drivers and who consumed alcohol within the last 30 days (N = 1,914). For males and females, the risk of alcohol-impaired driving rose significantly with increases in both the number of binge-drinking events and estimates of the number of drinks required to impair their driving. Drinking location was important in that students who drank outdoors or in a moving car or truck were at significant risk for drinking-driving. Drinking-driving risks specific to females were number of drinking occasions and drinking at someone else's house. Strategies to prevent drinking-driving among teenagers need to consider drinking patterns as well as drinking locations for both males and females.

Racial differences in adolescent drug use: the impact of religion

Contrary to popular stereotypes, current studies of adolescent populations suggest that Black teens are less likely to use illicit drugs than are White teens. This study investigates the extent to which differences in religiosity are responsible for racial differences in drug use. Using data from a national survey of United States high school seniors, our results indicate that religion does provide some protection from drug use by adolescents. However, religiosity has less of an impact on the drug use of Black adolescents, perhaps as a result of the diverse roles of the Black church.

Tobacco, alcohol, and illicit drug use among Mexican-American and non-Hispanic white high school students

This study examined the prevalence, age of initiation, and pattern of substance use among 1,617 Mexican-American and non-Hispanic White high school students residing within the same geographic community. Ethnic differences were present for current smoking, having used alcohol in the past month, "heavy drinking" per occasion, and ever used marijuana. Age of initiation of substance use and the pattern of use was similar for the two ethnic groups. Future research needs to determine if the progression of initiation represents a sequence of initiation, identify factors that influence movement along the sequence, and determine if there are ethnic differences.