Alcohol use among college athletes: do intercollegiate, club, or intramural student athletes drink differently?

The socio-ecological context of U.S. college student drinking: A latent class analysis

BACKGROUND

U.S. college student drinking typologies often consider quantity and frequency but not the socio-environmental contexts in which students obtain alcohol and drink. Understanding context could be important for preventive interventions.

METHODS

We used latent class analysis (LCA), a person-centered approach to understanding behavior patterns, to identify drinking typologies among 1390 college student drinkers from a representative survey at two interconnected private colleges in the Northeast. Classes were derived from drinking frequency and quantity as well as how students obtain alcohol, where they drink, and their perceptions of peer drinking. Resulting classes were correlated with demographic and developmental characteristics, participation in campus activities and connectedness, and alcohol consequences and protective behaviors.

RESULTS

Four distinct drinking profiles emerged. 'Tasters' (n = 290) included infrequent and low quantity drinkers who drank in dorms with alcohol provided by others. 'Bargoers' (n = 271) included low quantity and moderate frequency drinkers who purchased their own alcohol and drank at bars. 'Partiers' (n = 483) included moderate frequency and quantity drinkers who obtained alcohol from several sources and drank in many locations. 'Bingers' (n = 345) included high frequency and quantity drinkers and binge drinkers, who drank in many locations with alcohol obtained from multiple sources. Classes differed in demographics, age of first drink, campus activities and connectedness, alcohol protective behaviors, and alcohol problems.

CONCLUSION

Heterogeneous patterns of drinking based on quantity, frequency and social/environmental context emerged and suggested the need for different tailored interventions.

Family History and Alcohol Use Outcomes: Examining Transmission of Risk through Impulsivity and the Moderating Role of Organized Sports Participation

BACKGROUND

College students are at risk for alcohol misuse and those who participate in organized sports are at even higher risk. Family history of alcohol problems (FH) and impulsivity are well-documented risk factors for alcohol use outcomes, but no research has examined the role of organized sports participation in moderating these associations. This study examined the associations between FH, alcohol consumption and alcohol use disorder (AUD) symptoms, the role of UPPS-P (Urgency, Premeditation, Perseverance, Sensation Seeking, Positive Urgency impulsive behavior scale) impulsivity dimensions in mediating the association between FH and alcohol use outcomes, and whether these associations vary by students' organized sports participation.

METHOD

Participants (N = 3,959, 64.7% female, 51.8% White; Mean age = 18.48 years, SD = .40) were recruited from a large, public university and completed an online survey in the fall and spring semesters of their first year in college. Path analyses were conducted in Mplus.

RESULTS

FH was associated with higher levels of alcohol consumption and more AUD symptoms. Lack of premeditation, lack of perseverance, and negative urgency partially mediated the associations between FH and alcohol consumption and AUD symptoms. The association between negative urgency and AUD symptoms was stronger for organized sports participants.

CONCLUSIONS

Impulsivity dimensions are risk factors for both alcohol consumption and AUD symptoms and serve as important pathways for the transmission of risk between generations. Prevention and intervention efforts aimed at reducing problematic alcohol use should target impulsivity generally, and particularly negative urgency among college students who participate in organized sports.

Evaluation of a resilience training program for college student-athletes: A pilot study

Objective: To determine if a resilience training program improved knowledge of and intention to use adaptive coping strategies among college student-athletes; and explore college student-athletes' experiences and satisfaction with program components. Participants: Division I college student-athletes. Methods: Pretest-posttest design with surveys completed at baseline and immediately post-program. Results: A total of 79 participants were included (n = 43 [54.4%] females; n = 36 [45.6%] males; M_age = 20.94, [SD = 1.05]). Overall intention to use adaptive coping strategies significantly increased from baseline (M = 29.05, SD = 4.50) to post-program (M = 32.38, SD = 5.62) (p = 0.0004), as did intentions to use the coping strategies seeking social support (p = 0.0037) and self-controlling (p = 0.0007). We found no statistically significant differences in knowledge scores from baseline to post-program. Conclusions: Resilience training may increase college student-athletes' likelihood of using adaptive coping strategies to manage academic and sport-related stressors.

Do varsity college athletes have a greater likelihood of risky alcohol and cannabis use than non-athletes? Results from a National Survey in Brazil

OBJECTIVE

We examined the prevalence of risky alcohol and cannabis use among Brazilian varsity college athletes and whether this group had a greater likelihood of risky use than non-athletes.

METHODS

In 2009, Brazilian college students (n=12,711) were recruited for a national stratified random survey. Their sociodemographic characteristics, mental health, substance use, and participation in varsity sports were assessed. Binary logistic regression models were used to examine the association between varsity athlete status and moderate to high-risk alcohol and cannabis use.

RESULTS

Among varsity athletes, 67.6 and 10.7% reported risky alcohol and cannabis use, respectively. Varsity athletes had greater odds of risky alcohol consumption than non-athletes (aOR = 2.02, 95%CI 1.08-3.78). Varsity athletes also had greater odds of risky cannabis use than non-athletes in unadjusted analyses (OR = 2.57, 95%CI 1.05-6.28), although this relationship was attenuated after covariate adjustment.

CONCLUSIONS

Among college students in Brazil, varsity athletes had a higher prevalence of risky alcohol and cannabis use than non-athletes. The rates were considerably higher than those observed among samples of U.S. college athletes. Future research should examine the use of these substances among varsity college athletes in other middle-income countries since these findings will likely guide prevention and treatment efforts.

The functional and molecular effects of problematic alcohol consumption on skeletal muscle: a focus on athletic performance

Background: Chronic alcohol misuse is associated with alcoholic myopathy, characterized by skeletal muscle weakness and atrophy. Moreover, there is evidence that sports-related people seem to exhibit a greater prevalence of problematic alcohol consumption, especially binge drinking (BD), which might not cause alcoholic myopathy but can negatively impact muscle function and amateur and professional athletic performance.Objective: To review the literature concerning the effects of alcohol consumption on skeletal muscle function and structure that can affect muscle performance.Methodology: We examined the currently available literature (PubMed, Google Scholars) to develop a narrative review summarizing the knowledge about the effects of alcohol on skeletal muscle function and exercise performance, obtained from studies in human beings and animal models for problematic alcohol consumption.Results: Exercise- and sport-based studies indicate that alcohol consumption can negatively affect muscle recovery after vigorous exercise, especially in men, while women seem less affected. Clinical studies and pre-clinical laboratory research have led to the knowledge of some of the mechanisms involved in alcohol-related muscle dysfunction, including an imbalance between anabolic and catabolic pathways, reduced regeneration, increased inflammation and fibrosis, and deficiencies in energetic balance and mitochondrial function. These pathological features can appear not only under chronic alcohol misuse but also in other alcohol consumption patterns.Conclusions: Most laboratory-based studies use chronic or acute alcohol exposure, while episodic BD, the most common drinking pattern in amateur and professional athletes, is underrepresented. Nevertheless, alcohol consumption negatively affects skeletal muscle health through different mechanisms, which collectively might contribute to reduced sports performance.

Looking forward to student-athlete mental health: Racial/ethnic trends from 2010 to 2015

OBJECTIVE

This study examined trends in functionally impairing depression, significant anxiety, suicidal ideation, and suicide attempts among college student-athletes across time, racial/ethnic group, and student-athlete standing.

PARTICIPANTS

The sample consisted of 39,840 White, Black, Hispanic/Latinx, Asian/Pacific Islander, Native American, and Multiracial students who reported participating in "varsity" level college athletics in the past 12 months during the Spring 2010-2015 administrations of the American College of Health Association National College Health Assessment II.

METHODS

Chi-square and difference in proportion tests compared mental health rates across time, racial/ethnic groups, and student-athlete status (student-athlete versus non-athlete).

RESULTS

Findings suggested a lack of differences in mental health rates between 2010 and 2015, with the exception of a higher rate of anxiety for White student-athletes in 2015. Racial/ethnic comparisons pointed to relatively consistent heightened risks for depression and suicide concerns among Asian/Pacific Islander and Multiracial student-athletes compared to White student-athletes. Student-athlete status appeared most consistently to benefit White student-athletes, whereas there was evidence of potential liability of student-athlete status for Asian/Pacific Islander student-athletes.

CONCLUSIONS

Results make the case for adopting a racially/ethnically aware cultural lens when conceptualizing mental health risk and resilience among student-athletes.

The application of deep learning in college students’ sports cognition and health concept

Researchers and scientists in practical sports psychology are involved in the sports psychology practice process. Current models of training appear unsatisfied to assist trainees in psychology to learn the necessary humanistic skills for the requirement of athlete-centered services. This article aims to include an example of the value of Deep Neural Network Assisted Reflective Approaches (DNARA) as an alternative to clinical training, which may enable practitioners to manage themselves better in action. It addresses the essence of professional understanding; To describe reflection and present common examples of a reflective method in the “education professions” during the creation of reflective practice. It discusses how reflective exercise can support a clinician’s professional and personal growth within the field of sport psychology and illustrate how reflective practice may improve. Finally, there is a discussion about appropriate platforms for the distribution of insightful content. DNARA method achieves the highest classification accuracy of 94.12%, and error rate is reduced to 0.40, and DNARA method is more efficient for student health concepts.

Alcohol and Athletics: A Study of Canadian Student-Athlete Risk

American student-athletes (SAs) are at heightened risk for hazardous alcohol consumption compared with their nonathlete peers. However, little is known about this risk or the influence of psychosocial predictors on drinking behavior among Canadian SAs. This study compared rates of alcohol use across Canadian SAs and nonathletes and investigated whether the use of athlete-specific psychosocial predictors can improve the prediction of alcohol use outcomes in SAs. Participants (179 varsity athletes and 366 nonathletes) completed anonymous self-report questionnaires. Results suggest that Canadian athletes are at a heightened risk for experiencing alcohol-related problems compared with nonathletes, with general psychosocial predictors explaining the majority of variance in SA alcohol use. However, and quite notably, athlete-specific positive reinforcement motives predicted SA binge drinking. This research provides some of the first evidence of drinking-related problems among Canadian SAs and supports the potential use of preventative efforts to help SAs develop safe strategies for alcohol use.

How do college students use their free time? A latent profile analysis of leisure activities and substance use

College is a critical period of transition to independence and the substantial amount of time that students have to participate in leisure activities may be conducive to substance use. However, little is known about the associations between leisure activities and substance use over time, or whether these associations differ by residential status (i.e., living with parents vs. on their own). Using latent profile analysis, this study found six distinct profiles of leisure activity participation in a racially/ethnically diverse sample of college students (N=1,207). Overall, profiles with medium levels of leisure activity participation were associated with more alcohol use, heavy drinking, and marijuana use one year later; whereas profiles with the lowest levels of leisure activity participation were associated with more cigarette use one year later. Identifying mechanisms through which leisure activities influence substance use can help inform prevention efforts to either reduce risks associated with participation or support protective effects.

Empirical Development of a Screening Method to Assist Mental Health Referrals in Collegiate Athletes

The conspicuous absence of validated screening measures specific to mental health symptomology in collegiate athletes has negatively affected clinical practice in this population. Therefore, this study was performed to develop a sport specific measure to optimally identify collegiate athletes who are particularly likely to benefit from mental health programming. Participants were 289 collegiate-athletes who were assessed for mental health symptomology using the Global Severity Index of Symptom Checklist-90-Revised (GSI), factors that interfere with sport performance using the Problems in Sport Competition Scale (PSCS) and Problems in Sport Training Scale (PSTS), and motivation to pursue professional counseling using the Desire to Pursue Sport Psychology Scale (DSPS). As hypothesized, a hierarchical multiple regression analysis indicated that PSCS, PSTS and DSPS scores significantly predicted GSI scores, controlling gender and sport status (NCAA, club, intramural). Receiver operating characteristic (ROC) analysis indicated that high-risk athletes (GSI T-scores ≥ 60) could be correctly classified by PSTS and PSCS scores. Results suggest the PSCS and PSTS may assist identification of collegiate athletes who are especially appropriate for mental health programs. These scales additionally identify factors directly relevant to athletes’ sport performance.

Risks associated with alcohol and marijuana use among college student athletes: The case for involving athletic personnel in prevention and intervention

The purpose of this study was to describe alcohol and marijuana use patterns and related consequences among student athletes. A total of 12,510 students (n=1,233 athletes) completed four cross-sectional online annual surveys as part of a multi-site campus initiative. Chi-square tests of independence, t-tests, and regression models evaluated differences in alcohol and marijuana use between athletes and non-athletes. The prevalence of binge drinking and high intensity drinking was significantly higher among student athletes than non-athletes, even after controlling for demographic characteristics. Thirteen percent of student athletes experienced an alcohol-related injury during the past year; this was more common among binge drinkers than non-binge drinkers (20.5% and 2.6%, respectively). Among student athletes, past-month binge drinking and past-year marijuana use were significantly associated with lowered GPA (ps<.01). Skipping class was twice as prevalent among student athletes who used marijuana as compared with athletes who did not use marijuana, but no differences were found related to binge drinking. Components for a training for athletic personnel to reduce risks for alcohol-related injury and academic consequences that are associated with alcohol and marijuana use among student athletes are described. Involving athletic personnel might be an important strategy to identify and intervene with high-risk student athletes.

Substance abuse and HIV/STD prevention at a Hispanic-serving institution in South Texas: A study of racial/ethnic and gender heterogeneity and intersectionality

The purpose of this study is to examine racial/ethnic and gender variations and intersectionality in the knowledge, attitudes, intentions, and behaviors pertaining to substance abuse (SA) and human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention among racial/ethnic minority college students (ages 18-24) in South Texas. A total of 535 minority students completed a baseline survey between 2014 and 2016 (N = 535). Results revealed statistically significant (ranging from p < .05 to p < .001) racial/ethnic and gender variations in SA and HIV/STD prevention-related knowledge, attitudes, intentions, and behaviors. However, the significant interaction effects (i.e., intersectionality) were observed only for two of the nine composite variables. That is, although male minority students exhibited lower levels of awareness of sexual risks and safe sex negotiation skills than female minority students, Hispanic male students appeared to fare better in both awareness of sexual risks (p < .01) and safe sex negotiation skills (p < .05) compared to students of other racial/ethnic origin. Implications for prevention and intervention work involving minority college students are discussed.

Simultaneous Alcohol and Marijuana Use Among College Students: Patterns, Correlates, Norms, and Consequences

BACKGROUND

Alcohol and marijuana users often engage in simultaneous alcohol and marijuana (SAM) use (i.e., using the 2 substances together so that their effects overlap), which can result in more negative consequences than using either substance alone. Nevertheless, little is known about SAM use among contemporary college students to aid in the development of preventive interventions. This study examined SAM use patterns, demographic correlates of SAM use, and normative influences on SAM use and related negative consequences among college students.

METHODS

Students who had used alcohol and marijuana in the past year were recruited from 3 state universities in states with different laws regarding recreational marijuana use (N = 1,389). They completed an online survey, which assessed their own alcohol, marijuana, and SAM use and related consequences, their perceptions of the proportion of same-gender peers and close friends who engaged in SAM use, marijuana access, and demographic characteristics.

RESULTS

About three-fourths of participants reported at least 1 occasion of SAM use in the past year with an average frequency of twice per month among SAM users. There were significant differences in SAM use prevalence and frequency by sociodemographic characteristics controlling for past-year alcohol and marijuana frequency. Students in a state with decriminalized recreational marijuana use reported higher frequency of past-year SAM use than students in states with legalized or criminalized use. There were significant demographic differences in perceived norms regarding SAM use among close friends and same-gender peers. SAM users endorsed significantly higher perceived peer and friend norms than nonusers. Also, higher perceived norms predicted more frequent SAM use and more negative consequences of use.

CONCLUSIONS

Results indicate a need for prevention programs on college campuses that address SAM use. Interventions that use personalized normative feedback may be effective.

Association between sex, race/ethnicity, season, day of week, and alcohol use and related risks in college student athletes and nonathletes

Objective: To examine personal and social constructs (eg, sex, race) and external influences (ie, competition schedules) that are associated with the pattern and amount of alcohol consumption by student athletes compared to nonathletes. Participants: Students (n = 2,984; 57% female, 61% white, 16% athlete) on a single campus were surveyed in Fall 2011 and Spring 2012. Methods: Anonymous surveys included demographics, alcohol use, and related problems. Results: Student athletes consumed more alcohol than nonathletes, with male and white athletes posing the highest levels of risk for heavy consumption. Expanded examination of in- and out-of-season athletes found out-of-season athletes drink more frequently and more per occasion than their in-season peers. Athletes were more likely than nonathletes to drink on specific days of the week and daily patterns differed between in- and out-of-season athletes. Conclusions: The risk of athlete status is moderated by sex, race, season, and day of the week.

Recreational and ergogenic substance use and substance use disorders in elite athletes: a narrative review

BACKGROUND

Substances from various classes may be used for recreational purposes, self-treatment or to boost performance. When substance use shifts from occasional to regular, heavy or hazardous use, positive and negative effects can develop that vary by substance class and athlete. Regular use of recreational or performance enhancing substances can lead to misuse, sanctions or use disorders.

OBJECTIVE

To review the prevalence, patterns of use, risk factors, performance effects and types of intervention for all classes of recreational and performance enhancing substances in elite athletes by sport, ethnicity, country and gender.

METHODS

A comprehensive search was conducted to identify studies that compared the prevalence and patterns of substance use, misuse and use disorders in elite athletes with those of non-athletes and provided detailed demographic and sport variations in reasons for use, risk factors and performance effects for each main substance class.

RESULTS

Alcohol, cannabis, tobacco (nicotine) and prescribed opioids and stimulants are the most commonly used substances in elite athletes, but generally used at lower rates than in non-athletes. In contrast, use/misuse rates for binge alcohol, oral tobacco, non-prescription opioids and anabolic-androgenic steroids are higher among athletes than non-athletes, especially in power and collision sports. Cannabis/cannabinoids seem to have replaced nicotine as the second most commonly used substance.

CONCLUSIONS

Substance use in elite athletes varies by country, ethnicity, gender, sport and competitive level. There are no studies on substance use disorder prevalence in elite male and female athletes and few studies with direct comparison groups.

Management of mental health emergencies in elite athletes: a narrative review

Mental health emergencies require a rapid, effective response. We searched the literature on mental health emergencies in athletes and found five papers. None of these addressed elite athletes. Nonetheless, common mental health emergencies may present in the sports environment and may place the athlete and others at risk. Sports teams and organisations should anticipate which emergencies are likely and how medical and support staff can best respond. Responses should be based on general non-sporting guidelines. We stress the importance of clinicians following standard procedures.

Mental health in elite athletes: International Olympic Committee consensus statement (2019)

Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.

Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.

Collateral damage from college drinking: A conceptual framework for alcohol's harms to others among US college students

BACKGROUND

A growing literature shows that drinkers can harm bystanders through alcohol-related harms to others (HTO). The burden of HTO is particularly consequential in college environments, where heavy alcohol consumption and related harms are highly prevalent. A key limitation to the current literature on HTO among college students is that the determinants of HTO in college settings are not well-described.

OBJECTIVE

This article presents an evidence- and theory-based conceptual framework of HTO among United States college students.

METHODS

This study used a literature review in Embase, PsycInfo, PubMed, and Web of Science to determine the prevalence of HTO among college students and literature gaps. Researchers supplemented college HTO literature with broader HTO literature to develop a conceptual framework.

RESULTS

Prevalence estimates for HTO among college populations range from 59% to 84%. Literature on HTO among college students is mostly confined to brief sections of larger surveys. The college HTO literature lacks the level of detail necessary to support methodologically rigorous research.

CONCLUSIONS

HTO are prevalent among college populations but their prevalence and etiology are not well understood. This likely leads to systematic undercounting of the impact of alcohol in college settings, exacerbating the "translation" gap between what the research says is effective and what colleges actually do. Better understanding of HTO mechanisms through which drinkers harm those around them would inform alcohol research and policy on college campuses, and lead to more accurate assessments of the degree to which stronger alcohol policies could benefit all students, regardless of their drinking patterns.

Collegiate athletes' mental health services utilization: A systematic review of conceptualizations, operationalizations, facilitators, and barriers

BACKGROUND

While mental health among collegiate athletes is receiving increased attention, research on factors surrounding collegiate athletes' decision to seek mental health services is limited. The goal of the present review was to analyze and synthesize the current literature concerning collegiate athletes' utilization of mental health services, including the facilitators of and barriers to use of these services.

METHODS

The analysis was guided and organized using a socio-ecological framework, which considered the unique context in which collegiate athletes study and perform. A total of 21 articles, published between 2005 and 2016, which concern U.S. collegiate athletes' mental health services utilization (MHSU) were selected and included for the final analysis. Conceptualizations and operationalizations of MHSU were compared and contrasted. Facilitators of and barriers to athletes MHSU were examined and summarized while appropriately considering the proximity of each factor (facilitator or barrier) to the athletes.

RESULTS

Results showed variations in conceptualizations and operationalizations of MHSU in the articles analyzed, which made interpretation and cross comparison difficult. Collegiate athletes are willing to utilize mental health services, but gender, perceived stigma, peer norms-for athletes and coaches-plus service availability impact their MHSU.

CONCLUSION

Key stakeholders, administrators, and public health officials should partner to eliminate MHSU barriers, support facilitators, and generally empower collegiate athletes to actively manage their mental health.

It isn't all just fun and games: Collegiate participation in extracurricular activities and risk for generalized and sexual harassment, psychological distress, and alcohol use

Collegiate extracurricular activities, despite their benefits, may place students at an increased risk for experiencing harassment. This study utilizes multiple waves of data from an online longitudinal survey to examine how participation in college activities (intramural sports, fraternities/sororities, school clubs) relates to experiences of sexual and generalized harassment and outcomes (psychological distress, heavy alcohol use) among undergraduates (N = 1852, 58.6% female, 57.4% White) in the Midwestern United States. Activity participation was related to harassment, but the pattern depended on the activity, harassment type, and sex. Fraternity/sorority involvement was associated with generalized harassment, whereas school club involvement was linked to both generalized and sexual harassment. Female intramural athletes were at an increased risk to experience both harassment types. In addition to direct relations, activity participation was indirectly linked to future psychological distress (depression, anxiety) and heavy alcohol use via harassment. Implications for intervention with this college student population are discussed.

Factors Associated With Musculoskeletal Injuries in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder

BACKGROUND

Musculoskeletal injuries may be associated with attention-deficit/hyperactivity disorder (ADHD) symptom severity, comorbid psychiatric or medical conditions, and the prescribed psychostimulant.

METHODS

A population-based, retrospective cohort design was employed using South Carolina's Medicaid claims data set covering outpatient and inpatient medical services and medication prescriptions over an 11-year period (January 1, 1996, through December 31, 2006) for patients ≤ 17 years of age with ≥ 2 visits for ICD-9-CM diagnostic codes for ADHD. A cohort of 7,725 cases was identified and analyzed using logistic regression to compare risk factors for those who sustained focal musculoskeletal injuries and those who did not.

RESULTS

The risk of sustaining sprains, arthropathy and connective tissue disorders, or muscle and joint disorders was significantly related to being diagnosed with comorbid hypertension (adjusted odds ratios [aORs] = 1.60, 2.09, and 1.46, respectively) and a substance use disorder (aORs = 1.58, 1.38, and 1.28). Having a substance use disorder was also related to incident fractures and dorso/spinal injuries (aORs = 1.42 and 1.21). Diagnosed hypertension was related to incident concussions (aOR = 2.00), a diagnosed thyroid disorder was related to an increased risk of sprain and concussion (aORs = 1.44 and 2.05), a diagnosed anxiety disorder was related to an increased risk of dorso/spinal disorders (aOR = 1.71), and diagnosed diabetes was related to incident bone and cartilage disorders (aOR = 1.61).

CONCLUSIONS

Comorbid hypertension, substance use disorders, and thyroid disorders deserve increased clinical surveillance in children and adolescents with ADHD because they may be associated with an increased risk of more than one musculoskeletal injury.

Examination of the community-specific prevalence of and factors associated with substance use and misuse among Rural and Urban adolescents: a cross-sectional analysis in Bosnia and Herzegovina

OBJECTIVE

The community of residence (ie, urban vs rural) is one of the known factors of influence on substance use and misuse (SUM). The aim of this study was to explore the community-specific prevalence of SUM and the associations that exist between scholastic, familial, sports and sociodemographic factors with SUM in adolescents from Bosnia and Herzegovina.

METHODS

In this cross-sectional study, which was completed between November and December 2014, the participants were 957 adolescents (aged 17 to 18 years) from Bosnia and Herzegovina (485; 50.6% females). The independent variables were sociodemographic, academic, sport and familial factors. The dependent variables consisted of questions on cigarette smoking and alcohol consumption. We have calculated differences between groups of participants (gender, community), while the logistic regressions were applied to define associations between the independent and dependent variables.

RESULTS

In the urban community, cigarette smoking is more prevalent in girls (OR=2.05; 95% CI 1.27 to 3.35), while harmful drinking is more prevalent in boys (OR=2.07; 95% CI 1.59 to 2.73). When data are weighted by gender and community, harmful drinking is more prevalent in urban boys (OR=1.97; 95% CI 1.31 to 2.95), cigarette smoking is more frequent in rural boys (OR=1.61; 95% CI 1.04 to 2.39), and urban girls misuse substances to a greater extent than rural girls (OR=1.70; 95% CI 1.16 to 2.51,OR=2.85; 95% CI 1.88 to 4.31,OR=2.78; 95% CI 1.67 to 4.61 for cigarette smoking, harmful drinking and simultaneous smoking-drinking, respectively). Academic failure is strongly associated with a higher likelihood of SUM. The associations between parental factors and SUM are more evident in urban youth. Sports factors are specifically correlated with SUM for urban girls.

CONCLUSIONS

Living in an urban environment should be considered as a higher risk factor for SUM in girls. Parental variables are more strongly associated with SUM among urban youth, most probably because of the higher parental involvement in children' personal lives in urban communities (ie, college plans, for example). Specific indicators should be monitored in the prevention of SUM.