Relationships among alcohol availability, drinking location, alcohol consumption, and drinking problems in adolescents

Detecting and Understanding Social Influence During Drinking Situations: Protocol for a Bluetooth-Based Sensor Feasibility and Acceptability Study

BACKGROUND

High-risk alcohol consumption among young adults frequently occurs in the presence of peers who are also drinking. A high-risk drinking situation may consist of particular social network members who have a primary association with drinking. Fine-grained approaches such as ecological momentary assessment (EMA) are growing in popularity for studying real-time social influence, but studies using these approaches exclusively rely on participant self-report. Passive indicators of peer presence using Bluetooth-based technology to detect real-time interactions have the potential to assist in the development of just-in-time interventions.

OBJECTIVE

This study seeks to examine the feasibility and acceptability of using a Bluetooth-based sensor and smartphone app to measure social contact in real-world drinking situations.

METHODS

Young adults (N=20) who drink heavily and report social drinking will be recruited from the community to participate in a 3-week EMA study. Using a social network interview, index participants will identify and recruit 3 of their friends to carry a Bluetooth beacon. Participants will complete a series of EMA reports on their own personal Android devices including random reports; morning reports; first-drink reports; and signal-contingent reports, which are triggered following the detection of a beacon carried by a peer participant. EMA will assess alcohol use and characteristics of the social environment, including who is nearby and who is drinking. For items about peer proximity and peer drinking, a customized peer list will be presented to participants. Feedback about the study protocol will be ascertained through weekly contact with both index and peer participants, followed by a qualitative interview at the end of the study. We will examine the feasibility and acceptability of recruitment, enrollment of participants and peers, and retention. Feasibility will be determined using indexes of eligibility, enrollment, and recruitment. Acceptability will be determined through participant enrollment and retention, protocol compliance, and participant-reported measures of acceptability. Feasibility and acceptability for peer participants will be informed by enrollment rates, latency to enrollment, compliance with carrying the beacon, and self-reported reasons for compliance or noncompliance with beacon procedures. Finally, EMA data about peer proximity and peer drinking will support the validity of the peer selection process.

RESULTS

Participant recruitment began in February 2023, and enrollment was completed in December 2023. Results will be reported in 2025.

CONCLUSIONS

The protocol allows us to examine the feasibility and acceptability of a Bluetooth-based sensor for the detection of social contact between index participants and their friends, including social interactions during real-world drinking situations. Data from this study will inform just-in-time adaptive interventions seeking to address drinking in the natural environment by providing personalized feedback about a high-risk social context and alerting an individual that they are in a potentially unsafe situation.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/50650.

Limited Evidence of Associations Between Executive Functioning and Alcohol Involvement In UK Adolescents

Aims

Deficits in motor inhibitory control and working memory have been hypothesized to be both a cause and consequence of heavy alcohol use. Adolescence is a critical developmental stage for inhibitory control and working memory, and it is also a stage when individuals are most likely to initiate alcohol use. This study aimed to examine whether inhibitory control and working memory would predict alcohol use and involvement in a group of UK adolescents.

Methods

We recruited 220 (N = 178, female) adolescents, aged between 16 and 18, from eight higher education settings in the Merseyside region of the UK. Alcohol use was examined using the Timeline Follow-Back and involvement (and related problems) using the Adolescent Alcohol Involvement Scale. A reward-based inhibitory control task (Go/No-Go) was used to examine the inhibition and reward sensitivity, and a self-ordered pointing task was used to measure working memory.

Results

Multiple regression demonstrated that neither inhibitory control (b = 0.02 (95% confidence interval (CI): −0.21, 0.24)) nor working memory (b = −0.12 (95% CI: −0.30, 0.07)) were significant predictors of alcohol use (units consumed). Inhibitory control (b = 0.61 (95% CI: 0.12, 1.09), specifically, in the no reward condition and school deprivation (b = 0.67 (95% CI: 0.06, 1.28) significantly predicted alcohol-related problems.

Conclusions

Our findings demonstrated limited evidence that deficits in specific mechanisms of executive functioning (i.e. motor inhibition and working memory) were associated with alcohol-related problems in UK adolescents. This study adds to an increasing body of literature suggesting weak or non-existent links between inhibitory control, working memory and alcohol use.

An Examination of the Patterns of Substance Use in Activity Spaces and Their Relationship to Problematic Use

During adolescence, adolescents are given more freedom to independently interact with a variety of social contexts. The eco-developmental model suggests that the activity spaces where adolescents spend their time affect substance-use behaviors beyond peer influences, and that the relationships may differ based on the adolescent's demographic characteristics. This study examines adolescent patterns of reported substance use across activity spaces to determine whether the patterns of use are related to problematic substance use, and whether the relationships differ based on the participants' race. Cross-sectional survey data from the study, Drug Use Among Young American Indians: Epidemiology and Prediction, 1993-2006 and 2009-2013, were used. Five patterns of adolescent alcohol use and six patterns of adolescent drug use in activity spaces were identified. There were significant differences in the relationship between class membership and problematic substance use by race, suggesting that contexts may be interacting with an adolescent's race to influence use.

Similar countries, similar factors? Studying the decline of heavy episodic drinking in adolescents in Finland, Norway and Sweden

AIM

To (i) examine several factors associated with trends in heavy episodic drinking (HED) in Finland, Norway and Sweden, (ii) investigate similarities in these associations across the countries and (iii) analyse the contribution of these factors to the trend in HED and the differences across the countries.

DESIGN AND SETTING

Observational study using five waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from Finland, Norway and Sweden between 1999 and 2015.

PARTICIPANTS

A total of 18 128 male and 19 121 female 15- to 16-year-old students.

MEASUREMENTS

Monthly HED, perceived access to alcohol, truancy, parental control, leisure time activities and daily smoking. The Cochran-Armitage test was used to examine linear time trends in HED. Logit regression models using the Karlson-Holm-Breen (KHB) method were fitted for each country separately, including all the independent variables together with time and adjusted for family status, parental education and gender.

FINDINGS

In Finland, Norway and Sweden, perceived access to alcohol, truancy and daily smoking decreased significantly between 1999 and 2015 whereas risk perceptions, parental control and participation in sports increased in the same period. The confounding percentage of all the independent variables related to the trend in HED was 48.8%, 68.9% and 36.7% for Finland, Norway and Sweden, respectively. Decline in daily smoking (P < 0.001) and perceived access to alcohol (P < 0.001) were positively and increase in parental control (P < 0.001) negatively associated with the decline in HED in all three countries. Changes in truancy, going out with friends, and engaging in sports and other hobbies had little or no impact on the decline in HED or displayed no consistent results across the countries.

CONCLUSIONS

The decline in adolescent heavy episodic drinking in Finland, Norway and Sweden between 1999 and 2015 appears to be associated with a decline in adolescent daily smoking and perceived access to alcohol and an increase in parental control.

Changes in Drinking Contexts over the Night Course: Concurrent and Lagged Associations with Adolescents' Nightly Alcohol Use

BACKGROUND

Examining underage drinking contexts can advance the field of adolescent substance use prevention by supporting and informing interventions that can target adolescents in specific contexts. The current study examines how concurrent and lagged situational (i.e., alcohol availability and adult supervision), social (i.e., the number of people and presence of friends), and location (i.e., home vs other location) context characteristics change risks for alcohol use over the night course.

METHODS

Text messages with links to online surveys were used to collect ecological momentary assessment (EMA) data over 2 weekends from adolescents in California. Data were collected using adolescents' personal cell phones early and late in the evening and the following morning. Analyses were limited to adolescents with at least 1 drinking occasion during EMA (N = 58; Mage = 16.64, SD = 0.74; 48% female; 83% White).

RESULTS

Drinking earlier in the evening was positively associated with continued drinking over the night course. Context characteristics were found to play important concurrent and lagged roles in increasing the likelihood of alcohol use over evening hours.

CONCLUSIONS

Findings indicated substantive concurrent and lagged social, situational, and location-based contextual effects on adolescent alcohol use over the course of an evening. Importantly, context characteristics were differentially associated with alcohol use over the course of the evening. The fact that these contextual factors are modifiable suggests that the use of prevention strategies delivered to adolescents throughout the evening may reduce adolescents' drinking and related problems over the evening hours.

Social and Situational Party Characteristics Associated With High-Intensity Alcohol Use Among Youth and Young Adults

BACKGROUND

Rates of high-intensity drinking, which is alcohol consumption that exceeds standard heavy drinking levels, have increased in recent years and peak in young adulthood. To identify modifiable environmental targets for prevention of high-intensity drinking, we identified characteristics of parties attended by youth and young adults that were associated with high-intensity drinking and the consequences of this excessive form of drinking.

METHODS

Data are from 15- to 20-year-old participants in an online survey (n = 2,442; 55.4% female, 74.8% White) who resided in 24 communities across 7 states that were a part of a community randomized intervention trial to reduce the incidence and consequences of underage drinking parties. We used multinomial logistic regression to predict level of drinking by 6 party characteristics (size, location, age and gender composition, supervision, others' drinking behavior), and to predict 6 consequences (hangover, not remember event, passed out, punished by parents, broke something/got in fight, and sex against will) from level of drinking. We tested study hypotheses in 2 models, one that used a single binge drinking threshold (below binge vs. at or above binge level) and one that additionally used a high-intensity drinking level (below binge, 1 to 2 times binge, 2+ times binge level).

RESULTS

We found that larger party size and a mostly male composition were unique predictors of high-intensity drinking when compared to those who consumed 1 to 2 times the binge drinking level. Odds of passing out, not remembering the drinking event, breaking/damaging property, or getting in a fight were more than double for high-intensity drinkers compared to standard binge level drinkers.

CONCLUSIONS

Results from this study indicate there are unique precursors and consequences of high-intensity alcohol consumption among youth and young adults. These environmental factors associated with high-risk drinking contexts can be used to develop prevention strategies to mitigate the harms associated with excessive alcohol consumption.

Characteristics of drinking events associated with heavy episodic drinking among adolescents in the United States

PURPOSE

To examine associations between characteristics of drinking events and the quantity of alcohol consumed by adolescents in the United States.

METHODS

Analyses relied on 2011-2015 data from the National Survey on Drug Use and Health (NSDUH). The study sample included 8110 adolescents, ages 12-17years old, who drank alcohol in the past 30days. A logistic regression model, weighted for national estimation, was constructed to examine factors associated with heavy episodic drinking (HED; 5+ drinks for males, 4+ drinks for females) during the underage drinker's most recent drinking event. These models were adjusted for study year and individual characteristics, including past year drinking frequency, age of drinking onset, and demographic variables.

RESULTS

Buying alcohol off-premise or from another person and being given alcohol from non-parent social sources were associated with greater odds of HED compared to being given alcohol by one of their parents. Drinking alcohol at someone else's house or multiple locations were associated with heavier alcohol consumption compared to drinking at one's own home. Being older and an earlier age of alcohol onset were associated with greater odds of HED.

CONCLUSIONS

This study identifies contextual factors associated with HED by adolescents. Compared to global association studies, the findings from these event-specific analyses provide strong evidence of the environmental conditions that contribute to HED in American adolescents. Although no level of alcohol consumption is safe for adolescents, knowledge of event-level risk factors can inform targeted interventions.

Protective behavioral strategies as a context-specific mediator: A multilevel examination of within- and between-person associations of daily drinking

Research indicates that a drinker's environmental and social context can be differentially associated with drinking outcomes. Further, although many researchers have identified that more frequent use of protective behavioral strategies (PBS) is associated with lower alcohol consumption and negative consequences, scant research has examined how one's drinking context may promote or hinder PBS use. The present study examined how the context of drinking each day (i.e., where and with whom) is associated with level of consumption and reported alcohol-related problems among n = 284 college drinkers (69.0% female) directly, as well as indirectly through the use of PBS. Two different dimensions of PBS are examined (i.e., "Limits" or limiting consumption, and "Avoidance" or avoiding alcohol in general or specific alcohol situations), as well as their relationship with daily drinking. Moreover, we explored these relationships intraindividually (within-person across time), as well as interindividually (between people). Daily drinking was assessed using a weekly diary design. Using multilevel structural equation modeling, we found that environmental context (i.e., drinking at a bar or party) is associated with heavier alcohol use directly and indirectly through PBS that involve limiting one's drinking; these effects occurred only at the daily (within-person) level. Additionally, social context (i.e., drinking with friends) predicts elevated drinking but is unrelated to PBS use. Similar findings were present for alcohol-related problems, controlling for consumption level. College student drinking interventions may benefit from a focus on increasing the use of PBS within potentially risky drinking environments to help reduce problematic alcohol use. (PsycINFO Database Record

Identifying Strategies to Limit Youth Drinking in the Home

OBJECTIVE

The present study aims to better understand the situational, contextual, and social event-level characteristics that contribute to youth drinking behavior in the home.

METHOD

We used survey data from 1,217 adolescents (15-18 years, 47.7% female) living in 24 midsized, noncontiguous California cities. The study focused on those who reported at least one drink during their last drinking occasion at home or a friend's home (n = 336). We obtained data about total drinks at last event as well as contextual and situational characteristics at last event, including adult presence, number of people present, participant's home or friend's home, ease of alcohol access, and gender ratio. We also gathered information on individual-level characteristics such as past-year drinking behavior, perceived drinking norms, age, ethnicity, and gender. Multilevel Poisson regression models were used to analyze the data.

RESULTS

Among the full sample, the number of people at the event and the perceived ease of access were positively associated with an increase in number of drinks consumed. Among females, having a responsible adult present was associated with consuming fewer drinks. Among males, having more boys at the event was related to consuming fewer drinks, whereas increased perceived access to alcohol was positively associated with consuming more drinks.

CONCLUSIONS

Parents may be able to manage or manipulate the home drinking environment to reduce heavy drinking and alcohol-related problems. Future research is needed to explore additional contextual factors that may enable or inhibit heavy drinking.

Contextual influences on early drinking: Characteristics of drinking and nondrinking days

Research characterizing the adolescent drinking context is limited, often relies on samples of current drinkers reporting on recent/last or typical drinking experiences, and provides little information about the context of very early use. The present study uses repeated monthly assessments to describe the context of drinking days and matched nondrinking days to determine the unique risk associated with different drinking-related characteristics. Additionally, we used latent class analysis to empirically identify key configurations of drinking-related characteristics and both family- and nonfamily-related environmental characteristics (social context, physical location, source of alcohol). Data included 688 days (344 drinking days, 344 nondrinking days) from 164 middle-school students enrolled in a prospective study on drinking initiation and progression (62% female; 26% non-White, 11% Hispanic). Results supported 4 patterns: (a) heavier drinking occurring in a peer context, lighter drinking occurring in (b) a family context or (c) a peer context, and (d) drinking alcohol obtained at home without permission. Latent classes varied as a function of gender, age, peer norms, and parenting behaviors as well as alcohol type and perceived alcohol availability. Findings indicated that highly endorsed contexts were not necessarily the riskiest ones, and simply targeting an oft-reported source of alcohol, physical location, or social context may not be an effective strategy for reducing underage drinking. Additionally, although greater monitoring and anticipated parent reaction to drinking are typically protective against adolescent drinking, we found they were associated with parent-sanctioned drinking, suggesting the role of parenting practices must be considered in the context of drinking pattern. (PsycINFO Database Record

Alcohol Policy: Gaps between Legislative Action and Current Research

This paper compares alcohol policies under debate in U.S. state legislatures with policies that have been the focus of research attention. We reviewed the research literature to identify empirical studies of each policy and types of outcome variables analyzed. The two most evaluated alcohol control policies are the minimum legal drinking age and excise tax. Eight other policies had 20 or more studies evaluating them. The remaining alcohol policies received little attention in the research literature. Alcohol consumption and traffic crashes were the most frequent outcomes used in alcohol policy studies. Most studies evaluated policy changes at the state or national level, with few studies of local or institutional policies. During 1997 some 463 alcohol control bills were introduced at state legislatures. Many specific alcohol policies under debate in state legislatures have little research evidence to guide policy decision-making, pointing to areas where future research is needed.

Adolescent Drinking Risks Associated with Specific Drinking Contexts

BACKGROUND

To identify drinking contexts toward which prevention efforts should be directed, associations of context-specific alcohol use (past-year frequency of drinking and heavier drinking in the context) with a range of alcohol-related problems were examined in a population sample of adolescents.

METHODS

A sample of youths (ages 15 to 18) residing in 50 medium-to-large California cities (n = 473 drinkers) was obtained. Respondents provided information about 7 past-year alcohol-related problems in 3 domains (physiological consequences, alcohol-related violence, and conflict/trouble) and the number of times in the past year they used 6 distinct drinking contexts (parties, restaurants/bars, parking lots/street corners, beaches/parks, respondent's home without parents, and someone else's home without parents). Context-specific dose-response model was estimated for each context using censored Tobit models with heteroskedasticity corrections.

RESULTS

Physiological problems were associated with more frequent drinking in 5 of 6 contexts. Heavier drinking in restaurants/bars/nightclubs (b = 0.22, SE = 0.10) and someone else's home without parents (b = 0.14, SE = 0.06) was associated with greater risk of violence. Conflict/trouble was associated with more frequent drinking in parking lots/street corners, declining at higher levels of drinking.

CONCLUSIONS

Certain drinking contexts are related to problems among youths, some because they are associated with frequent alcohol consumption and others because they are associated with heavier drinking. Identifying which drinking contexts are related to specific alcohol-related problems and why is an essential component of developing effective preventive interventions.

Social host policies and underage drinking parties

Social host policies focused on underage drinking parties are implemented to reduce social availability of alcohol and high-risk drinking by adolescents in private locations. We examined the policies' relationship with drinking location, peer-group drinking size, heavy episodic drinking, and nonviolent consequences. Cross-sectional data from 11,205, 14-20-year olds, were analyzed using multilevel modeling. Policies were not associated with drinking location, decreased heavy episodic drinking, or nonviolent consequences. However, adolescents from communities with a preexisting policy had lower odds of drinking in large peer groups compared to those from communities without a policy at baseline. Additional research is needed to examine their effectiveness. The study's limitations are noted.

Outlet density as a predictor of alcohol use in early adolescence

INTRODUCTION

Recent national youth surveys suggest that alcohol availability plays a role in determining use. One measure of availability receiving recent attention is outlet density; however, few studies have examined the effects of outlet density in younger populations.

METHODS

Data were collected from a national sample of the United States (N = 5,903) followed between 6th and 8th grades, as part of a study funded by the Office of Juvenile Justice and Delinquency Prevention (OJJDP). Measures of outlet density were also acquired.

RESULTS

Students in high off-site density communities increased their alcohol use; however, students attending schools in low outlet density communities had higher initial levels of alcohol use that remained relatively stable.

DISCUSSION

The implications and limitations of these findings are discussed.

Does alcohol outlet density affect youth access to alcohol?

PURPOSE

To investigate how community alcohol outlet density may be associated with alcohol access among adolescents.

METHODS

Data were collected through a three-wave panel study with youth aged 14-16 at baseline using computer-assisted telephone interviews. Study participants were recruited from 50 zip codes with varying alcohol outlet density and median household income in California. Data analyses were conducted using multilevel, linear growth models and data from 1028 youth (52% male, 51% white).

RESULTS

After taking into account individual-level factors and zip code median household income, zip code alcohol outlet density was significantly and positively related to the initial levels of the likelihood and frequency of getting alcohol through various sources including commercial outlets, shoulder tapping, home or family members, and underage acquaintances.

CONCLUSIONS

High levels of alcohol outlets in the community enable youth access to alcohol through commercial outlets, family, and social networks.

Why My Classmates Drink

A structural equation model was estimated based on a Swiss national sample of 5649 12- to 18-year-olds to test whether individual drinking motives mediate the link between classmates' motives and individual alcohol use. Results showed that the social, enhancement, coping and conformity motives of individual students are associated with the corresponding motive dimension of other students in the class. No direct effect of the four classmates' motives on individual drinking, but an indirect effect via individual motives was observed. It appears that drinking motives within the adolescent social environment exert their influence on drinking by way of shaping individual motives.

Alcohol environments and disparities in exposure associated with adolescent drinking in California

OBJECTIVES

We investigated sociodemographic disparities in alcohol environments and their relationship with adolescent drinking.

METHODS

We geocoded and mapped alcohol license data with ArcMap to construct circular buffers centered at 14 595 households with children that participated in the California Health Interview Survey. We calculated commercial sources of alcohol in each buffer. Multivariate logistic regression differentiated the effects of alcohol sales on adolescents' drinking from their individual, family, and neighborhood characteristics.

RESULTS

Alcohol availability, measured by mean and median number of licenses, was significantly higher around residences of minority and lower-income families. Binge drinking and driving after drinking among adolescents aged 12 to 17 years were significantly associated with the presence of alcohol retailers within 0.5 miles of home. Simulation of changes in the alcohol environment showed that if alcohol sales were reduced from the mean number of alcohol outlets around the lowest-income quartile of households to that of the highest quartile, prevalence of binge drinking would fall from 6.4% to 5.6% and driving after drinking from 7.9% to 5.9%.

CONCLUSIONS

Alcohol outlets are concentrated in disadvantaged neighborhoods and can contribute to adolescent drinking. To reduce underage drinking, environmental interventions need to curb opportunities for youth to obtain alcohol from commercial sources by tightening licensure, enforcing minimum-age drinking laws, or other measures.

Person-environment transactions in youth drinking and driving

Drinking and driving is a significant health risk behavior for adolescents. This study tested mechanisms by which disinhibited personality traits (impulsivity and sensation seeking) and aspects of the adolescent home/social environment (parental monitoring and alcohol accessibility) can influence changes in drinking and driving behavior over time. Two hundred two high school age youths were assessed at 2 time points, approximately 8 months apart. Zero-inflated Poisson regression analyses were used to test (a) an additive model, where personality and environmental variables uniquely predict drinking and driving engagement and frequency; (b) a mediation model, where Time 2 environmental variables mediate the influence of disinhibited personality; and (c) an interaction model, where environmental factors either facilitate or constrain the influence of disinhibited personality on drinking and driving. Results supported both the additive and interaction model but not the mediation model. Differences emerged between results for personal drinking and driving and riding with a drinking driver. Improving our understanding of how malleable environmental variables can affect the influence of disinhibited personality traits on drinking and driving behaviors can help target and improve prevention/intervention efforts.

Alcohol outlets, youth drinking, and self-reported ease of access to alcohol: a constraints and opportunities approach

BACKGROUND

Despite recent research examining youth access to alcohol, the extent to which relative ease of access to alcohol from various sources translates into the use of these sources is not known.

METHODS

Patterns of adolescent alcohol access in California were studied using a hierarchical analysis of self-reported and archival measures. A survey of 30 youths age 14 to 16 in each of 50 zip codes selected to maximize variability in median household income and off-premise outlet densities was conducted.

RESULTS

(1) Both actual use of and perceived ease of access to formal sources were positively associated with off-premise outlet density (a measure of formal access). (2) Actual use of informal sources was negatively associated with outlet densities. (3) Perceived and realized informal access were associated positively with deviance and negatively with conventionality. (4) Deviance was associated with increased perceived and realized access from both formal and social sources, whereas conventionality was only associated with realized and perceived informal access.

CONCLUSIONS

Correlates of perceived and actual alcohol access differ somewhat, and the differences between informal and formal access (both perceived and actual) are many, creating a complex picture of the patterns of underage access to alcohol. Youth drinking is affected by opportunities and constraints. Specifically, as one form of access becomes constrained, youth appear to circumvent restrictions by relying on other modes of access. Thus interventions targeting formal alcohol access by youth may result in a shift to reliance on social sources. This complex problem requires a multi-faceted intervention approach.

A multilevel analysis of neighborhood and individual effects on individual smoking and drinking in Taiwan

Background

We assessed direct effects of neighborhood-level characteristics and interactive effects of neighborhood-level characteristics and individual socioeconomic position on adult smoking and drinking, after consideration of individual-level characteristics in Taiwan.

Methods

Data on individual sociodemographic characteristics, smoking, and drinking were obtained from Taiwan Social Change Survey conducted in 1990, 1995, and 2000. The overall response rate was 67%. A total of 5883 women and men aged over 20 living in 434 neighborhoods were interviewed. Participants' addresses were geocoded and linked with Taiwan census data for measuring neighborhood-level characteristics including neighborhood education, neighborhood concentration of elderly people, and neighborhood social disorganization. The data were analyzed with multilevel binomial regression models.

Results

Several interaction effects between neighborhood characteristics and individual socioeconomic status (SES) were found in multilevel analyses. Our results indicated that different neighborhood characteristics led to different interaction patterns. For example, neighborhood education had a positive effect on smoking for low SES women, in contrast to a negative effect on smoking for high SES women. This result supports the hypothesis of "relative deprivation," suggesting that poor people living in affluent neighborhoods suffer from relative deprivation and relative standing. On the other hand, neighborhood social disorganization has positive effects on drinking for low SES individuals, but not for high SES individuals. These interactive effects support the hypothesis of the double jeopardy theory, suggesting that living in neighborhoods with high social disorganization will intensify the effects of individual low SES.

Conclusion

The findings of this study show new evidence for the effects of neighborhood characteristics on individual smoking and drinking in Taiwan, suggesting that more studies are needed to understand neighborhood effects in Asian societies.

Adolescent alcohol and cannabis use in relation to peer and school factors. Results of multilevel analyses

The present study used a multilevel approach with multiple informants to determine whether, at individual level, association with substance-using peer groups, and, at class level, incidences of intoxicated students in school premises, are related to students' own substance use. Additionally, it tested the hypothesis that such school incidences affect the closeness of the relation between association with substance-using peers and students' own substance use. Multilevel regression models were estimated separately for drunkenness and cannabis use on the basis of cross-sectional data from 3,925 students of eighth and ninth grades in Switzerland (mean age 15.3, S.D. 0.9) and their teachers (N=220). For both drunkenness and cannabis use, the results confirmed that association with substance-using peers is strongly related to individual substance-use. A higher level of students' own cannabis use and a closer relation between association with cannabis-using peers and the students' own cannabis use were found in classes where students saw others coming cannabis-intoxicated to school or taking cannabis in school premises. Such relations were not found for alcohol. It appears that cannabis use at school or shortly before arriving at school creates an atmosphere that favors cannabis use whether or not students are associated with cannabis-using peers. Establishing an overarching environment of disapproval appears to be an effective means of preventing cannabis use by adolescents.

Drinking locations prior to impaired driving among college students: implications for prevention

Drinking and driving is perhaps the most serious problem associated with heavy drinking among college students in the United States. In this study, the authors examined drinking locations prior to impaired driving in a college student sample. They administered the Impaired Driving Assessment to 91 college students identified as high risk for drinking and driving. Participants reported an average of 7.98 (SD = 7.67) impaired driving episodes during the past 5 weeks. Using a random effects model, the authors found that location was a significant predictor of blood alcohol content (BAC), F(6,89.6) = 3.62, p = 0.0029. After drinking alcohol at a party, students' average estimated BAC prior to driving (geometric M = 0.089) was significantly greater than all other drinking locations (geometric M = 0.033). The findings of this study provide insight into drinking locations prior to impaired driving and can be used by college health practitioners to develop appropriate interventions to reduce the magnitude of this problem.

Community level alcohol availability and enforcement of possession laws as predictors of youth drinking

BACKGROUND

Despite a minimum legal drinking age, many young people use alcohol. Environmental strategies to control youth drinking focus on restricting access and the enforcement of possession laws. This study examines the relationship between use of these strategies and the frequency of youth alcohol use and related problems.

METHODS

Participants were 16,694 students, ages 16-17 in 92 communities in Oregon. A multi-level analysis of a repeated cross-sectional statewide student survey was conducted. The outcome measures examined include 30-day frequency of alcohol use, binge drinking, use of alcohol at school, and drinking and driving.

RESULTS

The rate of illegal merchant sales in the communities directly related to all four alcohol-use outcomes. There was also evidence that communities with higher minor in possession law enforcement had lower rates of alcohol use and binge drinking. The use of various sources in a community expanded and contracted somewhat depending on levels of access and enforcement.

CONCLUSIONS

This evidence provides empirical support for the potential utility of local efforts to maintain or increase alcohol access control and possession enforcement.

Tobacco outlet density, cigarette smoking prevalence, and demographics at the county level of analysis

The geographic associations between tobacco outlet density, cigarette smoking prevalence, and demographic variables at the county unit of analysis were examined. End of year 2002 data were derived from licenses of 4745 tobacco selling retail outlets in all 99 Iowa counties. The 2000 census and the 2002 Iowa Behavioral Risk Factor Surveillance System (IBRFSS) were used to gather data for demographic variables and smoking prevalence rates. The IBRFSS telephone interviews were conducted from January through December in 2002 with a random sample of 3662 Iowa residents. As expected, results showed that counties with higher density of tobacco outlets and smoking prevalence also tended to have a higher percentage of minority residents. Contrary to previous studies, however, counties with higher tobacco outlet density and smoking prevalence also tended to have higher median household income. Findings are discussed in light of the state's low income inequality. Implications of the study and directions for future research are discussed.

Do school surroundings matter? Alcohol outlet density, perception of adolescent drinking in public, and adolescent alcohol use

The aim of the present study was to investigate the relationship between alcohol outlet density, perception of adolescent drinking in public (both assessed at the school level), and adolescent drinking and drunkenness at individual level. Hierarchical linear regression models were calculated based on data from 1194 ninth graders in Switzerland (mean age=15.3, S.D.=0.7) and their schoolmasters (n=61). Apart from the positive main effects, the results reveal a negative interaction of alcohol outlet density and perception of adolescent drinking in public in predicting individual alcohol use among adolescents. In regions with a high density of shops, it appears that the schoolmasters' perception reflects the general drinking norm of the area where the school is located rather than the actual drinking level of adolescents. More research is needed, particularly in Europe and among adolescent populations, to reach a better understanding of school level predictors of adolescent alcohol use.

Secondhand effects of student alcohol use reported by neighbors of colleges: the role of alcohol outlets

This is a study of the secondhand effects of student alcohol use experienced by residents of neighborhoods near college campuses. We examined the relationship of a college's level of binge drinking and the number of alcohol outlets in the immediate area, to lowered quality of neighborhood life through such secondhand effects. Adults from 4661 households in the United States were interviewed through a stratified list-assisted random digit dialing telephone survey. The interview schedule included questions about residents' experiences of secondhand effects of alcohol use such as noise, vandalism or public disturbances. Reports about the quality of neighborhood life provided by respondents residing near colleges were compared with those of respondents who did not live near colleges; and reports of neighbors of colleges with high rates of binge drinking were compared with those of neighbors of colleges with lower rates. The presence of alcohol outlets in these areas was also compared. Residents near colleges and particularly near colleges with heavy episodic drinking reported the presence of more alcohol outlets within a mile. Those neighborhoods were characterized by lower socioeconomic status. Neighbors living near college campuses were more likely to report a lowered quality of neighborhood life through such secondhand effects of heavy alcohol use as noise and disturbances, vandalism, drunkenness, vomiting and urination. A path analysis indicated that the number of nearby alcohol outlets was an important factor mediating the relationship between colleges, especially those with high rates of binge drinking, and such secondhand effects. The results suggest that neighborhood disruptions around colleges due to heavy alcohol use may be reduced by limiting the presence of alcohol outlets in those areas, and the marketing practices that this engenders.