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CORK Bibliography: Religiosity and Religious Groups

64 citations. January 2009 to present

Prepared: December 2012

Agrawal A; Lynskey MT. Correlates of later-onset cannabis use in the National Epidemiology Survey on Alcohol and Related Conditions (NESARC). Drug and Alcohol Dependence 105(1/2): 71-75, 2009. (44 refs.)

Background: Much of the research surrounding correlates of cannabis initiation has focused on adolescent and young adult populations. However, there is growing evidence that cannabis onset occurs later in life as well and little is known of the risk and protective influences that are associated with late-onset cannabis initiation. Methods: We used data on 34,653 individuals that participated in both the first wave and the 3-year follow-up (3YFU) of the National Epidemiologyogical Survey on Alcohol and Related Conditions (NESARC). Univariate and multivariate logistic regression was used to examine the association between cannabis initiation at 3YFU and socio-demographic, religious/pro-social and psychiatric measures. Analyses were also conducted in age bands to further distinguish across the lifespan. Results: of the 27,467 lifetime abstainers at wave 1509 had initiated cannabis use at 3YFU. Consistent associations between divorce, religious attendance, volunteer/community service, alcohol abuse/dependence, nicotine dependence and cannabis initiation were noted in the full sample and across age-bands. Conclusions: Religious and pro-social activities are negatively associated with late-onset cannabis onset while divorce and alcohol and nicotine-related problems are positively associated with later onset.

Allamani A. The relationship between addiction and religion and its possible implication for care. (editorial). Substance Use & Misuse 45(14): 2375-2377, 2010. (2 refs.)

Allen TM; Lo CC. Religiosity, spirituality, and substance abuse. Journal of Drug Issues 40(2): 433-459, 2010. (76 refs.)

With data from the 2004 General Social Survey, the study examined effects of religiosity and spirituality on substance abuse. Also explored was whether and how social bonding mediates religiosity's effects on substance abuse. The results show that religiosity was negatively associated with substance abuse and, further, that social bonding variables did somewhat mediate this negative relationship between the two. Additionally, and as expected, with religiosity controlled, the likelihood of substance abuse increased along with increasing spirituality, in the models. Policy implications and further research needs are discussed.

Avalos LA; Mulia N. Formal and informal substance use treatment utilization and alcohol abstinence over seven years: Is the relationship different for blacks and whites? Drug and Alcohol Dependence 121(1-2): 73-80, 2012. (82 refs.)

Background: This study examines whether the effects of formal substance use treatment utilization and Alcoholics Anonymous (AA) on 30-day abstinence vary for black versus white Americans. Methods: The current analysis utilizes data from a longitudinal sample of 1013 black and white, dependent and problem drinkers across a 7-year period. Participants were identified through a probability survey in the general population and consecutive intakes in chemical dependency treatment programs in a California County. Generalized Estimating Equations assessing interactions between race and treatment utilization incorporated variables from four post-baseline interviews, controlling for baseline variables. Results: Formal treatment utilization was associated with 30-day abstinence (OR:1.6, 95%CI: 1.3, 2.1), yet this relationship did not differ for blacks and whites. In contrast, there was a significant interaction between AA utilization, race and 30-day abstinence. While both whites and blacks who attended AA were more likely to report 30-day abstinence compared to their non-AA attending counterparts (white OR:4.0, 95%CI: 3.2-5.1 and black OR:2.2, 95%CI: 1.5-3.2), the relationship was stronger for whites. Among those who did not attend AA, blacks were more likely than whites to be abstinent. Post hoc analyses suggest that these latter findings may be related to greater religiosity and "drier" social networks among black Americans. Conclusions: While utilization of formal treatment may yield similar benefits for blacks and whites, AA utilization may be more important for maintaining abstinence among whites than blacks. Future research should investigate racial differences in social network drinking patterns and religious reinforcement of sobriety, and the role these may play in AA outcomes.

Bahr SJ; Hoffmann JP. Parenting style, religiosity, peers, and adolescent heavy drinking. Journal of Studies on Alcohol and Drugs 71(4): 539-543, 2010. (24 refs.)

Objective: The purpose of this research was to examine whether authoritative, authoritarian, indulgent, and neglectful parenting styles were associated with adolescent alcohol use and heavy drinking, after controlling for peer use, religiosity, and other relevant variables. Method: Structural equation modeling was used to estimate direct and indirect associations of parenting style with alcohol use and heavy drinking among 4,983 adolescents in Grades 7-12. Results: Adolescents whose parents were authoritative were less likely to drink heavily than adolescents from the other three parenting styles, and they were less likely to have close friends who used alcohol. In addition, religiosity was negatively associated with heavy drinking after controlling for other relevant variables. Conclusions: Authoritative parenting appears to have both direct and indirect associations with the risk of heavy drinking among adolescents. Authoritative parenting, where monitoring and support are above average, might help deter adolescents from heavy alcohol use, even when adolescents have friends who drink. In addition, the data suggest that the adolescent's choice of friends may be an intervening variable that helps explain the negative association between authoritative parenting and adolescent heavy drinking.

Berg CJ; Swan DW; Fredrick G; Daniel S; Kegler MC. Smoke-free policies at home, church, and work: Smoking levels and recent quit attempts among a southeastern rural population, 2007. Preventing Chronic Disease 9: article 110110, 2012. (33 refs.)

Introduction: The objective of this study was to examine the cumulative effect of smoke-free policies and social support for smoking cessation in the home, at church, and at work on smoking levels and quit attempts in the context of a community-based study of rural African Americans and whites in the Southeast. Methods: We conducted a baseline survey to assess sociodemographics, smoking behavior, level of social support for smoking cessation, and smoke-free policies at home, church, and work. We created a variable for a weighted "dose" of smoking restrictions on the basis of the existence of policies in the 3 settings and a weighted score for social support and used bivariate analyses and multivariate regression to analyze data. Results: Of 134 survey participants, 18.7% had complete restrictions at home. Among church attendees, 39.4% had complete restrictions at church, and among those employed outside the home, 15.4% had complete restrictions at work. After controlling for age, sex, race, and education, the weighted dose of smoking restrictions was significantly related to having made a quit attempt in the past 12 months (odds ratio, 2.2; 95% confidence interval, 1.1-4.3) but not number of cigarettes smoked per day. Social support for cessation had no effect on recent quit attempts or number of cigarettes smoked per day. Conclusion: Smoke-free policies have a cumulative effect on smoking behavior. These findings may inform interventions aimed at promoting comprehensive community-wide smoke-free policies.

Borch A. Perceptions of gambling in households: A case study from Norway. Addiction Research & Theory 20(4): 317-328, 2012. (49 refs.)

Drawing on a qualitative study of Norwegian households (couples and singles) with and without reported gambling problems, this article explores how household members perceive their own gambling. The research indicates that different households subscribe to different views of gambling. Whereas households without any reported gambling problems perceived gambling according to the market view, which suggests that gambling is like any other product on the market, households with reported gambling problems articulated views corresponding with a medical view, according to which gambling is seen as a dangerous realm of addiction. Religious views were also articulated, although they were less pronounced. Implications for the understanding of risk and help-seeking behaviour are discussed.

Borders TF; Curran GM; Mattox R; Booth BM. Religiousness among at-risk drinkers: Is it prospectively associated with the development or maintenance of an alcohol-use disorder? Journal of Studies on Alcohol and Drugs 71(1): 136-142, 2010. (38 refs.)

Objective: This study examined whether particular dimensions of religiousness are prospectively associated with the development or maintenance of an alcohol-use disorder (AUD) among at-risk drinkers or persons with a history of problem drinking. Method: A prospective cohort study was conducted among at-risk drinkers identified through a population-based telephone survey of adults residing in the southeastern United States. The cohort was stratified by baseline AUD status to determine how several dimensions of religiousness (organized religious attendance, religious self-ranking, religious influence on one's life, coping through prayer, and talking with a religious leader) were associated with the development and, separately, the maintenance or remission of an AUD over 6 months. Multiple logistic regression analyses were conducted to estimate the odds of developing versus not developing an AUD and maintaining versus remitting from an AUD while adjusting for measures of social support and other covariates. Results: Among persons without an AUD at baseline, more frequent organized religious attendance, adjusted odds ratio (ORadj) = 0.73, 95% CI [0.55, 0.96], and coping through prayer ORadj = 0.63, 95% CI [0.45, 0.87], were associated with lower adjusted odds of developing an AUD. In contrast, among persons with an AUD at baseline, no dimension of religiousness was associated with the maintenance or remission of an AUD. Conclusions: The findings of this study suggest that religious attendance and coping through prayer may protect against the development of an AUD among at-risk drinkers. Further research is warranted to ascertain whether these or other religious activities and practices should be promoted among at risk drinkers.

Bourgois P; Hart LK. Science, religion and the challenges of substance abuse treatment. (editorial)18. Substance Use & Misuse 45(14): 2395-2400, 2010. (18 refs.)

Brechting EH; Brown TL; Salsman JM; Sauer SE; Holeman VT; Carlson CR. The role of religious beliefs and behaviors in predicting underage alcohol use. Journal of Child & Adolescent Substance Abuse 19(4): 324-334, 2010. (25 refs.)

Religious beliefs have consistently emerged as significantly and inversely related to alcohol use. This article seeks further understanding of this relationship by exploring the role of religious behaviors in this relationship in three ways. First, we aim to determine whether the relationship between religious beliefs and alcohol use differs with regard to frequency of participation in religious behaviors. Next, we seek to explore the role of religious behavior as a moderator of the relationship between religious beliefs and alcohol use. We find support for the hypothesis that individuals who possess strong religious beliefs but do not frequently take part in religious practices (e.g., attend services, engage in prayer) would report more frequent alcohol use than those who profess similar beliefs but more frequently participate in religious practices.

Burris JL; Sauer SE; Carlson CR. A test of religious commitment and spiritual transcendence as independent predictors of underage alcohol use and alcohol-related problems. Psychology of Religion and Spirituality 3(3): 231-240, 2011. (58 refs.)

Religiousness exerts a protective effect against underage alcohol use, but it is largely unknown whether its protective quality extends equally to alcohol-related problems. It is also unclear to what extent spirituality, which is related to religiousness, exerts a similar protective effect. The current study examined whether facets of religiousness and spirituality-religious commitment and spiritual transcendence-were differentially related to alcohol use and alcohol-related problems among an underage sample of young adults. Despite being underage, most participants (n = 344; 61% female) reported having an alcoholic drink at least once a month and having at least two to three drinks per occasion. Results of hierarchical linear regression analyses that controlled for demographics, positive alcohol expectancies, and impulsivity found unique associations between religious commitment and spiritual transcendence and alcohol use. Specifically, religious commitment operated as a protective factor, while spiritual transcendence operated as a risk factor for alcohol use. Neither religious commitment nor spiritual transcendence predicted alcohol-related problems. Results of this study inform future research by highlighting the importance of studying religiousness and spirituality as unique constructs with the potential for differential predictive utility.

Button TMM; Hewitt JK; Rhee SH; Corley RP; Stallings MC. The moderating effect of religiosity on the genetic variance of problem alcohol use. Alcoholism: Clinical and Experimental Research 34(9): 1619-1624, 2010. (31 refs.)

Background: Previous studies have demonstrated that the heritability of alcohol-related phenotypes depends upon the social background in which it is measured (e.g., urbanicity, marital status, and religiosity). The aim of the current study was to identify whether religiosity moderated the genetic variance of problem alcohol use in men and women at two time points: adolescence and early adulthood. Method: Participants were 312 male MZ pairs, 379 female MZ pairs, 231 male DZ pairs, 235 female DZ pairs, and 275 opposite sex DZ pairs participating in the University of Colorado Center on Antisocial Drug Dependence. Religiosity was measured using the Value on Religion Scale (Jessor and Jessor, 1977), and problem alcohol use was measured using the Composite International Diagnostic Interview-Substance Abuse Module (Cottler et al., 1989). Data were analyzed using a model-fitting approach to the twin data. Results: In adolescence, genetic variance of problem alcohol use decreased significantly with increasing levels of religiosity in both men and women, whereas in early adulthood, religiosity did not moderate the genetic variance of problem alcohol use in either men or women. Conclusion: Religiosity appears to moderate the genetic effects on problem alcohol use during adolescence, but not during early adulthood. The reduced genetic variance for problem alcohol use in adolescence may be the consequence of greater social control in adolescence than in young adulthood.

Chi FW; Kaskutas LA; Sterling S; Campbell CI; Weisner C. Twelve-Step affiliation and 3-year substance use outcomes among adolescents: Social support and religious service attendance as potential mediators. Addiction 104(6): 927-939, 2009. (78 refs.)

Twelve-Step affiliation among adolescents is little understood. We examined 12-Step affiliation and its association with substance use outcomes 3 years post-treatment intake among adolescents seeking chemical dependency (CD) treatment in a private, managed-care health plan. We also examined the effects of social support and religious service attendance on the relationship. We analyzed data for 357 adolescents, aged 13-18, who entered treatment at four Kaiser Permanente Northern California CD programs between March 2000 and May 2002 and completed both baseline and 3-year follow-up interviews. Measures at follow-up included alcohol and drug use, 12-Step affiliation, social support and frequency of religious service attendance. At 3 years, 68 adolescents (19%) reported attending any 12-Step meetings, and 49 (14%) reported involvement in at least one of seven 12-Step activities, in the previous 6 months. Multivariate logistic regression analyses indicated that after controlling individual and treatment factors, 12-Step attendance at 1 year was marginally significant, while 12-Step attendance at 3 years was associated with both alcohol and drug abstinence at 3 years [odds ratio (OR) 2.58, P < 0.05 and OR 2.53, P < 0.05, respectively]. Similarly, 12-Step activity involvement was associated significantly with 30-day alcohol and drug abstinence. There are possible mediating effects of social support and religious service attendance on the relationship between post-treatment 12-Step affiliation and 3-year outcomes. The findings suggest the importance of 12-Step affiliation in maintaining long-term recovery, and help to understand the mechanism through which it works among adolescents.

Chu DC. The links between religiosity, childhood sexual abuse, and subsequent marijuana use: An empirical inquiry of a sample of female college students. International Journal of Offender Therapy and Comparative Criminology 56(6): 937-954, 2012. (49 refs.)

A number of studies indicate that childhood sexual abuse (CSA) has a negative impact on later psychological well-being. It is well documented that experiences of CSA are associated with depression, self-destructiveness, and subsequent substance abuse or alcohol consumption. Compared with women who experienced no such sexual abuse in childhood, women who were victims of sexual abuse in childhood were more likely to be depressed and use drugs or consume alcohol in later life. Analyzing data of 1,569 females derived from the "Longitudinal Study of Violence Against Women," this study examines whether the strain caused by sexual victimization leads to a higher level of subsequent marijuana use and whether religiosity moderates the negative effects of CSA. It was found that CSA was associated with an increased level of marijuana use in high school. However, more proximate sexual victimization (victimization in college) seemed to override the impact of CSA on subsequent marijuana use. Religiosity was found to moderate the effect of CSA on marijuana use in high school. Religiosity was negatively associated with marijuana use in high school as well as the second and fourth collegiate years. Policy implications and promising directions for future research are discussed.

Conner BT; Anglin MD; Annon J; Longshore D. Effect of religiosity and spirituality on drug treatment outcomes. Journal of Behavioral Health Services & Research 36(2): 189-198, 2009. (12 refs.)

This study empirically tested one component of a comprehensive model of the role of religiosity and spirituality (R/S) in drug treatment that is presented as a companion article in this special issue. Data collected from individuals dependent on heroin receiving narcotic replacement therapy were used to assess the effects of R/S on drug treatment outcomes. Based on their R and S scores, participants were assigned to one of four groups: those whose scores remained consistently high across the 12-month study period were compared to those whose scores were consistently low, increased, or decreased across the same period. Results indicated that at both study completion (12 months after admission) and 6 months after that participants in the consistently high and increasing spirituality groups self-reported significantly fewer days of heroin and cocaine/crack use than those in the consistently low group (p < 0.05). There were no significant differences among the religiosity groups on self-reported heroin or cocaine/crack use. Results from chi(2) analyses indicated that at 12 months the results of urinalysis for the presence of opiates, but not cocaine/crack, were dependent on spirituality group membership (p < 0.01) but not religiosity group membership. Results also indicated that at the 6-month follow-up, there were significantly more participants in the decreasing group who were not in maintenance treatment who had a positive urinalysis and fewer in the increasing group than would be expected if the two variables were independent (p < 0.05). Implications for addictions health services are discussed.

Cuadrado M; Lieberman L. The Virgin of Guadalupe as an ancillary modality for treating Hispanic substance abusers: Juramentos in the United States. Journal of Religion and Health 50(4): 922-930, 2011. (20 refs.)

During a 6-month research study of substance abuse outreach and retention methods in Mexico, the authors learned about the common practice of a self-control mechanism to abstain from substance abuse: Juramentos. Juramentos are pledges usually made to the Virgin of Guadalupe in the presence of a Catholic priest. The Jurado promises not to drink during a specified period of time. The authors discuss the dynamics of Juramentos and present data from an exploratory study indicating that Juramentos are being used among Mexican migrants in Florida and may provide a culturally sensitive adjunct for treatment of Mexican and other Hispanic clients in the United States.

Dennis DL; Cox W; Black A; Muller S. The influence of religiosity and spirituality on drinking behaviors: Differences between students attending two southern universities. Journal of Drug Education 39(1): 95-112, 2009. (56 refs.)

The purpose of this study was to determine if-students (n = 431) from two southern universities -- one in the "buckle" of the Bible-belt, the other a southern "border" state -- have different drinking behaviors depending on their religiosity and spirituality. Approximately 95% of students indicated that they had at least one drink of alcohol during their lives, with almost 82% reporting that they used alcohol in the past 30 days. Binge drinking among underage students increased every year (approximately 43% to almost 70%). Students from the buckle university had higher degrees of religiosity and spirituality and reported fewer unhealthy drinking behaviors than those from the border university. By creating a learning environment where students are encouraged to increase the spiritual dimension of health, health educators may alleviate potentially deadly consequences of alcohol.

Desmond SA; Soper SE; Kraus R. Religiosity, peers, and delinquency: Does religiosity reduce the effect of peers on delinquency? Sociological Spectrum 31(6): 665-694, 2011. (76 refs.)

Do peer influences have the same effect on religious and nonreligious youth, or does religiosity reduce the effect of peers on delinquency? Using data from the National Youth Survey, we examined the interaction of religiosity and peer influences on marijuana use, alcohol use, hitting, and property offenses. The results suggest that, for marijuana use and alcohol use, three measures of peer influence-peer attitudes, behaviors, and pressure-have weaker effects on religious adolescents. Thus, even when religious youth are exposed to peers who encourage substance use, religiosity may serve as a protective factor that reduces the effect of peers. In contrast, religiosity does not seem to condition the effect of peers on hitting and property offenses.

Desmond SA; Soper SE; Purpura DJ; Smith E. Religiosity, moral beliefs, and delinquency: Does the effect of religiosity on delinquency depend on moral beliefs. Sociological Spectrum 29(1): 51-71, 2009. (52 refs.)

Does the effect of religiosity on delinquent behavior depend on moral beliefs? For example, will religious adolescents refrain from using marijuana, even if they do not believe using marijuana is wrong? We addressed this question using data from the third and fourth waves of the National Youth Survey. The results indicated a significant interaction between religiosity and moral beliefs for marijuana use and getting drunk, but not for hitting or property offenses. Religiosity has a stronger effect on marijuana and alcohol use when adolescents also believe these behaviors are wrong. Conversely, when it is not accompanied by strong moral beliefs, religiosity has less of an effect on marijuana use and drinking.

Dollinger SJ; Malmquist D. Reliability and validity of single-item self-reports: With special relevance to college students' alcohol use, religiosity, study, and social life. Journal of General Psychology 136(3): 231-241, 2009. (20 refs.)

The authors tested the assumption that single-item measures have unacceptably low reliability and validity. On 2 occasions 11 weeks apart, college students reported on the frequency and quantity of alcohol consumption, 2 religious behaviors, time of study and of socializing (focal items), and other qualities and characteristics. Most test-retest reliabilities were good to excellent; objective facts were more reliable than subjective evaluations; and target items had good validity when correlated with 2-week nightly log records of corresponding behaviors in a multimethod multitrait matrix. The exception was self-reported study, with relatively low reliability and validity, suggesting the non-trait-like quality of this behavior. Single-item measures may be better than commonly thought.

Drerup ML; Johnson TJ; Bindl S. Mediators of the relationship between religiousness/spirituality and alcohol problems in an adult community sample. Addictive Behaviors 36(12): 1317-1320, 2011. (34 refs.)

Johnson et al. (2008b) reported that, in a college student sample, the effect of religiousness on alcohol use was mediated by negative beliefs about alcohol, social influences, and spiritual well-being, and that these variables in turn impacted alcohol use and problems both directly and indirectly via motives for drinking. This study attempted to replicate those findings in a sample of community dwelling adults (N = 211). The effect of Religious/Spiritual Involvement was mediated by Negative Beliefs about Alcohol, Social Modeling, and Spiritual-Well-Being. However, Social Modeling had stronger relationships with motives for drinking and alcohol consumption than the other two mediators. The effect of Religious Struggle on Alcohol Problems was mediated by Spiritual Well-Being and coping motives for drinking. Results provide further support for the motivational model of alcohol use and suggest plausible mechanisms by which religiousness could causally impact alcohol use and problems. Religious struggle may be a clinically significant correlate of alcohol problems.

Edlund MJ; Harris KM; Koenig HG; Han XT; Sullivan G; Mattox R et al. Religiosity and decreased risk of substance use disorders: Is the effect mediated by social support or mental health status? Social Psychiatry and Psychiatric Epidemiology 45(8): 827-836, 2010. (60 refs.)

The negative association between religiosity (religious beliefs and church attendance) and the likelihood of substance use disorders is well established, but the mechanism(s) remain poorly understood. We investigated whether this association was mediated by social support or mental health status. We utilized cross-sectional data from the 2002 National Survey on Drug Use and Health (n = 36,370). We first used logistic regression to regress any alcohol use in the past year on sociodemographic and religiosity variables. Then, among individuals who drank in the past year, we regressed past year alcohol abuse/dependence on sociodemographic and religiosity variables. To investigate whether social support mediated the association between religiosity and alcohol use and alcohol abuse/dependence we repeated the above models, adding the social support variables. To the extent that these added predictors modified the magnitude of the effect of the religiosity variables, we interpreted social support as a possible mediator. We also formally tested for mediation using path analysis. We investigated the possible mediating role of mental health status analogously. Parallel sets of analyses were conducted for any drug use, and drug abuse/dependence among those using any drugs as the dependent variables. The addition of social support and mental health status variables to logistic regression models had little effect on the magnitude of the religiosity coefficients in any of the models. While some of the tests of mediation were significant in the path analyses, the results were not always in the expected direction, and the magnitude of the effects was small. The association between religiosity and decreased likelihood of a substance use disorder does not appear to be substantively mediated by either social support or mental health status.

Ford JA; Hill TD. Religiosity and adolescent substance use: Evidence from the National Survey on Drug Use and Health. Substance Use & Misuse 47(7): 787-798, 2012. (81 refs.)

Prior research indicates that religiosity is associated with lower levels of substance use in adolescence. The extant research, however, is limited by issues related to data quality and analytic strategy. The current research uses the National Survey on Drug Use and Health to further our understanding of the nature of the relationship between religiosity and substance use during adolescence. Results show that religiosity reduces the odds of tobacco use, heavy drinking, prescription drug misuse, marijuana use, and other illicit drug use. These associations are partially explained by respondent and peer attitudes toward substance use and, to a lesser extent, respondent psychological wellbeing. The influence of respondent substance use attitude is especially pronounced, explaining between 41% (marijuana) and 53% (tobacco) of the association between religiosity and substance use. In fully adjusted models, all mediators account for between 46% (marijuana) and 59% (tobacco) of the association between religiosity and substance use.

Frecska E; More CE; Vargha A; Luna LE. Enhancement of creative expression and entoptic phenomena as after-effects of repeated ayahuasca ceremonies. Journal of Psychoactive Drugs 44(3): 191-199, 2012. (51 refs.)

Studying the effect of psychedelic substances on expression of creativity is a challenging problem. Our primary objective was to study the psychometric measures of creativity after a series of ayahuasca ceremonies at a time when the acute effects have subsided. The secondary objective was to investigate how entoptic phenomena emerge during expression of creativity. Forty individuals who were self-motivated participants of ayahuasca rituals in Brazil completed the visual components of the Torrance Tests of Creative Thinking before and the second day after the end of a two-week long ceremony series. Twenty-one comparison subjects who did not participate in recent psychedelic use also took the Torrance tests twice, two weeks apart. Repeated ingestion of ayahuasca in the ritual setting significantly increased the number of highly original solutions and phosphenic responses. However, participants in the ayahuasca ceremonies exhibited more phosphenic solutions already at the baseline, probably due to the fact that they had more psychedelic experiences within six months prior to the study than the comparison subjects did. This naturalistic study supports the notion that some measures of visual creativity may increase after ritual use of ayahuasca, when the acute psychoactive effects are receded. It also demonstrates an increased entoptic activity after repeated ayahuasca ingestion.

Garrusi B; Nakhaee N. Religion and smoking: A review of recent literature. (review). International Journal of Psychiatry in Medicine 43(3): 279-292, 2012. (72 refs.)

Tobacco smoking and exposure to secondhand smoke are a major threat to human health worldwide. The effort to prevent tobacco use should be regarded as an important public health strategy. Given the significance of religion and spirituality in the daily life of more than 90% of the world's population, the relationship of religion and smoking should be seen as a critical research area. Religions are many and varied, but most value human well-being highly and so do not approve of tobacco use, even though they do not prohibit it entirely. In recent years, researchers have shown more interest in the subject of religion and health, including drug and tobacco use. Differences of focus and methodology notwithstanding, most studies have ascertained a deterrent role for religion as regards tobacco use, and several mechanisms have been proposed to explain the negative relationship between religion or spirituality and smoking. Many of the studies, however, suffer from shortcomings that need to be acknowledged and addressed, such as using nonstandard data-gathering tools, lack of a unified definition of religion or spirituality, and paucity of research in non-Christian and developing countries. Finally, the cross-sectional nature of many of the studies makes the meaningful interpretation of findings difficult.

Ghandour LA; Karam EG; Maalouf WE. Lifetime alcohol use, abuse and dependence among university students in Lebanon: Exploring the role of religiosity in different religious faiths. Addiction 104(6): 940-948, 2009. (41 refs.)

To examine alcohol consumption and the role of religiosity in alcohol use disorders in Christian, Druze and Muslim youth in Lebanon, given their distinct religious doctrines and social norms. Using a self-completed anonymous questionnaire, data were collected on 1837 students, selected randomly from two large private universities in Beirut. Life-time abuse and dependence were measured as per the Diagnostic and Statistical Manual version IV. Alcohol use was more common in Christians, who started drinking younger and were twice as likely to be diagnosed with abuse and dependence. However, among ever drinkers, the odds of alcohol use disorders were comparable across religious groups. Believing in God and practising one's faith were related inversely to alcohol abuse and dependence in all religious groups, even among ever drinkers (belief in God only). The associations were sometimes stronger for Muslims, suggesting that religiosity may play a larger role in a more proscriptive religion, as postulated by'reference group theory'. Students belonging to conservative religious groups may be shielded from the opportunity to try alcohol. Once an ever drinker, however, religion is not related to the odds of an alcohol use disorder. Religiosity (i.e. belief in God and religious practice) is, nevertheless, related inversely to alcohol-related problems, even among drinkers. Findings from this culturally and religiously diverse Arab country corroborate the international literature on religion, religiosity and alcohol use, highlighting potential differences between Christians and Muslims.

Gillum F; Obisesan TO; Jarrett NC. Smokeless tobacco use and religiousness. International Journal of Environmental Research and Public Health 6(1): 225-231, 2009. (19 refs.)

Although smoking shows a strong negative association with religiousness, no studies have appeared of use of smokeless tobacco (ST) and religiousness. To assess an association of use of ST and religiousness, data from 9,374 men aged 17 years and over with complete data on self-reported frequency of attendance at religious services and use of smokeless tobacco were analyzed. Among men aged 17-29 years, 4.9% of frequent attenders (>= 24 times/y) and 9.4% of others (< 24 times/y) were current users of ST (p=0.002). After adjusting for multiple confounders by logistic regression, infrequent attenders were twice as likely as frequent attenders to be ST users: odds ratio 2.09, 95% confidence limits 1.12-3.92, p=0.02. This negative association suggests a protective effect of early-life religiousness on ST use, which might be taken into account in planning ST prevention efforts.

Godlaski T. Dialogue on the relationship between addiction and religion and its possible implications for care. (editorial). Substance Use & Misuse 45(14): 2393-2395, 2010. (2 refs.)

Harden KP. Does religious involvement protect against early drinking? A behavior genetic approach. Journal of Child Psychology and Psychiatry 51(7): 763-771, 2010. (45 refs.)

Background: Adolescent involvement in religious organizations has been hypothesized to protect against early age at first drink. However, the correlation between adolescent religiosity and later age at first drink may be confounded by environmental or genetic differences between families. This study tests whether, after controlling for shared environmental and genetic confounds using a behavior genetic design, the association between individual levels of religiosity and earlier age at first drink is still evident. Method: Twin and sibling pairs were drawn from the National Longitudinal Study of Adolescent Health, a nationally-representative sample of US adolescents. Age at first drink was measured as how old adolescents were when they first had a drink of beer, wine, or liquor. Religiosity was measured using four items concerning frequency of religious activities and importance of religious beliefs. Using twins and siblings who were discordant for religiosity, analyses tested whether religious adolescents had a later age at first drink than their non-religious co-twins/co-siblings. Results: Religious adolescents did not differ from their non-religious siblings in their mean age at first drink. Results from survival models indicate that environmental differences between families completely account for the correlation between religiosity and later age at first drink. Conclusions: Results suggest that individual religious involvement is a proxy variable for family or cultural environments that are salient for when adolescents initiate alcohol use. Future research is needed to identify specific protective environments in religious families. These results have implications for both public policy and etiological theory.

Heinz AJ; Disney ER; Epstein DH; Glezen LA; Clark PI; Preston KL. A focus-group study on spirituality and substance-user treatment. Substance Use & Misuse 45(1/2): 134-153, 2010. (52 refs.)

Focus groups were conducted in 2005-2006 with 25 urban methadone-maintained outpatients to examine beliefs about the role of spirituality in addiction and its appropriateness informal treatment. Thematic analyses suggested that spirituality and religious practices suffered in complex ways during active addiction, but went "hand in hand" with recovery. Participants agreed that integration of a voluntary spiritual discussion group into formal treatment would be preferable to currently available alternatives. One limitation was that all participants identified as strongly spiritual. Studies of more diverse samples will help guide the development and evaluation of spiritually based interventions in formal treatment.

Hemphill SA; Heerde JA; Herrenkohl TI; Patton GC; Toumbourou JW; Catalano RF. Risk and protective factors for adolescent substance use in Washington State, the United States and Victoria, Australia: A longitudinal study. Journal of Adolescent Health 49(3): 312-320, 2011. (40 refs.)

Purpose: To compare the levels of risk and protective factors and the predictive influence of these factors on alcohol, tobacco, and cannabis use over a 12-month follow-up period in Washington State in the United States and in Victoria, Australia. Method: The study involved a longitudinal school-based survey of students drawn as a two-stage cluster sample recruited through schools, and administered in the years 2002 and 2003 in both states. The study used statewide representative samples of students in the seventh and ninth grades (n = 3,876) in Washington State and Victoria. Results: Washington State students, relative to Victorian students, had higher rates of cannabis use but lower rates of alcohol and tobacco use at time 1. Levels of risk and protective factors showed few but important differences that contribute to the explanation of differences in substance use; Washington State students, relative to Victorian students, reported higher religiosity (odds ratio, .96 vs. .79) and availability of handguns (odds ratio, 1.23 vs. 1.18), but less favorable peer, community, and parental attitudes to substance use. The associations with substance use at follow-up are generally comparable, but in many instances were weaker in Washington State. Conclusions: Levels of risk and protective factors and their associations with substance use at follow-up were mostly similar in the two states. Further high-quality longitudinal studies to establish invariance in the relations between risk and protective factors and substance use in adolescence across diverse countries are warranted.

Hofstetter CR; Ayers JW; Irvin VL; Sim DEK; Hughes SC; Reighard F et al. Does church participation facilitate tobacco control? A report on Korean immigrants. Journal of Immigrant and Minority Health 12(2): 187-197, 2010. (76 refs.)

Background: This study explores hypotheses linking church attendance to smoking prevalence, cessation, exposure to environmental tobacco smoke (ETS), and household smoking bans among Korean immigrants in California. Methods: Data were drawn from telephone interviews with Korean adults (N = 2085) based on a probability sample during 2005-2006 in which 86% of those contacted completed interviews. Results: Koreans who reported that they had attended church were less likely to be current smokers and to be exposed to ETS, and more likely to have quit smoking and to have a complete smoking ban than non-attenders after statistical controls for behavioral covariates. Discussion: Whether or not participants reported attending church was associated with increased tobacco control practices. Public health interventions may profit by seeking to expand cooperation with religious congregations to facilitate efforts to promote healthy lifestyles among immigrant populations beyond the influences of church attendance.

Hook JN; Worthington EL; Davis DE; Jennings DJ; Gartner AL; Hook JP. Empirically supported religious and spiritual therapies. Journal of Clinical Psychology 66(1): 46-72, 2010. (74 refs.)

This article evaluated the efficacy status of religious and spiritual (R/S) therapies for mental health problems, including treatments for depression, anxiety, unforgiveness, eating disorders, schizophrenia, alcoholism, anger, and marital issues. Religions represented included Christianity, Islam, Taoism, and Buddhism. Some studies incorporated a generic spirituality. Several R/S therapies were found to be helpful for clients, supporting the further use and research on these therapies. There was limited evidence that R/S therapies outperformed established secular therapies, thus the decision to use an R/S therapy may be an issue of client preference and therapist comfort.

Hooper MW; Baker EA; de Ybarra DR; McNutt M; Ahluwalia JS. Acculturation predicts 7-day smoking cessation among treatment-seeking African-Americans in a group intervention. Annals of Behavioral Medicine 43(1): 74-83, 2012. (27 refs.)

African-Americans suffer disproportionately from tobacco-associated morbidity and mortality. Considering the relationship between cultural variables and cessation may be important for reducing disparities. This study aimed to examine acculturation as a predictor of smoking cessation following a standard group intervention. Treatment-seeking smokers (N = 140) participated in a group intervention for cessation plus transdermal nicotine patch therapy and completed the African American Acculturation Scale-Revised at baseline. The primary outcome was self-reported 7-day point prevalence abstinence at the end-of-counseling and 3 and 6 months postintervention. Adjusted logistic regression analyses found that acculturation predicted end-of-counseling and 3-month 7-day point prevalence abstinence; traditional African-Americans (i.e., less acculturated) were less likely to quit smoking. Cultural superstitions, religious beliefs and practices, and interracial attitudes were predictive of smoking cessation. Acculturation was associated with cessation following a group-based intervention. Culturally specific adaptations to established interventions might improve outcomes for traditional smokers.

Horton KD; Ellison CG; Loukas A; Downey DL; Barrett JB. Examining attachment to God and health risk-taking behaviors in college students. Journal of Religion & Health 51(2): 552-566, 2012. (41 refs.)

Drawing on insights from attachment theory, this study examined whether three types of attachment to God -- secure, avoidant, and anxious -- were associated with health-risk behaviors, over and above the effects of religious attendance, peer support, and demographic covariates, in a sample of 328 undergraduate college students. Contrary to prior theory, secure attachment to God is not inversely associated with recent alcohol or marijuana use, or substance use prior to last sexual intercourse. Instead, avoidant and anxious attachment to God are associated with higher levels of drinking; anxious attachment to God is associated with marijuana use; and avoidant attachment to God is associated with substance use prior to last sexual intercourse. These patterns are gender-specific; problematic attachment to God is linked with negative outcomes solely among men.

Huguelet P; Borras L; Gillieron C; Brandt PY; Mohr S. Influence of spirituality and religiousness on substance misuse in patients with schizophrenia or schizo-affective disorder. Substance Use & Misuse 44(4): 502-513, 2009. (27 refs.)

Substance misuse represents a major issue in the treatment of schizophrenia patients. Spirituality and religiousness have been shown to reduce substance misuse and to foster recovery among substance misusers in the general population. One hundred and fifteen stabilized outpatients with schizophrenia (mean age 39; 70% male) were selected in 2004 for an interview about religious coping. Religious involvement was significantly inversely correlated to substance use and abuse. A content analysis showed that religion may play a protective role toward substance misuse in 14% of the total sample, especially for patients who had stopped substance misuse (42%). It played a negative role in 3% of cases. Religion may play a role in the recovery of schizophrenia patients with substance misuse comorbidity.

Jang SJ; Johnson BR. The effects of childhood exposure to drug users and religion on drug use in adolescence and young adulthood. Youth & Society 43(4): 1220-1245, 2011. (27 refs.)

Previous research finds drug-using peers and religiosity to be key predictors of drug use among youth, but the effects of childhood exposure to drug users and religion on later drug use have been understudied. The authors hypothesize a child's exposure to parental drug use and religious upbringing have a causal influence on drug use in youth primarily through drug-using peer association and religiosity during adolescence and young adulthood. To test this hypothesis, the authors analyze nationally representative three-wave panel data spanning ages 6 to 22. Results from estimating a structural equation model provide empirical support for the hypothesis, as the causal influence was found to be indirect via the proximate predictors of drug use among youths; that is, childhood risk and protective factors were positively associated with their adolescent and young adulthood counterparts, which in turn had a causal effect on drug use by youth.

Jones SC; Rossiter JR. Social and religious factors in adolescents' drug use. Journal of Child & Adolescent Substance Abuse 18(1): 85-92, 2009. (12 refs.)

The original purpose of this study was to test several types of anti-cannabis messages. Analysis of the results led to a second, post hoc purpose: to explain why pre-intervention substance usage rates varied so greatly between the sampled schools. Participants were Australian ninth-grade students at a state government high school and a non-denominational Christian high school. Analysis of the open-ended responses indicated that attending a school that has a strong moral prohibition on substance usereinforced by peers, families, and churchacts as a protective factor in preventing substance use. Studies such as this suggest that providing adolescents with supportive environments will encourage them to make sensible choices about drugs, with long-term benefits for the individual and the community.

Kelly JF; Pagano ME; Stout RL; Johnson SM. Influence of religiosity on 12-step participation and treatment response among substance-dependent adolescents. Journal of Studies on Alcohol and Drugs 72(6): 1000-1011, 2011. (95 refs.)

Objective: Religious practices among adults are associated with more 12-step participation which, in turn, is linked to better treatment outcomes. Despite recommendations for adolescents to participate in mutual-help groups, little is known about how religious practices influence youth 12-step engagement and outcomes. This study examined the relationships among lifetime religiosity, during-treatment 12-step participation, and outcomes among adolescents, and tested whether any observed beneficial relation between higher religiosity and outcome could be explained by increased 12-step participation. Method: Adolescents (n = 195; 52% female, ages 14-18) court-referred to a 2-month residential treatment were assessed at intake and discharge. Lifetime religiosity was assessed with the Religious Background and Behaviors Questionnaire; 12-step assessments measured meeting attendance, step work (General Alcoholics Anonymous Tools of Recovery), and Alcoholics Anonymous (AA)/Narcotics Anonymous (NA)-related helping. Substance-related outcomes and psychosocial outcomes were assessed with toxicology screens, the Adolescent Obsessive Compulsive Drinking Scale, the Children's Global Assessment Scale, and the Narcissistic Personality Inventory. Results: Greater lifetime formal religious practices at intake were associated with increased step work and AA/NA-related helping during treatment, which in turn were linked to improved substance outcomes, global functioning, and reduced narcissistic entitlement. Increased step work mediated the effect of religious practices on increased abstinence, whereas AA/NA-related helping mediated the effect of religiosity on reduced craving and entitlement. Conclusions: Findings extend the evidence for the protective effects of lifetime religious behaviors to an improved treatment response among adolescents and provide preliminary support for the 12-step proposition that helping others in recovery may lead to better outcomes. Youth with low or no lifetime religious practices may assimilate less well into 12-step oriented treatment and may need additional 12-step facilitation, or a different approach, to enhance treatment response.

Kendler KS; Myers J. A developmental twin study of church attendance and alcohol and nicotine consumption: A model for analyzing the changing impact of genes and environment. American Journal of Psychiatry 166(10): 1150-1155, 2009. (36 refs.)

Objective: Church attendance is one of the most consistent predictors of alcohol and nicotine consumption. The authors sought to clarify changes in the role of genetic and environmental factors in influencing church attendance and the interrelationship between church attendance and alcohol and nicotine use from early adolescence into adulthood. Method: The authors used data from two interview waves 6 years apart of 1,796 male twins from a population-based register, in which respondents were asked about current and past church attendance and psychoactive drug use. Structural twin models were fitted and tested using the Mx software program. Results: As twins developed from childhood through adulthood, the influence of shared environmental factors on church attendance declined dramatically while genetic factors increased. In early and late adolescence, the negative correlations between church attendance and alcohol and nicotine consumption resulted largely from shared environmental factors. In adulthood, the inverse relationship between church attendance and substance use became stronger and arose largely from genetic factors. Conclusions: As individuals mature, they increasingly shape their own social environment in large part as a result of their genetically influenced temperament. When individuals are younger and living at home, frequent church attendance reflects a range of familial and social-environmental influences that reduce levels of substance use. In adulthood, by contrast, high levels of church attendance largely index genetically influenced temperamental factors that are protective against substance use. Using genetically informative designs such as twin studies, it is possible to show that the causes of the relationship between social risk factors and substance use can change dramatically over development.

Khallad Y. Health risk behaviors among college youths: A cross-cultural comparison. Journal of Health Psychology 15(6): 925-934, 2010. (41 refs.)

The present study examined the frequency of smoking, seatbelt use, and vehicular speeding among American and Jordanian college students, and assessed the relationship between these risk behaviors and gender, socioeconomic status, and religiosity. Significantly more Jordanian students were smokers. Jordanian students were less likely than American students to buckle up, but American students were more likely to engage in vehicular speeding. Female students, especially among Jordanians, were less likely than male students to engage in risky behaviors. Among Jordanian participants, smoking and passenger seatbelt use were positively associated with indices of socioeconomic status, and smoking was negatively associated with religiosity.

Koenig LB; Haber JR; Jacob T. Childhood religious affiliation and alcohol use and abuse across the lifespan in alcohol-dependent men. Psychology of Addictive Behaviors 25(3): 381-389, 2011. (36 refs.)

The current study examined the relationship between childhood religious affiliation and alcohol use across the life span. A sample of 931 men (average age of 51) from the Vietnam Era Twin Registry, which includes an overrepresentation of alcohol-dependent men, completed the Lifetime Drinking History interview, which assessed drinking across the life span. Childhood religious affiliation was obtained from the men's spouse/partner. Affiliations were subdivided into four categories: nonreligious, accommodating (religions that are relatively more accepting of the larger culture), differentiating (religions that set themselves apart from the larger culture), and Catholic. Differences in a variety of alcohol use variables by religious affiliation were examined, as well as the protective effect of childhood religious affiliation on three alcohol use variables at 5-year intervals from age 20 to age 50. Significant differences were found for abstinence, regular drinking, and current quantity-frequency (QFI) scores, with individuals in differentiating religions having the highest rates of abstinence/nonregular drinking and the lowest consumption levels. When examining QFI and alcohol dependence symptoms and diagnoses over time, the nonreligious group had more alcohol use than the religious groups, with the differentiating affiliations showing the least alcohol use. The differences between affiliations were not always significant, but the consistent pattern suggests that childhood religious affiliation may continue to affect alcohol use even into adulthood.

Krentzman AR; Robinson EAR; Perron BE; Cranford JA. Predictors of membership in Alcoholics Anonymous in a sample of successfully remitted alcoholics. Journal of Psychoactive Drugs 43(1): 20-26, 2011. (25 refs.)

This study identities factors associated with Alcoholics Anonymous (AA) membership in a sample of 81 persons who have achieved at least one year of total abstinence from alcohol and other drugs. Forty-four were AA members, 37 were not. Logistic regression was used to test the cross-sectional associations of baseline demographic, substance-related, spiritual and religious, and personality variables with AA membership. Significant variables from the bivariate analyses were included in a multivariate model controlling for previous AA involvement. Having more positive views of God and more negative consequences of drinking were significantly associated with AA membership. This information can be used by clinicians to identify clients for whom AA might be a good fit, and can help others overcome obstacles to AA or explore alternative forms of abstinence support.

Kulis S; Hodge DR; Ayers SL; Brown EF; Marsiglia FF. Spirituality and religion: Intertwined protective factors for substance use among urban American Indian youth. American Journal of Drug and Alcohol Abuse 38(5): 444-449, 2012. (27 refs.)

Background and objective: This article explores the aspects of spirituality and religious involvement that may be the protective factors against substance use among urban American Indian (AI) youth. Methods: Data come from AI youth (N = 123) in five urban middle schools in a southwestern metropolis. Results: Ordinary least squares regression analyses indicated that following Christian beliefs and belonging to the Native American Church were associated with lower levels of substance use. Conclusions and Scientific Significance: Following AI traditional spiritual beliefs was associated with antidrug attitudes, norms, and expectancies. Having a sense of belonging to traditions from both AI cultures and Christianity may foster integration of the two worlds in which urban AI youth live.

Kungskulniti N; Charoenca N; Kengganpanich T; Kusolwisitkul W; Pichainarong N; Kerdmongkol P et al. Smoking prevalence among monks in Thailand. Evaluation & the Health Professions 35(3): 305-322, 2012. (22 refs.)

Previous studies among Buddhist monks in Thailand have reported smoking rates to be as high as 55%. Because 95% of Thais are Buddhist, monks are highly influential in establishing normative behavioral patterns. As the first population-based study on smoking among Buddhist monks in Thailand, this study aims to determine the smoking prevalence in six regions of the country, and to examine smoking knowledge, risk perceptions, behaviors, and associated demographics among full-fledged and novice monks (n = 6, 213). Results demonstrated that the overall prevalence for current smoking monks is 24.4% (95% confidence interval [24.453, 24.464]), with regional differences ranging from 14.6% (North) to 40.5% (East). Findings suggest that integrating prevention and cessation programming into religious courses may be one avenue for reaching many incoming monks. Further, involving monks in tobacco control education and setting a nonsmoking standard among them is vital to the success of reducing smoking rates among the general population in Thailand.

Labate BC. Consumption of ayahuasca by children and pregnant women: Medical controversies and religious perspectives. Journal of Psychoactive Drugs 43(1): 27-35, 2011. (42 refs.)

In 2010, the Brazilian Government agency responsible for drug-related issues formulated official Resolutions that categorized the consumption of ayahuasca by pregnant women and children in the Santo Daime and Uniao do Vegetal ayahuasca-based religions as an "exercise of parental rights." Although ayahuasca groups do enjoy a relative degree of social legitimacy and formal legal recognition in Brazil, the participation of pregnant women and children nevertheless continues to provoke heated discussion. This article raises the main issues involved in the public debate over this subject. In the first part, a diverse group of biomedical and health specialists was consulted, and their opinions were briefly analyzed. In the second, a full interview with a follower of one branch of Santo Daime, mother of four children who took ayahuasca during all her pregnancies, and whose children all drink ayahuasca, is presented. Her interview reveals important cultural parameters of ayahuasca consumption. The article explores common themes and contradictions found between the biomedical, anthropological, and ayahuasca-users' discourses. It raises central issues regarding the limits of freedom of religion and the state's right to interfere in family matters. The following analysis also has implications regarding the role of science in influencing policy decisions on drug use.

Li SD. The religious context of parenting, family processes, and alcohol use in early adolescence. Journal of Drug Issues 41(4): 619-648, 2011. (64 refs.)

Personal religiosity has been identified as a protective factor against adolescent use and misuse of alcohol. Less is known about the influence of the religious context of parenting on the drinking behavior of adolescents. This study addresses this gap by investigating how religious context of parenting is related to marital relationship, parenting practice, child-parent bonding, and alcohol use and misuse in early adolescence. Through a structural equation modeling analysis of the data from the National Longitudinal Survey of Youth 1997, this study finds that the religious context of parenting is negatively related to prevalence of alcohol use, frequency of alcohol consumption, and frequency of heavy drinking among early adolescents. In addition to its direct effect on adolescent drinking behavior, religious context of parenting appears to inhibit alcohol use and misuse indirectly by decreasing interparental conflict and increasing effective parenting and child-parent relationship.

Lo CC; Tenorio KA. Roles of marriage and religiosity in co-occurring substance abuse and psychological distress. Drug and Alcohol Review 29(Supplement 1): 44, 2010. (0 refs.)

The study examined whether the social support factors marriage and religiosity help bond individuals to conventionality and protect them against co-occurring substance abuse and severe psychological distress. It was intended to gauge how the two factors might explain differences in such mental health problems among various racial/ethnic and income groups. Using the national dataset 2007 National Household Survey on Drug Use and Health, we conducted multinomial logistic regression to analyse data and observed three important tentative results. First, co-occurring substance abuse and psychological distress were more common among individuals with low incomes, whites, the less religious, and those not married. Second, marriage's role in explaining mental health problems is significant but differs from one racial/ethnic group to the next. In our study, being married was significantly more likely to protect whites versus blacks or Hispanics from such problems. Marriage also better protected the economically well off from the co-occurring diagnoses, versus those less well off. Third, religiosity's role in explaining differential co-occurring diagnoses by race/ethnicity and income was found to be minimal. Our results offer implications for prevention and treatment of co-occurring substance abuse and psychological distress.

Lo CC; Tenorio KA; Cheng TC. Racial differences in co-occurring substance use and serious psychological distress: The roles of marriage and religiosity. Substance Use & Misuse 47(6): 734-744, 2012. (70 refs.)

The study examined how marriage and religiosity can protect members of certain racial/ethnic groups against co-occurring substance use and serious psychological distress. Using the national dataset 2007 National Survey on Drug Use and Health, we analyzed data via multinomial logistic regression, observing several important results. Our findings generally support the deprivation-compensation thesis, in that religiosity elevates the mental health of racial/ethnic minority individuals more than that of Whites. We also found, however, that race/ethnicity moderates effects of education and poverty on the co-occurring behaviors, with Whites' mental health benefiting more from wealth and education than Blacks' or Hispanics' mental health did.

Longshore D; Anglin MD; Conner BT. Are religiosity and spirituality useful constructs in drug treatment research? Journal of Behavioral Health Services & Research 36(2): 177-188, 2009. (81 refs.)

Religiosity and spirituality (R/S) have been shown to be related to better outcomes in many health service areas, including drug abuse treatment. The latter area, however, lacks a fully emergent empirical framework to guide further study. Moreover, although scientists have tested isolated hypotheses, no comprehensive process model has been designed and validated, limiting conceptual development as well. This paper reviews the relevant R/S and health research literature with a primary focus on drug treatment processes. Then a conceptual model is suggested to guide future incremental study of R/S assessment and intervention development. Implications for addiction health services include increased efforts to empirically validate R/S interventions, to increase practitioner competencies in this area, and to disseminate relevant research findings.

Lorencova R. Religiosity and spirituality of alcohol and marijuana users. Journal of Psychoactive Drugs 43(3): 180-187, 2011. (34 refs.)

This study focuses on measuring the spirituality of alcohol and marijuana users, using the new and exclusively Czech measuring tool, the Prague Spiritual Questionnaire (PSQ). The data from 155 respondents shows that users of both marijuana and alcohol scored significantly higher in the mysticism dimension of spirituality than those who only drank alcohol. People who mentioned that the specified spiritual feelings resulted from drug use are significantly more spiritual than those who do not associate their experiences with any drugs. The gender, age, education and professions of respondents show no significant effect on spirituality, while there is a significant difference between religious and nonreligious drug users in the specific dimensions of spirituality. Various implications of these findings, as well as the limitations of the PSQ, are further discussed.

Lucchetti G; Peres MFP; Lucchetti ALG; Koenig HG. Religiosity and tobacco and alcohol use in a Brazilian shantytown. Substance Use & Misuse 47(7): 837-846, 2012. (36 refs.)

This article analyzes the role of religious involvement and religious beliefs in the prevalence and frequency of smoking and alcohol consumption. This was a cross-sectional, population-based study. In 2005, we conducted door-to-door interviews with 383 people, aged 18 years or more, randomly selected from the "Paraisopolis" shantytown in Sao Paulo, Brazil. Four regression models were created to explain the relationships among religious involvement, tobacco and alcohol use, controlling for demographic, social, and psychobehavioral factors. High religious attendance was associated with less alcohol use, alcohol abuse, tobacco use, and combined alcohol/tobacco use, as well as less days consuming alcoholic beverages per week, controlling for confounding factors. Additionally, high nonorganizational religious behavior was associated with less tobacco and combined alcohol/tobacco use. Religiosity plays an important role in the control of alcohol and tobacco use in a shantytown setting; further management initiatives in the area should consider this issue. The study's limitations are noted.

Magura S. A few thoughts on addiction and religion. (editorial). Substance Use & Misuse 45(14): 2400-2402, 2010. (5 refs.)

Marsiglia FF; Ayers SL; Hoffman S. Religiosity and adolescent substance use in central Mexico: Exploring the influence of internal and external religiosity on cigarette and alcohol use. American Journal of Community Psychology 49(1-2): 87-97, 2012. (70 refs.)

This study explores the multidimensional nature of religiosity on substance use among adolescents living in central Mexico. From a social capital perspective, this article investigates how external church attendance and internal religious importance interact to create differential pathways for adolescents, and how these pathways exert both risk and protective influences on Mexican youth. The data come from 506 self-identified Roman Catholic youth (ages 14-17) living in a semi-rural area in the central state of Guanajuato, Mexico, and attending alternative secondary schools. Findings indicate that adolescents who have higher church attendance coupled with higher religious importance have lower odds of using alcohol, while cigarette use is lower among adolescents who have lower church attendance and lower religious importance. Adolescents are most at risk using alcohol and cigarettes when church attendance is higher but religious importance is lower. In conclusion, incongruence between internal religious beliefs and external church attendance places Mexican youth at greater risk of alcohol and cigarette use. This study not only contributes to understandings of the impact of religiosity on substance use in Mexico, but highlights the importance of understanding religiosity as a multidimensional phenomenon which can lead to differential substance use patterns.

Mason SJ; Deane FP; Kelly PJ; Crowe TP. Do spirituality and religiosity help in the management of cravings in substance abuse treatment? Substance Use & Misuse 44(13): 1926-1940, 2009. (39 refs.)

The purpose of this study was to examine the relationship of spirituality, religiosity and self-efficacy with drug and/or alcohol cravings. A cross-sectional survey was completed by 77 male participants at an Australian Salvation Army residential rehabilitation service in 2007. The survey included questions relating to the participants' drug and/or alcohol use and also measures for spirituality, religiosity, cravings, and self-efficacy The sample included participants aged between 19 and 74 years, with more than 57% reporting a diagnosis for a mental disorder and 78% reporting polysubstance misuse with alcohol most frequently endorsed as the primary drug of concern (71%). Seventy-five percent of the clients reported that spirituality and religious faith were useful components of the treatment program. A multivariate multiple regression analysis identified that spirituality and self-efficacy have significant relationships with cravings. Self-efficacy mediated the relationship between spirituality and drug and/or alcohol cravings. The limitations of this study included its cross-sectional design and a sample that was drawn from a faith-based program. Future research would benefit from the longitudinal examination of the relationship between spirituality, self-efficacy, and cravings: the exploration of a broader range of client-specific and interpersonal variables; and the inclusion of a control group from a secular treatment facility.

McFadden D; Croghan IT; Piderman KM; Lundstrom C; Schroeder DR; Hays JT. Spirituality in tobacco dependence: A Mayo Clinic survey. Explore: Journal of Science and Healing 7(3): 162- 167, 2011. (23 refs.)

Context: With widespread interest in natural remedies and "wholistic" treatments, there has been a renewed focus on the impact of spirituality related alternative therapy for many current chronic diseases. Objective: To assess the potential impact of spiritual beliefs on lifestyle choices such as tobacco use, we conducted a patient survey. Design:/Setting: This cross-section study was conducted using a 27-question survey of patients seen at the Mayo Clinic over a 14-week period. Patients: We invited all patients (smokers and nonsmokers) seen in several Mayo Clinic divisions to participate in this voluntary survey. Interventions: The survey included demographic information, history of tobacco use or nonuse, and assessment of spirituality. Main Outcome Measure: Among the 501 patients who participated, 370 were nonsmokers and 131 were smokers. Compared with smokers, nonsmokers more often participated in religious activities such as regular weekly church attendance (48% vs. 24%), daily prayer, and Bible study (49% vs. 24%; P < .001). Current smoking was negatively correlated with religious activities. However, after adjustment for demographic facdtors, there was no significant difference in intrinsic spirituality (importance of religion) between the two groups (P < .130). Result: Nonsmokers are more likely to engage in religious activities such as prayer, Bible study, and regular church attendance. Further studies may be helpful to clearly define the potential impact of spirituality on smoking cessation.

Mellor JM; Freeborn BA. Religious participation and risky health behaviors among adolescents. Health Economics 20(10): 1226-1240, 2011. (26 refs.)

Previous studies have shown that adolescent religious participation is negatively associated with risky health behaviors such as cigarette smoking, alcohol consumption, and illicit drug use. One explanation for these findings is that religion directly reduces risky behaviors because churches provide youths with moral guidance or with strong social networks that reinforce social norms. An alternative explanation is that both religious participation and risky health behaviors are driven by some common unobserved individual trait. We use data from the National Longitudinal Study of Adolescent Health and implement an instrumental variables approach to identify the effect of religious participation on smoking, binge drinking, and marijuana use. Following Gruber (2005), we use a county-level measure of religious market density as an instrument. We find that religious market density has a strong positive association with adolescent religious participation, but not with secular measures of social capital. Upon accounting for unobserved heterogeneity, we find that religious participation continues to have a significant negative effect on illicit drug use. On the contrary, the estimated effects of attendance in instrumental variables models of binge drinking and smoking are statistically imprecise.

Miller ML; Saunders SM. A naturalistic study of the associations between changes in alcohol problems, spiritual functioning, and psychiatric symptoms. Psychology of Addictive Behaviors 25(3): 455-461, 2011. (31 refs.)

The study evaluated how spiritual and religious functioning (SRF), alcohol-related problems, and psychiatric symptoms change over the course of treatment and follow-up. Problem drinkers (n = 55, including 39 males and 16 females) in outpatient treatment were administered questionnaires at pretreatment, posttreatment, and follow up, which assessed two aspects of SRF (religious well-being and existential well-being), two aspects of alcohol misuse (severity and consequences), and two aspects of psychiatric symptoms (depression and anxiety). Significant improvements in SRF, psychiatric symptoms and alcohol misuse were observed from pretreatment to follow-up. Although SRF scores were significantly correlated with psychiatric symptoms at all three time points, improvement in the former did not predict improvement in the latter. When measured at the same time points, SRF scores were not correlated with the measures of alcohol misuse. However, improvement in SRF (specifically in existential well-being) over the course of treatment was predictive of improvement in the alcohol misuse measures at follow-up. These results suggest that the association between SRF, emotional problems, and alcohol misuse is complex. They further suggest that patients who improve spiritual functioning over the course of treatment are more likely to experience improvement in drinking behavior and alcohol-related problems after treatment has ended.

Moos R. Spirituality and religiosity in context. (editorial). Substance Use & Misuse 45(14): 2386-2388, 2010. (5 refs.)

Nakhaee N; Divsalar K; Jadidi N. Religious involvement and cigarette smoking among Iranian university students. International Journal of Psychiatry in Medicine 39(2): 189-198, 2009. (19 refs.)

Objectives: To find out the prevalence of cigarette smoking in a group of Iranian Muslim students and also to find out if there is a relationship between religious practices and cigarette smoking. Methods: In this cross-sectional study, 950 university students in Kerman, Iran were asked to fill out a self-administered questionnaire consisting of questions on demographic data, cigarette smoking, and religious practices. It was explained that the study was anonymous and voluntary, and confidentiality was assured. Results: All 833 subjects who participated in the study were Muslims, 54.1% of whom were female and 89.3% were single. Approximately 40% of male students and 5.8% of the female ones were smokers. Based on bivariate analysis, some differences were noted in the prevalence of smoking according to gender, marital status, income, average university scores, close friend's smoking, parental smoking, reading the Quran, saying prayers, mosque attendance, and fasting. Using multivariate analysis, male gender, higher income, lower average exam scores, and close friend's smoking being associated with the likelihood to smoke cigarettes. The odds ratio for cigarette smoking in the upper tertile compared with those in the lower tertile of religious activity was 0.53 (CI 95% 0.33-0.84). Conclusion: Religious activities may have a protective role against cigarette smoking among Muslim college students in the country.

Nencini P; Grant KA. Psychobiology of drug-induced religious experience: From the brain "locus of religion" to cognitive unbinding. Substance Use & Misuse 45(13): 2130-2151, 2010. (79 refs.)

The recent interest in the psychopharmacological underpinnings of religious experiences has led to both the laboratory characterizations of drug-induced mystical events and psychobiological models of religious experiences rooted in evolution and fitness. Our examination of this literature suggests that these theories may be congruent only within more modern religious and cultural settings and are not generalizable to all historical beliefs, as would be expected from an evolutionarily conserved biological mechanism. The strong influence of culture on the subjective effects of drugs as well as religious thoughts argues against the concept of a common pathway in the brain uniquely responsible for these experiences. Rather, the role of personal beliefs, expectations and experiences may interject bias into the interpretation of psychoactive drug action as a reflection of biologically based religious thought. Thus, psychobiological research proposing specific brain mechanisms should consider anthropological and historical data to address alternative explanations to the "fitness" of religious thought. A psychobiological model of the religious experience based on the concept of cognitive unbinding seems to accommodate these data better than that of a specific brain locus of religion.

Page RL; Ellison CG; Lee J. Does religiosity affect health risk behaviors in pregnant and postpartum women? Maternal and Child Health Journal 13(5): 621-632, 2009. (58 refs.)

Objectives: We examined the association between religious involvement and health risk behaviors such as smoking, drinking, marijuana use, and having multiple sex partners among a multiethnic sample of pregnant and postpartum women. Methods: Using data from the National Survey of Family Growth, we estimated multivariate logistic regression models to determine the association between various aspects of religious involvement (e.g., attendance, salience, and denomination) and certain behaviors known to be risky for pregnant women and their offspring. Results Frequent (more than once a week) and regular (once a week) attenders at religious services had 80% and 60% (respectively) lower odds of drinking alcohol compared to women who attended less than once a week. Similar patterns surfaced with regard to smoking tobacco with the odds of smoking roughly 85% lower (OR = 0.146, P < 0.001) among frequent attenders, and nearly 65% lower among regular attenders (OR = 0.369, P < 0.001). For smoking marijuana, religious attendance again emerges as a strong predictor. The odds of marijuana smoking are nearly 75% lower for women who attend services frequently (OR = 0.260, P < 0.05) and more than 65% lower for those who attend regularly (OR = 0.343, P < 0.01), as compared with their counterparts who attend services less often. Conclusions: Religious attendance emerged as an important correlate of less-risky health behaviors among this nationwide sample of pregnant and postpartum women. Future research should include an examination of the links between religious involvement and other important lifestyle factors that may influence maternal and child health.

Piko BF; Kovacs E; Kriston P; Fitzpatrick KM. "To believe or not to believe?" Religiosity, spirituality, and alcohol use among Hungarian adolescents. Journal of Studies on Alcohol and Drugs 73(4): 666-674, 2012. (47 refs.)

Objective: A growing number of studies focus on the relationship between religiosity/spirituality and substance use, including drinking. Although these studies often find a negative association between religiosity and adolescent alcohol use, different religious variables may play an altering role in alcohol-related activities. The primary goal of the present study was to examine the relationship between a set of religious variables (religious denomination, church membership, religious attendance, praying, religiosity, spiritual beliefs, and well-being) and drinking patterns (current alcohol use, lifetime prevalence of drinking, and heavy episodic drinking) among a sample of Hungarian youth. Method: Data were collected among high school students (N = 592; ages between 14 and 17 years; 48.1% male) from a randomly selected set of schools in Szeged, Hungary, using a self-administered questionnaire and standardized procedures. Student participation was voluntary and confidential. Results: Despite a high level of alcohol use and a relatively low level of religiosity in the sample, we detected a relationship between the importance of religiousness/religious well-being and alcohol use, although religious denomination and affiliation were not significant correlates. Religious attendance and private praying were associated with lower odds of alcohol use among girls; boys who reported a belief in traditional religion were less likely to engage in alcohol use. Conclusions: These exploratory results provide further details to a growing body of research showing that despite adolescents' low religious involvement, religiosity can play an important role in some youth's lives and may serve as a protective factor against alcohol use and misuse.

Rasic D; Kisely S; Langille DB. Protective associations of importance of religion and frequency of service attendance with depression risk, suicidal behaviours and substance use in adolescents in Nova Scotia, Canada. Journal of Affective Disorders 132(3): 389-395, 2011. (58 refs.)

Purpose: We examined relationships of measures of personal importance of religion and frequency of attendance at religious services with risk of depression and risk behaviours in high school students in Cape Breton, Canada. We examined the impact of confounding and explanatory factors on these relationships. Methods: Data were drawn from self-report surveys of adolescents aged 15-19 (N=1615) at three high schools in May, 2006. We used logistic regression to assess associations of religious importance and religious service attendance with risk of depression, suicidal behaviour, binge drinking and frequent marijuana use, controlling in multivariate models for sociodemographic factors, family structure and social capital. Results: Among females, higher personal importance of religion was associated with decreased odds of depression, suicidal ideation, drinking and marijuana use, while more religious attendance was protective for substance use behaviours and suicidal ideation. In males, both measures of religiosity were associated with decreased substance use. In multivariate models, religious importance had weak protective effects for depression and suicidal thinking in females, which were respectively modified by social trust and substance use. Attendance was protective for suicidal thinking in females, and was modified by depression. These associations were not seen in males. Attendance was consistently associated with less substance use in females, while importance was not. Importance was consistently protective for marijuana use and attendance was protective for binge drinking in males. Limitations: This was a cross-sectional self-report survey and causality cannot be inferred. Conclusion: Protective associations of measures of religiosity are seen in Canadian adolescents, as they are elsewhere.

Rawana JS; Ames ME. Protective predictors of alcohol use trajectories among Canadian aboriginal youth. Journal of Youth and Adolescence 41(2): 229-243, 2012. (44 refs.)

Some Aboriginal youth are at disproportionate risk of using substances and developing abuse and dependence disorders. However, not all Aboriginal youth misuse substances and limited research has examined the protective factors conferring against substance use among these youth. The present study aimed to identify protective factors related to the alcohol use trajectories from early adolescence to emerging adulthood among off-reserve Canadian Aboriginal youth. Participants (N = 330; 50.3% male) aged 12-23 were selected from cycles 2-7 of Statistics Canada's NLSCY. Multilevel modeling was employed to identify protective factors for two constructs of alcohol use. Participation in weekly activities and optimism were found to be protective for both the frequency of alcohol use and heavy drinking trajectories. Attendance of religious services was also found to be protective for heavy drinking behaviors. In contrast, positive peer relationships were a risk factor for frequency of alcohol use, but not heavy drinking. The results provide preliminary evidence of important developmental factors to integrate into substance use intervention programs targeting Aboriginal youth.

Reitzel LR; Nguyen N; Strong LL; Wetter DW; McNeill LH. Subjective social status and health behaviors among African Americans. American Journal of Health Behavior 37(1): 104-111, 2013. (35 refs.)

Objectives: To examine associations of the US and community subjective social status (SSS) ladders with smoking status, at-risk drinking, fruit and vegetable intake, physical activity, and body mass index among 1467 church-going African American adults from a larger cohort study. Methods: Regression analyses, adjusted for sociodemographics, examined associations between SSS ladders and health behaviors. Results: The SSS-US ladder was significantly associated with fruit and vegetable consumption (p = .007) and physical activity (p = .005). The SSS-community ladder was not significantly associated with any health behaviors. Conclusions: Among this sample of African Americans, the SSS-US ladder is more predictive of some health behaviors than is the SSS-community ladder.

Robertson AA; Xu XH; Stripling A. Adverse events and substance use among female adolescent offenders: Effects of coping and family support. Substance Use & Misuse 45(3): 451-472, 2010. (86 refs.)

This study examined a stress-coping model for substance use among female adolescents (N = 305, 69% African American) involved in the Mississippi juvenile justice system. Participants were interviewed in 2006, regarding exposure to adverse and traumatic events, and they completed self-administered measures of social support from relatives, coping strategies, and questions on frequency of alcohol and other drug use. Results from nested regression models revealed that stressors are associated with drug, but not alcohol use. The use of supportive kinship ties and religion to cope were protective factors. The implications and limitations of the study are discussed.

Robinson EAR; Krentzman AR; Webb JR; Brower KJ. Six-month changes in spirituality and religiousness in alcoholics predict drinking outcomes at nine months. Journal of Studies on Alcohol and Drugs 72(4): 660-668, 2011. (48 refs.)

Objective: Although spiritual change is hypothesized to contribute to recovery from alcohol dependence, few studies have used prospective data to investigate this hypothesis. Prior studies have also been limited to treatment-seeking and Alcoholics Anonymous (AA) samples. This study included alcohol-dependent individuals, both in treatment and not, to investigate the effect of spiritual and religious (SR) change on subsequent drinking outcomes, independent of AA involvement. Method: Alcoholics (N = 364) were recruited for a panel study from two abstinence-based treatment centers, a moderation drinking program, and untreated individuals from the local community. Quantitative measures of SR change between baseline and 6 months were used to predict 9-month drinking outcomes, controlling for baseline drinking and AA involvement. Results: Significant 6-month changes in 8 of 12 SR measures were found, which included private SR practices, beliefs, daily spiritual experiences, three measures of forgiveness, negative religious coping, and purpose in life. Increases in private SR practices and forgiveness of self were the strongest predictors of improvements in drinking outcomes. Changes in daily spiritual experiences, purpose in life, a general measure of forgiveness, and negative religious coping also predicted favorable drinking outcomes. Conclusions: SR change predicted good drinking outcomes in alcoholics, even when controlling for AA involvement. SR variables, broadly defined, deserve attention in fostering change even among those who do not affiliate with AA or religious institutions. Last, future research should include SR variables, particularly various types of forgiveness, given the strong effects found for forgiveness of self.

Rodek J; Sekulic D; Pasalic E. Can we consider religiousness as a protective factor against doping behavior in sport? Journal of Religion and Health 48(4): 445-453, 2009. (26 refs.)

Religiousness is rarely studied in relation to doping behaviors in sport. In this study, we sampled 27 weightlifting/powerlifting athletes from Bosnia and Herzegovina. Using the originally developed questionnaire and by means of Spearman's correlation, we interpreted data and discussed relationships between (a) social, religious, sport, and educational factors, and (b) substance use criteria, including cigarettes, alcohol, analgesics, nutritional supplementation, and doping behaviors. In conclusion, we found (1) that religiousness can be considered as a potential protective factor against doping, but also (2) that religious subjects tend to deny and underestimate the doping behaviors in their sport. Both of these findings should be extensively studied in future investigations.

Rostosky SS; Danner F; Riggle EDB. Religiosity as a protective factor against heavy episodic drinking (HED) in heterosexual, bisexual, gay, and lesbian young adults. Journal of Homosexuality 57(8): 1039-1050, 2010. (28 refs.)

Although religiosity has been shown to be associated with positive outcomes in studies of general population samples, few studies have considered the potential differential effect of religiosity on those who are consolidating gay, lesbian, or bisexual (GLB) identities. Logistic regression analyses using a sample of 13,038 emerging adults from the National Longitudinal Survey of Adolescent Health (Add Health) revealed main effects for religiosity and a significant religiosity x sexual identity interaction in women. Specifically, religiosity was protective against alcohol use and heavy episodic drinking (HED) in heterosexual women, but not lesbian women. In bisexual women, higher religiosity increased the odds of alcohol use and HED. Among men, religiosity was protective, with no differential effects based on sexual identity. Prevention efforts should consider that individual religiosity may be a risk, rather than protective factor for some young adults.

Salmoirago-Blotcher E; Fitchett G; Ockene JK; Schnall E; Crawford S; Granek I et al. Religion and healthy lifestyle behaviors among postmenopausal women: The Women's Health Initiative. Journal of Behavioral Medicine 34(5): 360-371, 2011. (47 refs.)

Worship attendance has been associated with longer survival in prospective cohort studies. A possible explanation is that religious involvement may promote healthier lifestyle choices. Therefore, we examined whether attendance is associated with healthy behaviors, i.e. use of preventive medicine services, non-smoking, moderate drinking, exercising regularly, and with healthy dietary habits. The population included 71,689 post-menopausal women enrolled in the Women's Health Initiative observational study free of chronic diseases at baseline. Attendance and lifestyle behaviors information was collected at baseline using self-administered questionnaires. Healthy behaviors were modeled as a function of attendance using logistic regression. After adjustment for confounders, worship attendance (less than weekly, weekly, and more than weekly vs. never) was positively associated with use of preventive services [OR for mammograms: 1.34 (1.19, 1.51), 1.41 (1.26, 1.57), 1.33 (1.17, 1.52); breast self exams: 1.14 (1.02, 1.27), 1.33 (1.21, 1.48), 1.25 (1.1, 1.43); PAP smears: 1.22 (1.01, 1.47-weekly vs. none)]; non-smoking: [1.41 (1.35, 1.48), 1.76 (1.69, 1.84), 2.27 (2.15, 2.39)]; moderate drinking [1.35 (1.27, 1.45), 1.60 (1.52, 1.7), 2.19 (2.0, 2.4)]; and fiber intake [1.08 (1.03, 1.14), 1.16 (1.11, 1.22), 1.31 (1.23, 1.39), respectively], but not with regular exercise or with lower saturated fat and caloric intake. These findings suggest that worship attendance is associated with certain, but not all, healthy behaviors. Further research is needed to get a deeper understanding of the relationship between religious involvement and healthy lifestyle behaviors and of the inconsistent patterns in this association.

Sanchez ZM; Opaleye ES; Chaves TV; Noto AR; Nappo SA. God forbids or mom disapproves? Religious beliefs that prevent drug use among youth. Journal of Adolescent Research 26(5): 591-616, 2011. (37 refs.)

Researches have emphasized religiosity as a protective factor against drug use although the mechanism through which it occurs is still unknown. This article aims to explore religious beliefs that could prevent drug use among youth. Three sources of qualitative data were used: participant observation in 21 religious institutions, semistructured interviews of 37 religious leaders, and 6 focus groups comprised of 55 religious drug-naive youths. The young people's discourses and the sermons of religious leaders revealed that conceptions about drugs were based on media content, with little religious or scientific context. Catholics and Spiritists considered the consumption of licit drugs less harmful than that of illicit ones and were especially tolerant of the use of alcohol. Protestants were more emphatic when describing all drugs as being harmful to one's health. Findings suggest that young people who practice a religion invoke several religious concepts to justify their choice for not using drugs, and they attribute this position more to the family legacy than to their own religiosity. Thus youths' antidrug position was more reflective of family values than religious beliefs.

Sebena R; El Ansari W; Stock C; Orosova O; Mikolajczyk RT. Are perceived stress, depressive symptoms and religiosity associated with alcohol consumption? A survey of freshmen university students across five European countries. Substance Abuse Treatment, Prevention and Policy 7: article 21, 2012. (68 refs.)

Background: The aim of this study was to investigate the association of perceived stress, depressive symptoms and religiosity with frequent alcohol consumption and problem drinking among freshmen university students from five European countries. Methods: 2529 university freshmen (mean age 20.37, 64.9% females) from Germany (n = 654), Poland (n = 561), Bulgaria (n = 688), the UK (n = 311) and Slovakia (n = 315) completed a questionnaire containing the modified Beck Depression Inventory for measuring depressive symptoms, the Cohen's perceived stress scale for measuring perceived stress, the CAGE-questionnaire for measuring problem drinking and questions concerning frequency of alcohol use and the personal importance of religious faith. Results: Neither perceived stress nor depressive symptoms were associated with a high frequency of drinking (several times per week), but were associated with problem drinking. Religiosity (personal importance of faith) was associated with a lower risk for both alcohol-related variables among females. There were also country differences in the relationship between perceived stress and problem drinking. Conclusion: The association between perceived stress and depressive symptoms on the one side and problem drinking on the other demonstrates the importance of intervention programs to improve the coping with stress.

Sobiecki JF. Psychoactive ubulawu spiritual medicines and healing dynamics in the initiation process of southern Bantu diviners. Journal of Psychoactive Drugs 44(3): 216-223, 2012. (28 refs.)

The use of psychoactive plants by traditional healers in southern Africa appears to be a neglected area of ethnobotanical research. This article explores the healing dynamics involved in the use of popular psychoactive plant preparations known as ubulawu in the initiation rituals of Southern Bantu diviners. Research methods include a review of the literature, fieldwork interviews with Southern Bantu diviners, and an analysis of experiential accounts from diverse informants on their use of ubulawu. Findings reveal that there is widespread reliance on ubulawu as psychoactive spiritual medicines by the indigenous people of southern Africa to communicate with their ancestral spirits so as to bring luck, and to treat mental disturbances. In the case of the Southern Bantu diviners, ubulawu used in a ritual initiation process acts as a mnemonic aid and medicine to familiarize the initiates with enhanced states of awareness and related psychospiritual phenomena such as enhanced intuition and dreams of the ancestral spirits, who teach the initiates how to find and use medicinal plants. The progression of the latter phenomena indicates the steady success of the initiates' own healing integration. Various factors such as psychological attitude and familiarization, correct plant combinations/synergy and a compatible healer-initiate relationship influence ubulawu responsiveness.

Spivak AL; Fukushima M; Kelley MS; Jenson TS. Religiosity, delinquency, and the deterrent effects of informal sanctions. Deviant Behavior 32(8): 677-711, 2011. (58 refs.)

Past research in deterrence theory suggests that informal social sanctions intervene in the effect of religiosity on criminal and delinquent behavior, such that more religious individuals tend to perceive stronger informal sanctions (Grasmick, Bursik and Cochran 1991a; Grasmick, Kinsey and Cochran 1991b). This study examines the influence of religiosity and social deterrence on college students' delinquent behavior, as measured by anticipated violation of a university's alcohol policy. Data were collected through a survey of undergraduate students (n = 484) at a large South-Midwestern public university that instituted a campus alcohol ban. The survey took place three months after the ban was implemented and asked students about religiosity, perceptions of informal deterrence, and expectations of violating the policy. Results partially support the hypothesis that religiosity predicts conformity primarily through the deterrent threat of informal sanctions. Religiosity increased perceived threats of shame and embarrassment, which in turn reduced the likelihood of anticipated policy violation. When controlling for demographics, college lifestyle, attitudes, and past drinking behavior, shame remained a significant predictor of expected policy violation, but embarrassment did not. Also, contrary to expectations, one measure of fundamentalist religiosity (biblical literalness) retained a direct main effect on intended compliance, even when taking informal sanctions into account. Theoretical, methodological, and policy implications are discussed.

Sussman S. Addiction, religion, spirituality, treatment. (editorial). Substance Use & Misuse 45(14): 2383-2386, 2010. (15 refs.)

Tenorio KA; Lo CC. Social location, social integration, and the co-occurrence of substance abuse and psychological distress. American Journal of Drug and Alcohol Abuse 37(4): 218-223, 2011. (37 refs.)

Background: In the United States, social stratification has generally led individuals occupying lower social locations to have more health problems than other individuals, even acknowledging that social groups are distinguished by their particular manifestations of health problems. Objectives: This study examined whether two social integration factors, marriage and religiosity, mediate the relationship between social location and co-occurrence of substance abuse and psychological distress and the nature of this relationship. Methods: Multinomial logistic regression was conducted on data from a national sample of 34,650 adults mostly between the ages of 18 to 35, collected through the 2007 National Survey on Drug Use and Health. Results: White males who were lesser educated and living in poverty were more likely to exhibit co-occuring substance abuse and psychological distress than their demographically similar counterparts. Additionally, being married and religious appeared to be protective factors within the overall study cohort with fewer co-occurring behaviors reported. Conclusion: The data generally confirm the hypothesis concerning mediating roles for religiosity and marriage. Scientific Significance: Confirmation that marriage and religiosity can protect adults against co-occurring substance abuse and psychological distress potentially provides the information necessary to better target health policy and interventions that serve to further enhance the population's mental health.

The National Center on Addiction and Substance Abuse at Columbia University. Adolescent Substance Use: America's #1 Public Health Problem. New York: National Center on Addiction and Substance Abuse, 2011. (1,892 refs.)

This Report finds that adolescent smoking, drinking, misusing prescription drugs and using illegal drugs is, by any measure, a public health problem of epidemic proportion, presenting clear and present danger to millions of America's teenagers and severe and expensive long-range consequences for our entire population. This report is a wake-up call for all of us, regardless of whether we seek to win the future by investing in our youth or seek to cut public spending to avoid a back-breaking financial burden on our children and grandchildren. The findings and recommendations in this report offer common ground and opportunity to help achieve both objectives. The Report is organized into eleven sections. The first section consists of an introduction and executive summary. Section II, Understanding Teen Substance Use and Addiction deals with physiological factors that make adolescents vulnerable to substance use and addiction. Section II considers the dimensions of the problem providing data on the prevalence of substance use and substance use disorders, by substance, i.e. alcohol, nicotine, polydrug use, marijuana, prescription medication and other psychoactive substances. Section IV discusses the consequences of teen substance use, in terms of substance use disorders, mental health and physical health problems, mortality, suicide, risk of dangerous behaviors, impaired academic and career performance, impaired social functioning, second-hand effects, and financial costs. Section V discusses pervasive cultural influences that promote teen substance use, in respect to parental, school, community, and media influences, as well accessibility to addictive substances. Section VI focuses upon teen perceptions and expectation about substance use. Section VII discusses a range of factors that compound the risk of teen substance use and addiction: genetic predisposition; family history of high risk substance use; mental health disorders; temperament and self-esteem; part-time employment; divorced and single parent families; risky behavior affecting health and safety, i.e., driving, weight control, risky driving, sleep problems, and fighting and aggression; and high risk groups. Section VIII identifies factors that reduce the risk of teen substance use -- parental engagement, role models and positive peer influence, future goals; schools, community and athletic involvement; and religious involvement. Section IX is devoted to prevention approaches and barriers to improvement: screening and brief interventions; taxation and government regulation and enforcement; public awareness and education; school-based policies; and school-based prevention initiatives. Section X considers treatment and the gap between evidence and practice, and the barriers to treatment. Section XI, the concluding section, sets forth recommendations and next steps. Appendices include the methodology, and the survey of parents, students, high school teachers and school personnel.

Vaughan EL; de Dios MA; Steinfeldt JA; Kratz LM. Religiosity, alcohol use attitudes, and alcohol use in a national sample of adolescents. Psychology of Addictive Behaviors 25(3): 547-553, 2011. (24 refs.)

The purpose of this study was to investigate alcohol use attitudes as a mediator of the relationship between religiosity and the frequency of past month alcohol use in a national sample of adolescents. Data were drawn from 18,314 adolescents who participated in the 2006 and 2007 National Survey on Drug Use and Health. Variables included religiosity, alcohol use attitudes, and past month frequency of alcohol use. Structural equation modeling was used to test alcohol use attitudes as a mediator of the relationship between religiosity and frequency of alcohol use and to test model invariance across 4 racial/ethnic groups. Results suggest that alcohol use attitudes partially mediate the relationship between religiosity and frequency of alcohol use. Furthermore, while the pattern of these relationships is similar across racial/ethnic groups, the magnitude of alcohol use attitudes on frequency of alcohol use differed. Implications for prevention programs include targeting alcohol use attitudes in a variety of settings.

Webb JR; Brewer K. Forgiveness and college student drinking in southern Appalachia. Journal of Substance Use 15(6): 417-433, 2010. (62 refs.)

Methods: As such, cross-sectional associations between dimensions of forgiveness (Fetzer) and drinking (AUDIT) were examined among college students (n = 721; female = 516; M-age = 23) from the rural southern Appalachian region of the United States. Results: Using multiple regression analyses and independent of demographic variables and religiousness, while no forgiveness dimension was predictive of drinking in the first place (yes/no), Feeling Forgiven by God predicted a decreased likelihood of problematic drinking (Non/OK drinking vs. problematic drinking). Further, among problematic drinkers (n = 126; female = 75; M-age = 22), Feeling Forgiven by God predicted fewer alcohol-related problems and Forgiveness of Self predicted lower HALT scores, all with medium effect sizes. Forgiveness of Others was not associated with the alcohol-related variables. Conclusions: Of the dimensions of forgiveness measured, it appears that Feeling Forgiven by God may be most important in the context of drinking and problems therewith, while Forgiveness of Self may be most important in the context of relapse prevention.

Webb JR; Robinson EAR; Brower KJ. Mental health, not social support, mediates the forgiveness-alcohol outcome relationship. Psychology of Addictive Behaviors 25(3): 462-473, 2011. (77 refs.)

Religiousness and spirituality are important to most Americans, and evidence suggests that they may contribute to both addiction and recovery. Forgiveness is a specific dimension of religiousness and spirituality that may enhance recovery, but the mechanism(s) through which it operates is unknown. We hypothesized that higher levels of forgiveness would be associated with higher levels of mental health and social support, which, in turn, would be associated with improved alcohol-related outcomes. Baseline and 6-month longitudinal data from a sample of 149 individuals with alcohol use disorders seeking outpatient substance abuse treatment were analyzed through multiple-mediation statistical techniques. While previous research has shown direct associations among forgiveness, alcohol-related outcomes, mental health, and social support, this study found that the direct associations between forgiveness and alcohol-related outcomes were no longer significant when mental health and social support were analyzed as mediator variables. At baseline, for each alcohol-related outcome measured (alcohol-related problems, percent heavy drinking days, percent days abstinent, and drinks per drinking day), mental health individually played a role in the relationship with both forgiveness of self and forgiveness of others, fully mediating or operating through an indirect-only pathway. For alcohol-related problems only, mental health fully mediated the relationship with forgiveness of self at follow-up and operated through an indirect-only pathway with forgiveness of others longitudinally. Social support and feeling forgiven by God were nonsignificant variables at baseline, follow-up, and longitudinally.

Wells GM. The effect of religiosity and campus alcohol culture on collegiate alcohol consumption. Journal of American College Health 58(4): 295-304, 2010. (24 refs.)

Religiosity and campus culture were examined in relationship to alcohol consumption among college students using reference group theory. Participants and Methods: College students (N = 530) at a religious college and at a state university complete questionnaires on alcohol use and religiosity. Statistical tests and logistic regressioxn were utilized to examine alcohol use, religiosity, and campus environment. Results: Alcohol consumption was significantly higher among students at the university (M = 26.9 drinks) versus students at the religious college (M = 11.9 drinks). University students also had lower religiosity scores (M = 23.8) than students at the religious college (M = 26.5). Students who attend a secular university are 4 times more likely to be moderate or heavy drinkers compared to students attending a religiously affiliated college. Students with the least religiosity were 27 times more likely to be a heavy alcohol user and 9 times more likely to be a moderate alcohol user compared to students with greater religiosity.

Yeung JWK; Chan YC; Lee BLK. Youth religiosity and substance use: A meta-analysis from 1995 to 2007. Psychological Reports 105(1): 255-266, 2009. (50 refs.)

In this meta-analysis, the magnitude of the protective effects of religiosity on Youth involvement in substance use was investigated. Based on 22 studies in peer-reviewed journals published between 1995 and 2007, the average weighted mean correlation was Z(r) = .16, significant regardless of the definitions of religiosity. The homogeneity test of variance showed consistent protective effects of religiosity on four types of substance use, namely, alcohol, cigarette, marijuana, and other illicit drugs.

Yu M; Stiffman AR. Positive family relationships and religious affiliation as mediators between negative environment and illicit drug symptoms in American Indian adolescents. Addictive Behaviors 35(7): 694-699, 2010. (38 refs.)

The present study tests how positive family relationships and religious affiliation mediate between negative familial and social environments, and adolescent illicit drug abuse/dependence symptoms. The theoretical framework is based on an integration of two theories: the ecological model of human development (Bronfenbrenner, 1979) and the social development model (Hawkins & Weis, 1985). We used a stratified random sample of 401 American Indian adolescents. A path analysis tested the integrative theoretical model. Findings showed that positive family relationships mediated the negative impact of addicted family members, violence victimization, and negative school environment on illicit drug abuse/dependence symptoms. Religious affiliation mediated the negative effect of deviant peers on positive family relationships. Intervention and prevention efforts may benefit from promoting positive family relationships and religious affiliation to reduce the impact of complex familial and social problems on illicit drug symptoms.