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...on Adolescents
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www.ProjectCork.org
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Summer 2006
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Mediators and moderators of magazine advertisement effects on adolescent cigarette smoking.
Aloise-Young PA; Slater MD; Cruickshank CC. Journal of Health Communication 11(3): 281-300, 2006. (45 refs.)
The purpose of the present study is to examine the relation between magazine advertising for cigarettes and adolescent cigarette smoking. Participants ( 242 adolescents) reported their frequency of reading 46 magazines and their attention to cigarette ads. Recognition of cigarette ads, passive peer pressure (i.e., normative beliefs), and the smoker image also were assessed. Results indicate that exposure to cigarette advertising and recognition of ads augment the effect of passive peer pressure on smoking. In addition, a positive smoker image was associated with attention to advertising and mediated the relation between attention and smoking. It is suggested that the effect of magazine ads on adolescents should be considered in policymaking on cigarette advertising. Copyright 2006, Taylor & Francis, Inc.
Reducing the risk of HIV infection associated with illicit drug use.
American Academy of Pediatrics, Committee on Pediatric AIDS. Pediatrics 117(2): 566-571, 2006. (48 refs.)
Substance abuse, specifically the use of illicit drugs that are administered intravenously, continues to play a role in the transmission of human immunodeficiency virus type 1 (HIV-1) among adolescents and young adults (youth). Risks of HIV-1 infection may result from direct exposure to contaminated blood through sharing of injection drug equipment and from unsafe sexual practices (while under the influence of drugs and/or in exchange for drugs). Reducing the risk of HIV-1 infection that is associated with illicit drug use requires prevention education and prompt engagement in treatment. Providing patients with education, instruction on decontamination of used injection drug equipment, improved access to sterile syringes and needles, and postexposure prophylaxis may decrease their risk of acquiring HIV-1 infection. Pediatricians should assess risk behaviors as part of every health care encounter, including queries about tobacco, alcohol, and marijuana use. The risks and benefits of postexposure prophylaxis with antiretroviral drugs should be considered for youth with a single recent (within 72 hours) high-risk exposure to HIV-1 through sharing needles/syringes with an HIV-1-infected individual or having unprotected intercourse with an individual who engages in injection drug use. Such prophylaxis must be accompanied by risk-reduction counseling, appropriate referrals for treatment, and evaluation for pregnancy and associated sexually transmitted infections. There is an urgent need for more substance-abuse prevention and treatment programs, legislation that facilitates unencumbered access to sterile syringes, and expedient availability of reproductive health care services for sexually active youth, including voluntary HIV-1 counseling and testing. Copyright 2006, American Academy of Pediatrics.
The relationship between youth's moral and legal perceptions of alcohol, tobacco and marijuana and use of these substances.
Amonini C; Donovan RJ. Health Education Research 21(2): 276-286, 2006. (57 refs.)
Youth's perceptions of the morality of alcohol and other drug use and the perceived legitimacy of laws regulating such use have received scant attention in the international public health literature. To date, the focus has mainly been on emphasizing the health and social disbenefits of substance use in an attempt to counter the perceived psychological benefits (positive expec-tancies) of use and peer reinforcement. Following exploratory qualitative research, a structured questionnaire was administered to a sample of 611 youths aged 14-17 years. Analysis of the data found that use of alcohol, tobacco and marijuana was directly related to moral perceptions: those considering use as 'wrong under any circumstance' were less likely to be users than those who considered it 'ok under some or any circumstance'. Substance use was also related to legitimacy perceptions: those who thought laws relating to alcohol, tobacco and marijuana use were justified were less likely to be users than those who thought these laws were not justified. The implications of these findings for future research and for the design of more effective intervention strategies are discussed. It is suggested that interventions including student discussion of the moral and legal issues surrounding substance use may prove effective in postponing or even preventing substance use, particularly tobacco and marijuana consumption, or reducing the excess use of these substances. Copyright 2006, Oxford University Press. .
Popular ergogenic drugs and supplements in young athletes. (review).
Calfee R; Fadale P. Pediatrics 117(3): E577-E589, 2006. (102 refs.)
Ergogenic drugs are substances that are used to enhance athletic performance. These drugs include illicit substances as well as compounds that are marketed as nutritional supplements. Many such drugs have been used widely by professional and elite athletes for several decades. However, in recent years, research indicates that younger athletes are increasingly experimenting with these drugs to improve both appearance and athletic abilities. Ergogenic drugs that are commonly used by youths today include anabolic-androgenic steroids, steroid precursors (androstenedione and dehydroepiand-rosterone), growth hormone, creatine, and ephedra alkaloids. Reviewing the literature to date, it is clear that children are exposed to these substances at younger ages than in years past, with use starting as early as middle school. Anabolic steroids and creatine do offer potential gains in body mass and strength but risk adverse effects to multiple organ systems. Steroid precursors, growth hormone, and ephedra alkaloids have not been proven to enhance any athletic measures, whereas they do impart many risks to their users. To combat this drug abuse, there have been recent changes in the legal status of several substances, changes in the rules of youth athletics including drug testing of high school students, and educational initiatives designed for the young athlete. This article summarizes the current literature regarding these ergogenic substances and details their use, effects, risks, and legal standing. Copyright 2006, American Academy of Pediatrics. .
Juvenile drug court: Enhancing outcomes by integrating evidence-based treatments.
Henggeler SW; Halliday-Boykins CA; Cunningham PB; Randall J; Shapiro SB. Journal of Consulting and Clinical Psychology 74(1): 42-54, 2006. (45 refs.)
Evaluated the effectiveness of juvenile drug court for 161 juvenile offenders meeting diagnostic criteria for substance abuse or dependence and determined whether the integration of evidence-based practices enhanced the outcomes of juvenile drug court. Over a 1-year period, a four-condition randomized design evaluated outcomes for family court with usual community services, drug court with usual community services, drug court with multisystemic therapy, and drug court with multisystemic therapy enhanced with contingency management for adolescent substance use, criminal behavior, symptomatology, and days in out-of-home placement. In general, findings supported the view that drug court was more effective than family court services in decreasing rates of adolescent substance use and criminal behavior. Possibly due to the greatly increased surveillance of youths in drug court, however, these relative reductions in antisocial behavior did not translate to corresponding decreases in rearrest or incarceration. In addition, findings supported the view that the use of evidence-based treatments within the drug court context improved youth substance-related outcomes. Clinical and policy implications of these findings are discussed. Copyright 2006, American Psychological Association, Inc. .
Treatment readmissions and criminal recidivism in youth following participation in chemical dependency treatment.
Luchansky B; He LJ; Longhi D; Krupski A; Stark KD. Journal of Addictive Diseases 25(1): 87-94, 2006. (30 refs.)
The purpose of this study was to use administrative records of admissions to substance abuse treatment to construct episodes of care for publicly funded adolescent clients in Washington State, and then to analyze two important outcomes after an index episode: re-admissions to treatment and criminal convictions (including felony convictions and any conviction). The Study population was youth, ages 1.4 to 17, who began and ended an index episode in 1997 and 1998 (n = 5903). The youth were followed for 18 months after the end of their episode, and survival analysis techniques were used to determine the treatment correlates of the outcomes. Clients who completed treatment, compared to those who did not, had significantly lower risks of each outcome, while those with treatment episodes longer than 90 days had lower risks of readmission and felony convictions. Copyright 2006, Haworth Press, Inc. .
Racial disparities in tobacco use and social influences in a rural southern middle school.
Muilenburg JL; Johnson WD; Annang L; Strasser SM. Journal of School Health 76(5): 195-200, 2006. (37 refs.)
This study investigated racial differences of tobacco use and social exposure to tobacco products in a sample of middle school students. Questionnaires were administered in January 2005 to 290 students in a Mississippi Delta-area middle school. The participants were 51.0% female and 566% African American. Unadjusted odds ratios revealed that Caucasian students were statistically more likely than were African American students to (1) have ever tried smoking, (2) have ever been a daily smoker, (3) have smoked in the past 30 days, (4) live with someone who smokes, (5) have seen a parent or guardian smoke, and (6) have friends who smoke. In contrast, African Americans were more likely to report "no one is allowed to smoke" in their home. Caucasian females had the highest rates of smoking, as well as the highest exposure to social smoking behaviors. This study not only showed that Caucasians were indeed smoking more but also that African American adolescents do not have the same exposure to social smoking, particularly African American females. Of particular interest was why the differences eventually dissipate and smoking rates are virtually the same in adulthood. A greater understanding of the impact of exposure to tobacco use on all adolescent's own tobacco use is vital to prevention efforts, especially in regard to racial differences. Future research on youth tobacco prevention and cessation programs should focus on sociocultural and racial differences in the development of tobacco use in adolescents. Copyright 2006, America School Health Association. .
Is alcopop consumption in Switzerland associated with riskier drinking patterns and more alcohol-related problems?
Wicki M; Gmel G; Kuntsche E; Rehm J; Grichting E. Addiction 101(4): 522-533, 2006. (53 refs.)
Objectives: To examine (a) whether consumers of alcopops compared to consumers of other alcoholic beverages but not alcopops have riskier drinking patterns and more alcohol-related consequences (e.g. truancy, scuffles, problems with parents) and (b) whether the amount of alcopops consumed is associated independently with risky drinking patterns and alcohol-related consequences over and above those associated with the amount of other alcoholic beverages consumed. Sample: As part of the ESPAD international study, a cross-sectional national representative sample of 5444 drinkers aged 13-16 years was interviewed by means of an anonymous, self-report questionnaire administered in a classroom setting. Results: Earlier initiation of consumption, more frequent risky single occasion drinking (RSOD), and a higher likelihood of negative consequences for consumers than for non-consumers of alcopops were due mainly to higher overall consumption. Other alcoholic beverages had similar effects, and whether the same amount of alcohol was consumed as alcopops or as any conventional alcoholic beverage made no difference. Conclusions: Alcopops in Switzerland do not seem to be linked to specific riskier drinking patterns or consequences per se. Like all alcoholic beverages, they add to the problems caused by drinking and seem to be consumed in addition to conventional alcoholic beverages without replacing them. As the alcohol industry will continue to launch new beverages, prevention targeting alcohol consumption in general might be more effective than focusing on new beverages only. Copyright 2006, Society for the Study of Addiction to Alcohol and Other Drugs. .
Drug counselor report of adolescents abuse of nicotine replacement therapy.
Hyland A; Bradford D; Gitchell J. Journal of Addictive Diseases 24(4): 105-113, 2005. (9 refs.)
Background. Nicotine replacement products (NRT) are formulated and marketed to reduce their abuse liability among adolescents. Few studies have examined the extent of adolescent abuse. The objective of this manuscript is to describe the Youth abuse rate for NRT and other over-the-counter (OTC) abusable substances. Methods. Two cross-sectional telephone surveys of Safe and Drug Free School Coordinators were conducted in 1996/7 (N = 562) and 1998/9 (N = 501). Abuse of NRT and other OTC drugs and circumstances surrounding NRT abuse was ascertained. Results. NRT abuse rates were low and did not change significantly between the two surveys (2.7% in 1996/7 to 4.6% in 1998/9). NRT abuse rates were well below those of other OTC abusable substances (e.g., diet pills and inhalants). Conclusions. Concerns over promotion of youth dependence to nicotine by offering the sale of NRT OTC to adults have not been realized and policymakers should consider reducing barriers to access these products. Copyright 2005, The Haworth Press, Inc. .
Brief report: Social risk factors predict cigarette smoking progression among adolescents with asthma.
Tercyak KP. Journal of Pediatric Psychology 31(3): 246-251, 2006. (17 refs.)
Objective: To compare smoking progression in adolescents with and without asthma and to compare their psychosocial risk factors. Methods: Participants were 1,507 adolescents with asthma and 1,507 healthy matched controls from Waves I and II of the Add Health Project assessed at baseline and again 1 to 2 years later at follow-up. Three levels of smoking progression (defined as smoking more frequently and/or intensely over time) were identified: (a) Late Experimenters (never smokers at baseline, ever smokers at follow-up), (b) Early Experimenters (ever smokers at baseline, current/current frequent smokers at follow-up), and (c) Early Smokers (current smokers at baseline, current frequent smokers at follow-up). Results Twenty percent of adolescents experienced progression in their smoking behavior; those with and without asthma were equally likely to progress. Among adolescents who progressed, 37% were Late Experimenters, 42% were Early Experimenters, and 21% were Early Smokers. Exposure to friends who smoked was a consistent and powerful social risk factor for smoking progression among adolescents with asthma-more so than among adolescents without asthma. This effect was intensified among Late Experimenters by the presence of a positive history of parent smoking. Conclusions: Findings underscore the importance of addressing cigarette smoking behavior and its social risk factors among adolescents with asthma in both clinical and public health contexts, during early adolescence, and through research on this topic. Copyright 2006, Oxford University Press. .
Childhood and adolescent antecedents of drug and alcohol problems: A longitudinal study. (review).
Fothergill KE; Ensminger ME. Drug and Alcohol Dependence 82(1): 61-76, 2006. (121 refs.)
Despite the serious health and economic consequences of drug and alcohol abuse and dependence, few studies have prospectively examined the etiology of this problem in non-clinical populations. This longitudinal study examines childhood and adolescent antecedents of drug and alcohol problems in adulthood among an African American cohort (n = 1242; 51% female) from Woodlawn, a neighborhood in chicago. The participants were followed from age 6 to 32 years, and data were collected in first grade, adolescence, and adulthood. Structural equation modeling showed that, for both males and females, educational attainment was directly associated with a reduced risk for substance use problems. For males, first grade shyness was directly associated with a reduced risk of substance use problems, and adolescent substance use was directly associated with an increased risk. First grade aggression, low family socioeconomic status (SES), and low school bonds were indirectly associated with substance use problems for both males and females. For males, first grade underachievement had an indirect effect, and, for females, first grade shyness and strong parental supervision had indirect effects. This study is among the first to identify life course trajectories to substance use problems among an African American, community-based population. These results help to identify the targets and timing of interventions that may help to reduce the risk of drug and alcohol problems in adulthood. Copyright 2006, Elsevier Science.
Interest of adolescents in genetic testing for nicotine addiction susceptibility.
Tercyak KP; Peshkin BN; Wine LA; Walker LR. Preventive Medicine 42(1): 60-65, 2006. (46 refs.)
Objectives. Genetic tests for nicotine addiction susceptibility may someday offer preventive medicine specialists new tools to reduce smoking among adolescents. This paper examines adolescents' interest in, and reasons behind interest in, such testing and correlates of interest. Methods. The sample included 211 healthy patients (ages 13-21) recruited from Georgetown University Medical Center's adolescent medicine clinic. Subjects completed a one-time behavioral survey immediately prior to or following a general medical check-up during calendar years 2001-2005. A 4-point self-report survey item served as the dependent variable. Results. Sixty-two percent of adolescents were interested in genetic testing. Among the 72% of adolescents who provided a reason for their interest, 35% would find the information interesting for general or nonspecific reasons, 30% would find it personally useful, 8% noted it would be irrelevant, and 13% stated it would be unimportant; school performance and interest in cancer susceptibility testing were associated with interest in nicotine addiction susceptibility testing (adjusted r(2) = 21%; P < 0.0001). Conclusions. Adolescent primary care patients will likely be receptive to comprehensive tobacco control programs incorporating genetic testing. Higher levels of educational achievement and greater interest in DNA-based preventive medicine may characterize those most interested. Offering testing will be contingent upon the development of safe and effective genetic tests. Copyright 2006, Academic Press Inc. .
Patterns of global tobacco use in young people and implications for future chronic disease burden in adults.
Warren CW; Jones NR; Eriksen MP; Asma S; GTSS Collaborative Group. Lancet 367(9512): 749-753, 2006. (24 refs.)
Background Tobacco use is a leading preventable risk factor for many chronic disorders, which are expected to account for an increasing share of the global disease burden. As part of the Global Youth Tobacco Survey (GYTS), we aimed to assess the effect of tobacco use by young people on global mortality. Methods GYTS is a school-based survey of students aged 13-15 years. The survey was undertaken at 395 sites in 131 countries and the Gaza Strip and West Bank. We questioned students about current tobacco use, susceptibility to smoking among non-smokers, and exposure to secondhand smoke at home and in public places. Findings The difference in current cigarette smoking between boys and girls is narrower than expected in many regions of the world. Use of tobacco products other than cigarettes by students is as high as cigarette smoking in many regions. Almost one in five never-smokers reported they were susceptible to smoking in the next year. Student exposure to secondhand smoke was high both at home (more than four in ten) and in public places (more than five in ten). Never-smokers were significantly less likely than current smokers to be exposed to secondhand smoke at home (prevalence 39.1% [95% CI 36.6-41.6] vs 72.8% [64.0-81.6]) and in public places (49.5% [46.7-52.3] vs 81.2% [74.2-88.2]). Interpretation Our findings are troubling for the future of chronic disease and tobacco-related mortality. Reduction of tobacco consumption will require a redoubling of efforts to prevent initiation and promote cessation among the large proportion of young people who currently use tobacco. High exposure to secondhand smoke suggests a need for countries to pass strong and effective smoke-free policies. Copyright 2006, Lancet Ltd. .
Childhood predictors of drunkenness in late adolescence among males: A 10-year population-based follow-up study.
Niemela S; Sourander A; Poikolainen K; Helenius H; Sillanmaki L; Parkkola K et al. Addiction 101(4): 512-521, 2006. (47 refs.)
Aims: To study childhood precursors of drunkenness frequency among 18-year-old boys in a representative, nation-wide 10-year follow-up study. Design In 1989, a general population sample of 2946 8-year-old boys was collected. Three different informant sources were used: parents, teachers and the boys themselves. The follow-up was 10 years later in 1999, when the boys were called up for their obligatory military service at age 18. Information about drunkenness frequency was obtained from 78.3% (n = 2306) of the original sample. Setting Finland, nation-wide; in 1989 at schools, in 1999 at the obligatory military call-up. Participants: General population sample of Finnish boys born in 1981. Measurements: At age 8, the Rutter A2 scale, Rutter B2 scale and Child Depression Inventory (CDI) were used. At age 18, self-reported drunkenness frequency during the previous 6 months was determined. Findings: Of the subjects, 15.0% reported never being drunk from alcohol, 74.6% reported being occasionally drunk and 10.4% reported being drunk at least once a week during the previous 6 months. After adjusting for other variables, teacher's estimate of the child's problem behaviour at age 8 predicted frequent drunkenness in late adolescence. Hyperactive problems predicted both occasional and frequent drunkenness. Conduct problems at age 8 predicted only frequent drunkenness. High teacher-reported scores of emotional problems predicted lower occurrence of drunkenness-orientated alcohol use. Conclusions: The educational system has a potential role in detecting boys at risk of later risk-taking behaviours, such as frequent drunkenness. Early interventions in children with conduct problems and hyperactivity are called for. Copyright 2006, Society for the Study of Addiction to Alcohol and Other Drugs. .
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