The influence of school environment and self-regulation on transitions between stages of cigarette smoking: a multilevel analysis.

In this research, hierarchical linear modeling (HLM) was used to address how school context influences the likelihood of transitioning between stages of cigarette smoking as well as modifies the individual-level risk factor of self-regulation. Survey data were collected from 25,186 middle and high school students attending 38 public schools in Kentucky. Results show that students are less likely to increase use in schools with higher levels of teacher discipline and faculty involvement. The analyses of the multi-level interactions between self-regulation and school context reveal that students possessing low emotional regulation are more likely to initiate experimental smoking in schools with poor levels of discipline and involvement than similar types of students in schools with higher levels of these characteristics. This study illustrates how psychological risk factors for substance use may vary across social environments.

Differences in alcohol use and alcohol-related problems among fraternity and sorority members.

This study examined gender differences in alcohol consumption and problem behaviors among fraternity and sorority college students. Males were more likely to drink 13+ drinks at one time; females were more likely to drink 1-3, 4-6, and 7-12 drinks. Females experienced more problems at the 4-6 level; number of problems experienced were approximately equal at the 7-12 and 13+ levels. The correlation between consumption and problems was stronger for females (r = 0.58) than for males (r = 0.42). Problem behaviors might be due to individual differences or environmental forces acting upon individuals. Longitudinal studies should investigate possible causal pathways to inform the design of interventions for this at-risk population.

The effects of role socialization on the initiation of cocaine use: an event history analysis from adolescence into middle adulthood.

This research examines three relatively unexplored questions about the effects of role socialization on the initiation of cocaine use: (1) What are the effects of adult social roles on the initiation of cocaine use? (2) What are the effects of the life-course timing of entry into adult social roles on the initiation of cocaine use? and (3) What are the effects of life-course timing of the initiation of other drugs -- on the initiation of cocaine use? The data used in these analyses are from a national probability sample of men born between 1944 and 1954, inclusive (N = 1,933). Results indicate that the marital role was the only role which demonstrated a significant effect on the initiation of cocaine use. We find that either early or late entry into the marital role reduces its effect to nonsignificance. The timing of entry in the drug use roles indicates that the later the initiation of drug use the greater the odds of cocaine initiation. Results are discussed in light of the role socialization and developmental perspectives.

Alcohol risk reduction for fraternity and sorority members.

OBJECTIVE: The primary objective of this study is to evaluate the effectiveness of "Talking about Alcohol and Drugs... Among Greeks" (TAAD), a lifestyle risk reduction program that is research- and theory-based, protocol-driven, and targeted for fraternity and sorority members. METHOD: One fraternity and two sororities on five campuses participated in the program. A total of 780 participants completed pre- and posttest questionnaires. Posttest data were collected 1 academic year after pretest data collection. RESULTS: Results indicate that the program decreased positive attitudes toward alcohol consumption among program participants, with participants in the true experimental condition indicating greater disagreement than control participants (F = 3.05, 2/701 df, p < .05). Belief in myths about the etiology of alcoholism was reduced among experimental participants who did not actually attend the program, with those participants indicating greater disagreement than control or true experimental participants (F = 10.92, 2/702 df, p < .0001). The program had no apparent effect on alcohol consumption by experimental participants. CONCLUSIONS: The program's ability to influence behavior was hindered by systemic problems, such as trainer credibility and implementation infidelity, and probable participant psychological reactance. Training by professionals and mandatory attendance would set the stage for improved program effectiveness. Beyond that, an approach that emphasized how high-risk drinking norms jeopardize the goals of the fraternities and sororities might be better received than the current approach, which focuses on how individual attitudes, beliefs and behaviors lead to alcohol-related problems and alcoholism.

Sensation seeking and drug use by adolescents and their friends: models for marijuana and alcohol.

OBJECTIVE: To investigate the prospective influence of individual adolescents' sensation seeking tendency and the sensation seeking tendency of named peers on the use of alcohol and marijuana, controlling for a variety of interpersonal and attitudinal risk and protective factors. METHOD: Data were collected from a cohort of adolescents (N = 428; 60% female) at three points in time, starting in the eighth grade. Respondents provided information about sensation seeking, the positivity of family relations, attitudes toward alcohol and drug use, perceptions of their friends' use of alcohol and marijuana, perceptions of influence by their friends to use alcohol and marijuana, and their own use of alcohol and marijuana. In addition, they named up to three peers, whose sensation seeking and use data were integrated with respondents' data to allow for tests of hypotheses about peer clustering and substance use. RESULTS: Structural equation modeling analyses revealed direct effects of peers' sensation seeking on adolescents' own use of both marijuana and alcohol 2 years later. An unexpected finding was that the individual's own sensation seeking had indirect (not direct) effects on drug use 2 years later. CONCLUSIONS: These findings indicate the potential importance of sensation seeking as a characteristic on which adolescent peers cluster. Furthermore, the findings indicate that, beyond the influence of a variety of other risk factors, peer sensation seeking contributes to adolescents' substance use.

The association of testosterone with nicotine use in young adult females.

This pilot laboratory study examined the relationship of testosterone levels, carbon monoxide (CO) levels, current and adolescent nicotine use, and histories of pubertal onset in 30 young adult female smokers. These females had completed questionnaires regarding nicotine use in the 7th through 10th grades, and again at age 21 as part of a cohort study of drug use. In addition, history of pubertal onset was obtained at age 21, as were testosterone and CO levels. Testosterone levels were positively correlated with cigarette use in the last 30 days (P< or =.01), CO levels (P< or =.05), cigarette use reported in the 7th and 10th grades (P< or =.05), and negatively correlated with age of pubertal onset (P< or =.001). The relationship of testosterone to nicotine will be discussed.

Substance use among Dutch dental students.

OBJECTIVES: The objectives were to assess the prevalence of substance use among Dutch dental students and to determine their attitudes about substance use and its consequences. METHODS: In association with a national study of drug use among US dental students, a questionnaire was translated from English into Dutch and administered to dental students at two dental schools in The Netherlands. Students received an anonymous 115-item questionnaire in the fall of 1996. RESULTS: Alcohol was the students' drug of choice for lifetime (95%), past year (94%) and past month (88%) use. No significant correlations were found between alcohol use and gender, schools, and years in dental education. In the past month, 58% of students reported drinking on 5 or more days; 53% had 5 or more drinks on the same occasion, 20% had 5 or more drinks on the same occasion on 5 or more days; and 17% reported getting drunk at least monthly. Prevalence rates for past month use of tobacco was 24% and marijuana, 4%. Male students smoked twice as much as females, with significant differences found for all three periods of use (X2>19.00, P<0.01). When asked whether their schools offered policies and education programs on alcohol and other drugs, 52% of students reported that these were not available. CONCLUSIONS: Dental schools should develop effective programmes to educate students about responsible use of alcohol and other licit and illicit drugs. Schools should also inform students about their susceptibilities to substance abuse and dependency.

Stop-smoking program using nicotine reduction therapy and behavior modification for heavy smokers.

One hundred eighteen volunteers were studied in a hospital-based smoking cessation program in which nicotine polacrilex (Nicorette) was used as an adjunct to behavioral modification (group support). The "success" rate of 40% to 47% at 1 year was chemically verified. The regimen for using the nicotine polacrilex was "within labeling" but decidedly different from the regimen used in most smoking cessation programs involving this product.

Multiple drug use. Epidemiology, correlates, and consequences.

The initial focus is on the conceptual issues essential to the understanding of multiple drug use. This is followed by a discussion of the developmental nature of multiple drug use and the various strategies that have been designed to measure multiple use. The third section of the paper contains a review of the extent of multiple drug use in various segments of society with data from the Monitoring-the-Future surveys of high school seniors, the National Survey on Drug Abuse, and the Treatment Outcome Prospective Study of drug abuse treatment clients. The conclusion is that multiple drug use is pervasive. The next section deals with several consequences associated with multiple drug use: automobile accidents, delinquency, and emergency room visits. The final section outlines some of the prevention and treatment implications of multiple drug use from a public policy perspective.

Drug prevention: The past as the future?

This article presents selected themes which the authors believe have helped shape drug prevention in the United States. These themes include prevention interventions as well as research and evaluation activities focused on preventing drug abuse. Recommendations are also presented for future prevention-activities.

The prevention of drug use among youth: Implications of "legalization".

This paper examines what would happen if marijuana were legalized in the United States.

Stages in involvement with drugs.

There are distinct stages in involvement with drugs, and data obtained in the 1985 National Household Survey on Drug Abuse are presented to show the extent to which people follow these stages. Cigarette smoking usually precedes consumption of alcoholic beverages, and use of these licit substances precedes use of marijuana and cocaine.

A contextual model of adolescent alcohol use across the rural-urban continuum.

In the research presented here, we develop and test with respondents from a broad range of contexts a multilevel social control model of adolescent substance use, integrating macro- and microsociological and criminological perspectives. Specifically, this research examines the individual-level social control processes or mechanisms thought to lead to alcohol use embedded in school contexts in different community settings along the rural-urban continuum. In this way we determine 1) the main effects of individual- and contextual school-level variables and 2) the conditioning or moderating influences of school climate on individual alcohol use and on individual-level processes leading to alcohol use. Furthermore, given that our sample contains students from a broad range of settings along the rural-urban continuum, our findings address the appropriateness of conceptualizing rural and urban drug use and their respective etiologies as dichotomous. In this respect our findings suggest that heterogeneity in drug use exists within rural school settings as well as within urban school settings, and that examining rural drug use as separate from urban drug use is not justified.

"Turning on" other persons to drugs.

Data obtained in a recent national survey are examined to test two hypotheses about drug transmission. The hypothesis that transmission of drug use to others is most likely to occur within a short period of time after initial use is supported. For each drug or drug class, at least one-half of the users who transmitted drug use to others did so within a span of 2 years after they began to use the drug. One-fourth of the marijuana users "turned on" others. Marijuana users are more likely to transmit their drug use than are users of other illicit drugs, but most drug users never "turn on" others. The hypothesis that drug transmission occurs only within a short period of time after onset of use is rejected. Among marijuana users who "turned on" others, 29% of them did so 5 or more years after they first used marijuana.

Interpersonal influences on male drug use and drug use intentions.

The relationship between (1) the respondent's perception of the drug behavior of his father, mother, siblings, current friends, and wife/female partner; and (2) past drug use and future drug use intentions for tobacco, alcohol, marijuana, psychedelics, stimulants, sedatives, heroin, other opiates, and cocaine is examined among a representative sample of men in the U.S. population who were 20-30 years old in 1974 (N = 2,510). For each drug the results indicated that current friends' and wife/partner's drug behaviors are the factors most strongly associated with the respondent's past drug use as well as his intentions of future drug use. Although substantially less important, siblings' drug behavior also appears to be a source of influence, while the drug behavior of mothers and fathers is only minimally associated with drug use and future intentions.

The epidemiology of alcohol and drug abuse among adolescents.

The primary purpose of this paper was to review systematically some of the more salient findings from a decade of research on the epidemiology of alcohol and drug abuse among adolescents. Data from most of the on-going nationwide studies regarding lifetime, past year, and past month use of various drugs were examined. While there is evidence of a downturn for some of the indicators, it is still too early to know if this is a temporary shift in rates or the beginning of meaningful trends toward lower levels of drug use. The second purpose was to challenge the alcohol and drug fields to consider more seriously the problem of multiple drug use and abuse. This was accomplished by showing that the relative percentage of youth who have used "only marijuana" has gone down as the percentage of youth who have used marijuana, other illicit drugs, and cigarettes and alcohol as well, has increased. Regression and discriminant analyses of data from the 1980 Monitoring the Future study of high school seniors reveals that variables that previously have differentiated users from nonusers are also useful in differentiating types of multiple drug users. The most important conclusion from this paper is that persons characterized as "daily" users of marijuana are better typed as multiple drug users.

The effectiveness of Drug Abuse Resistance Education (project DARE): 5-year follow-up results.

BACKGROUND: This article reports the results of a 5-year, longitudinal evaluation of the effectiveness of Drug Abuse Resistance Education (DARE), a school-based primary drug prevention curriculum designed for introduction during the last year of elementary education. DARE is the most widely disseminated school-based prevention curriculum in the United States. METHOD: Twenty-three elementary schools were randomly assigned to receive DARE and 8 were designated comparison schools. Students in the DARE schools received 16 weeks of protocol-driven instruction and students in the comparison schools received a drug education unit as part of the health curriculum. All students were pretested during the 6th grade prior to delivery of the programs, posttested shortly after completion, and resurveyed each subsequent year through the 10th grade. Three-stage mixed effects regression models were used to analyze these data. RESULTS: No significant differences were observed between intervention and comparison schools with respect to cigarette, alcohol, or marijuana use during the 7th grade, approximately 1 year after completion of the program, or over the full 5-year measurement interval. Significant intervention effects in the hypothesized direction were observed during the 7th grade for measures of students' general and specific attitudes toward drugs, the capability to resist peer pressure, and estimated level of drug use by peers. Over the full measurement interval, however, average trajectories of change for these outcomes were similar in the intervention and comparison conditions. CONCLUSIONS: The findings of this 5-year prospective study are largely consonant with the results obtained from prior short-term evaluations of the DARE curriculum, which have reported limited effects of the program upon drug use, greater efficacy with respect to attitudes, social skills, and knowledge, but a general tendency for curriculum effects to decay over time. The results of this study underscore the need for more robust prevention programming targeted specifically at risk factors, the inclusion of booster sessions to sustain positive effects, and greater attention to interrelationships between developmental processes in adolescent substance use, individual level characteristics, and social context.