Alcohol-Tolerant Workplace Environments Are a Risk Factor for Young Adult Alcohol Misuse on and off the Job in Australia and the United States.

The workplace has been understudied as a setting for the prevention of young adult alcohol misuse. This study examined if alcohol-tolerant workplace environments are associated with greater risk for alcohol use and misuse on and off the job among young adults. Data were collected in 2014 from state-representative, sex-balanced samples (51% female) of 25-year-olds in Washington, U.S. (n = 751) and Victoria, Australia (n = 777). Logistic regressions indicated that availability of alcohol at work, absence of a written alcohol policy, and alcohol-tolerant workplace norms and attitudes were independently associated with a 1.5 to 3 times greater odds of on-the-job alcohol use or impairment. Alcohol-tolerant workplace norms were associated also with greater odds of high-risk drinking generally, independent of on-the-job alcohol use or impairment. Associations were mostly similar in Washington and Victoria, although young adults in Victoria perceived their workplaces to be more alcohol-tolerant and were more likely to use alcohol or be impaired at work and to misuse alcohol generally than young adults in Washington. Cross-nationally, workplace interventions that restrict the availability of alcohol, ban alcohol at work, and reduce alcohol-tolerant norms have the potential to prevent and reduce young adults' alcohol use and misuse on and off the job.

Predicting Alcohol Misuse Among Australian 19-Year-Olds from Adolescent Drinking Trajectories.

BACKGROUND: Alcohol use in adolescence predicts future alcohol misuse. However, the extent to which different patterns of adolescent use present risk remains unclear. OBJECTIVES: This study investigated how adolescent trajectories of alcohol consumption during the school years predict alcohol misuse at age 19 years. METHODS: Data were drawn from 707 students from Victoria, Australia, longitudinally followed for 7 years. Five alcohol use trajectories were identified based on the frequency of alcohol use from Grade 6 (age 12 years) to Grade 11 (age 17 years). At age 19 years, participants completed measures indicating Heavy Episodic Drinking (HED), dependency - Alcohol Use Disorders Identification Test (AUDIT) and social harms. RESULTS: At 19 years of age, 64% of participants reported HED, 42% high AUDIT scores (8+), and 23% social harms. Participants belonging to a steep escalator trajectory during adolescence had twice the odds at 19 years of age of high AUDIT scores and social harms, and three times greater odds of HED than participants whose alcohol use slowly increased. Stable moderate consumption was also associated with an increased risk of HED compared to slowly increasing use. Abstinence predicted a reduced likelihood of all forms of misuse at 19 years of age compared to slowly increased alcohol use. CONCLUSIONS: Trajectories of drinking frequency during adolescence predict alcohol misuse at age 19 years. Although rapid increasing use presents the greatest risk, even slowly increasing drinking predicts increased risk compared to abstinence. The findings indicate that alcohol policies should recommend nonuse and reduced frequency of use during adolescence.

Developmental trajectories of adolescent cannabis use and their relationship to young adult social and behavioural adjustment: A longitudinal study of Australian youth.

This study aimed to identify distinct developmental trajectories (sub-groups of individuals who showed similar longitudinal patterns) of cannabis use among Australian adolescents, and to examine associations between trajectory group membership and measures of social and behavioural adjustment in young adulthood. Participants (n=852, 53% female) were part of the International Youth Development Study. Latent class growth analysis was used to identify distinct trajectories of cannabis use frequency from average ages 12 to 19, across 6 waves of data. Logistic regression analyses and analyses of covariance were used to examine relationships between trajectory group membership and young adult (average age: 21) adjustment, controlling for a range of covariates. Three trajectories were identified: abstainers (62%), early onset users (11%), and late onset occasional users (27%). The early onset users showed a higher frequency of antisocial behaviour, violence, cannabis use, cannabis-related harms, cigarette use, and alcohol harms, compared to the abstinent group in young adulthood. The late onset occasional users reported a higher frequency of cannabis use, cannabis-related harms, illicit drug use, and alcohol harms, compared to the abstinent group in young adulthood. There were no differences between the trajectory groups on measures of employment, school completion, post-secondary education, income, depression/anxiety, or alcohol use problems. In conclusion, early onset of cannabis use, even at relatively low frequency during adolescence, is associated with poorer adjustment in young adulthood. Prevention and intervention efforts to delay or prevent uptake of cannabis use should be particularly focussed on early adolescence prior to age 12.

Longitudinal effects of school drug policies on student marijuana use in Washington State and Victoria, Australia.

OBJECTIVES: We examined the longitudinal effect of schools' drug policies on student marijuana use. METHODS: We used data from the International Youth Development Study, which surveyed state-representative samples of students from Victoria, Australia, and Washington State. In wave 1 (2002), students in grades 7 and 9 (n = 3264) and a school administrator from each participating school (n = 188) reported on school drug policies. In wave 2 (2003), students reported on their marijuana use. We assessed associations between student-reported and administrator-reported policy and student self-reported marijuana use 1 year later. RESULTS: Likelihood of student marijuana use was higher in schools in which administrators reported using out-of-school suspension and students reported low policy enforcement. Student marijuana use was less likely where students reported receiving abstinence messages at school and students violating school policy were counseled about the dangers of marijuana use. CONCLUSIONS: Schools may reduce student marijuana use by delivering abstinence messages, enforcing nonuse policies, and adopting a remedial approach to policy violations rather than use of suspensions.

A longitudinal study of the association of adolescent polydrug use, alcohol use and high school non-completion.

AIMS: Failure to complete high school predicts substantial economic and social disadvantage in adult life. The aim of this study was to determine the longitudinal association of mid-adolescent polydrug use and high school non-completion, relative to other drug use profiles. DESIGN: A longitudinal analysis of the relationship between polydrug use in three cohorts at grade 9 (age 14-15 years) and school non-completion (reported post-high school). SETTING: A State-representative sample of students across Victoria, Australia. PARTICIPANTS: A total of 2287 secondary school students from 152 high schools. The retention rate was 85%. MEASUREMENTS: The primary outcome was non-completion of grade 12 (assessed at age 19-23 years). At grade 9, predictors included 30-day use of eight drugs, school commitment, academic failure and peer drug use. Other controls included socio-economic status, family relationship quality, depressive symptoms, gender, age and cohort. FINDINGS: Three distinct classes of drug use were identified-no drug use (31.7%), mainly alcohol use (61.8%) and polydrug use (6.5%). Polydrug users were characterized by high rates of alcohol, tobacco and cannabis use. In the full model, mainly alcohol users and polydrug users were less likely to complete school than non-drug users [odds ratio (OR) = 1.54, 95% confidence interval (CI) = 1.17-2.03) and OR = 2.51, 95% CI = 1.45-4.33), respectively, P < 0.001]. These effects were independent of school commitment, academic failure, peer drug use and other controls. CONCLUSIONS: Mid-adolescent polydrug use in Australia predicts subsequent school non-completion after accounting for a range of potential confounding factors. Adolescents who mainly consume alcohol are also at elevated risk of school non-completion.

Adolescent predictors and environmental correlates of young adult alcohol use problems.

AIMS: To examine the rates of young adult alcohol and drug use and alcohol problems, adolescent predictors of young adult alcohol problems and correlations with young adult social, work and recreational environments. DESIGN: Adolescents were followed longitudinally into young adulthood. Predictors were measured in grade 9 (average age 15), and environmental correlates and outcomes in young adulthood (average age 21). SETTING: Students recruited in Victoria, Australia in 2002, were resurveyed in 2010/11. PARTICIPANTS: Analytical n=2309, 80% retention. MEASUREMENTS: Adolescent self-report predictors included past-month alcohol use. Young adults completed the Alcohol Use Disorders Identification Test (AUDIT) together with reports of environmental influences. FINDINGS: Comparisons to United States national school graduate samples revealed higher rates of alcohol, tobacco and illicit drug use (other than cannabis) in Victoria. For example, rates of past month use at age 21-22 were: alcohol 69.3% US versus 84.9%, 95% confidence interval (CI) 81.3-88.6% Victoria; illicit drugs (other than cannabis) 8.8 versus 12.7%, CI 9.7-15.7%. AUDIT alcohol problems (scored 8+) were identified for 41.2%, CI 38.8-43.6% of young adults in Victoria. The likelihood of young adult alcohol problems was higher for frequent adolescent alcohol users and those exposed to environments characterized by high alcohol use and problems in young adulthood. CONCLUSIONS: High rates of alcohol problems are evident in more than two in five Australian young adults, and these problems appear to be influenced both by earlier patterns of adolescent alcohol use and by young adult social, work and recreational environments.

The impact of school alcohol policy on student drinking.

Although it is common for secondary schools to implement alcohol policies to reduce alcohol misuse, there has been little evaluation of the efficacy of these policies. The purpose of this study was to test the impact of the degree and type of alcohol policy enforcement in state representative samples of secondary students in Washington State, USA, and Victoria, Australia (n = 1848). Multivariate logistic regressions were used to examine the prospective association between student reports of school alcohol policy in Grade 8 and self-reported alcohol use in Grade 9, controlling for age, gender, state, family socio-economic status and Grade 8 alcohol use. The likelihood of students drinking on school grounds was increased when students perceived lax policy enforcement. Student perceptions of harm minimization alcohol messages, abstinence alcohol messages and counselling for alcohol policy violators predicted reduced likelihood of binge drinking. Students perceiving harm minimization messages and counselling for alcohol policy violators had a reduced likelihood of experiencing alcohol-related harms. Perceptions of harsh penalties were unrelated to drinking behaviour. These results suggest that perceived policy enforcement may lessen drinking at school 1 year later and that harm minimization messages and counselling approaches may also lessen harmful drinking behaviours as harm minimization advocates suggest.

Adolescent exposure to drink driving as a predictor of young adults' drink driving.

The purpose of this study was to investigate the influence of exposure to others' drink driving during adolescence on self-reported driving under the influence (DUI) of alcohol in young adulthood. Data were drawn from 1956 participants with a driving license enrolled in the International Youth Development Study from Victoria, Australia. During 2003 and 2004, adolescents in Grades 7, 9 and 10 (aged 12-17) completed questionnaires examining whether they had ridden in a vehicle with a driver who had been drinking, as well as other demographic, individual, peer and family risk factors for DUI. In 2010, the same participants (aged 18-24) then reported on their own DUI behaviour. 18% of young adults with a driving license reported DUI in the past 12 months. Exposure to others' drink driving during adolescence was associated with an increased likelihood of DUI as a young adult (OR=2.13, 95% CI 1.68-2.69). This association remained after accounting for the effects of other potential confounding factors from the individual, peer and family domains (OR=1.62, 95% CI 1.23-2.13). Observing the drink driving behaviours of others during adolescence may increase the likelihood of DUI as a young adult. Strategies to reduce youth exposure to drink driving are warranted.

The impact of school tobacco policies on student smoking in Washington State, United States and Victoria, Australia.

This paper measures tobacco policies in statewide representative samples of secondary and mixed schools in Victoria, Australia and Washington, US (N = 3,466 students from 285 schools) and tests their association with student smoking. Results from confounder-adjusted random effects (multi-level) regression models revealed that the odds of student perception of peer smoking on school grounds are decreased in schools that have strict enforcement of policy (odds ratio (OR) = 0.45; 95% CI: 0.25 to 0.82; p = 0.009). There was no clear evidence in this study that a comprehensive smoking ban, harsh penalties, remedial penalties, harm minimization policy or abstinence policy impact on any of the smoking outcomes.

School, parent, and student perspectives of school drug policies.

BACKGROUND: Schools use a number of measures to reduce harmful tobacco, alcohol, and drug use by students. One important component is the school's drug policy, which serves to set normative values and expectations for student behavior as well as to document procedures for dealing with drug-related incidents. There is little empirical evidence of how policy directly or indirectly influence students' drug taking. This study compares how effectively schools communicate school drug policies to parents and students, how they are implemented, and what policy variables impact students' drug use at school and their perceptions of other students' drug use at school. METHODS: Data were obtained from 3876 students attending 205 schools from 2 states in the United States and Australia, countries with contrasting national drug policy frameworks. School policy data were collected from school personnel, parents, and students. RESULTS: Schools' policies and enforcement procedures reflected national policy approaches. Parents and students were knowledgeable of their school's policy orientation. CONCLUSIONS: When delivered effectively, policy messages are associated with reduced student drug use at school. Abstinence messages and harsh penalties convey a coherent message to students. Strong harm-minimization messages are also associated with reduced drug use at school, but effects are weaker than those for abstinence messages. This smaller effect may be acceptable if, in the longer term, it leads to a reduction in harmful use and school dropout within the student population.

p16/cyclin-dependent kinase inhibitor 2A deficiency in human melanocyte senescence, apoptosis, and immortalization: possible implications for melanoma progression.

BACKGROUND: The melanoma susceptibility locus cyclin-dependent kinase inhibitor 2A encodes two unrelated cell growth inhibitors, p16 and alternative reading frame (ARF). In fibroblasts, both proteins are implicated in cellular senescence, a key barrier to tumor development. The p16 coding sequence is more often mutated in melanoma families than is the ARF sequence. To investigate the role of p16 in melanocytes, we assessed aspects of growth, apoptosis, and immortalization in melanocytes cultured from two melanoma patients, both of whom had two inactive p16 alleles but functional ARF. METHODS: Growth and senescence were evaluated by cumulative population-doubling curves, and apoptosis by terminal deoxytransferase labeling. Expression of p53 and p21, which are associated with fibroblast senescence, was assessed by immunoblotting. Amphotropic retroviruses were used to transfer exogenous gene sequences into the melanocytes. RESULTS: Both melanocyte cultures showed high rates of apoptosis, which were reduced when the cells were grown in the presence of keratinocyte feeder cells or human stem cell factor plus endothelin 1. With these growth factors, both cultures proliferated for 45-55 net population doublings, markedly longer than the maximum of 10 net population doublings of normal adult human melanocytes in similar media, indicating impaired senescence. One of the cultures developed chromosomal aberrations, with numerous dicentric chromosomes at senescence, consistent with telomere dysfunction. p53 and p21 levels were not elevated in senescent normal melanocytes but were elevated in senescent p16-deficient melanocytes. Interference with p53 function by transfer of human papillomavirus 16-E6 further extended the lifespan of p16-deficient melanocytes. Human telomerase reverse transcriptase was sufficient to immortalize both these cell strains but not normal melanocytes. CONCLUSION: Normal senescence in human melanocytes requires p16 activity. p53 contributes to a delayed form of senescence that requires telomere shortening, in p16-deficient melanocytes. These findings provide some basis for the role of p16 in melanoma susceptibility.

p16(Ink4a) in melanocyte senescence and differentiation.

BACKGROUND: The Ink4a-Arf tumor suppressor locus encodes two growth inhibitors, p16 and Arf, both of which are also implicated as effectors in cellular senescence. Because human germline defects in the INK4A-ARF locus are associated with familial melanoma, melanocytes may have unusual INK4A-ARF functions or controls of cell senescence. Because senescence is believed to be an anticancer mechanism, we investigated the role of Ink4a-Arf and its individual components in melanocyte senescence. METHODS: Melanocytes were cultured from littermate mice with zero, one, or two functional copies of the Ink4a-Arf locus. Senescence was evaluated by cumulative population doubling curves and by the assessment of acidic beta-galactosidase (an indicator of senescence) expression. Pigmentation and cell size were evaluated by spectrophotometry and microscopy. p16 and Arf expression in primary and spontaneously immortalized melanocyte or melanocyte precursor cell lines were evaluated by immunoblotting. Retroviral vectors containing normal p16 and Arf complementary DNAs were used to restore expression of these genes in Ink4a-Arf(-/-) melanocytes. RESULTS: Wild-type melanocytes (i.e., Ink4a-Arf(+/+)) senesced within 4-5 weeks of culture. Ink4a-Arf(-/-) melanocytes did not senesce and readily became immortal. Ink4a-Arf(+/-) melanocytes showed defective senescence. Senescent Ink4a-Arf(+/+) melanocytes were heavily pigmented, but Ink4a-Arf(+/-) and Ink4a-Arf(-/-) melanocytes were less pigmented. All of six spontaneously immortalized melanocyte or melanocyte precursor lines from Ink4a-Arf(+/+) mice lacked p16 protein expression, although most retained Arf protein expression. After restoration of p16 but not Arf expression, Ink4a-Arf(-/-) melanocytes stopped growing, became highly melanized, and expressed acidic beta-galactosidase. By contrast, restoration of Arf but not p16 expression led to cell death without evidence of senescence. CONCLUSION: Normal mouse melanocyte senescence and associated pigmentation require both copies of Ink4a-Arf and appear to depend more on p16 than on Arf function. Mutations of the INK4A-ARF locus may favor tumorigenesis from melanocytes by impairing senescence, cell differentiation, and (where ARF is disrupted) cell death.