Depression mediates the relationship between adverse childhood experiences and risky drinking among Hispanic young adults.

BACKGROUND AND OBJECTIVES: Hispanic young adults in the United States have consistently high rates of risky drinking, adverse childhood experiences (ACEs), depression, and anxiety. There is a positive association between ACEs and alcohol use among Hispanic populations; it is unknown if mental health symptomatology mediates this relationship. The purpose of this study was to test whether depression and anxiety mediated the relationship between ACEs and risky drinking among Hispanic young adults who engage in risky drinking. METHODS: Data from 264 Hispanic young adults, ages 19 to 30, were collected via an online questionnaire. Participants were recruited via social media, emails/listservs across colleges, the community, and web-panels. The questionnaire assessed ACEs, risky drinking, depression, and anxiety. We conducted a mediational analysis to test whether depression and anxiety mediated the relationship between ACEs and risky drinking. RESULTS: Of the sample, 59.8% identified as female and 40.2% as male. The average age was 24.37 (SD = 3.069). Participants (61%) identified as Mexican, Mexican American, or Chicano, and 84.1% identified as second-generation. ACEs were positively associated with risky drinking, depression, and anxiety. Depression mediated the relationship between ACEs and risky drinking. CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Depression explained the association between ACEs and risky drinking among Hispanic young adults, adding to our understanding of how mediators can illustrate pathways that lead from ACEs to risky drinking. Practitioners and interventionists should continue supporting Hispanic youth by integrating them into early prevention programs to mitigate the mental health consequences of ACEs that could lead to risky drinking.

Substance-related diagnosis type predicts the likelihood and co-occurrence of preterm and cesarean delivery.

This article aimed to evaluate whether a substance-related diagnosis (SRD; i.e., alcohol, opioids, cannabis, stimulants, nicotine) predicts the likelihood and co-occurrence of preterm (20-37 weeks' gestation) and cesarean delivery.This study reviewed electronic health record data on women (aged 18-44 years) who delivered a single live or stillbirth at ≥ 20 weeks of gestation from 2012 to 2019. Women with and without an SRD were matched on key demographic characteristics at a 1:1 ratio. Adjusting for covariates, odds ratios and 95% confidence intervals were calculated.Of the 19,346 deliveries, a matched cohort of 2,158 deliveries was identified. Of these, 1,079 (50%) had an SRD, 280 (13%) had a preterm delivery, 833 (39%) had a cesarean delivery, and 166 (8%) had a co-occurring preterm and cesarean delivery. An SRD was significantly associated with preterm and cesarean delivery (AOR = 1.84 [95% CI, 1.41-2.39], p-value= <0.0001; AOR = 1.51 [95% CI, 1.23-1.85], p-value= <0.0001). An alcohol-related diagnosis (AOR = 1.82 [95% CI, 1.01-3.28], p-value= 0.0471), opioid-related diagnosis (AOR = 1.94 [95% CI, 1.26-2.98], p-value= 0.0027), stimulant-related diagnosis (AOR = 1.65 [95% CI, 1.11-2.45], p-value= 0.0142), and nicotine-related diagnosis (AOR = 1.54 [95% CI, 1.05-2.26], p-value= 0.0278) were associated with co-occurring preterm and cesarean delivery.Pregnant women with an SRD experienced disproportionally higher odds of preterm and cesarean delivery compared to pregnant women without an SRD. Substance-type predicts the type of delivery outcome. An SRD in pregnant women should be identified early to reduce potential harm through intervention and treatment.

Association of alcohol and other substance-related diagnoses with severe maternal morbidity.

BACKGROUND: Pregnant women with a substance-related diagnosis, such as an alcohol use disorder, are a vulnerable population that may experience higher rates of severe maternal morbidity, such as hemorrhage and eclampsia, than pregnant women with no substance-related diagnosis. METHODS: This retrospective cross-sectional study reviewed electronic health record data on women (aged 18-44 years) who delivered a single live birth or stillbirth at ≥ 20 weeks of gestation from March 1, 2016, to August 30, 2019. Women with and without a substance-related diagnosis were matched on key demographic characteristics, such as age, at a 1:1 ratio. Adjusting for these covariates, odds ratios and 95% confidence intervals were calculated. RESULTS: A total of 10,125 deliveries met the eligibility criteria for this study. In the matched cohort of 1,346 deliveries, 673 (50.0%) had a substance-related diagnosis, and 94 (7.0%) had severe maternal morbidity. The most common indicators in women with a substance-related diagnosis included hysterectomy (17.7%), eclampsia (15.8%), air and thrombotic embolism (11.1%), and conversion of cardiac rhythm (11.1%). Having a substance-related diagnosis was associated with severe maternal morbidity (adjusted odds ratio = 1.81 [95% CI, 1.14-2.88], p-value = 0.0126). In the independent matched cohorts by substance type, an alcohol-related diagnosis was significantly associated with severe maternal morbidity (adjusted odds ratio = 3.07 [95% CI, 1.58-5.95], p-value = 0.0009), while the patterns for stimulant- and nicotine-related diagnoses were not as well resolved with severe maternal morbidity and opioid- and cannabis-related diagnoses were not associated with severe maternal morbidity. CONCLUSION: We found that an alcohol-related diagnosis, although lowest in prevalence of the substance-related diagnoses, had the highest odds of severe maternal morbidity of any substance-related diagnosis assessed in this study. These findings reinforce the need to identify alcohol-related diagnoses in pregnant women early to minimize potential harm through intervention and treatment.

Results of a Randomized Trial of Screening, Brief Intervention, and Referral to Treatment (SBIRT) to Reduce Alcohol Misuse Among Active-Duty Military Personnel.

OBJECTIVE: Rates of heavy alcohol use among active-duty military personnel in the United States are high and negatively affect individuals within the service branches. This study tested the effectiveness of a military-focused screening, brief intervention, and referral to treatment (SBIRT) intervention for reducing risky alcohol use among active-duty patients. METHOD: We used a randomized, parallel, two-group design to test the effectiveness of the SBIRT intervention in a convenience sample of service members recruited from the emergency department of a military hospital. A total of 791 participants were randomized to the SBIRT or usual care conditions, and 472 participants (59.7%) completed a 6-month follow-up. Fifteen percent of the sample was female. Self-reported Alcohol Use Disorders Identification Test (AUDIT), controlled drinking self-efficacy (CDSE), and readiness to change drinking behaviors were assessed at baseline and follow-up. RESULTS: Among higher risk participants (i.e., AUDIT ≥8), results of a complete case analysis showed a significant reduction in scores on the AUDIT-C (consumption questions from the AUDIT) and a significant increase in CDSE. Null findings were observed for intent-to-treat analyses testing the effectiveness of the SBIRT intervention; significant decreases in AUDIT and AUDIT-C scores and significant increases in CDSE were observed over time, irrespective of condition assignment for both complete case and intent-to-treat analyses. CONCLUSIONS: Results of a complete case analysis provided some support for the effectiveness of the SBIRT intervention for higher risk participants. The results of the more conservative intent-to-treat analyses did not support any of the study hypotheses. Future SBIRT effectiveness trials should also test electronic SBIRT intervention approaches.

Self-Reported Drug Use and Hearing Measures in Young Adults.

Purpose The purpose of this study was to examine marijuana or other substance use on pure-tone thresholds and distortion product otoacoustic emissions (DPOAEs) in young adults. Method Young adults (n = 243; 182 women, 61 men; M age = 20.9 years, SD = 2.7 years) participated in this study. Survey data included personal music system use, marijuana use, and misuse of prescription medications. Otoscopy, tympanometry, pure-tone audiometry, and DPOAEs were obtained. Pure tones from octave frequencies of 0.25 through 8 kHz were obtained, and DPOAEs were recorded between f2 frequencies of 1 and 6 kHz using two continuously presented stimulus tones swept in frequency. Results Those who reported marijuana or stimulant use had similar pure-tone averages (0.5, 1, 2, and 4 kHz) compared to those who reported never using marijuana or stimulants. Women who reported marijuana use in the past 30 days > two times had statistically significant higher mean DPOAEs compared to women who reported ≤ two times or no marijuana use in the past 30 days. Men, however, who reported marijuana use in the past 30 days > two times had lower, but not statistically significant, mean DPOAEs compared to men who reported ≤ two times or no marijuana use in the past 30 days. Women who reported ever using stimulants had statistically significant higher mean DPOAEs compared to women who reported never using stimulants; for men, mean DPOAEs were similar between those who reported ever using stimulants and those who never used stimulants. Conclusions The results of this study demonstrate different and contradictory associations between marijuana use, stimulant use, and hearing outcomes as a function of sex. Future research is needed to explore these associations utilizing larger sample sizes while accounting for additional harmful exposures to other noise exposures.

Prevalence and correlates of "popper" (amyl nitrite inhalant) use among HIV-positive Latinos living in the U.S.-Mexico border region.

Poppers (nitrite inhalants) are legal, commonly used by men who have sex with men, and associated with HIV acquisition, yet research is lacking on popper use and associated adverse outcomes. People living with HIV (PLWH) in the U.S.-Mexico border region lead binational lives, including accessing care and having sex and drug use partners on both sides of the border, with broad personal and public health implications. Understanding popper use provides crucial information to guide policy and develop targeted interventions for binational PLWH. We examine prevalence and correlates of popper use among HIV-positive Latinos in the border region, an underserved population at risk for poor health outcomes. This cross-sectional study recruited a convenience sample from agencies in San Diego and Tijuana to complete quantitative surveys. Participants (N = 121) were primarily male (82.6%) and gay/bisexual (62%). Lifetime substance use (excluding cannabis) was reported by 72% of participants, and 25.6% reported lifetime popper use. Individuals recruited in the U.S. were significantly more likely to report use of poppers than were participants recruited in Mexico. Our regression model found that identifying as gay/bisexual and having bought, sold, or traded sex for money, drugs, or other goods were independently associated with popper use. Findings shed light on the profile of individuals who use poppers and lay the foundation for further research to understand the context of popper use as it relates to high-risk behavior among PLWH in this region of high transborder mobility. Binational collaborative approaches are needed to improve regional HIV care outcomes and reduce transmission risk.

Headphones and other risk factors for hearing in young adults.

BACKGROUND: Personal listening device (PLD) use with headphones is increasing in young adults and in most listening environments occur in background noise. Headphone choice can be important because certain headphones are more effective in limiting background noise than stock earbuds. Binge drinking, marijuana, and hard drug use have also been associated with high-volume PLD use. The purpose of this study was to explore the relationship between preferred headphone type, listening level, and other health risk behaviors. METHODS: Two-hundred and twenty undergraduates were recruited and completed a PLD use and risk behavior survey. Survey data included self-reported alcohol and marijuana use. Bilateral otoscopy, tympanometry, and pure-tone threshold testing (0.25-8 kHz) were completed. Participants listened to one hour of music using preferred headphone type with a probe microphone in the ear canal to measure equivalent continuous sound level (LAeq). RESULTS: Mean LAeq was similar for the three types of headphones used. Participants who reported higher amounts of drinks per month and smoking marijuana within the last month had significantly higher LAeq levels than those who reported lower amounts of drinks per month and not smoking marijuana in the last month. There was no significant interaction between headphone type and reported drinks per month or marijuana use. CONCLUSION: Young adults with normal hearing who have higher preferred listening levels also reported more alcohol and marijuana use, although headphone type was not associated with any of these variables.

Can Self-Reported Personal Audio System Volume Predict Actual Listening Levels in Young Adults?

BACKGROUND: Most young adults report using personal audio systems (PAS) with earphones as part of their daily activities. PAS exposure is intermittent and research examining the levels these young adults are listening to is increasing. On average, preferred listening levels are below what would be considered at risk in an occupational setting. PURPOSE: The purpose of this study was to evaluate how two questions predicted preferred listening level in young adults with normal hearing; specifically, whether these young adults could identify if they listen at a high level or not. STUDY SAMPLE: One hundred and sixty young adults (111 women, 49 men) with normal hearing completed a questionnaire that had questions about PAS listening habits and then had preferred listening level assessed using a probe microphone system while listening to 1 hour of music through earphones. DATA COLLECTION AND ANALYSIS: Otoscopy, tympanometry, and pure-tone thresholds were completed in a randomly determined test ear. As part of the Risk Factors Survey, two closed-set questions were completed. First, "For a typical day, what is the most common volume used during this day?" with the following response options "Low," "Medium/Comfortable," "Loud," or "Very Loud." And second, "Do you listen to your personal music system at a volume where you…" with the following response options "Easily hear people," "Have a little trouble hearing people," "Have a lot of trouble hearing people," or "Cannot hear people." Using a probe microphone, chosen listening level (A-weighted, diffuse-field correction and a conversion to free-field equivalent [LDFeq]) was calculated over 1 hour while the participant listened to music with earphones. Sensitivity and specificity were determined to see how well young adults could identify themselves as listening at a high level (>85 dBA) or not. Linear regression analyses were performed to determine the amount of variance explained by the two survey questions as predictors of measured LDFeq. RESULTS: Almost half of the participants reported a longest single use of a PAS as <1 hour daily and more than half reported listening at a medium/comfortable volume and had a little trouble hearing people. Mean LDFeq was 72.5 dBA, with young adult men having a significantly higher mean LDFeq (76.5 dBA) compared with young adult women (70.8 dBA). Sensitivity was 88.9% and specificity was 70.6% for the question asking about volume on a typical day. For the question asking about being able to hear other people while listening to music sensitivity was 83.3% and specificity was 82.5%. Two variables, listening volume on a typical day and sex, accounted for 28.4% of the variability associated with LDFeq; the answer to the question asking about being able to hear others and sex accounted for 22.8% of the variability associated with LDFeq. CONCLUSIONS: About 11% of young adults in the present study listen to a PAS with earphones at a high level (>85 dBA) while in a quiet background. The participants who do report listening at a high level, however, do well at self-reporting this risk behavior in survey questions.

The Relationship Between Emerging Adult Alcohol Consumption and Military Enlistment.

BACKGROUND: The use and abuse of alcohol among active duty personnel is well documented in the research literature. Over the last decade rates of heavy and excessive drinking within the military have increased significantly, coinciding with both Operation Enduring Freedom and Operation Iraqi Freedom. The heavy use of alcohol by military personnel can be attributed to multiple factors such as the psychosocial and environmental stressors of military life and is frequently linked to mental health issues, the transient nature of the armed forces, the number and length of deployments, and exposure to life-threatening situations in combat environments. However, it is also likely rates of heavy alcohol use in the military are influenced by the possibility that individuals who already drink heavily choose to enlist in the armed services. The purpose of the present study was to test the association between drinking in emerging adulthood and military enlistment in a nationally representative sample of participants. METHODS: Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we tested the relationship between alcohol consumption in emerging adulthood and military enlistment in a sample of young adults ages 24 to 32 (n = 12,288). Results were stratified for men and women. FINDINGS: Results of the multivariate logistic regression models stratified by gender indicated male participants who reported consuming alcohol in the past year were more likely to join the military relative to nondrinkers after controlling for respondent age, race, and education. There were no significant associations between alcohol consumption and military enlistment for women. DISCUSSION: These findings demonstrate limited support for a relationship between alcohol consumption and military service. For men who drink, choosing military service may be influenced by the culture of drinking within the armed services. However, given the limited support found in the present study for a link between drinking in emerging adulthood and military service, the current high use of alcohol among active duty personnel is likely influenced by socialization processes within the military as well as from the stress of increased deployments to life-threatening combat situations. These results have important implications for informing policy and prevention programs within the armed services to improve both the short-term and long-term success of military service members.

Factors Associated with Self-Estimated Breath Alcohol Concentration Among Bar Patrons.

BACKGROUND: Few studies have examined the context in which drinkers underestimate their breath alcohol concentration (BrAC) in natural drinking environments. This study examined factors associated with bar patrons' self-estimated BrAC in high-risk college town settings. METHODS: Guided interview and BrAC data were collected from 510 participants recruited as they exited bars located close to large universities: 1 in Florida and 1 in Texas. RESULTS: Participants with the highest measured BrACs underestimated their BrAC levels the most. Findings from multivariable linear regression analysis indicated that BrAC (std ß = 0.014, p < 0.001), number of alcoholic drinks consumed (std ß = 0.006, p < 0.01), and perceived drunkenness (std ß = 0.024, p < 0.001) had significant positive associations with BrAC self-estimates, where the regression coefficients were scaled by values approximately equal to each variable's interquartile range. Among the 321 participants with BrAC levels ≥ 0.08 g/dl, 21.2% believed their BrAC was below the legal per se driving limit of 0.08 g/dl. Results from a logistic regression analysis indicated that higher levels of perceived drunkenness were associated with better self-recognition that one's BrAC level exceeded the legal driving threshold (OR = 3.312, p < 0.001). Further, participants under 26 years of age had reduced odds of recognizing that their BrAC was greater than 0.079 g/dl (OR = 0.245, p < 0.05). CONCLUSIONS: These findings highlight the inaccuracy of self-estimated BrAC when drinking, particularly among younger drinkers. Adjusting for BrAC, situational factors were strongly associated with self-estimated BrAC. Future research is needed to better understand how altering drinking environments may improve accuracy of BrAC self-estimates and deter driving after drinking.

The Effect of Adverse Childhood Experience on Clinical Diagnosis of a Substance Use Disorder: Results of a Nationally Representative Study.

BACKGROUND: Substance abuse is one of the most common health outcomes associated with adverse childhood experience, and poses a significant public health threat. OBJECTIVES: The purpose of this study is to demonstrate a relationship between adverse childhood experience and a substance use disorder using nationally representative data as well as to test whether religion moderates this relationship. METHODS: We conducted a secondary analysis using data from the National Longitudinal Study of Adolescent to Adult Health (n = 11,279). Three types of adverse childhood experiences were considered; physical, emotional, and sexual abuse. Logistic regression was used to determine whether risk for developing an alcohol use, cannabis use, or other drug use disorder in adulthood increased as exposure to multiple types of adverse childhood experiences increased while controlling for prior substance use and other demographic variables that have shown associations with substance use. In addition, religiosity was investigated as a possible moderator of the relationship between adverse childhood experience and substance abuse. RESULTS: The likelihood of developing a substance use disorder later in life increased as the score on the adverse childhood experience index increased. While religiosity did significantly reduce the likelihood of developing a substance use disorder, no moderating effects were observed. Conclusions/importance: This study underscores the long-term consequences of exposure to childhood adversity.

Associations Between Cigarette Print Advertising and Smoking Initiation Among African Americans.

OBJECTIVES: The objective of this study was to examine changes in the annual number of cigarette advertisements in magazines with a predominantly African-American audience following the broadcast ban on tobacco, and whether fluctuations in cigarette print advertising targeting African Americans during the late-1970s until the mid-1980s were associated with declines in smoking initiation. DESIGN: We tabulated the annual number of cigarette advertisements from magazines with large African-American readerships (Ebony, Essence, and Jet) from 1960 to 1990. Advertisements were coded depending on whether they featured African-American models. We calculated the incidence rate of regular smoking initiation from 1975 to 1990 for African-American 14-25 years old using data from the 1992-1993, 1995-1996, 1998-1999, and 2001-2002 Tobacco Use Supplements of the Current Population Survey. We examined whether trends in smoking initiation coincided with trends in cigarette advertising practices among African Americans. RESULTS: The annual aggregated number of printed cigarette advertisements in Ebony, Essence, and Jet magazines increased at least five-fold starting in 1971, following the broadcast ban on cigarette advertising. A decrease in the percentage of ads by Brown & Williamson that showed African-American models was positively correlated (r = 0.30) with declines in the incidence rate of smoking initiation among African Americans from the late-1970s to the mid-1980s. CONCLUSION: The tobacco industry adapted quickly following the broadcast ban on cigarettes by increasing print advertising in African-American magazines. However, changes in print advertising practices by were associated with declines in smoking initiation among African Americans from the late-1970s to mid-1980s.

Lifetime nonmedical use of prescription medications and socioeconomic status among young adults in the United States.

BACKGROUND: Despite decreases in the use of illicit drugs in the United States, prescription medications have become a major category of substances used by young adults. OBJECTIVE: This study examines the relationship between the socioeconomic status (SES) of young adult respondents (ages 24-32) and their history of nonmedical use of prescription medications (NUPM). METHOD: A secondary analysis was conducted with nationally representative data gathered from several waves (n = 15 701) of the National Longitudinal Study of Adolescent Health (Add Health). Four categories of NUPM were examined: (i) sedatives; (ii) tranquilizers; (iii) stimulants; and (iv) pain killers. SES was defined by several measures in the Add Health survey. Given the complex sampling plan of the Add Health, all analyses were weighted appropriately. RESULTS: Results indicated higher levels of personal SES, such as having health insurance or not experiencing a financial hardship in the past year, decreased the likelihood of reporting lifetime NUPM. In contrast higher levels of parent SES (e.g. parental education) were associated with an increased likelihood of reporting lifetime use of NUPM tranquilizers and stimulants. CONCLUSIONS: The results of this study suggest parental SES may have a stronger influence over NUPM than personal levels of SES, particularly for the categories of tranquilizers and stimulants. Furthermore, these findings indicate more research is needed on this subject to better understand the NUPM epidemic in order to effectively develop comprehensive clinical, public health, and policy-related intervention and prevention approaches.

Drinking behavior among low-income older adults: a multimethod approach to estimating alcohol use.

BACKGROUND: Substance abuse is the fastest growing health concern for older adults. Heavy drinking among older persons is associated with an increased risk of health consequences such as diabetes, cognitive impairment, sleep issues, and depression. It is important to note, however, the prevalence estimates of alcohol use among older adults are often based on inconsistent methodology. To address these potential methodological shortcomings, this study examines drinking patterns among low-income older adults using both self-report and unobtrusive methods. METHODS: The study was conducted in a low-income residential senior center in the United States. A total of 174 participants, aged 60 years or older, completed 2 self-administered cross-sectional surveys. A bogus recycling program was implemented to assess the amount of alcohol consumed by residents. Logistic regression analysis was utilized to model predictors of drinking status and to determine predictors of 3 category Alcohol Use and Disorders Identification Test scores. Bivariate associations that predicted associations with alcohol use were included in the final multivariate model. Alcohol containers collected from recycling were converted to standard drink estimates in order to calculate the capital consumption of residents. RESULTS: About 40% of respondents reported consuming alcohol and 25% reported drinking at least once a week. On average, a total of 1,079 drinks were consumed per month. There were 3 significant predictors of drinking status: age, education, and diagnosis of diabetes. Additionally, there appears to be an increase in recycled alcohol containers coinciding with the time residents received their social security checks. CONCLUSIONS: Overall, the combination of self-report and unobtrusive measures of alcohol consumption has potential to highlight different aspects of drinking behavior with a population living in a single dwelling such as a senior center apartment complex, residential hall, and the like.

The relationship between drinking games and intentions to continue drinking, intentions to drive after drinking, and adverse consequences: results of a field study.

BACKGROUND: Drinking games have become a nearly universal aspect of excessive drinking on university campuses with 50-62% of college students reporting playing drinking games in the past month. Participation in drinking games has been correlated with numerous negative consequences and increased consumption of alcohol. OBJECTIVES: The present study addresses the influence of drinking games on three drinking-related outcomes: problems experienced the night of the drinking event, the intent to keep drinking, and the intent to drive after drinking. METHODS: The data collected for the present study were part of a study testing environmental influences of drinking behaviors of young adults. A total of 226 randomly selected parties (representing 1725 partygoers) were selected for study inclusion. Three multilevel logistic regression models tested the relationship between drinking games and the three drinking-related outcomes. RESULTS: Participants who reported playing drinking games were 1.58 times more likely to report continued drinking intentions than participants who did not play drinking games. If drinking games were observed at a party, participants were 2.38 times more likely to plan to drive while intoxicated. Additionally, participants who reported playing drinking games were 1.59 times more likely to report experiencing a drinking-related problem than participants who did not play drinking games. CONCLUSION: Drinking games have consequences beyond increasing the level of intoxication; they contribute to problematic behavior at individual and environmental levels. Preventing drinking games is warranted.

The relationship between group size, intoxication and continuing to drink after bar attendance.

OBJECTIVE: The present study was undertaken to explore multilevel determinants of planning to continue to drink alcohol after leaving public drinking events. We assessed whether individual-level factors, group-related factors, or event-level bar characteristics were associated with post-bar drinking. METHOD: We recruited a total of 642 participants from 30 participating bars in urban Southern California. Groups who arrived to patron a bar were interviewed upon their entrance and exit. Given data nesting, we employed a multilevel modeling approach to data analysis. RESULTS: More than one-third (40%) of our sample reported the intention to continue drinking as they exited the bar. Results of our multilevel model indicated eight individual-level variables significantly associated with intending to continue to drink. Time of night moderated the relationship between BrAC change and intentions to continue to drink. Although none of the group factors were significant in our model, a significant cross-level interaction between BrAC change and number of group members indicated the effect of intoxication on planning to continue to drink increases as group members increase. At the bar level, the presence of temporary bars and server offers of non-alcoholic drinks significantly decreased intentions to continue to drink. CONCLUSIONS: Given the large percentage of participants who reported the intention to continue drinking after exiting a bar, this study draws attention to the fact that field studies of drinking behavior may assess drinking mid-event rather than at the end of a drinking event.

Evaluating self-checkout lanes as a potential source of alcoholic beverages for minors.

OBJECTIVE: This exploratory study examined the ability of young adults to purchase alcoholic beverages through self-checkout lanes without being asked for age verification. Although the minimum drinking age in all 50 U. S. states is 21 years of age, drinking among underage persons (ages 12-20) remains a serious public health concern. Self-checkout options in off-sale alcoholic beverage outlets (e.g., grocery store chains, liquor stores) may represent a potential source of illicit access to alcohol compared with traditional checkout purchases. METHOD: A total of 216 stores with self-checkout lanes were randomly selected in five Southern California counties. Pseudo-patrons independently judged to be 23 years of age or younger purchased alcohol in each store. RESULTS: Overall, 8.8% of all purchase observations resulted in a failure to ask for identification to purchase alcohol. CONCLUSIONS: The growing number of self-checkout options at supermarkets can be a potential source of alcohol for minors; however, the risk they pose is similar to that of traditional checkout purchases. Policies relating to the purchase of alcohol at any store, regardless of checkout type, should be modified so that every purchase of alcohol requires an identification card to be swiped regardless of age.

Self-Reported Age of Onset and Telescoping for Cigarettes, Alcohol, and Marijuana Across Eight Years of the National Longitudinal Survey of Youth.

Smoking, drinking, and illicit drug use are leading causes of morbidity and mortality, both during adolescence as well as later in life. Although for some adolescents, substance use may last for only a brief period of experimentation, use of these substances in adolescence may have negative consequences. The determination of how well national and local policy and intervention efforts address teen substance use depends largely on the collection of valid and accurate data. Assessments of substance use rely heavily on retrospective self-report measures. The reliability and validity of self-reported substance use measures, however, may be limited by various sources of measurement error. This study utilizes four waves of data from the National Longitudinal Survey of Youth spanning eight years. Our wave-to-wave analyses examined the accuracy of self-reported age of onset for cigarette, alcohol and marijuana users. Findings indicate that approximately one-fourth of cigarette users, one-fifth of alcohol users and one-third of marijuana users reported their age of onset exactly the same across waves. Of those who reported the age of onset inaccurately, the error tended to be in the direction of reporting their age of onset as older at a latter wave relative to what was reported previously, known as forward telescoping. Results from multiple linear regression analyses showed that the single most consistent variable associated with telescoping was the number of years since the substance was first reported. Time since first report was the single consistent and strongly associated with telescoping in each wave-to-wave comparison for all three substances under study. Implications for policy and research are discussed.

Drinking plans and drinking outcomes: examining young adults' weekend drinking behavior.

This study examined relationships among drinking intentions, environments, and outcomes in a random sample of 566 undergraduate college students. Telephone interviews were conducted with respondents before and after a single weekend assessing drinking intentions for the coming weekend related to subsequent drinking behaviors. Latent class analyses found evidence for four distinct drinking environments distinguished by private/public setting and presence of few/many intoxicated people. There was evidence that the drinking environment mediated the relationship between drinking intentions and heavy episodic drinking in this young adult sample. Future research might focus on examining person/environment interactions as they relate to heavy episodic drinking.