Drug driving: a secondary analysis of factors associated with driving under the influence of cannabis in Jamaica.

OBJECTIVES: To determine cannabis use patterns, the predictive sociodemographic correlates of driving under the influence of cannabis (DUIC) and the association between risk perception and cannabis dependence among vehicle drivers in Jamaica. DESIGN: Secondary data analysis. SETTING: Used the Jamaica National Drug Prevalence Survey 2016 dataset. PARTICIPANTS: 1060 vehicle drivers extracted from the population sample of 4623. PRIMARY AND SECONDARY OUTCOME MEASURES: Analysis used Pearson's χ2 test and logistic regression. ORs and 95% CIs were recorded. A p<0.05 was considered statistically significant. RESULTS: More than 10% of Jamaican drivers admitted to DUIC in the past year. Approximately 43.3% of drivers who currently use cannabis reported DUIC only. Evidently, 86.8% of drivers who DUIC were heavy cannabis users. Approximately 30% of drivers with moderate to high-risk perception of smoking cannabis sometimes or often were dependent on cannabis. Notwithstanding, drivers with no to low-risk perception of smoking cannabis sometimes or often were significantly likelier to be dependent (p<0.001 and p<0.001, respectively). Logistic regression highlighted male drivers (OR 4.14, 95% CI 1.59 to 14.20, p=0.009) that were 34 years and under (OR 2.97, 95% CI 1.71 to 5.29, p<0.001) and were the head of the household (OR 2.22, 95% CI 1.10 to 4.75, p=0.031) and operated a machine as part of their job (OR 1.87, 95% CI 1.09 to 3.24, p=0.023) were more likely to DUIC, while those who were married (OR 0.42, 95% CI 0.22 to 0.74, p=0.004) and had achieved a tertiary-level education (OR 0.26, 95% CI 0.06 to 0.76, p=0.031) were less likely. CONCLUSIONS: Two in five Jamaican drivers, who currently smoke cannabis, drive under its influence, with over 85% engaging in heavy use. Public health implications necessitate policy-makers consider mobile roadside drug testing and amending drug-driving laws to meet international standards.

Investigating the associations of age of initiation and other psychosocial factors of singular alcohol, tobacco and marijuana usage on polysubstance use: analysis of a population-based survey in Jamaica.

OBJECTIVES: This study aimed to examine concurrent polysubstance use of alcohol, tobacco and marijuana and determine correlations with access to marijuana, friend and familial drug use habits, risk perception and the age of initiation associated with the singular use of these substances. DESIGN: A secondary data analysis. SETTING: Used the Jamaica National Drug Prevalence Survey 2016 dataset. PARTICIPANTS: Involved the entire dataset comprising 4623 randomly selected respondents between 12 and 65 years old. OUTCOME MEASURES: Primary outcome: concurrent polysubstance use recorded as using two or more of alcohol, tobacco and marijuana. Predictor variables include risk perception and age of initiation of singular alcohol, tobacco and marijuana use, ease of marijuana access and family and friend alcohol and illegal drug use. RESULTS: Approximately 58%-66% of respondents commenced singular alcohol, tobacco or marijuana use under 17. Participants commencing marijuana use at 11 years and under and between 12 and 17 were 3.346 and 4.560 times more likely to report past month concurrent polysubstance use (p=0.030 and p<0.001). Respondents who did not believe that smoking tobacco sometimes (p=0.049), and smoking marijuana sometimes and often was harmful, had increased odds of concurrent polysubstance use (p=0.047 and p<0.001, respectively). Respondents who indicated access to marijuana as easy were significantly more likely to report past month concurrent polysubstance use compared with those who reported access as difficult (p=0.002). Participants who indicated that friends or family members get drunk and take illegal drugs were associated with 1.722 and 1.864 increased odds of reporting past month concurrent polysubstance use (p=0.004 and p=0.017, respectively). CONCLUSIONS: Decreased perceived risk, childhood and adolescent age of initiation and easy access to marijuana were significantly associated with polysubstance use among Jamaicans. The influence of friends and family members' drug and alcohol use behaviours on individuals developing polysubstance use habits further endorses the need for interventions.

Drunk driving: a secondary analysis of factors associated with driving under the influence of alcohol in Jamaica.

OBJECTIVES: To determine the prevalence of alcohol use patterns, sociodemographic factors and risk of alcohol dependence among vehicle drivers in Jamaica. DESIGN: A secondary data analysis. SETTING: This study was conducted using the Jamaica National Drug Prevalence Survey 2016 dataset. PARTICIPANTS: This included 1060 vehicle drivers derived from the population sample of 4623. The participants from each household were randomly selected as the respondent for the survey. PRIMARY AND SECONDARY OUTCOME MEASURES: Alcohol use and dependence were measured using the Alcohol Use Disorders Identification Test questionnaire. Driving under the influence of alcohol (DUIA) was assessed by questions regarding its use in the past 12 months. The analysis involved the use of Pearson's χ2 test and logistic regression. RESULTS: 75% of Jamaicans reported lifetime alcohol use. Approximately 65% of drivers indicated that they currently drink alcohol. 18% of drivers who currently drink alcohol admitted to DUIA. Reportedly, 54.5% of these drivers were alcohol binge drinkers, with 41.5% also driving under the influence of cannabis. The bivariate analysis demonstrated that DUIA was higher among Christian participants and those who worked in non-machine operator jobs (p=0.002 and p=0.008, respectively). Vehicle drivers altogether and drivers who drive under the influence of alcohol had significant associations with hazardous drinking (p=0.011 and p<0.001, respectively). Logistic regressions highlighted drivers 34 years and under (p=0.012), male drivers (p=0.002) and the head of the household (p=0.050) were 1.82, 3.30 and 1.86 times more likely, respectively, to report driving under the influence of alcohol in the past year. CONCLUSIONS: The prevalence of alcohol use among Jamaica's population and vehicle drivers is high. That one in five drivers, who currently consume alcohol, also admits to driving under the influence suggests the urgent need for mitigation strategies and legislative action as part of a preventative effort to reduce drunk driving.

Prevalence and sociodemographic factors associated with polysubstance use: analysis of a population-based survey in Jamaica.

BACKGROUND: In Latin America and the Caribbean, there is a dearth of research exploring polysubstance use. This study aims to determine the prevalence, varying combinations and associated sociodemographic characteristics of polysubstance use in Jamaica. METHODS: This study involved a secondary data analysis of the Jamaica National Drug Prevalence Survey 2016 dataset where 4,623 participants between the age of 12 and 65 years from each household were randomly selected as respondents. Statistical analysis was performed to determine the prevalence and the sociodemographic correlates of polysubstance use among Jamaicans. RESULTS: 19.6% of respondents used two or more drugs in their lifetime. Of this amount 68.7% reported past year use and 61.9% reported past month use. Bivariate analyses reported polysubstance use was statistically significantly higher amongst males (U = 54,579, p = 0.000), those living in rural areas (U = 91,892, p = 0.003), non-Christian (U = 89,514, p = 0.014), and married persons (U = 74,672, p = 0.000). Past month polysubstance use was statistically significantly higher among employed persons than unemployed persons were (U = 81,342, p = 0.001). Surprisingly, there was a lack of significant differences between education level, household income and past month concurrent polysubstance use (p = 0.609; p = 0.115 respectively). Logistic regression model indicated males were 3.076 times more likely than females to report past month polysubstance use than females. Also, when compared to those 55-65 years old, participants 35-54 years were 2.922 times more likely and those 18-34 years were 4.914 times more likely to report past month polysubstance use. Additionally, those living in rural areas were 1.508 times more likely than participants living in urban areas to report past month polysubstance use. As it relates to occupational status, when compared to armed forces, skilled workers were 4.328 times more likely and unskilled workers were 7.146 times more likely to report past month polysubstance use. CONCLUSIONS: One in five Jamaicans identified as polysubstance users, predominated by marijuana as the most common factor amongst the polysubstance combinations examined, signalling the need for early marijuana interventions.

Prevalence, perceived risk and associated factors of tobacco use amongst young, middle-aged and older adults: analysis of a national survey in Jamaica.

Introduction: tobacco smoking remains a significant threat to public health. This paper sought to examine the prevalence, perceived risk and the associated factors of current tobacco use amongst Jamaican adults. Methods: this study is a secondary data analysis of the Jamaican National Household Survey 2016. The data for this study was extracted from a pre-coded questionnaire using a standardized extraction sheet. Adults were categorized into young adults (18-35), Middle-aged adults (36-55) and Older adults (56 and older) groups. Statistical analysis was performed to determine the prevalence, perceived risk and associated factors of tobacco use among Jamaican adults. Results: young adults had the lowest lifetime prevalence of tobacco smoking at 23% yet the highest percentage of current users at 48.3% (p=0.000), with gender being the only significant associated factor. Males were 2.565 times more likely to be current tobacco users than females (p < 0.01). In middle-aged adults, and older adults the highest predictive factor was risk perception. Current tobacco use was 3.375 times higher in middle-aged adults (p=0.044) and 2.815 times higher in older adults with low risk perception (p=0.025). Conclusion: four out of 10 Jamaican adult tobacco users are current users. Young adults had significantly fewer mitigating factors to tobacco usage despite being the most prevalent group for current use. Significantly, perception of risk impacted current usage in middle-aged and older adults but not in younger adults. Innovative and targeted approaches are needed in young adults such as incorporating the health and wellness promotion model with tobacco emphasis.