Predictors of retention in an alcohol, tobacco, and other drug prevention study

This article explored retention patterns, as well as factors that predicted these patterns, in the evaluation of a relationship-based substance abuse prevention intervention study that targeted inner-city African American youth. A total of 851 contacts were made to retain 82% (n = 104) of the baseline sample (N = 127) in the evaluation. Results from multinomial regression analyses indicated that participants who were retained in the evaluation were more likely to perceive alcohol, tobacco, and other drug use as less risky and were more likely to report higher levels of family supervision than were evaluation attrits. Those who were easy to retain reported lower family conflict and fewer family relocations during the past year than those who were difficult to retain. Implications of these findings for developing retention strategies, as well as future research, are discussed.     

Prevalence and patterns of tobacco,alcohol, and drug use among Iranian adolescents: A meta-analysis of 58 studies

Adolescence is the critical age when adopting high-risk and health-threatening behaviors including smoking, drug and alcohol use is at its peak. Accordingly, this meta-analysis aimed to provide comprehensive nationwide estimates of tobacco, alcohol, and drug use among Iranian adolescents; and to compare their habits with other societies.Electronic databases, including PubMed, Medline, Embase, Google scholar and National Persian databases of SID, Magiran, and IranMedex were utilized in identifying relevant articles. The included studies were those having publications of quantitative estimates and standard errors of the prevalence of cigarette and drug use among 14–19-year-old high school students in Iran from 2000 to 2014. Random-effects meta-analyses were done including a total of 80,588 high school students.The most common drugs among adolescents in Iran were hallucinogens [25.3% (95% CI: 23.9–26.8)], sleeping pills and tranquilizers [25% (95% CI: 24–26.1)], hookah [23.1% (95% CI: 22.2–23.9)], opiates [22% (95% CI: 21.3–22.7)] and central nervous system (CNS) stimulants [20.1% (95% CI: 19.1–21.1)]. Furthermore, overall estimates for cigarette smoking, alcohol and chewing tobacco/Pan/Nas in the participants were 16.8% (95% CI: 16.4–17.2), 14.7% (95% CI: 14.2–15.3) and 10.0% (95% CI: 8.7–11.4), respectively. However, there was some heterogeneity in the pattern of drug use across the country (P < 0.01). Additionally, the risk of smoking, drinking and drug use by boys was considerably greater than girls. Moreover, data showed a varying trend of drug use over three studied periods of time.In conclusion, a diverse pattern and trend of tobacco smoking, alcohol drinking and drug use among adolescents in Iran was verified. Therefore, preventive and control measures (i.e. education) provided in schools should be compatible with age groups, with emphasis being laid on pattern of use in different parts of the country.     

The effect of active parental consent on the ability to generalize the results of an alcohol,tobacco, and other drug prevention trial to rural adolescents

The authors report the effect of active parental consent on sample bias among rural seventh graders participating in a drug abuse prevention trial. Students obtaining active consent from their parents to complete the survey were of higher academic standing, missed fewer days of school, and were less likely to participate in the special education program at their school as compared to students who did not return a parental consent form. However, students with consent were not significantly different from students whose parents actively declined. The sample obtained under active parental consent represents students less at risk for problem behaviors than would have been obtained under passive consent procedures.     

Feasibility study for collecting alcohol and other drug use data among secondary school students: a web-based survey approach

This study examined the feasibility of using a Web-based survey to collect alcohol and other drug use data from secondary school students in an urban school district in the Midwest. A Web-based survey was self-administered by a random sample of 6th through 11th grade students in the spring of 2002. The final sample consisted of 1,536 secondary school students (781 women and 755 men). The sample was 57% White, 40% African American, and 3% from other racial and ethnic groups. Several indicators of data quality were examined including response rate, absenteeism, refusals, substantive data, and data processing time. The study achieved a response rate of 89.1%. The results of the present study provide evidence that a Web-based survey can be successfully implemented in an economically and racially diverse urban sample of secondary students. While researchers conducting survey research within secondary schools should consider using Web-based survey approaches, additional research is needed to compare Web-based surveys to more traditional approaches to collecting data.     

A cross-country comparison of alcohol,tobacco, and marijuana use among youth who are employed,in school or out of the labor force and school (OLFS)

Labor force and school attachment may influence alcohol, tobacco, and marijuana use in the US and Canada. Differences in social welfare provision, which provide protections for individuals with insecure attachments to the labor force or education, may in turn impact the behavior and health of youth in these countries. Yet, there is little research to understand the health consequences for youth of being out of the labor force and school (OLFS). Data of 25–29 year old participants of the National Longitudinal Survey of Youth (year 2010) and the Canadian Community Health Survey (2009–2010) were used to examine differences in substance use by labor force and school attachment. Logistic regression suggests that OLFS in the US and Canada were less likely to report alcohol uptake and more likely to use tobacco compared to employed youth. Unemployment was differentially associated with substance use behaviors by country. Country of residence and subsequent exposure to social welfare policy does not appear to impact substance use behaviors among OLFS. However, associations of unemployment and gender by country indicates differences in substance use behavior. More research should seek to understand factors that influence alcohol, tobacco, and marijuana use among OLFS and unemployed youth.     

Toward an ecstasy and other club drug (EOCD) prevention intervention for rave attendees

A growing body of recent research has identified that "rave" attendees are at high risk for the use of "club drugs," such as 3,4-methylenedioxymethamphetamine (MDMA or "ecstasy"). Rave attendees, however, comprise only one of several club-going populations. In the current study, we explore the prevalence of ecstasy and other club drug (EOCD) use among a sample of club attendees in Washington, DC. Data were collected from adult, primarily homosexual, club attendees during the summer of 2003. Data collection was scheduled between 11 p.m. and 3 a.m. Participation rates were high. Of the 211 club attendees approached, 88% (n = 186) completed the interview. Drug use prevalence rates were low. With the exception of alcohol and marijuana, 2-day self-reports were less than 1% for each drug. These findings, amalgamated with results from other EOCD-related studies involving several distinct populations, offer considerable insight into the state of ecstasy in American society. Based on a meta-analysis of this literature, we offer a community-level prevention intervention for the population at highest risk for EOCD use-rave attendees.     

Cigarette,alcohol, and marijuana use among adolescents in foster family homes

Data from a cross-sectional study conducted in a random sample of children who were placed in foster family homes were used to examine the prevalence and associated factors of substance use (i.e., cigarette, alcohol, and marijuana), and to explore if adolescents in foster family homes had different rates of substance use than those in the general population matched on age, gender and race/ethnicity. Logistic regression models were used to determine factors associated with substance use and McNemar tests were used to compare prevalence rates of substance use. Substance use was common among adolescents in foster family homes. A higher number of placement settings were significantly associated with current cigarette use (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.09–1.60), and being placed in special study homes (i.e., fictive kin) was significantly associated with current marijuana use (OR, 6.43; 95% CI, 1.40–29.52). Compared to adolescents in the general population, those in foster family homes had lower rates of current alcohol (9.1% vs. 38.3%, p < 0.0001) and marijuana (13.6% vs. 29.7%, p = 0.005) use. No significant difference was observed for current cigarette use (18.2% vs. 11.5%, p = 0.08). More research is needed to confirm the lower rate of current substance use in foster family homes than those matched in the general population, and to explore why adolescents in special study homes were more vulnerable to marijuana use.     

An impact evaluation of two versions of a brief intervention targeting alcohol use and physical activity among adolescents

The purpose of the study was to evaluate the immediate impact of two new versions of the Project SPORT program, a brief one-on-one tailored consult addressing alcohol use and physical activity for adolescents. One new version was a brief interactive CD-ROM (Study one) and a second was a brief small group consultation (Study two). In study one, high school students were exposed to either an interactive CD-ROM consultation or a non-interactive computer program. In study two, students either participated in a small group consultation or health booklet control. These studies suggest both interventions were highly acceptable to participants, however, the new CD-ROM version of Project SPORT had a greater positive effective on females than males. Suggestions to make the CD-ROM more acceptable and effective for males are presented. The small group version of Project SPORT was largely acceptable and potentially efficacious for both male and female adolescents, with the largest impact seen on participants' images, beliefs, and commitment related to physical activity.     

Characteristics of smokeless tobacco use among high school football players as related to type of smokeless tobacco and period of use.

The present study was conducted to assess differences in the behavioral and demographic characteristics of snuff (dip) users as compared to users of chewing tobacco. High School football players (1116) were surveyed concerning their use and perceptions of smokeless tobacco. Adolescent athletes who tried smokeless tobacco were more likely to be white, to use cigarettes, alcohol, and cigars and to have family users than those who never tried. Initial use was highest before the age of fourteen years and was influenced by friends, curiosity and family. Dippers tended to initiate use because of friends, while chewers started because of family users. Users of both dip and chew started primarily because of curiosity. Users of both were more likely to consume greater amounts to alcohol and cigarettes and to smoke cigars and pipes. It appears that the longer smokeless tobacco is consumed, the more likely both dip and chew will be used. Users of smokeless tobacco for more than two years tended to consume more of the product each week, used it for more hours/day, initiated use at an earlier age, and used it more often at school and work than those using it for less than two years. Use of cigars/pipes, consumption of alcohol, and quantity of cigarette consumption increased significantly with longer duration of smokeless tobacco use. Intervention and prevention programs would be helped by understanding differences between users of various smokeless tobacco products and differences related to the duration of use. In addition, further analyses of smokeless tobacco users should study chewers, dippers, and users of both separately.     

A general causal model to guide alcohol, tobacco, and illicit drug prevention: assessing the research evidence

The problems associated with the use of alcohol, tobacco, and other drugs (ATOD) extract a significant health, social, and economic toll on American society. While the field of substance abuse prevention has made great strides during the past decade, two major challenges remain. First, the field has been disorganized and fragmented with respect to its research and prevention practices; that is, there are often separate ATOD prevention "specialists." Second, both the prevention researchers who test the efficacy of specific prevention strategies and the practitioners who implement prevention efforts often lack an overall perspective to guide strategy selection. To address these limitations, we present an ATOD causal model that seeks to identify those variables (Domains) that are theoretically salient and empirically connected across alcohol, tobacco, and illicit drugs. For the researcher, the model demonstrates important commonalities, as well as gaps, in the literature. For the practitioner, the model is a means to recognize both the complexity of the community system that produces ATOD problems and the multiple intervention points that are possible within this system. Researchers and practitioners are thus challenged to work synergistically to find effective and cost-effective approaches to change or reduce ATOD use and associated problems.     

The role of perceptions of partner's alcohol use in heavy alcohol use and alcohol reduction intervention preferences among LGBQ adults in primary,romantic relationships

Correlates of heavy episodic alcohol and alcohol reduction intervention preferences were examined among lesbian, gay, bisexual, and queer (LGBQ) adults in romantic relationships. Anonymous data were collected online; analyses included logistic and multinomial regression models. One-fourth of participants reported recent heavy episodic alcohol use. Perceptions of partners' engaging in heavy alcohol use was associated with an increased odds of engaging in heavy alcohol use. Perceptions of partners' heavy alcohol use was associated with an increased odds of preferring a couples-based alcohol intervention compared to preferring no intervention. Findings highlight the need to consider partners in alcohol interventions for LGBQ couples.     

Trends in long-acting reversible contraceptive (LARC) use,LARC use predictors,and dual-method use among a national sample of college women

Objective: Assess long-acting reversible contraceptive (LARC) and other contraceptive use trends, identify LARC use predictors, and examine dual method use. Participants: Women in the American College Health Association-National College Health Assessment (ACHA-NCHA) II, aged 18–24 years, who reported having vaginal sex (N = 37,899). Methods: Secondary analyses of Fall 2011–2014 ACHA-NCHA II data. Results: Statistically significant increases in LARC usage and, specifically, implant usage, were found. Characteristics associated with LARC use included age, race/ethnicity, relationship status, and school type. Students reporting LARC use had lower odds of condom usage compared with non-LARC hormonal method users. Conclusion: This analysis of LARC predictors and dual LARC/condom use has implications for research and health promotion efforts. Findings suggest that college health services are well positioned to meet the sexual and reproductive health needs of diverse populations of students. College health professionals should elicit students' individual and/or relationship priorities to tailor messaging/services offered for pregnancy/STI prevention.     

Evaluation of a tobacco prevention program on knowledge, attitudes, intention and behavior of tobacco use among fourth grade students--a preliminary study

This was a preliminary study to evaluate the effectiveness of a tobacco prevention program on knowledge, attitude, intention, and behavior of tobacco use among fourth-grade students in four north central Florida counties. The results suggest that the program was effective in improving students' knowledge, attitudes, and intention toward not using tobacco products. Data analysis showed that students in the education group had a greater improvement in knowledge than the comparison group. Students in the education group also improved their attitude and intention scores while the comparison group did not show any improvement. The results also indicated positive responses from the students. In addition, teachers also gave a very positive response to the program.     

Exposure to school and community based prevention programs and reductions in cigarette smoking among adolescents in the United States, 2000-08

Smoking remains prevalent among US youth despite decades of antismoking efforts. Effects from exposure to prevention programs at national level may provide informative and compelling data supporting better planning and strategy for tobacco control.A national representative sample of youth 12-17 years of age from the National Survey on Drug Use and Health was analyzed. A 3-stage model was devised to estimate smoking behavior transitions using cross-sectional data and the Probabilistic Discrete Event System method. Cigarette smoking measures (prevalence rates and odds ratios) were compared between exposed and non-exposed youth.More than 95% of the sample was exposed to prevention programs. Exposure was negatively associated with lifetime smoking and past 30-day smoking with a dose-response relation. Reduction in smoking was related to increased quitting in 2000-02, to increased quitting and declined initiation in 2003-05, and to initiation, quitting and relapse in 2005-08.Findings of this analysis suggest that intervention programs in the United States can reduce cigarette smoking among youth. Quitting smoking was most responsive to program exposure and relapse was most sensitive to funding cuts since 2003. Health policy and decision makers should consider these factors in planning and revising tobacco control strategies.     

Evaluating the effectiveness of a school drug and alcohol prevention curriculum: a new look at "Here's Looking at You, Two"

The article reports on the results of an evaluation of a school drug and alcohol prevention curriculum marketed under the title, "Here's Looking at You, Two." Previous evaluations, unreported in the literature and having unresolved methodological problems, have found that while the program appears effective at transmitting information regarding drug and alcohol abuse, it has not been effective at changing the underlying attitudes and behaviors that, in part, explain substance abuse. Employing a more rigorous methodology, our examination of a relatively large sample across five school districts provides support for previous findings. Over the short-term of one year, the program was particularly effective at transmitting substance information to primary and middle school students. The program, however, produced very little of the expected effect on the underlying attitudes that are critical to changing substance abuse behaviors.     

Trends in marijuana and other illicit drug use among college students: results from 4 Harvard School of Public Health College Alcohol Study surveys: 1993-2001

The authors examined changes in college students' illicit drug use, patterns of polydrug use, and the relationship between students' ages of initiation of substance use and later use of marijuana and other illicit drugs between 1993 and 2001. Data from 119 US colleges and universities in the Harvard School of Public Health College Alcohol Study were used in the study. They found significant increases in percentages of students' use of marijuana in the past 30 days (from 13% to 17%), past year (from 23% to 30%), and lifetime (from 41% to 47%) between 1993 and 2001, with most of the increase occurring between 1993 and 1997. Past 30-day use of other illicit drugs increased from 4% to 7% and past year use increased from 11% to 14%. More than 98% of marijuana and other illicit drug users used another substance. They also either smoked, were binge drinkers, and/or were users of another illicit drug. Drug prevention programs should emphasize heavy alcohol use and smoking and should start when students are in high school or earlier.     

An evaluation of a social norms marketing project for tobacco prevention with middle, high, and college students; use of funds from the Tobacco Master Settlement (Virginia)

The Anti-Tobacco Media Blitz (ATMB), a social-norms marketing program, was utilized for tobacco prevention with middle and high school students. University students assisted middle and high school students with the implementation of this campaign, which included a variety of media. Students worked in teams to design, develop, and evaluate tobacco-free messages through posters, radio, television, and peer-led activities. Evaluation of the campaign was constant and included assessment of message retention and demonstration of positive behaviors. This article discusses the procedures of this project, the five-step social norms marketing model, with emphasis on the student-centered evaluation and results.