Drug Abuse Prevention

Research Findings from February, 2001 Director's Report

This section lists selected summaries from NIDA funded research projects that investigate youth drug abuse prevention. The summaries provided were selected from recent issues of the Director's Report to the National Advisory Council on Drug Abuse. For a more comprehensive listing of NIDA funded projects see the Director's Report.

Links Between School Misbehavior, Academic Achievement, and Cigarette Use

The directionality of the association between substance abuse behaviors and negative school behaviors is unclear. In a study using the Monitoring the Future follow-up panel data, investigators at the University of Michigan examined relations among academic achievement, school bonding, school misbehavior, and cigarette use from 8th to 12th grade in two national panel samples of youth (n=3056). A series of competing conceptual models developed a priori was tested using structural equation modeling (SEM). The findings suggest that during middle adolescence the predominant direction of influence is from school experiences to cigarette use. School misbehavior and low academic achievement contribute to increased cigarette use over time both directly and indirectly. Two-group SEM analyses involving two cohorts -- gender and ethnicity -- showed robust findings. In addition, comparisons between high school dropouts and non-dropouts and between 8th grade cigarette use initiators and nonusers revealed few differences in direction or magnitude of effects. Results suggest that prevention programs that attempt to reduce school misbehavior and academic failure, as well as to help students who misbehave and have difficulty in school constructively avoid negative school- and health-related outcomes, are likely to be effective in reducing adolescent cigarette use. Bryant, A.L., Schulenberg, J., Bachman, J.G., O'Malley, P.M., and Johnston, L.D. Understanding the Links Among School Misbehavior, Academic Achievement, and Cigarette Use: A National Panel Study of Adolescents. Prevention Science, 1(2), pp 71-87, 2000.

Adolescents' Reactions to Rock Stars in Anti-Drug-Abuse Commercials

Two studies by Michael Newcomb and his affiliates examined adolescents' perceptions and effectiveness of rock stars in antidrug-abuse public-service announcements (PSAs). In the pilot study (N = 24 teenagers), adolescents expected rock musicians, and in particular heavy metal musicians, to be drug users. In this experimental study (N = 78 high school students aged I5 to 16 years), one group was shown 4 PSAs produced by Rock Against Drugs¨, using rock stars Jon Don Jovi, Aimee Mann, Gene Simmons, and Belinda Carlysle as spokespersons. The comparison group was shown 4 equivalent PSAs that were created using unknown actors selected for their similarity to the rock stars in terms of age, ethnicity, and gender, but without any reference to rock music. PSA ratings were taken on 4 scales: attractiveness, expertness, trustworthiness, and overall PSA rating. Pretest and posttest measures of drug attitudes supported the hypotheses that countermessages from rock stars denormalize the connection between rock music and drugs, and that adolescents respond more positively to PSAs with rock stars than to PSAs without rock stars. Newcomb, M.D., Mercurio, C.S., and Wollard, C.A. Rock Stars in Anti-drug-abuse Commercials: An Experimental Study of Adolescents' Reactions. Journal of Applied Social Psychology, 30(6), pp. 1160-1185, 2000.

School Dropout and Injecting Drug Use in a National Sample of White Non-Hispanic American Adults

Researchers at Johns Hopkins conducted a study to extend their previous finding of an association between school dropout and injecting drug use (IDU) among African Americans by testing the association in a sample of White non-Hispanic Americans. A nationally representative sample of White non-Hispanic Americans age eighteen years and older was drawn from public use data files of the 1995-1996 National Household Surveys on Drug Abuse (NHSDA). Adults with a self-report history of IDU were identified, and were matched to non-IDU adults in the same neighborhoods of residence. Conditional logistic regression was used to estimate the association between dropping out of high school and the occurrence of IDU. White non-Hispanic American high school dropouts were more likely than high school graduates to have injected a drug at least once. The findings of this research on non-Hispanic Whites are generally consistent with earlier evidence on the association between educational status and a history of IDU among African-American adults. School dropout prevention programs may merit attention in an overall strategy of preventing injecting drug use and HIV/AIDS. Obot, I.S. and Anthony, J.C. School Dropout and Injecting Drug Use in a National Sample of White Non-Hispanic American Adults. Journal of Drug Education, 30(2), pp. 145-155, 2000.

Clusters of Drug Involvement in Panama

Researchers at Johns Hopkins University reported on the first epidemiological investigation of clustering of tobacco, alcohol, inhalant, and other drug involvement within individual schools using data from Panama's 1996 National Youth Survey on Alcohol and Drug Use. Clustering was estimated with the Alternating Logistic Regression method. Adjusted estimates of pair-wise cross-product ratios (PWCPR), a measure of clustering, show modest clustering (i.e. PWCPR > 1.0) at the school level for tobacco smoking (PWCPR = 1.41; 95% confidence interval, CI = 1.22-1.64), alcohol consumption (PWCPR = 1.33; 95% CI = 1.22-1.45), use of inhalants, (PWCPR = 1.35; 95%CI = 1.07-1.69), and other drug use (PWCPR = 1.38; 95%CI = 1.14-1.68). These findings provide preliminary evidence that the odds of drug use among youth who attend school increase when other youth in the same school use drugs. This suggests the need for new research on within-school diffusion, which should include the identification of school-level factors that contribute to student drug use. Delva, J., Bobashev, G., Gonzalez, G., Cedeno, M., and Anthony, J.C. Clusters of Drug Involvement in Panama: Results from Panama's 1996 National Youth Survey. Drug and Alcohol Dependence, 60(3), pp. 251-257, 2000.

Implications of Genetic Epidemiology for the Prevention of Substance Use Disorders

Despite advances in characterizing human genotypes, the complex process through which genes exert their influence limits the application of molecular genetics to human diseases. Substance use disorders are necessarily complicated by gene-environment interaction because exposure to an exogenous substance is required for their development. The methods of genetic epidemiology are specifically designed to identify sources of complexity that impede etiologic findings and prevention efforts. Researchers at Yale report a study illustrating the application of family study methods to identify risk factors for substance abuse and their implications for prevention. The Yale Family Study is a controlled family study of the comorbidity of substance and psychiatric disorders. The sample consists of 223 probands with substance use and/or an anxiety disorders and community controls, 1218 adult first degree relatives and spouses, and 203 offspring (ages 7-17) followed for 8 years. Results indicated familial aggregation of substance disorders in adults and children, independence of familial aggregation of alcoholism and drug dependence, and specificity of familial clustering of some drugs of abuse. Familial factors are more strongly associated with substance dependence than abuse, with an attributable risk of 55%. Premorbid psychiatric disorders -social phobia and bipolar affective disorder in adults, and depression, anxiety, conduct, and oppositional defiant disorders in children - were strongly associated with the subsequent development of substance dependence (attributable risks ranging from 44 to 86%). A family history of substance abuse and premorbid psychopathology are strongly associated with the development of substance use disorders. As specific genetic vulnerability markers for substance use disorders become identified, application of the tools of genetic epidemiology may be employed to identify specific environmental risk factors that may serve as targets for prevention. Merikangas, K.R. and Avenevoli, S. Implications of Genetic Epidemiology for the Prevention of Substance Use Disorders. Addictive Behaviors, 25(6), pp. 807-820, 2000.

Ethnicity and Gender in Polydrug Use

The purpose of this study was to determine if ethnic and gender differences in polydrug use exist among a cohort of inner-city adolescents during the three-year middle school period. Students in 22 urban schools completed self-report questionnaires with measures of drug use (smoking, drinking, and marijuana use) at three annual assessments. For participating students, (N=2354), analyses of variance were conducted to test for ethnic group (Asian, Black, Hispanic, and White) and gender differences in polydrug use. Ethnic differences were found for polydrug use measures at each assessment point. Asian and Black adolescents generally reported less polydrug use than White and Hispanic youth. When gender differences were evident, boys engaged in more use than girls. The relatively high rates of polydrug use indicate that prevention intervention programs that target multiple substances may be more efficient in reducing overall risk than prevention programs that focus on a single substance (e.g., smoking prevention only). Epstein, J.A., Botvin, G.J., Griffin, K.W., and Diaz, T. Role of Ethnicity and Gender in Polydrug Use Among a Longitudinal Sample of Inner-City Adolescents. Journal of Alcohol and Drug Education, 45, pp. 1- 12, Fall 2000.

Reducing Adolescent Aggressive Behavior

Data from a randomized trial including 22 public schools assigned either to the Iowa Strengthening Families Program or a control condition were examined for long-term effects of this seven-session intervention for parents and their sixth-grade children on aggressive and hostile behaviors of adolescents. Analyses supported sample representativeness of this general population study and failed to show differential attrition effects 4 years after baseline. The multi-informant, multi-method measures included independent observer ratings of adolescent aggressive and hostile behaviors in adolescent-parent interactions, family-member report of aggressive and hostile behaviors in those interactions, and adolescent self-report of aggressive and destructive conduct across settings. Data were collected during the 6th (pre- and post-intervention), 7th, 8th, and 10th grades. All measures showed a generally positive trend in intervention compared to the control group over time. During 10th grade, significant intervention-control differences were found for adolescent self-report of aggressive and destructive conduct with relative reduction rates ranging from 31.7% to 77.0%. Significant differences were shown for observer-rated aggressive and hostile behaviors in adolescent-parent interactions; differences in family member reports of those behaviors were not significant. Supplemental analyses interaction behavior measures, specific to parent gender, indicated significant experimental group differences in interactions with mothers for both measures, but not with fathers. Spoth, R.L., Redmond, C., and Shin, C. Reducing Adolescents' Aggressive and Hostile Behaviors - Randomized Trial Effects of a Brief Family Intervention Four Years Past Baseline. Archives of Pediatrics and Adolescent Medicine, 154 (12), pp. 1248-1257, 2000.

Competence Skills Protect Inner-City Adolescents from Alcohol Use

In a three-wave longitudinal study of inner city students in middle or junior high school at baseline, investigators found that decision making and self-efficacy predicted higher refusal assertiveness relative to alcohol use. Refusal assertiveness in turn predicted less drinking at the 2-year follow-up. Earlier drinking also predicted 2-year follow-up drinking. Epstein, J.A., Griffin, K.W. and Botvin, G.J. Role of General and Specific Competence Skills in Protecting Inner-City Adolescents from Alcohol Use. J. of Studies on Alcohol, 61(3), pp. 379-386, 2000.

Effects of the "Preparing for the Drug Free Years" Curriculum on Growth in Alcohol Use and Risk for Alcohol Use in Early Adolescence

Preparing for the Drug-Free Years (PDFY) is a curriculum designed to help parents learn skills to consistently communicate clear norms against adolescent substance use, effectively and proactively manage their families, reduce family conflict, and help their children learn skills to resist antisocial peer influences. This study examined the effects of PDFY on the trajectories of these factors, as well as on the trajectory of alcohol use from early to mid adolescence. The sample consisted of 424 rural families of sixth graders from schools randomly assigned to an intervention or a control condition. Data were collected from both parents and students at pretest, posttest, and 1, 2, and 3 1/2-year follow-ups. Latent growth models were used to examine the data. PDFY significantly reduced the growth of alcohol use and improved parent norms regarding adolescent alcohol use over time. Implications for prevention and evaluation are discussed. Park, J., Kosterman, R., Hawkins, D.J., Haggerty, K.P., Duncan, T.E., Duncan, S.C. and Spoth, R. Effects of the "Preparing for the Drug Free Years" Curriculum on Growth in Alcohol Use and Risk for Alcohol Use in Early Adolescence. Prevention Science, 1 (3), pp. 125-138, 2000.

Group Self-Identification and Prediction of Drug Use and Violence in High-Risk Youth

This study provides a 1-year prospective analysis of group self-identification as a predictor of adolescent drug use and violence. In most comparisons, 1 year later, a high-risk group reported greater levels of drug use and violence-related exposure than other groups, and the statistical relation between group self-identification and drug use or violence remained after controlling for baseline assessment of the drug use or violence measure. This is the first study to demonstrate that group self-identification is a significant prospective predictor of drug use and other problem behaviors. Sussman, S., Dent, C.W., and McCullar, W.J. Group Self-Identification as a Prospective Predictor of Drug Use and Violence in High-Risk Youth. Psychology of Addictive Behaviors, 14(2), pp. 192-196, 2000.

Group Self-Identification and Prediction of Drug Use and Violence in High-Risk Youth

This study provides a 1-year prospective analysis of group self-identification as a predictor of adolescent drug use and violence. In most comparisons, 1 year later, a high-risk group reported greater levels of drug use and violence-related exposure than other groups, and the statistical relation between group self-identification and drug use or violence remained after controlling for baseline assessment of the drug use or violence measure. This is the first study to demonstrate that group self-identification is a significant prospective predictor of drug use and other problem behaviors. Sussman, S., Dent, C.W., and McCullar, W.J. Group Self-Identification as a Prospective Predictor of Drug Use and Violence in High-Risk Youth. Psychology of Addictive Behaviors, 14(2), pp. 192-196, 2000.

Development of Marijuana Use From Childhood to Young Adulthood

The present study was designed to examine the relationship between unconventionality and marijuana use over time. The sample for this paper consisted of 532 male and female participants interviewed during early adolescence, late adolescence, their early twenties, and their late twenties. Latent growth modeling was used. The findings indicated that (1) the influence of initial unconventionality (T2) on initial marijuana use (T2) was stronger for males, (2) unconventionality at T2 was not significantly related to overall rate of growth in marijuana use, and (3) change in unconventionality was related to overall growth rate of marijuana use. The implications of the findings for prevention and treatment are discussed. Brook, J.S., Whiteman, M., Finch, S.J., Morojele, N.K. and Cohen, P. Individual Latent Growth Curves in the Development of Marijuana Use from Childhood to Young Adulthood. J Behav Med 23(5), pp. 451-464, 2000.