Archive for May, 2012

Substance use reduces educational achievement

Although various kinds of substance use are associated with reduced educational attainment, these associations have been mixed and may also be partially due to risk factors such as socioeconomic disadvantages. A study of substance use and education among male twins from a veteran population has found a strong relationship among early alcohol use, alcohol dependence, daily nicotine use, and fewer years of educational attainment.

Results will be published in Alcoholism: Clinical & Experimental Research and are currently available at Early View.

Mixed Results

“Evidence for an association between substance use/abuse/dependence and reduced lifetime educational attainment is mixed,” said Julia D. Grant, research assistant professor of psychiatry at Washington University School of Medicine as well as corresponding author for the study.

“In addition,” said Matt McGue, a professor in the department of psychology at the University of Minnesota, “what is missing is an explanation for the basis of the association. We might consider two possibilities. One, adolescent substance use results in diminished educational achievement because substance use is neurotoxic to the developing adolescent brain, or because adolescents who use substances have experiences that reduce the likelihood they will pursue higher education.”

Another possibility, he added, is that “individuals who use substances in adolescence differ from those who do not on a range of risk factors prior to substance use exposure, which not only lead to their use of substances but also reduce the likelihood they achieve a college education. This possibility means that adolescent substance use is merely an indicator of the risk factors that diminish the likelihood of college attainment.”

Lifetime Educational Attainment

“Because our participants were in their late 30s when their educational attainment was assessed, we were better able to address lifetime educational attainment than most previous studies, which have focused on high school dropouts or educational attainment in 18-25 year-olds,” said Grant. “We also examined educational attainment in a veteran cohort that had access to education via benefits of the G.I. bill, thereby alleviating some of the economic barriers to higher education that might otherwise be confounded with alcohol and drug outcomes.”

Grant and her colleagues examined data collected from two points in time: a 1987 questionnaire, and a 1992 telephone diagnostic interview of 6,242 male twins (n=3,121 pairs with a mean age of 41.9 years in 1992) who had served in the U.S. military during the Vietnam-era and were therefore eligible for educational benefits after military service. Specific factors addressed were reduced educational attainment – defined as less than 16 years – as well as early alcohol and cannabis use, daily nicotine use, lifetime cannabis use, and alcohol, nicotine, cannabis, and any illicit drug dependence.

“Although all substance use measures were associated with lower educational attainment in preliminary analyses,” said Grant, “only early alcohol use, alcohol dependence, and daily nicotine use remained significantly associated with reduced educational attainment in twin pairs discordant for substance use. In contrast, the associations between cannabis/other illicit drugs and educational attainment were not significant, suggesting that this association may be attributable to familial influences shared by the two measures.”

Sober Twin More Likely to Finish College

“In this study, they conclude that within twin pairs discordant for adolescent substance use, the unexposed twin was more likely to complete college than his/her exposed cotwin,” said McGue. “This provides much stronger support for a causal influence than a standard epidemiological study because of the control afforded by comparing the discordant twins. However, it is important to recognize that it does not prove causality.”

“It is possible that early alcohol use and alcohol dependence impede later educational attainment,” noted Grant. “Possible mechanisms for this include cognitive and motivational changes stemming from early alcohol use/dependence that hinder academic success. Although daily nicotine use is not likely to impair cognitive functioning, it may lead to motivational changes that affect academic performance. It is also possible that the association between these substances and lower educational attainment remains because both are attributable to a factor that we did not control for in our present analyses, such as personality characteristics and cognitive ability prior to substance use.”

Complicated Relationship

Grant said these findings underscore the complicated relationship between substance use and educational attainment.

“By controlling for all familial influences that contribute to both substance use and educational attainment, through our discordant twin design, we have a much stronger indicator of the direct association between substance use and educational attainment,” she said. “However, because we were studying higher levels of education – 16+ years – in high school graduates, we may have understated the true effect of alcohol on education. It may be that these effects are more pronounced at even lower levels of education. Nonetheless, our findings lend credence to ongoing public health efforts to reduce adolescent smoking and drinking, which in turn may have beneficial effects on school dropout and lifelong educational attainment.”

May 16th, 2012  in Substance Abuse 1 Comment »

Apartment dwellers often subjected to neighbors’ smoke

Noisy neighbors and broken-down elevators are common downsides of apartment living. You also can add unwanted tobacco smoke to the list of hazards, according to research to be presented Sunday, April 29, at the Pediatric Academic Societies (PAS) annual meeting in Boston.

Studies have shown that tobacco smoke can seep from one apartment into another. The extent to which this happens, however, is unclear.

Unwanted Tobacco Smoke

Researchers from the American Academy of Pediatrics Julius B. Richmond Center of Excellence surveyed a nationally representative sample of adults living in apartments to examine factors associated with unwanted tobacco smoke. The center, named for a former U.S. surgeon general, is committed to protecting children from tobacco and secondhand smoke.

Apartment dwellers were asked whether they experienced smoke incursion, which was defined as smelling tobacco smoke in their building and/or unit. They also were asked if they had children and if their apartment building had any smoking restrictions. Only respondents who reported that no one had smoked in their home for the previous three months were included in the study.

Results showed that nearly one-third of the 323 eligible respondents reported smelling tobacco smoke in their buildings, and half of these residents reported smelling smoke in their own units. In particular, residents with children were more likely to smell smoke in their building than those with no children (41 percent vs. 26 percent).

Daily Exposure to Smoke

Survey results also showed that 38 percent of those who reported smelling smoke said they did so weekly, while 12 percent smelled smoke daily.

“A significant number of residents of multi-unit housing are being unwillingly exposed to tobacco smoke, in some cases on a daily basis, and children seem to be especially vulnerable,” said lead author Karen M. Wilson, MD, MPH, FAAP, section head, pediatric hospital medicine at Children’s Hospital Colorado and assistant professor of pediatrics, University of Colorado School of Medicine. “This exposure could put children at risk for respiratory diseases and illness if it is persistent or if the child has a significant respiratory illness such as asthma or cystic fibrosis.”

“A smoke-free building protects the shared indoor air that all residents, including infants and children, are forced to breathe. Every parent needs to hear about this research because it could be their infant or child who is exposed next,” said Jonathan P. Winickoff, MD, MPH, FAAP, associate professor in pediatrics, MassGeneral Hospital for Children, Boston.

Residents receiving government housing subsidies also were more likely to smell smoke.

Options Are Limited

“Options for such housing are limited, and residents forced to experience smoke exposure in their buildings may not have the option to move to a smoke-free complex,” Dr. Wilson added.

Partial measures, such as limiting common area smoking, appeared to be ineffective at protecting nonsmokers from exposure in their own units. As long as smoking was allowed in the individual units of a building, higher rates of exposure were reported. Only completely smoke-free buildings were associated with lower incursion rates.

“This finding supports grassroots efforts by multi-unit housing resident groups, apartment managers and owners to make buildings smoke-free for the comfort, health and safety of their residents, and because of the far lower costs associated with managing nonsmoking apartments,” Dr. Wilson concluded.

May 3rd, 2012  in Tobacco No Comments »

It takes a village to keep teens substance free

During high school the parents of teenagers’ friends can have as much effect on the teens’ substance use as their own parents, according to prevention researchers.

“Among friendship groups with ‘good parents’ there’s a synergistic effect — if your parents are consistent and aware of your whereabouts, and your friends’ parents are also consistent and aware of their (children’s) whereabouts, then you are less likely to use substances,” said Michael J. Cleveland, research assistant professor at the Prevention Research Center and the Methodology Center, Penn State. “But if you belong to a friendship group whose parents are inconsistent, and your parents are consistent, you’re still more likely to use alcohol. The differences here are due to your friends’ parents, not yours.”

Parents Can Play a Key Role

Cleveland and his colleagues report parenting behaviors and adolescents’ substance-use behaviors to be significantly correlated in the “expected directions” in this month’s issue of the Journal of Studies on Alcohol and Drugs. Results show higher levels of parental knowledge and disciplinary consistency leading to a lower likelihood of substance use, whereas lower levels lead to a higher likelihood of substance use.

However if adolescents’ parents are consistent and generally aware of their children’s activities, but the parents of the children’s friends are inconsistent and generally unaware of their own children’s activities, the adolescents are more likely to use substances than if their friends’ parents were more similar to their own parents.

Peer Influence Very Powerful

“The peer context is a very powerful influence,” said Cleveland. “We’ve found in other studies that the peer aspect can overwhelm your upbringing.”

While long suspected to be the case, the researchers believe this to be the first study where parenting at the peer level proved to have a concrete and statistically significant impact on child outcomes.

Friendship Groups Studied

The researchers surveyed 9,417 ninth-grade students during the spring semester, and then again the following spring semester. The students came from 27 different rural school districts in Pennsylvania and Iowa, all participating in the Promoting School-university-community Partnerships to Enhance Resilience (PROSPER) study. In ninth grade, the researchers asked the students to name five of their closest friends. The researchers identified social networks within the schools by matching up the mutually exclusive friendships. Overall, the researchers identified 897 different friendship groups, with an average of 10 to 11 students in each group.

At that time students also answered questions about their perceptions of how much their parents knew about where they were and who they were with. They were also asked about the consistency of their parents’ discipline. In the tenth-grade follow-up, students responded to questions about their substance use habits, specifically their use of alcohol, cigarettes and marijuana.

Parents Can Influence Friends, Too

Behaviors of friends’ parents influenced substance use even when taking into account the effects of the teens’ own parents’ behaviors and their friends’ substance use, demonstrating the powerful effect of peers on adolescent behavior.

“I think that it empowers parents to know that not only can they have an influence on their own children, but they can also have a positive influence on their children’s friends as well,” said Cleveland. “And that by acting together — the notion of ‘it takes a village’ — can actually result in better outcomes for adolescents.”

May 2nd, 2012  in Substance Abuse No Comments »

TV alcohol ads may play role in underage drinking

Minors who were familiar with television alcohol advertisements were more likely to have tried alcoholic beverages and binge drink than those who could not recall seeing such ads, according to a study to be presented Sunday, April 29, at the Pediatric Academic Societies (PAS) annual meeting in Boston.

“Underage drinking remains an important health risk in the U.S.,” said lead author Susanne E. Tanski, MD, MPH, FAAP, assistant professor in the Department of Pediatrics at Children’s Hospital at Dartmouth, Dartmouth-Hitchcock Medical Center. “In this study, we have shown a link between recognition of nationally televised alcohol advertisements and underage drinking initiation and heavier use patterns.”

Promoting Risky Behaviors

Previous research by Dr. Tanski and her colleagues showed an association between seeing smoking and drinking in movies and adolescents engaging in these risky behaviors. This study expanded on that research by exploring whether there is an association between young people’s exposure to television alcohol advertising and substance use.

The researchers surveyed a national sample of 2,541 youths ages 15 to 20 years. Participants were asked about their age, gender, race, if their friends drank, if their parents drank, whether they had a favorite alcohol ad and whether they owned alcohol-branded merchandise. They also were asked questions to assess whether they engaged in “sensation-seeking” behavior.

Participants then were shown 20 still images selected from television ads for the top beer and spirit alcohol brands that aired on national television in the year before the survey as well as 20 ads for fast-food restaurants. The images were digitally edited to remove the brands and logos. Individuals were asked if they remembered seeing the ad, if they liked the ad and if they knew the product or restaurant being advertised.

TV Ads and Teens

Results showed that 59 percent of underage youths previously drank alcohol. Of those who drank, 49 percent binge drank (had more than six drinks in a row) at least once in the past year.

Familiarity with TV alcohol advertising was significantly higher for drinkers than for non-drinkers. Other factors linked with drinking alcohol included older age, seeing alcohol in movies, having a favorite alcohol ad, having greater propensity for sensation seeking, having friends who drink alcohol, and having parents who drink alcohol at least weekly.

Among those who drank alcohol, familiarity with TV alcohol advertising was linked with greater alcohol use and binge drinking. Other factors linked with more hazardous drinking included owning alcohol-branded merchandise, having a favorite alcohol ad, older age, male gender, sensation seeking and friend drinking.

More Strict Standards Needed?

Familiarity with fast-food TV advertising was not linked to drinking behavior, suggesting that the relationship between alcohol ad familiarity and drinking is specific and not due to overall familiarity with advertising, Dr. Tanski said.

“At present, the alcohol industry employs voluntary standards to direct their advertising to audiences comprised of adults of legal drinking age,” Dr. Tanski said. “Our findings of high levels of familiarity with alcohol ads demonstrate that underage youth still frequently see these ads. While this study cannot determine which came first — the exposure to advertising or the drinking behavior — it does suggest that alcohol advertising may play a role in underage drinking, and the standards for alcohol ad placement perhaps should be more strict.”

May 1st, 2012  in Alcohol No Comments »