Substance Abuse News

It’s considered a rite of passage among young people – acting out their independence through heavy, episodic drinking. But a new University of Cincinnati study, the first of its kind nationally, is showing how binge drinking among adolescents and young adults could be causing serious damage to a brain that’s still under development at this age.

Researcher Tim McQueeny, a doctoral student in the UC Department of Psychology, is presenting the findings this week at the 34th annual meeting of the Research Society on Alcoholism in Atlanta.

Binge Drinking and the Brain

High-resolution brain scans on a sample of 29 weekend binge drinkers, aged 18 to 25, found that binge-drinking – consuming four or more drinks in one incident for females and five or more drinks for males – was linked to cortical-thinning of the pre-frontal cortex, the section of the brain related to executive functioning such as paying attention, planning and making decisions, processing emotions and controlling impulses leading to irrational behavior.

McQueeny examined the brain’s gray matter, the parts of brain cells that do the thinking, receiving and transmitting of messages. “We have seen evidence that binge drinking is associated with reduced integrity in the white matter, the brain’s highways that communicate neuron messaging, but alcohol may affect the gray matter differently than the white matter,” he says.

The pilot study examined whether the researchers could see a relationship between gray matter thickness and binge drinking among college-aged young adults. They found that greater number of drinks per binge is associated with cortical thinning. McQueeny is now interested in pursuing future research to examine whether binge drinking is affecting the brain’s gray matter and white matter differently, or if they’re both equally affected.

Brain Is Still Growing

“Alcohol might be neurotoxic to the neuron cells, or, since the brain is developing in one’s 20s, it could be interacting with developmental factors and possibly altering the ways in which the brain is still growing,” he says.

The findings affect a significant population. A publication from the National Institute on Drug Abuse reports that 42 percent of young American adults between 18 and 25 have engaged in binge drinking.

McQueeny adds that the depressant effects of alcohol emerge later in life, so for young adults, the effect of alcohol can be very stimulating and activate tolerance over time.

“In the past, in terms of what’s known about the physical toll of alcohol, the focus on neurobiology has been in pathological populations and adult populations who were disproportionately male, so there was a significant gap in research in terms of when people started risky drinking. We’re looking at developmental aspects at an age when binge drinking rates are highest, and we’re also looking at gender effects,” says McQueeny. “There might actually be indications of early micro-structural damage without the onset of pathological symptoms such as abuse, or dependence on alcohol.”

Resonsible Drinking Suggested

McQueeny’s advisor, UC Psychology Professor Krista Lisdahl Medina, served as senior author on the paper. She adds, “Our preliminary evidence has found a correlation between increased abstinence of binge drinking and recovery of gray matter volume in the cerebellum. Additional research examining brain recovery with abstinence is needed.”

In terms of educating young adults about responsible drinking, Medina says there appear to be better efforts about communicating the dangers of drinking and driving. “However, people can still be doing damage to their brain as a result of the prevalence and acceptance of binge drinking. There is also evidence that drinking below the binge level may be less harmful,” she says.

The high-resolution imaging was conducted at UC’s Center for Imaging Research.

The research was supported by a $300,000 grant awarded to Medina’s lab by the National Institute on Drug Abuse. McQueeny was also awarded a University Research Council Summer Graduate Fellowship.

Tobacco companies increased the advertising and lowered the sale price of menthol cigarettes in stores near California high schools with larger populations of African-American students, according to a new study from the Stanford School of Medicine.

Although cigarette makers have denied using race or ethnicity to target customers, the lead researcher for the study said the data shows a “predatory” marketing pattern geared to luring young African Americans into becoming smokers.

Racial Targeting Denied

“The tobacco companies went out of their way to argue to the Food & Drug Administration that they don’t use racial targeting,” said Lisa Henriksen, PhD, senior research scientist at the Stanford Prevention Research Center. “This evidence is not consistent with those claims.”

Henriksen is the first author of this study, which will be published online June 24 in Nicotine & Tobacco Research.

The study comes at a time when the FDA is gathering information on whether to ban menthol as a flavoring agent in cigarettes. A federal law passed in 2008 banned 13 candy flavorings in cigarettes but allowed for the continued use of menthol. Menthol makes the smoke from tobacco smoother and less harsh; even non- menthol cigarettes often have low levels of the substance.

A draft report by the Tobacco Products Scientific Advisory Committee, which the FDA asked to investigate the harms from the use and marketing of menthol cigarettes, found that the use of menthol cigarettes is highest among minorities, teenagers and low-income populations. Advertisements often tout the “freshness” of menthol cigarettes, and the report said many smokers mistakenly believe that the addition of menthol makes cigarettes less of a health risk.

The committee’s report says that “removal of menthol cigarettes from the marketplace would benefit public health in the United States,” but the FDA doesn’t have to follow the group’s recommendation. The committee is scheduled to meet July 21 in Rockville, Md., to discuss final changes to the document. An FDA spokesman said the edited version of the report will be posted soon on the agency’s website, but there is no timeline yet as to when the FDA will make a decision on menthol.

“The committee was charged with considering a broad definition of harm to smokers and other populations, particularly youth,” said Henriksen. “We think our study, which shows the predatory marketing in school neighborhoods with higher concentrations of youth and African-American students, fits a broad definition of harm.”

Preference for Menthol Cigarettes

In the Stanford study, Henriksen and her colleagues note that the preference for menthol cigarettes among teenage smokers increased from 43.4 percent in 2004 to 48.3 percent in 2008. Menthol cigarettes were also most popular among African-American smokers ages 12-17 (71.9 percent), compared to Hispanics (47 percent) and non-Hispanic whites (41 percent) of the same ages.

To find out how the leading brands of menthol and non-menthol cigarettes were promoted near California high schools, the researchers randomly selected convenience stores, small markets and other tobacco retailers within easy walking distance of 91 schools. The researchers then rated how the cigarettes were marketed in those stores. The data were collected in 2006.

The researchers found that for every 10-percentage-point increase in the proportion of African-American students at a school, the proportion of advertisements for menthol cigarettes increased by 5.9 percentage points. Additionally, the odds of an advertised discount for Newport, the leading brand of menthol cigarettes, were 1.5 times greater.

When it came to price, the average per-pack price for Newport was $4.37 at the time of the study, with Marlboro – the leading non-menthol brand – averaging $3.99. It also found that for every 10-percentage-point increase in the proportion of African-American students at the nearby school, the per-pack price for Newport was 12 cents lower. Advertised discounts and prices for Marlboro, however, were unrelated to school or neighborhood demographics.

“That’s important because lower prices tend to lead to increased cigarette use,” Henriksen said.

In addition, the study found that for each 10-percentage-point increase in the proportion of neighborhood residents ages 10-17, the proportion of menthol advertisements increased by 11.6 percentage points, and the odds of an advertised discount for Newport was 5.3 times greater.

Although the study was limited to California high schools, the authors believe the findings would be similar throughout the country.

Advertising Targets Teens

“When kids are exposed to more cigarette advertising they are more likely to start smoking, which will undoubtedly lead to dire health consequences,” said senior author Stephen Fortmann, MD, a professor emeritus of medicine at Stanford who is now a senior investigator at Kaiser Permanente Center for Health Research in Portland, Ore. “Our study finds that tobacco companies are trying to make smoking more attractive to teens, when we as a society should be doing just the opposite.”

Given previous research that young smokers and African-American smokers are more sensitive to prices than other groups, Fortmann and Henriksen said they believe this study clearly shows how tobacco companies are trying to target black teens in marketing menthol cigarettes.

“Adding menthol to cigarettes makes it easier to smoke and harder to quit, so the public health community strongly supports an FDA ban on menthol flavoring,” Fortmann said.

While alcohol has a wide range of pharmacological effects on the body, the brain is a primary target. However, the molecular mechanisms by which alcohol alters neuronal activity in the brain are poorly understood. Participants in a symposium at the June 2010 annual meeting of the Research Society on Alcoholism in San Antonio, Texas addressed recent findings concerning the interactions of alcohol with prototype brain proteins thought to underlie alcohol actions in the brain.

Proceedings will be published in the September 2011 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

Effects of Alcohol on the Brain

“Alcohol is the most common drug in the world, has been used by diverse human communities longer than recorded history, yet our understanding of its effects on the brain is limited when compared to other drugs,” said Rebecca J. Howard, a postdoctoral fellow at The University of Texas at Austin Waggoner Center for Alcohol & Addiction Research and corresponding author for this study.

Howard explained that neuroscientists have discovered how marijuana, cocaine, and heroin each bind to a special type of protein on the surface of brain cells, fitting like a key into a lock to change that protein’s normal function. Yet alcohol has special properties that make it difficult to characterize its lock-and-key binding in detail, for example, alcohol is much smaller than other drugs, and appears to interact with several different types of proteins.

“The adverse effects of alcohol abuse are devastating on a personal level and on a societal level,” added Gregg Homanics, a professor of anesthesiology and pharmacology & chemical biology at the University of Pittsburgh. “Alcohol abuse costs our society more than the costs of all illegal drug abuse combined. For many years, most investigators thought that alcohol exerted nonspecific effects on the brain and simply perturbed neuronal function by dissolving in the membranes of nerve cells. However, our understanding of alcohol action has dramatically shifted in the last 10 to 15 years or so. There is now solid experimental evidence that alcohol binds in a very specific manner to key protein targets in the brain to cause the drug’s well known behavioral effects. This review summarizes some of the most recent research.”

Recent Alcohol Research

Some of the key points were:

Combining X-ray crystallography, structural modeling, and site-directed mutagenesis may be better suited to studying alcohol’s low-affinity interactions than traditional techniques such as radioligand binding or spectroscopy.

“One major problem in studying alcohol binding to brain proteins is that the alcohol key does not fit very tightly into any particular protein lock,” said Howard. “That is, alcohol has a ‘low affinity’ for proteins, compared to how other drugs interact with their own protein targets. We think this is one reason it takes such a large quantity of alcohol to affect the brain: whereas users of cocaine or heroin may consume just a few milligrams at a time, a person drinking a shot of strong liquor consumes about 1,000 times that much alcohol (several grams). The low affinity of alcohol for its protein targets [also] makes it difficult to study by traditional methods that rely on detecting stable drug-protein complexes over a long period of time.”

Some common themes are beginning to emerge from a review of diverse proteins such as inwardly rectifying potassium, transient receptor potential, and neurotransmitter-gated ion channels, as well as protein kinase C epsilon.

Alcohol Targets in the Brain

“It is now very clear that hydrophobic pockets exist in the structure of various brain proteins and alcohols can enter those pockets,” said Homanics. “Alcohols interact with specific amino acids that line those pockets in a very specific manner.”

In particular, evidence is emerging that supports characteristic, discrete alcohol binding sites on protein targets.

“Different drugs bind to different types of proteins on the surface of brain cells, each fitting like a key, or drug, into a lock, or binding site, on a protein to change its normal function,” explained Howard. “Understanding the exact shape of that lock and key helps us to understand how individuals with special mutations may be affected differently by drugs, and can help scientists design new medicines to help people with drug abuse or other problems.”

The Brain’s Binding Sites

“I feel that there is now overwhelming evidence that specific alcohol binding sites exist on a variety of brain protein targets,” added Homanics. “This is significant because we can now focus on defining these sites in greater detail, ultimately at the level of each atom involved. This will allow for, one, a more complete understanding of the molecular pharmacology of alcohol action, two, the discovery of similar sites on other important brain proteins, and three, the rational design of drugs that can selectively target these binding sites.”

“Our review summarizes very recent advances in understanding the molecular details of alcohol binding sites, which now include human brain targets, not just metabolic enzymes and receptors from other species,” said Howard. “This information will give researchers new opportunities to characterize human mutations and design new medicines. Furthermore, common themes emerging about alcohol binding sites may help scientists identify important binding sites in other important brain proteins.”

Highly Selective Targets

“In other words,” said Homanics, “alcohol exerts its effects via binding sites on target molecules just like all other drugs we know about. There is now solid evidence from several different putative alcohol targets using several different techniques that alcohol interacts with specific brain targets in a highly selective manner. This is particularly important for more senior clinicians and researchers that were trained years ago when the predominant theory of alcohol action was via nonspecific effects on the nervous system.” Both Howard and Homanics are hopeful that this research will aid the development of therapies and treatments for individuals with alcohol problems.

“Great progress is being made in understanding how alcohol exerts its effects on the brain at the molecular level,” noted Homanics. “Understanding how alcohol affects brain proteins on a molecular level is essential if we are to effectively develop rational treatments to combat alcohol use disorders.”

A new report shows that alcohol dependence is four times more likely to occur among adults with mental illness than among adults with no mental illness (9.6-percent versus 2.2-percent).

Based on a nationwide survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) the report also shows that the rate of alcohol dependency increases as the severity of the mental illness increases. For example, while 7.9-percent of those with mild mental illness were alcohol dependent, 10-percent of those with moderate mental illness and 13.2-percent of those with serious mental illness were alcohol dependent.

“Mental and substance use disorders often go hand in hand. This SAMHSA study adds to the evidence of this connection,” said SAMHSA Administrator Pamela S. Hyde, J.D. “Co-occurring mental illness and substance use disorders are to be expected not considered the exception. Unfortunately, signs and symptoms of these behavioral health conditions are often missed by individuals, their friends and family members and unnoticed by health professionals. The results can be devastating and costly to our society.”

Behavioral Health Issues

The SAMHSA Spotlight report, “Alcohol Dependence is More Likely among Adults with Mental Illness than Adults without Mental Illness” was developed as part of SAMHSA’s strategic initiative on data, outcomes, and quality – an effort to inform policy makers and service providers on the nature and scope of behavioral health issues. The report is based on data from the 2009 National Survey of Drug Use and Health – a state-of-the-art scientific survey of a large representative sample of people throughout the United States.

The full report is available on the web.

Female prisoners who did not participate in a drug treatment program after their release were 10 times more likely to return to prison within one year than other prisoners, a new study has found.

More than one-third of those women were sent back to prison within six months, according to the national study led by Flora Matheson, a medical sociologist at St. Michael’s Hospital.

The findings, published in the American Journal of Public Health, underline the importance of post-release treatment programs for prisoners with substance abuse problems, Matheson said.

Women Vulnerable to Relapse

Since women are particularly vulnerable to drug relapse in the first two or three weeks after release, it’s important to begin the community care programs as soon as possible, she said.

“We don’t want these women re-offending, we want them to remain in the community and be successful,” said Matheson, a scientist in the hospital’s Centre for Research on Inner City Health who collaborated on the study with the Research Branch of the Correctional Service of Canada.

Matheson evaluated the effectiveness of the Community Relapse Prevention and Maintenance program, which was developed by CSC in 2003 for women on parole from six federal prisons. At the time the study was conducted, the community portion of the program consisted of 20, two-hour group sessions offered on a weekly basis. Cocaine was the most common drug that had been used by women in the program (58.9 per cent), followed by crack cocaine (44.3 per cent).

Women who were not exposed to the program were more than 10 times more likely to be back in prison within 52 weeks.

One-Third of Convictions Drug Related

Women make up five per cent of the federal prison population in Canada, although that number has tripled in the past 20 years. About one-third of them were convicted of drug-related offenses.

Matheson noted that drug-using offenders are twice as likely to have unstable housing in the community, are less able to manage stress, are hospitalized more often for mental health issues and have higher recidivism rates than do non-substance-abusing women. Many of them have experienced trauma in their lives, such as childhood, physical or sexual abuse, or domestic abuse, which may have contributed to their substance abuse and mental health issues.

She said there are many barriers to women who want to participate in post-release treatment programs, including childcare and high unemployment rates that make it difficult to afford transportation. Canada is such a vast country geographically that it’s difficult for CSC and other correctional jurisdictions to offer treatment programs in every community.

Teenagers who drink alcohol spend more time on their computers for recreational use, including social networking and downloading and listening to music, compared with their peers who don’t drink.

Results of an anonymous survey of 264 teenagers were reported in the online edition of the journal Addictive Behaviors in a study authored by Weill Cornell Medical College public health researcher Dr. Jennifer Epstein.

Early Exposure to the Internet

“While the specific factors linking teenage drinking and computer use are not yet established, it seems likely that adolescents are experimenting with drinking and activities on the Internet. In turn, exposure to online material such as alcohol advertising or alcohol-using peers on social networking sites could reinforce teens’ drinking,” says Dr. Epstein, assistant professor of public health at Weill Cornell Medical College. “Children are being exposed to computers and the Internet at younger ages. For this reason it’s important that parents are actively involved in monitoring their children’s computer usage, as well as alcohol use.

“According to a national study conducted by the Pew Internet and American Life Project, more than half of parents of teenagers had filters installed on the computers their child uses to block content parents find objectionable, yet many parents do not use any form of parental monitoring, particularly for older teens,” continues Dr. Epstein.

Drinking Linked to Computer Use

The Weill Cornell survey was completed by participants aged 13 to 17 and residing in the United States. Results showed that teens who reported drinking in the last month used a computer more hours per week excluding school work than those who did not; however, there was no demonstrated link between alcohol use and computer use for school work. Drinking was also linked to more frequent social networking and listening to and downloading music. There was no strong link between video games and drinking or online shopping and drinking.

“Going forward, we would like to collect more detailed and longer-term data on adolescent alcohol and computer use, including the degree and duration of their drinking habit,” says Dr. Epstein.

Teenagers typically first experiment with alcohol at age 12 or 13. Family risk factors include lax parental supervision and poor communication, family conflicts, inconsistent or harsh discipline and a family history of alcohol or drug abuse.

Impact of New Media

“Parents may also need to reinforce their family ground rules on alcohol use and computer use,” Dr. Epstein says.

“This is an innovative study that is an important first step to understanding the potential impact that the Internet and new media may have on today’s youth,” says Dr. Gil Botvin, professor of public health and chief of the Division of Prevention and Health Behavior at Weill Cornell Medical College. “The Internet offers a wealth of information and opportunities for intellectual and social enrichment. However, it is becoming clear that there may also be a downside to Internet use. More systematic research is needed to better understand to those potential dangers and how to combat them.”

ncreasing access to rogue online pharmacies – those which dispense medications without a doctor’s prescription – may be an important factor behind the rapid increase in the abuse of prescription drugs. In a report in the journal Health Affairs, investigators from Massachusetts General Hospital (MGH) and the University of Southern California (USC) find that states with the greatest expansion in high-speed Internet access from 2000 to 2007 also had the largest increase in admissions for treatment of prescription drug abuse.

Internet Growth a Factor

“We know we face a growing problem with prescription drug abuse in the United States. One need only look at statistics for college campuses, where prescription drugs are fast replacing illegal substances, to see the magnitude of the problem,” says Dana Goldman, PhD, director of the Schaeffer Center for Health Policy and Economics at USC, the study’s senior author. “Our findings suggest that Internet growth may partly explain the increase in prescription drug abuse, since it is well known that these drugs are easily available online.” Goldman is also the Norman Topping/National Medical Enterprises Chair in Medicine and Public Policy at USC.

In their report, Goldman and lead author Anupam B. Jena, MD, PhD, of the MGH Department of Medicine, note that the recent marked rise in the abuse of prescription narcotic painkillers – drugs like Percocet and Oxycontin – corresponds with an increase in the presence of online pharmacies, many of which do not adhere to regulations requiring a physician’s prescription. Drugs that are frequently abused – painkillers, stimulants, sedatives and tranquilizers – often can be purchased from rogue sites that may be located outside the U.S. The current study was designed to examine the potential link between online availability and prescription drug abuse, an association that has been suspected but not investigated in depth.

Increase in High-Speed Access

Using data available from the Federal Communications Commission, the researchers first compiled statistics on access to high-speed Internet service in each state during the years studied. Since actual rates of prescription drug abuse would be difficult if not impossible to calculate, they used information on admissions to substance abuse treatment facilities from a database maintained by the U.S. Substance Abuse and Mental Health Administration.

Changes in both measures over the seven years were analyzed on a per-state basis, and treatment admissions were categorized by the particular types of abused substances involved.

No Increase in Illegal Drug Use

The analysis indicated that each 10 percent increase in the availability of high-speed Internet service in a state was accompanied by an approximately 1 percent increase in admissions for prescription drug abuse. The increases were strongest for narcotic painkillers, followed by anti-anxiety drugs, stimulants and sedatives. During the same period admissions to treat abuse of alcohol, heroin or cocaine, substances not available online, showed minimal growth or actually decreased.

“The lack of an increase in abuse of drugs not available on the Internet suggests that an overall growth in drug-seeking behavior cannot explain the rise in prescription drug abuse,” Jena says. “Further studies need to better evaluate how easily commonly abused prescription drugs can be purchased online and explore the importance to the problem of foreign Internet pharmacies, which are outside the jurisdiction of the U.S. government.”

Binge drinking is prevalent among university students, especially in the United States. One brain structure particularly sensitive to alcohol’s neurotoxicity during development is the hippocampus, which plays a key role in learning and memory. A study of the association between binge drinking and declarative memory – a form of long-term memory – in university students has found a link between binge drinking and poorer verbal declarative memory.

“In northern European countries, there is a strong tradition of a sporadic, drunkenness-orientated, drinking style,” explained María Parada, a postdoctoral researcher at the Universidade de Santiago de Compostela, Spain and first author of the study. “In contrast, countries on the Mediterranean coast, such as Spain, have traditionally been characterized by a more regular consumption of low doses of alcohol. In recent years, the pattern of binge drinking among young people has become more widespread throughout Europe, hence the growing concern about this issue.”

Binge Drinking and Memory

“I think it´s important to examine alcohol´s effects on the hippocampus because in animal studies, particularly in rats and monkeys, this region appears sensitive to the neurotoxic effects of alcohol, and this structure plays a main role in memory and learning,” said Marina Rodríguez Álvarez, a senior researcher at the Universidad de Santiago de Compostela. “In other words, binge drinking could affect memory of young adults, which might affect their day-to day lives.”

“Our interest in studying the effects of binge drinking patterns on declarative memory results from the well-established role of the hippocampus – a small seahorse-shaped brain structure located in the medial regions of the cerebral hemispheres – in this cognitive function,” added Parada. “Both animal studies as well as some neuroimaging studies in humans have shown the hippocampus to be particularly vulnerable to the effects of alcohol, so we wondered whether hippocampus-dependent learning and memory could be affected by heavy episodic drinking.”

Parada and her colleagues examined 122 Spanish university students between 18 and 20 years of age divided into two groups: those who engaged in binge drinking (n=62; 32 men, 30 women) and those who did not (n=60; 31 men, 29 women). All were administered a neuropsychological assessment that included the Rey Auditory Verbal Learning Test and the Wechsler Memory Scale-3rd ed. (WMS-III) Logical Memory subtest to measure verbal declarative memory, as well as the WMS-III Family Pictures subtest to measure visual declarative memory.

College Students Affected

“Our main finding was a clear association between binge drinking and a lower ability to learn new verbal information in healthy college students, even after controlling for other possible confounding variables such as intellectual levels, history of neurological or psychopathological disorders, other drug use, or family history of alcoholism,” said Parada.

“Young adults with a binge drinking pattern of alcohol consumption who have poorer verbal declarative memory will need more neural resources to perform memory tasks and to learn new information, which probably would affect their academic performance,” observed Rodríguez Álvarez.

Parada was a little more cautious. “Although it seems reasonable to expect that these differences in declarative memory affect academic performance – because it depends on the ability to learn new information – there are many other variables that may modulate and explain this relationship, for example, student effort or class attendance,” she said. “We are currently carrying out a longitudinal study of these young people, and collecting information on their academic achievements, so we hope to be able to answer this question more definitively in the near future.”

One of the strengths of this study, added Parada, is that it controlled for confounding variables such as psychiatric comorbidity, genetic vulnerability, or other drug use, such as marijuana. “This allowed us to establish a clearer association between binge drinking patterns and poorer performance on memory tasks,” she said.

An additional strength, said Rodríguez Álvarez, was the finding that women are not more vulnerable than men to the neurotoxic effects of binge drinking.

Both Parada and Rodríguez Álvarez noted the importance of prevention programs and policies to address this issue.

Low Perception of Risk

“One of the factors that appear to be behind this pattern of consumption is the low perception of risk,” said Parada. “Whereas most attention has focused on negative consequences such as traffic accidents, violence or public disorder, society and students themselves are unaware of the damaging effects binge drinking may have on the brain. Policies and prevention programs in Europe aimed at controlling this pattern of consumption on campus are still rare.”

Yet the opposite should be occurring, added Rodríguez Álvarez. “These results should be taken into account by parents, clinicians, university administrators, and also governments because it is vital to address all that surrounds the brain’s development in our adolescents and young adults.”

Results will be published in the August 2011 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

Teenagers who drink alcohol spend more time on their computers for recreational use, including social networking and downloading and listening to music, compared with their peers who don’t drink.

Results of an anonymous survey of 264 teenagers were reported in the online edition of the journal Addictive Behaviors in a study authored by Weill Cornell Medical College public health researcher Dr. Jennifer Epstein.

Experimenting With Drinking

“While the specific factors linking teenage drinking and computer use are not yet established, it seems likely that adolescents are experimenting with drinking and activities on the Internet. In turn, exposure to online material such as alcohol advertising or alcohol-using peers on social networking sites could reinforce teens’ drinking,” says Dr. Epstein, assistant professor of public health at Weill Cornell Medical College. “Children are being exposed to computers and the Internet at younger ages. For this reason it’s important that parents are actively involved in monitoring their children’s computer usage, as well as alcohol use.

“According to a national study conducted by the Pew Internet and American Life Project, more than half of parents of teenagers had filters installed on the computers their child uses to block content parents find objectionable, yet many parents do not use any form of parental monitoring, particularly for older teens,” continues Dr. Epstein.

More Computer Use

The Weill Cornell survey was completed by participants aged 13 to 17 and residing in the United States. Results showed that teens who reported drinking in the last month used a computer more hours per week excluding school work than those who did not; however, there was no demonstrated link between alcohol use and computer use for school work. Drinking was also linked to more frequent social networking and listening to and downloading music. There was no strong link between video games and drinking or online shopping and drinking.

“Going forward, we would like to collect more detailed and longer-term data on adolescent alcohol and computer use, including the degree and duration of their drinking habit,” says Dr. Epstein.

Teenagers typically first experiment with alcohol at age 12 or 13. Family risk factors include lax parental supervision and poor communication, family conflicts, inconsistent or harsh discipline and a family history of alcohol or drug abuse.

Reinforce Ground Rules

“Parents may also need to reinforce their family ground rules on alcohol use and computer use,” Dr. Epstein says.

“This is an innovative study that is an important first step to understanding the potential impact that the Internet and new media may have on today’s youth,” says Dr. Gil Botvin, professor of public health and chief of the Division of Prevention and Health Behavior at Weill Cornell Medical College. “The Internet offers a wealth of information and opportunities for intellectual and social enrichment. However, it is becoming clear that there may also be a downside to Internet use. More systematic research is needed to better understand to those potential dangers and how to combat them.”

Parents shouldn’t let up when it comes to discouraging their kids from smoking.

That’s the message of a study to be presented Monday, May 2, at the Pediatric Academic Societies (PAS) annual meeting in Denver.

Previous research has shown that parents can deter adolescents from smoking by monitoring them and enforcing anti-smoking practices at home. Researchers, led by E. Melinda Mahabee-Gittens, MD, an emergency medicine physician at Cincinnati Children’s Hospital Medical Center, sought to determine if family factors continue to protect adolescents as they grow older and whether these factors affect youths of varying racial/ethnic backgrounds differently.

Family Factors in Smoking

Investigators studied 3,473 pairs of white, black and Hispanic parents and nonsmoking youths who participated in the National Survey of Parents and Youth in November 1999-June 2001 (Time 1) and again in July 2002-June 2003 (Time 2). They looked at whether youths remained nonsmokers throughout the study period, and they assessed changes in family factors thought to protect against smoking initiation over time.

Results showed no differences in the rate of smoking initiation between Time 1 and Time 2 by race. In addition, youths in all three racial/ethnic groups reported associating more with peers who smoked at Time 2 than at Time 1.

The levels of protective family factors decreased significantly from Time 1 to Time 2 across all racial/ethnic groups in both smokers and nonsmokers. However, levels of protective factors were consistently higher in nonsmoking youths compared to smokers. Continued, higher levels of connectedness and monitoring by parents decreased the risk of smoking initiation by as much as 30 percent in both whites and Hispanics.

Increased Risk of Smoking

Meanwhile, decreases in the following family factors from Time 1 to Time 2 were associated with an increased risk that youths would start smoking: 1) punishment: up to 43 percent increased risk in all three racial/ethnic groups; 2) monitoring: 42 percent increased risk in blacks only; and 3) connectedness: up to 26 percent increased risk in both blacks and Hispanics.

“Even though the level of protective family factors decreased as youth grew older, they remained important in continuing to protect against smoking initiation,” said Dr. Mahabee-Gittens, who is also associate professor of pediatrics at the University of Cincinnati. “These findings support smoking prevention interventions that encourage parents of all three racial/ethnic groups to enforce consistent consequences of smoking behavior, and encourage continued monitoring and connectedness in minority groups.”