This study investigated whether legalization of recreational marijuana sales and retail availability of marijuana in Oregon counties were associated with higher levels of marijuana use and related ...beliefs among adolescents.
Biennial data for 6th, 8th, and 11th graders from the 2010–2018 Student Wellness Survey in 35 Oregon counties (n=247,403) were analyzed in 2019 to assess changes in past 30–day marijuana use and beliefs (e.g., perceived availability of marijuana) in counties that allowed recreational marijuana sales in unincorporated areas beginning in October 2015 versus counties that did not. Analyses were also conducted with 2016 and 2018 Student Wellness Survey data (n=101,419) to determine whether the association between allowing recreational marijuana sales and marijuana use could be accounted for by retail marijuana outlet density and beliefs.
Higher rates of past 30–day marijuana use and more favorable beliefs were observed in counties that allow recreational marijuana sales in unincorporated areas, both before and after legalization of recreational sales in 2015. The prevalence of past 30–day marijuana use increased, relative to the downward secular trend, after legalization both in counties that did and did not allow recreational marijuana sales. There were parallel changes in beliefs favorable to marijuana use. Analyses with 2016 and 2018 Student Wellness Survey data suggested that the association between allowing recreational marijuana sales and past 30–day marijuana use could be accounted for by retail marijuana outlet density and beliefs.
Legalization and greater retail availability of recreational marijuana are positively associated with marijuana use among adolescents.
•Situational and social context characteristics increase risks for simultaneous use.•Larger numbers of underage drinkers increase risks for simultaneous use.•Lack of adult supervision increases risks ...for simultaneous use.•Simultaneous use is associated with increased subsequent risks.•Alcohol may be the primary contributor to risks associated with simultaneous use.
We investigated contexts of simultaneous use of alcohol and marijuana and the impact of simultaneous use on problems among adolescents. Ecological momentary assessment data were obtained over two weekends from 150 adolescents in California (47% female, M age=16.36years), using smartphone surveys administered early and late in the evening and again the following morning. We assessed whether, in what context, and with whom adolescents drank alcohol and used other substances over 3 evening hours. We assessed problems they experienced each evening on the following morning. Results showed that greater adult supervision in every context was associated with a 55% lower risk of simultaneous use (RRR=0.45, p≤.05). Contexts with no other underage drinkers were associated with 99% lower risk of simultaneous use (RRR=0.01, p≤.005). Each occasion of simultaneous use was related to 110% increase in the number of problems (IRR=2.10, p≤.005), with 83%, 221% and 311% greater odds of violence (OR=1.83, p≤.05), driving under the influence or riding with a drunk driver (OR=3.21, p≤.05), or being drunk (OR=4.11, p≤.005). Additional analyses showed that these problems may be attributed largely to the alcohol consumed in each context. Results demonstrate that it is essential to consider situational and social characteristics of substance use contexts to better understand adolescent simultaneous use of alcohol and drugs and problems.
This article provides a systematic review of cross-sectional research examining associations between exposure to alcohol marketing and alcohol use behaviors among adolescents and young adults.
...Literature searches of eight electronic databases were carried out in February 2017. Searches were not limited by date, language, country, or peer-review status. After abstract and full-text screening for eligibility and study quality, 38 studies that examined the relationship between alcohol marketing and alcohol use behaviors were selected for inclusion.
Across alcohol use outcomes, various types of marketing exposure, and different media sources, our findings suggest that cross-sectional evidence indicating a positive relationship between alcohol marketing exposure and alcohol use behaviors among adolescents and young adults was greater than negative or null evidence. In other words, cross-sectional evidence supported that alcohol marketing exposure was associated with young peoples' alcohol use behaviors. In general, relationships for alcohol promotion (e.g., alcohol-sponsored events) and owning alcohol-related merchandise exposures were more consistently positive than for other advertising exposures. These positive associations were observed across the past four decades, in countries across continents, and with small and large samples.
Despite issues of measurement and construct clarity within this body of literature, this review suggests that exposure to alcohol industry marketing may be important for understanding and reducing young peoples' alcohol use behavior. Future policies aimed at regulating alcohol marketing to a greater extent may have important short- and long-term public health implications for reducing underage or problematic alcohol use among youth.
ObjectiveWe conducted meta-analyses of studies that investigated the associations between tobacco outlet density around homes and schools and adolescents’ past-month cigarette smoking.Data ...sourcesSystematic literature searches of eight databases were carried out in February 2017. Searches were not limited by date, language, country or peer-reviewed status.Study selectionAfter screening for quality, studies that examined the relationship between tobacco outlet density and adolescents’ past-month smoking were selected for inclusion.Data extractionTwo investigators screened study abstracts and full texts and independently extracted data. Consensus was reached at each stage.Data synthesisRandom-effects meta-analyses were conducted on 11 studies that provided 13 effect sizes. Results showed that there was a significant association between tobacco outlet density around homes and adolescents’ past-month smoking behaviour, with an overall effect size of OR=1.08 (95% CI 1.04 to 1.13; P<0.001; I2=0%). For density around schools, the association was not statistically significant (OR=1.01, 95% CI 0.98 to 1.03; P=0.53; I2=39%).ConclusionsThese findings suggest that exposure to tobacco outlets near home environments may be important for understanding adolescents’ past-month smoking. Restricting access to tobacco outlets and controlling the number of outlets in residential areas may be an effective preventive strategy to help reduce adolescents’ smoking.
The legalization of recreational marijuana use and retail sales raises concerns about possible effects on marijuana use among adolescents. We evaluated the effects of recreational marijuana ...legalization (RML) in California in November 2016 on use among adolescents and investigated subgroup differences in these effects.
We analyzed data from successive cross-sectional samples of 7th, 9th, and 11th grade students (N = 3,330,912) who participated in the California Healthy Kids Survey from 2010-2011 to 2018-2019. Participants reported grade, sex, ethnicity, race, and lifetime and past-30-day marijuana use.
Multilevel analyses showed that RML was associated with increases in the likelihood of lifetime (odds ratio = 1.18, 95% CI 1.15, 1.21, p < .01) and past-30-day marijuana use (odds ratio = 1.23, 95% CI 1.20, 1.26, p < .01) relative to previous downward trends. RML was more strongly associated with increases in prevalence of marijuana use among 7th versus 9th and 11th graders, females versus males, non-Hispanic versus Hispanic youth, and White versus African American, American Indian/Native Alaskan, and multiracial youth. Overall, RML was not significantly associated with frequency of past-30-day use among users, although stronger positive associations between RML and frequency of use were found for 11th graders, Asian Americans, and African Americans. The association was weaker for females.
RML in California was associated with an increase in adolescent marijuana use in 2017-2018 and 2018-2019. Demographic subgroup differences in these associations were observed. Evidence-based prevention programs and greater local control on retail marijuana sales may help to reduce marijuana availability and use among adolescents.
Little is known about the possible impacts of recreational marijuana legalization on alcohol and marijuana co-use among underage youth. This study examines the association between recreational ...marijuana legalization in California in 2016 and alcohol and marijuana co-use among adolescents. Additional analyses investigate the associations between recreational marijuana legalization and co-use among past 30–day drinkers and marijuana users and the frequency of alcohol and marijuana use among co-users.
This study used annual cross-sectional data from 7th, 9th, and 11th graders (N=3,319,329) who participated in the California Healthy Kids Survey from 2010–2011 to 2018–2019. Measures included past 30–day alcohol and marijuana use and student demographic characteristics, survey year, pre–post recreational marijuana legalization, and urbanicity. Multilevel regression analyses were conducted in 2021.
Recreational marijuana legalization was associated with greater odds of past 30–day alcohol and marijuana co-use in the total sample (OR=1.06, 95% CI=1.05, 1.07). Recreational marijuana legalization was more strongly associated with co-use among adolescents who reported past 30–day alcohol use (OR=1.58, 95% CI=1.52, 1.62) and heavy drinking (OR=1.25, 95% CI=1.21, 1.29) but was inversely related to co-use among past 30–day marijuana users (OR=0.76, 95% CI=0.74, 0.78). Among past 30–day co-users, there was a positive association with the frequency of marijuana use (β=0.36, SE=0.07).
Recreational marijuana legalization may increase the risk of alcohol and marijuana co-use among adolescents. Greater restrictions on the numbers of alcohol and marijuana retail outlets and hours of operation and advertising and higher taxes on alcohol and marijuana products may help reduce the availability of these substances to adolescents.
The onset of alcohol use during adolescence is associated with concurrent and subsequent related problems. Research on drinking contexts that underly these key first-time experiences and how they ...differ by initiation type is needed. The current study examined the physical, social, and situational characteristics of three types of initiation: first drink, first heavy episodic drinking (HED), and first intoxication and considered variations between early and later initiating adolescents.
A mixed-methods approach was used to survey and interview adolescents who reported lifetime drinking. Survey responses from 471 participants were analyzed using multilevel multinomial and logistic regressions accounting for nesting of drinking events (i.e., type of initiation) within respondents. A subsample of 50 participants recruited at baseline took part in-depth interviews that were thematically coded.
After controlling for demographics, initiation of HED and intoxication, compared to initiation of a whole drink, were more likely to occur when more close friends are present and when those close friends are also drinking. The likelihood of early initiation of a whole drink and intoxication was also positively associated with being in an outdoor setting. Narratives identified distinct and shared patterns of context characteristics across the types of alcohol initiation.
The quantitative and qualitative findings revealed several parallels as well as aspects that differ, enriching our understanding of early drinking contexts. Results highlight the importance of considering contextual characteristics by initiation type for prevention efforts.
•Contexts were examined for three types of alcohol initiation: whole drink, heavy episodic drinking, and intoxication.•Physical, social, and situational context characteristics were uniquely associated with initiation type.•Adolescents explained the role of these contexts when considering their initiation of alcohol use.•Results suggest distinguishing initiation type for prevention.
Abstract Purpose This study investigates the associations between local tobacco policy, tobacco outlet density, and youth smoking. A primary focus is on whether local tobacco policy moderates the ...relation between outlet density and youth smoking. Methods In all, 1,491 youth (51.9% male, mean age = 14.7 years, standard deviation = 1.05) in 50 midsized California cities were surveyed through a computer-assisted telephone interview. Measures of local clean air policy and youth access policy were created based on a review of tobacco policies in these cities. Outlet density was calculated as the number of retail tobacco outlets per 10,000 persons, and city characteristics were obtained from 2000 U.S. Census data. Results Using multilevel regression analyses and controlling for city characteristics, tobacco outlet density was positively associated with youth smoking. No significant main effects were found for the two tobacco policy types on any of the smoking outcomes after controlling for interactions and covariates. However, statistically significant interactions were found between local clean air policy and tobacco outlet density for ever smoked and past 12-month cigarette smoking. Comparisons of simple slopes indicated that the positive associations between tobacco outlet density and youth smoking behaviors were stronger at the lowest level of local clean air policy compared with the moderate and high levels. Conclusions Our results suggest that tobacco outlet density is related to youth smoking. In addition, local clean air policy may act as a moderator of relationship between tobacco outlet density and youth smoking, such that density is less important at moderate and high levels of this tobacco policy.
We investigated social and situational characteristics associated with adolescents' drinking at party and non-party events and whether these associations vary by party location (homes versus other ...locations). Ecological momentary assessment data were obtained over two weekends from 149 adolescents in California (46% female, M age=16.4years), using smartphone surveys administered early and late in the evening and the following morning. We assessed whether, where, and with whom adolescents drank alcohol. Social contexts with more people (RRR=1.05, p≤0.005) and with mixed gender composition (RRR=3.15, p≤0.05) were positively associated with increased risks of alcohol use at parties, but not at non-party events. Conversely, social contexts with friends were positively associated with alcohol use at non-party events (RRR=4.32, p≤0.005), but not at parties. Perceived access to alcohol was associated with increased risks for alcohol use at both party and non-party events, but the association was stronger for alcohol use at parties than non-parties (RRR=1.85, p<0.005 versus 4.01, p≤0.005). Additional analyses showed that contexts with mixed gender composition were positively associated with alcohol use at parties not in homes (RRR=11.29, p≤0.05), and perceptions of getting caught by parents or police were negatively associated with non-party alcohol use in homes (RRR=0.57, p≤0.005). This study identified social-ecological contexts of underage drinking parties, which are high risk settings for heavier drinking and other alcohol-related problems. Findings can inform context-based interventions to target these high-risk settings, whether at homes or other locations.
•Parties with large numbers of people are risky contexts for underage drinking.•Access to alcohol increases risk for underage drinking at parties in home contexts.•Contexts with friends and people of mixed gender are risky for non-party drinking.•Perceptions of getting caught can prevent non-party underage drinking at home.•Enforcement and other prevention efforts should target and consider these contexts.
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