Background
Examining underage drinking contexts can advance the field of adolescent substance use prevention by supporting and informing interventions that can target adolescents in specific ...contexts. The current study examines how concurrent and lagged situational (i.e., alcohol availability and adult supervision), social (i.e., the number of people and presence of friends), and location (i.e., home vs other location) context characteristics change risks for alcohol use over the night course.
Methods
Text messages with links to online surveys were used to collect ecological momentary assessment (EMA) data over 2 weekends from adolescents in California. Data were collected using adolescents’ personal cell phones early and late in the evening and the following morning. Analyses were limited to adolescents with at least 1 drinking occasion during EMA (N = 58; Mage = 16.64, SD = 0.74; 48% female; 83% White).
Results
Drinking earlier in the evening was positively associated with continued drinking over the night course. Context characteristics were found to play important concurrent and lagged roles in increasing the likelihood of alcohol use over evening hours.
Conclusions
Findings indicated substantive concurrent and lagged social, situational, and location‐based contextual effects on adolescent alcohol use over the course of an evening. Importantly, context characteristics were differentially associated with alcohol use over the course of the evening. The fact that these contextual factors are modifiable suggests that the use of prevention strategies delivered to adolescents throughout the evening may reduce adolescents’ drinking and related problems over the evening hours.
We examined how concurrent and lagged context characteristics change risks for alcohol use among adolescents over the night course. Using an ecological momentary assessment data, results show that situational (i.e., alcohol availability and adult supervision), social (i.e., the number of people and presence of friends), and location (i.e., home settings) context characteristics change risks for adolescents’ nighttime alcohol use. Results suggest that the use of prevention strategies delivered throughout the evening hours may reduce adolescents’ drinking and related problems.
Background and Aim
To inform the development of effective night‐time preventive interventions, our goal was to assess adolescents’ residence (i.e. being at) and transitions across contexts during ...evening hours and risks for drinking and drinking‐related problems in relation to contexts and to these transitions.
Design
Ecological momentary assessment and survey methods.
Setting
Twelve mid‐sized cities (50 000–500 000 population) in California, USA from December 2014 to September 2015.
Analytical sample
A total of 153 adolescents (mean age = 16.4, 46.2% female).
Measurement
Initial conditions (e.g. past‐year heavy drinking, gender, best friend's approval of drinking); adolescents’ residence (i.e. being at) and transitions between (a) their own homes, (b) others’ homes and (c) public spaces (e.g. restaurants, parks, concert venues) at early, middle and late evening hours; drinking in these contexts at early, middle and late evening hours; and drinking‐related problems across evening hours.
Findings
Risks for drinking were 23.5 times greater in others’ homes (P < 0.01) and somewhat less in public spaces odds ratio (OR) = 6.01, P < 0.01, compared with own home. Risks for problems in any evening time were elevated in relation to being in others’ homes (OR = 2.37, P < 0.05) and public spaces (OR = 2.71, P < 0.01) versus at own home. Drinking in others’ homes was related to 5.9 times increase in odds of transitioning back to own home (OR = 5.93, P < 0.05), 11.9 times increase in odds of remaining in others’ homes (OR = 11.86, P < 0.01) or 7.3 times increase in odds of transitioning from others’ homes to public spaces (OR = 7.3, P < 0.05). Initial conditions were associated with being in states, drinking and problems during evening hours and transitions across states.
Conclusions
In California, adolescents who are older, female, Hispanic or have greater spending money may be more likely to be outside their own home during evening hours than adolescents who do not match those criteria. In turn, being outside one's home during evening hours appears to be related to greater risks for drinking and drinking‐related problems. Finally, transitions between contexts increased differential risks for drinking such that, for example, drinking in others’ homes was highly related to transitioning to public spaces and less to returning to own home.
Introduction
To address gaps in existing research, the current study used a mixed‐methods approach to describe, contextualise and understand harm perceptions of vaping nicotine relative to cigarette ...smoking and associations with nicotine and tobacco (NT) use among young adults who identify their genders and sexualities in ways that classify them as sexual and gender minorities (SGM).
Methods
Results are based on cross‐sectional surveys and online qualitative interviews with 98 SGM young adults (18–25 years old) in California's San Francisco Bay Area who currently or formerly used combustible tobacco. We generated a measure assessing participants' relative harm perceptions of e‐cigarette use versus cigarette smoking and identified those who perceived cigarette smoking as more harmful than e‐cigarette use compared to those who perceived it to be equally or less harmful.
Results
We found that relative harm perceptions of cigarette smoking versus e‐cigarette use are likely related to much uncertainty and confusion about the harms of e‐cigarette use. Moreover, findings illustrate that public health messages regarding the risks of e‐cigarette use may have unintended consequences of increasing cigarette use to replace e‐cigarette use for some SGM young adults, a practice that is incongruent with scientific evidence demonstrating that cigarettes and other combustible tobacco products are riskier than e‐cigarettes and other forms of NT use.
Discussion and Conclusions
Results suggest the need for evidence‐based, clear, and direct messaging about the relative harms of cigarettes versus e‐cigarettes to reduce NT‐related inequities in SGM populations.
Aims
To examine whether daily exposure to tobacco outlets within activity spaces is associated with cigarette smoking and with the number of cigarettes smoked by youth that day.
Design
The study used ...geographic ecological momentary assessment (GEMA) data that combined daily surveys with ecological momentary assessment of global positioning systems (GPS) using geographic information systems (GIS) to allow for real‐time data collection of participants' environments and behaviors.
Setting
Eight mid‐sized California (USA) city areas.
Participants
The analytical sample included 1065 days, which were clustered within 100 smoker and non‐smoker participants (aged 16–20 years, 60% female).
Measurements
Any cigarette smoking and number of cigarettes smoked on a given day, the number of tobacco outlets within 100 m of activity space polylines each day, the number of minutes participants spent within 100 m of tobacco outlets each day and demographic characteristics (age, sex, race/ethnicity and perceived socio‐economic status).
Findings
Controlling for demographic characteristics, the findings of multi‐level mixed effects logistic models were inconclusive, whether or not the number of tobacco outlets within 100 m of youths' activity space polylines or the number of minutes spent within 100 m of tobacco outlets were associated with whether the participant smoked cigarettes on a given day odds ratio (OR) = 1.05, P = 0.24; OR = 0.99, P = 0.81, respectively. However, in multi‐level zero‐inflated negative binomial models, the risk of smoking an additional cigarette on a given day increased with each additional tobacco outlet incidence rate ratio (IRR) = 1.04, P < 0.05 and each additional minute spent within 100 m of tobacco outlets (IRR = 1.01, P < 0.001) each day.
Conclusions
Among young people in urban California, differences in day‐to‐day exposure to tobacco outlets within activity spaces does not seem to be significantly associated with whether a person smokes a cigarette on a given day, but higher exposure to tobacco outlets appears to be positively associated with the number of cigarettes smoked on that day.
Introduction and Aims. Little is known about social–ecological correlates of simultaneous use of alcohol with other substances. This study examined places and social contexts associated with ...simultaneous use of alcohol, tobacco and marijuana among young adults. Design and Methods. We used survey data obtained from 1538 young adult recent alcohol drinkers (49% male; 18–30 years old) in 24 non‐contiguous cities in California. Event‐level measures included alcohol, tobacco and marijuana use, drinking places and social characteristics of the event. Individual‐level measures included alcohol expectancies, depression and demographics. Results. Bars and restaurants had less alcohol and marijuana use (odds ratio = 0.34; 95% confidence interval 0.18, 0.62; P < 0.001) and alcohol, marijuana and tobacco use (odds ratio = 0.27; 95% confidence interval 0.14, 0.54; P < 0.001) compared with alcohol use only. Perceived percent of intoxicated people at an event was associated with greater likelihood of using alcohol with tobacco and marijuana at the event. At the individual level, greater age was generally associated with increased odds of simultaneous use. Participants who were male, less educated, more depressed and had positive alcohol expectancies were more likely to simultaneously co‐use alcohol with tobacco and marijuana. Those with negative expectancies were less likely to simultaneously use these substances. Discussion and Conclusions. Social events in private settings with a high percentage of people who are intoxicated had increased likelihood of simultaneous use of alcohol, tobacco and marijuana. Prevention efforts in these settings may reduce simultaneous use of these substances and related harms. Lipperman‐Kreda S, Paschall MJ, Saltz RF, Morrison CN. Places and social contexts associated with simultaneous use of alcohol, tobacco and marijuana among young adults. Drug Alcohol Rev 2017;00:000–000
Background
To identify drinking contexts toward which prevention efforts should be directed, associations of context‐specific alcohol use (past‐year frequency of drinking and heavier drinking in the ...context) with a range of alcohol‐related problems were examined in a population sample of adolescents.
Methods
A sample of youths (ages 15 to 18) residing in 50 medium‐to‐large California cities (n = 473 drinkers) was obtained. Respondents provided information about 7 past‐year alcohol‐related problems in 3 domains (physiological consequences, alcohol‐related violence, and conflict/trouble) and the number of times in the past year they used 6 distinct drinking contexts (parties, restaurants/bars, parking lots/street corners, beaches/parks, respondent's home without parents, and someone else's home without parents). Context‐specific dose–response model was estimated for each context using censored Tobit models with heteroskedasticity corrections.
Results
Physiological problems were associated with more frequent drinking in 5 of 6 contexts. Heavier drinking in restaurants/bars/nightclubs (b = 0.22, SE = 0.10) and someone else's home without parents (b = 0.14, SE = 0.06) was associated with greater risk of violence. Conflict/trouble was associated with more frequent drinking in parking lots/street corners, declining at higher levels of drinking.
Conclusions
Certain drinking contexts are related to problems among youths, some because they are associated with frequent alcohol consumption and others because they are associated with heavier drinking. Identifying which drinking contexts are related to specific alcohol‐related problems and why is an essential component of developing effective preventive interventions.
Aims
To estimate the relationships of tobacco outlet density, cigarette sales without ID checks and local enforcement of underage tobacco laws with youth's life‐time cigarette smoking, perceived ...availability of tobacco and perceived enforcement of underage tobacco laws and changes over time.
Design
The study involved: (a) three annual telephone surveys, (b) two annual purchase surveys in 2000 tobacco outlets and (c) interviews with key informants from local law enforcement agencies. Analyses were multi‐level models (city, individual, time).
Setting
A sample of 50 mid‐sized non‐contiguous cities in California, USA.
Participants
A total of 1478 youths (aged 13–16 at wave 1, 52.2% male); 1061 participated in all waves.
Measurements
Measures at the individual level included life‐time cigarette smoking, perceived availability and perceived enforcement. City‐level measures included tobacco outlet density, cigarette sales without ID checks and compliance checks.
Findings
Outlet density was associated positively with life‐time smoking OR = 1.12, P < 0.01. An interaction between outlet density and wave (OR = 0.96, P < 0.05) suggested that higher density was associated more closely with life‐time smoking at the earlier waves when respondents were younger. Greater density was associated positively with perceived availability (β = 0.02, P < 0.05) and negatively with perceived enforcement (β = −0.02, P < 0.01). Sales rate without checking IDs was related to greater perceived availability (β = 0.01, P < 0.01) and less perceived enforcement (β = −0.01, P < 0.01). Enforcement of underage tobacco laws was related positively to perceived enforcement (β = 0.06, P < 0.05).
Conclusions
Higher tobacco outlet density may contribute to life‐time smoking among youths. Density, sales without ID checks and enforcement levels may influence beliefs about access to cigarettes and enforcement of underage tobacco sales laws.
Introduction and Aims
Clerks and servers at alcohol establishments often fail to verify age. Using mystery shoppers to provide performance feedback is one approach to improving age verification. Few ...controlled studies have evaluated mystery shop interventions. This paper reports on a cluster randomised cross‐over trial of a mystery shop intervention in 16 communities in four US states.
Design and Methods
The intervention comprised monthly mystery shops after which clerks and servers received immediate feedback to reinforce age verification. Managers received monthly reports. Communities in each state were matched into pairs and, following a 3‐month baseline, were randomly assigned within each pair to receive the intervention beginning after the fourth (Early Intervention) or the tenth (Delayed Intervention) mystery shop. On average, 17 (range = 14–20) randomly selected on‐premises and 18 (range = 11–23) off‐premises outlets participated in each community (N = 557).
Results
Fixed effects multi‐level logistic regressions indicated that the intervention led to a two‐fold increase in the odds of age verification, odds ratio (OR) = 2.05; P < 0.001; 95% confidence interval (CI) 1.76, 2.39. Overall, ID‐checking increased from an average of 80% pre‐intervention to 94–96% by the end of the program. Significant effects were found for on‐premises, OR = 1.79; P < 0.001; 95% CI 1.43, 2.24, and off‐premises establishments, OR = 2.29; P < 0.001; 95% CI 1.86, 2.82.
Discussion and Conclusions
Mystery shop interventions can increase age verification for alcohol purchases and may be an effective supplement to compliance checks and responsible beverage service programs.
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.
Aims
To examine relationships between characteristics of the local alcohol environment and adolescent alcohol use and beliefs in 50 California cities.
Design
The study used longitudinal survey data ...collected from adolescents; city‐level measures of local alcohol policy comprehensiveness, policy enforcement, adult drinking and bar density; and multi‐level modeling with three levels (city, individual, time), allowing for random effects. Models included interaction terms (time × alcohol environment characteristics) and main effects, controlling for city and youth demographic characteristics. Analyses also examined possible mediating effects of alcohol‐related beliefs.
Setting
Fifty California cities (50 000–500 000 population).
Participants
Random samples of 1478 adolescents and 8553 adults.
Measurements
Past‐year alcohol use and heavy drinking, and alcohol‐related beliefs (e.g. perceived alcohol availability) among adolescents; past 28‐day alcohol use among adults; ratings of local alcohol control policies; funding for enforcement activities; bars per roadway mile.
Findings
Local alcohol policy comprehensiveness and enforcement were associated with lower levels of past‐year alcohol use (betas = −0.003 and −0.085, P < 0.05). Bar density was associated with a higher level of past‐year alcohol use (beta = 1.086, P < 0.01). A greater increase in past‐year alcohol use and heavy drinking over time was observed among adolescents living in cities with higher levels of adult drinking (betas = 0.224 and 0.108, P < 0.01). Effects of bar density appeared to be mediated through perceived alcohol availability and perceived approval of alcohol use.
Conclusions
Adolescent alcohol use and heavy drinking are related to characteristics of the local alcohol environment, including alcohol control policies, enforcement, adult drinking and bar density. Change in adolescents' drinking appears to be influenced by community‐level adult drinking. Bar density effects appear to be mediated through perceived alcohol availability and approval of alcohol use.
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