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October 16, 1987, Vol 258, No. 15 >
ARTICLE | October 16, 1987

Perspectives on Adolescent Substance Use: Title and subTitle BreakA Defined Population Study FREE

Thomas N. Robinson, MPH; Joel D. Killen, PhD; C. Barr Taylor, MD; Michael J. Telch, PhD; Susan W. Bryson, MS; Keith E. Saylor, PhD; David J. Maron, MD; Nathan Maccoby, PhD; John W. Farquhar, MD
[+] Author Affiliations

Reprint requests to Adolescent Heart Health Project, Stanford Center for Research in Disease Prevention, Health Policy and Research Bldg, Room 9, Stanford, CA 94305 (Mr Robinson).


JAMA. 1987;258(15):2072-2076. doi:10.1001/jama.1987.03400150064030
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References

We asked 1447 tenth graders to complete a survey on physical activity, nutrition, stress, and substance use and to undergo basic physical assessments. In a multiple regression analysis, increased level of substance use by both boys and girls was most strongly predicted by friends' marijuana use. For boys, this was followed by perceived safety of cigarette smoking; poor school performance; parents' education; and use of diet pills, laxatives, or diuretics for weight control, accounting for 44% of the overall variation in substance use. For girls, friends' marijuana use was followed by poor school performance; self-induced vomiting for weight control; perceived safety of cigarette smoking; use of diet pills, laxatives, or diuretics for weight control; parents' education; perceived adult attitudes about cigarettes; and nonuse of seat belts, accounting for 53% of the overall variance. Separate multiple regression analyses for each substance produced similar results. The homogeneity of the study population precluded ethnic comparisons. These findings suggest that for many purposes substance use may be considered a single behavior regardless of the specific substance(s) used and that substance use may exist as part of a syndrome of adolescent problem behaviors. In addition, the potent influence of perceived social environment suggests that a social influence resistance model may represent the most successful preventive strategy.

(JAMA 1987;258:2072-2076)

REFERENCES

1 +
Johnston LD, O'Malley PM, Bachman JG: Drug Use Among American High School Students, College Students, and Other Young Adults: National Trends Through 1985 , US Dept of Health and Human Services publication (ADM) 86-1450. National Institute on Drug Abuse, 1986;.
2 +
Jessor R, Jessor SL: Problem Behavior and Psychosocial Development: A Longitudinal Study of Youth . Orlando, Fla, Academic Press Inc, 1977;.
3 +
Chassin L, Presson CC, Bensenberg M, et al:  Predicting adolescents' intentions to smoke cigarettes . J Health Soc Behav 1981;;22:445-455.
4 +
Rooney JF, Wright TL:  An extension of Jessor and Jessor's problem behavior theory from marijuana to cigarette use . Int J Addict 1982;;17:1273-1287.
5 +
Donovan JE, Jessor R:  Adolescent problem drinking: Psychosocial correlates in a national sample study . J Stud Alcohol 1978;;39:1506-1524.
6 +
Jessor R, Chase JA, Donovan JE:  Psychosocial correlates of marijuana use and problem drinking in a national sample of adolescents . Am J Public Health 1980;;70:604-613.
7 +
Jessor R, Costa F, Jessor L, et al:  Time of first intercourse: A prospective study . J Pers Soc Psychol 1983;;44:608-626.
8 +
Maron DJ, Telch MJ, Killen JD, et al:  Correlates of seat belt use by adolescents: Implications for health promotion . Prev Med 1986;;15:614-623.
9 +
Jessor R:  Adolescent development and behavioral health , in Matarazzo JD, Weiss SM, Herd JA, et al (eds): Behavioral Health: A Handbook of Health Enhancement and Disease Prevention . New York, John Wiley & Sons Inc, 1984;, pp 69-90.
10 +
Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980;.
11 +
Keys A, Flaminio R, Karvonen MJ, et al:  Indices of relative weight and obesity . J Chronic Dis 1972;;25:329-343.
12 +
Killen J, Vanderburg D, Harlan WR:  Application of weight-height ratios and body indices to juvenile populations: The national health examination survey data . J Chronic Dis 1978;;31:529-537.
13 +
Skinfold Thickness of Youths 12-17 Years , US Dept of Health and Human Services, Vital and Health Statistics, Series 11, No. 132. Rockville, Md, Health Resources Administration, (January) 1974;.
14 +
Pandina RJ:  Methods, problems, and trends in studies of adolescent drinking practices . Ann Behav Med 1986;;8:20-26.
15 +
Barnes GM, Welte JW:  Patterns and predictors of alcohol use among 7-12th grade students in New York State . J Stud Alcohol 1986;;47:53-62.
16 +
White HR, Johnson V, Horwitz A:  An application of three deviance theories to adolescent substance use . Int J Addict 1986;;21:347-366.
17 +
Pandina RJ, White HR, Yorke J:  Estimation of substance use involvement: Theoretical considerations and empirical findings . Int J Addict 1981;; 16:1-24.
18 +
Kandel DB:  Epidemiological and pyschosocial perspectives on adolescent drug use . J Am Acad Child Psychiatry 1982;;21:328-347.
19 +
Mittelmark MB, Murray DM, Luepker RV, et al:  Predicting experimentation with cigarettes: The childhood antecedents of smoking study (CASS) . Am J Public Health 1987;;77:206-208.
20 +
McKirnan DJ, Johnson T:  Alcohol and drug use among 'street' adolescents . Addict Behav 1986;;11: 201-205.
21 +
Killen JD, Taylor CB, Telch MJ, et al:  Evidence for an alcohol-stress link among normal weight adolescents reporting purging behavior . Int J Eating Disord 1987;;6:349-356.
22 +
Bauman KE, Koch GG:  Validity of self-reports and descriptive and analytical conclusions: The case of cigarette smoking by adolescents and their mothers . Am J Epidemiol 1983;;118:90-98.
23 +
Midanik L:  The validity of self-reported alcohol consumption and alcohol problems: A literature review . Br J Addict 1982;;77:357-382.
24 +
Single E, Kandel DB, Johnson B:  The reliability and validity of drug use responses in a large scale longitudinal survey . J Drug Issues 1975;;5: 426-443.
25 +
Biglan A, Gallison C, Ary D, et al:  Expired air carbon monoxide and saliva thiocyanate: Relationships to self-reports of marijuana and cigarette smoking . Addict Behav 1985;;10:137-144.
26 +
Vogt TM, Selvin S, Widdowson G, et al:  Expired air carbon monoxide and serum thiocyanate as objective measures of cigarette exposure . Am J Public Health 1977;;67:545-549.
27 +
Greer RO Jr, Poulson RC:  Oral tissue alterations associated with the use of smokeless tobacco by teenagers . Oral Surg 1983;;56:275-284.
28 +
Telch MJ, Killen JD, McAlister AL, et al:  Longterm follow-up of a pilot project on smoking prevention with adolescents . J Behav Med 1982;;5:1-7.
29 +
Killen JD:  Prevention of adolescent tobacco smoking: The social pressure resistance training approach . J Child Psychol Psychiatry 1985;;26:7-15.
30 +
Best JA, Thomson SJ, Santi SM, et al:  Preventing cigarette smoking among school children . Annu Rev Public Health , in press.
31 +
Coulehan JL, Zettler-Segal M, Block M, et al:  Recognition of alcoholism and substance abuse in primary care patients . Arch Intern Med 1987;;147: 349-352.
32 +
Singer M, Anglin T:  The identification of adolescent substance abuse by health care professionals . Int J Addict 1986;;21:247-254.
33 +
Klitzner M, Schwartz RH, Gruenewald P, et al:  Screening for risk factors for adolescent alcohol and drug use . AJDC 1987;;141:45-49.
34 +
Blum RW:  Adolescent substance abuse: Diagnostic and treatment issues . Pediatr Clin North Am 1987;;34:523-537.
35 +
Anglin TM:  Interviewing guidelines for the clincal evaluation of adolescent substance abuse . Pediatr Clin North Am 1987;;34:381-398.
36 +
American Academy of Pediatrics, Committee on Adolescence:  The role of the pediatrician in substance abuse counseling . Pediatrics 1983;;72: 251-252.
37 +
American Academy of Pediatrics, Committee on Adolescence:  Alcohol use and abuse: A pediatric concern . Pediatrics 1987;;79:450-453.
38 +
American Academy of Pediatrics, Committee on Adolescence:  Tobacco use by children and adolescents . Pediatrics 1987;;79:479-481.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Johnston LD, O'Malley PM, Bachman JG: Drug Use Among American High School Students, College Students, and Other Young Adults: National Trends Through 1985 , US Dept of Health and Human Services publication (ADM) 86-1450. National Institute on Drug Abuse, 1986;.
2 +
Jessor R, Jessor SL: Problem Behavior and Psychosocial Development: A Longitudinal Study of Youth . Orlando, Fla, Academic Press Inc, 1977;.
3 +
Chassin L, Presson CC, Bensenberg M, et al:  Predicting adolescents' intentions to smoke cigarettes . J Health Soc Behav 1981;;22:445-455.
4 +
Rooney JF, Wright TL:  An extension of Jessor and Jessor's problem behavior theory from marijuana to cigarette use . Int J Addict 1982;;17:1273-1287.
5 +
Donovan JE, Jessor R:  Adolescent problem drinking: Psychosocial correlates in a national sample study . J Stud Alcohol 1978;;39:1506-1524.
6 +
Jessor R, Chase JA, Donovan JE:  Psychosocial correlates of marijuana use and problem drinking in a national sample of adolescents . Am J Public Health 1980;;70:604-613.
7 +
Jessor R, Costa F, Jessor L, et al:  Time of first intercourse: A prospective study . J Pers Soc Psychol 1983;;44:608-626.
8 +
Maron DJ, Telch MJ, Killen JD, et al:  Correlates of seat belt use by adolescents: Implications for health promotion . Prev Med 1986;;15:614-623.
9 +
Jessor R:  Adolescent development and behavioral health , in Matarazzo JD, Weiss SM, Herd JA, et al (eds): Behavioral Health: A Handbook of Health Enhancement and Disease Prevention . New York, John Wiley & Sons Inc, 1984;, pp 69-90.
10 +
Committee on Nomenclature and Statistics: Diagnostic and Statistical Manual of Mental Disorders , ed 3. Washington, DC, American Psychiatric Association, 1980;.
11 +
Keys A, Flaminio R, Karvonen MJ, et al:  Indices of relative weight and obesity . J Chronic Dis 1972;;25:329-343.
12 +
Killen J, Vanderburg D, Harlan WR:  Application of weight-height ratios and body indices to juvenile populations: The national health examination survey data . J Chronic Dis 1978;;31:529-537.
13 +
Skinfold Thickness of Youths 12-17 Years , US Dept of Health and Human Services, Vital and Health Statistics, Series 11, No. 132. Rockville, Md, Health Resources Administration, (January) 1974;.
14 +
Pandina RJ:  Methods, problems, and trends in studies of adolescent drinking practices . Ann Behav Med 1986;;8:20-26.
15 +
Barnes GM, Welte JW:  Patterns and predictors of alcohol use among 7-12th grade students in New York State . J Stud Alcohol 1986;;47:53-62.
16 +
White HR, Johnson V, Horwitz A:  An application of three deviance theories to adolescent substance use . Int J Addict 1986;;21:347-366.
17 +
Pandina RJ, White HR, Yorke J:  Estimation of substance use involvement: Theoretical considerations and empirical findings . Int J Addict 1981;; 16:1-24.
18 +
Kandel DB:  Epidemiological and pyschosocial perspectives on adolescent drug use . J Am Acad Child Psychiatry 1982;;21:328-347.
19 +
Mittelmark MB, Murray DM, Luepker RV, et al:  Predicting experimentation with cigarettes: The childhood antecedents of smoking study (CASS) . Am J Public Health 1987;;77:206-208.
20 +
McKirnan DJ, Johnson T:  Alcohol and drug use among 'street' adolescents . Addict Behav 1986;;11: 201-205.
21 +
Killen JD, Taylor CB, Telch MJ, et al:  Evidence for an alcohol-stress link among normal weight adolescents reporting purging behavior . Int J Eating Disord 1987;;6:349-356.
22 +
Bauman KE, Koch GG:  Validity of self-reports and descriptive and analytical conclusions: The case of cigarette smoking by adolescents and their mothers . Am J Epidemiol 1983;;118:90-98.
23 +
Midanik L:  The validity of self-reported alcohol consumption and alcohol problems: A literature review . Br J Addict 1982;;77:357-382.
24 +
Single E, Kandel DB, Johnson B:  The reliability and validity of drug use responses in a large scale longitudinal survey . J Drug Issues 1975;;5: 426-443.
25 +
Biglan A, Gallison C, Ary D, et al:  Expired air carbon monoxide and saliva thiocyanate: Relationships to self-reports of marijuana and cigarette smoking . Addict Behav 1985;;10:137-144.
26 +
Vogt TM, Selvin S, Widdowson G, et al:  Expired air carbon monoxide and serum thiocyanate as objective measures of cigarette exposure . Am J Public Health 1977;;67:545-549.
27 +
Greer RO Jr, Poulson RC:  Oral tissue alterations associated with the use of smokeless tobacco by teenagers . Oral Surg 1983;;56:275-284.
28 +
Telch MJ, Killen JD, McAlister AL, et al:  Longterm follow-up of a pilot project on smoking prevention with adolescents . J Behav Med 1982;;5:1-7.
29 +
Killen JD:  Prevention of adolescent tobacco smoking: The social pressure resistance training approach . J Child Psychol Psychiatry 1985;;26:7-15.
30 +
Best JA, Thomson SJ, Santi SM, et al:  Preventing cigarette smoking among school children . Annu Rev Public Health , in press.
31 +
Coulehan JL, Zettler-Segal M, Block M, et al:  Recognition of alcoholism and substance abuse in primary care patients . Arch Intern Med 1987;;147: 349-352.
32 +
Singer M, Anglin T:  The identification of adolescent substance abuse by health care professionals . Int J Addict 1986;;21:247-254.
33 +
Klitzner M, Schwartz RH, Gruenewald P, et al:  Screening for risk factors for adolescent alcohol and drug use . AJDC 1987;;141:45-49.
34 +
Blum RW:  Adolescent substance abuse: Diagnostic and treatment issues . Pediatr Clin North Am 1987;;34:523-537.
35 +
Anglin TM:  Interviewing guidelines for the clincal evaluation of adolescent substance abuse . Pediatr Clin North Am 1987;;34:381-398.
36 +
American Academy of Pediatrics, Committee on Adolescence:  The role of the pediatrician in substance abuse counseling . Pediatrics 1983;;72: 251-252.
37 +
American Academy of Pediatrics, Committee on Adolescence:  Alcohol use and abuse: A pediatric concern . Pediatrics 1987;;79:450-453.
38 +
American Academy of Pediatrics, Committee on Adolescence:  Tobacco use by children and adolescents . Pediatrics 1987;;79:479-481.

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