Anne E. Smith

GENDER DIFFERENCES IN ADOLESCENT MARIJUANA USE AND ASSOCIATED PSYCHOSOCIAL CHARACTERISTICS

Marijuana use in adolescents is associated with many adverse outcomes, including neurobiological and health consequences. Despite this, little is known about gender differences in the correlates of adolescent marijuana use. This study attempted to fill this gap by examining gender differences in the correlates of lifetime and past 30-day marijuana use. Data from a cross-sectional statewide survey of adolescent risk behavior participation in Connecticut were analyzed using &khgr;2 and hierarchical logistic regression methodologies to examine the demographic, psychosocial, and risk behavior correlates of adolescent marijuana use. Gender-by-trait interactions were tested with hierarchical logistic regression. Of the 4523 participants (51.8% females, 75.8% white), 40.4% endorsed lifetime marijuana use and 24.5% endorsed past 30-day marijuana use. Risk behavior participation, particularly other substance use, had the most robust associations with lifetime and past 30-day adolescent marijuana use; participation in extracurricular activities seemed protective. Gender interactions were observed for African American, Asian, or other race and participation in extracurricular activities; in these 3 cases, males had a greater likelihood of use. They were also observed for having a job (lifetime use only), with females having elevated odds, and past 30-day cigarette smoking (past 30-day use only), with males having elevated odds. Finally, there was preliminary evidence of a faster transition from initiation of marijuana use to regular use in females, when compared with males. These results indicate important gender differences in the correlates of marijuana use in adolescents, and these findings may facilitate the development of gender-informed prevention and early intervention programs for adolescent marijuana use.

IMPULSIVE SENSATION SEEKING, PARENTAL HISTORY OF ALCOHOL PROBLEMS, AND CURRENT ALCOHOL AND TOBACCO USE IN ADOLESCENTS

Objectives:This study attempted to evaluate whether impulsive sensation seeking mediated the relationship between parental alcohol problems and offspring alcohol and tobacco use. Methods:Participants were Connecticut high school students (n = 2733) completing a survey of high-risk behaviors. Variables of interest included past month alcohol use, past month binge alcohol use, frequency of past month alcohol use, past month tobacco use, having a biologic parent with an alcohol problem, and score on the Impulsive Sensation Seeking scale (ImpSS) from the Zuckerman–Kuhlman Personality Questionnaire—Form III. Results:ImpSS scores were elevated in past month users of alcohol, binge users of alcohol, users of both tobacco and alcohol, and they increased with increasing frequency of past month alcohol use. Also, parental history of alcohol use increased the likelihood of past month alcohol use, binge use, use of both tobacco and alcohol, and higher levels of past month alcohol use. Mediational analyses did not seem to support the hypothesis that impulsive sensation seeking mediates the relationship between parental history of alcohol problems and alcohol and tobacco use in offspring. Conclusions:Impulsive sensation seeking and parental history of alcohol problems seem to be independent factors that contribute to the co-occurrence of alcohol and tobacco use in adolescents. These findings can inform prevention and treatment efforts.

Combining Cognitive Behavioral Therapy with Contingency Management for Smoking Cessation in Adolescent Smokers: A Preliminary Comparison of Two Different CBT Formats

This pilot study evaluated the optimal format of cognitive behavioral therapy (CBT) to combine with contingency management (CM) in a four-week, high school-based smoking cessation program. Thirty-four adolescent smokers received a standard weekly version of CBT or a frequent brief behavioral intervention. Results indicate a trend toward a higher seven-day point prevalence end-of-treatment abstinence rate and percent days abstinent during treatment in the CBT condition. In addition, significantly more participants in the CBT group completed treatment. These preliminary results suggest that when combined with CM, the standard weekly format of CBT is more acceptable to adolescent smokers.

Smoking Expectancies, Weight Concerns, and Dietary Behaviors in Adolescence

OBJECTIVE: The objective of this study was to examine the association of cigarette smoking and weight concerns in adolescents, given that adolescents may begin smoking or have difficulty quitting because of their expectancies of the effects of smoking on body weight. METHODS: This study used data from a cross-sectional survey of 4523 Connecticut high school adolescents to assess the influence of gender, smoking intensity, and dietary-restrictive behavior on smoking-related weight concerns. RESULTS: Heavy smokers were significantly less likely to engage in healthy dietary restrictions than nonsmokers; however, light smokers did not differ from nonsmokers. Both light and heavy smokers were significantly more likely to engage in unhealthy dietary restriction when compared with nonsmokers. In the model that was used to examine smokers only, heavy smokers were significantly less likely to engage in healthy dietary restriction than light smokers, but smoking level was not associated with unhealthy dietary restrictions. Dietary restrictions are significantly associated with smoking-related weight concerns; however, this seems to be related to type of dietary-restrictive behavior, with greater weight concerns observed only in those smokers who engaged in unhealthy dietary restrictions and not in those who engaged in healthy dietary restrictions or no restrictions. CONCLUSIONS: Although limited by its cross-sectional nature, the findings from this large, geographically diverse sample have clinical implications for smoking prevention and cessation interventions in adolescents.

Pubertal Status, Sensation-Seeking, Impulsivity, and Substance Use in High School-Aged Boys and Girls

Objective:To examine how factors such as pubertal status, sensation-seeking, and impulsivity are related to substance use (cigarettes, alcohol, and marijuana) in high school students and examine these associations by gender. Methods:Ten public high schools in Connecticut participated in a survey of high-risk behaviors. Adolescents from grades 9 to 12 (N = 3068) completed measures of physical development (Pubertal Development Scale), perceived pubertal timing, impulsivity and sensation-seeking (Zuckerman-Kuhlman Personality Questionnaire—Form III), and cigarette, marijuana, and alcohol use in the past 30 days. Results:Logistic regression analyses modeling each substance use (cigarettes, marijuana, and alcohol) and gender separately showed that (1) early perceived pubertal timing was associated with cigarette use but Pubertal Development Scale was not associated with any substance use, (2) sensation-seeking was associated with use of all 3 substances, and (3) gender differences were detected: impulsivity was associated with use of all 3 substances among girls, but this was not found among boys. Conclusion:Future studies should examine the relationship among pubertal status, sensation-seeking, and impulsivity from preadolescence through late adolescence to better understand how these relationships to substance use may change with time and growth.

Preliminary examination of tobacco withdrawal in adolescent smokers during smoking cessation treatment.

Tobacco withdrawal symptoms have been shown to play a significant role in mediating relapse to smoking in adult smokers; however, few prospective studies have examined the course of tobacco withdrawal symptoms over time and their connection to lapse in adolescent smokers. Withdrawal symptoms were assessed weekly for 4 weeks in a sample of adolescent smokers participating in a pilot cessation intervention. Adolescent smokers experienced an exacerbation in overall withdrawal symptoms, particularly of cravings and restlessness, although symptoms were generally mild. The course of symptoms was different for boys and girls: Girls generally experienced a peak and subsequent decline in symptoms early in the establishment of abstinence, whereas boys experienced a constant level of symptoms that did not decline over the 4 weeks. Finally, withdrawal symptoms experienced on quit day were not related to lapse to smoking during the course of treatment for either boys or girls. These results suggest that although withdrawal symptoms may be uncomfortable, they may not be the most salient to a lapse to smoking for adolescent smokers attempting to quit. These findings have direct implications for the design and implementation of treatment of nicotine dependence in adolescent smokers.

Preliminary Examination of Adolescent Spending in a Contingency Management-Based Smoking-Cessation Program

Contingency management (CM) utilizing monetary incentives is efficacious in enhancing abstinence in an adolescent smoking-cessation program, but how adolescents spend their money has not been examined. We assessed spending habits of 38 adolescent smokers in a CM-based smoking-cessation project prior to quitting and during treatment using a questionnaire about spending in a number of categories, including cigarettes, other addictive substances, durable goods, and disposable goods. Our preliminary results indicate that participation in a CM-based program for smoking cessation did not lead to greater spending on cigarettes and other substances and may have produced more socially acceptable spending.