Pallav Pokhrel

Behavioral and Emotional Regulation and Adolescent Substance Use Problems: A Test of Moderation Effects in a Dual-Process Model

In a structural model, we tested how relations of predictors to level of adolescent substance use (tobacco, alcohol, marijuana), and to substance-related impaired-control and behavior problems, are moderated by good self-control and poor regulation in behavioral and emotional domains. The participants were a sample of 1,116 public high-school students. In a multiple-group analysis for good self-control, the paths from negative life events to substance use level and from level to behavior problems were lower among persons scoring higher on good behavioral self-control. In a multiple-group analysis for poor regulation, the paths from negative life events and peer use to level of substance use were greater among persons scoring higher on poor behavioral (but not emotional) regulation; an inverse path from academic competence to level was greater among persons scoring higher on both aspects of poor regulation. Paths from level to impaired-control and behavior problems were greater among persons scoring higher on both poor behavioral and poor emotional regulation. Theoretical implications concerning the role of behavioral and emotional regulation in moderation effects are discussed.

Associations Between Family Structure, Family Functioning, and Substance Use Among Hispanic/Latino Adolescents

This study examined the role of family structure and functioning in predicting substance use among Hispanic/Latino adolescents, surveyed in 9th and 10th grade. The sample (N = 1433) was half female, mostly of Mexican descent, and the majority was born in the United States. Living with a single father was associated with less parental monitoring and less family cohesion (gamma = -0.07, -0.06, respectively). Living with a single mother was associated with less parental monitoring (gamma = -0.10). Living with neither parent was associated with less communication (gamma = -0.08), less parental monitoring (gamma = -0.09), more family conflict (gamma = 0.06), and less family cohesion (gamma = -0.06). Less monitoring was associated with substance use at follow-up (beta = -0.17). Low rates of parental monitoring appear to mediate the association between parental family structure and substance use. Results suggest that improving basic parenting skills and offering additional social support and resources to assist parents in monitoring adolescents may help prevent substance use. These interventions may be particularly beneficial for single parents.

Electronic cigarette use outcome expectancies among college students

BACKGROUND E-cigarette use outcome expectancies and their relationships with demographic and e-cigarette use variables are not well understood. Based on past cigarette as well as e-cigarette use research, we generated self-report items to assess e-cigarette outcome expectancies among college students. The objective was to determine different dimensions of e-cigarette use expectancies and their associations with e-cigarette use and use susceptibility. METHODS Self-report data were collected from 307 multiethnic 4- and 2-year college students [M age=23.5 (SD=5.5); 65% Female; 35% current cigarette smokers] in Hawaii. Data analyses were conducted by using factor and regression analyses. RESULTS Exploratory factor analysis among e-cigarette ever-users indicated 7 factors: 3 positive expectancy factors (social enhancement, affect regulation, positive sensory experience) and 4 negative expectancy factors (negative health consequences, addiction concern, negative appearance, negative sensory experience). Confirmatory factor analysis among e-cigarette never-users indicated that the 7-factor model fitted reasonably well to the data. Being a current cigarette smoker was positively associated with positive expectancies and inversely with negative expectancies. Higher positive expectancies were significantly associated with greater likelihood of past-30-day e-cigarette use. Except addiction concern, higher negative expectancies were significantly associated with lower likelihood of past-30-day e-cigarette use. Among e-cigarette never-users, positive expectancy variables were significantly associated with higher intentions to use e-cigarettes in the future, adjusting for current smoker status and demographic variables. CONCLUSIONS E-cigarette use expectancies determined in this study appear to predict e-cigarette use and use susceptibility among young adults and thus have important implications for future research.

Receptivity to e-cigarette marketing, harm perceptions, and e-cigarette use.

OBJECTIVE To test whether exposure and receptivity to e-cigarette marketing are associated with recent e-cigarette use among young adults through increased beliefs that e-cigarettes are less harmful than cigarettes. METHODS Data were collected from 307 multiethnic 4- and 2-year college students; approximately equal proportions of current, never, and former cigarette smokers [mean age = 23.5 (SD = 5.5); 65% female]. RESULTS Higher receptivity to e-cigarette marketing was associated with perceptions that e-cigarettes are less harmful than cigarettes, which in turn, were associated with higher recent e-cigarette use. CONCLUSIONS The findings provide preliminary support to the proposition that marketing of e-cigarettes as safer alternatives to cigarettes or cessation aids is associated with increased e-cigarette use among young adults. The findings have implications for development of e-cigarette regulations.

Physical and relational aggression as predictors of drug use: gender differences among high school students.

The present study investigated the longitudinal relationships between physical and relational aggression and later drug use, as moderated by gender. Self-reported data were gathered from 2064 high school students at pretest and 1-year post-test to test the hypotheses that (1) males would engage in more physical aggression than females, whereas females would engage in more relational aggression than males; and (2) physical aggression would be a stronger drug use predictor for males and relational aggression a stronger predictor for females. Results indicated that males reported engaging in more physical aggression than females at baseline; however, females and males reported engaging in similar rates of relational aggression. After controlling for relational aggression, baseline drug use, and demographic variables, physical aggression at baseline was found to predict alcohol use 1-year later for males but not for females. After controlling for physical aggression, baseline drug use, and demographic variables, relational aggression was found to predict cigarette use and marijuana use for females but not for males. However, relational aggression was found to predict later alcohol and hard drug equally across gender. These findings suggest that both physical and relational aggression are predictive of subsequent drug use and have important implications for violence and drug use prevention intervention efforts.

Tobacco Control in Developing Countries: Tanzania, Nepal, China, and Thailand as Examples

This paper illustrates case studies of four developing countries and compares them as to relative advancement in tobacco control as prescribed by the Framework Convention on Tobacco Control. Tobacco-control efforts first seem to involve assessment of tobacco use prevalence and passage of tobacco-control legislation (e.g., warning labels). Tanzania, Nepal, and China serve as examples. Eventually, an integrated tobacco-control stance that demonstrates several cycles of tobacco-control activities occurs, as is shown in Thailand. Through these case studies, one can achieve a sense of the direction of progress in tobacco control in developing countries.

Non drug use- and drug use-specific spirituality as one-year predictors of drug use among high-risk youth.

The present article explored two different dimensions of spirituality that might tap negative and positive relations with adolescent drug use over a 1-year period. Non-drug-use–specific spirituality measured how spiritual the person believes he or she is, participation in spiritual groups, and engagement in spiritual practices such as prayer, whereas drug-use–specific spirituality measured using drugs as a spiritual practice. Self-report questionnaire data were collected during 1997–1999 from a sample of 501 adolescents in 18 continuation high schools across southern California. Participants ranged in age from 14 to 19 and were 57% male, with an ethnic distribution of 34% White, 49% Latino, 5% African American, 7% Asian, and 5% other. A series of general linear model analyses were conducted to identify whether or not two different spirituality variables predict drug use (cigarettes, alcohol, marijuana, hallucinogens, and stimulants) at 1-year follow-up. After controlling for baseline drug use, non-drug-use–specific spirituality was negatively predictive of alcohol, marijuana, and stimulant use, whereas drug-use–specific spirituality failed to be found predictive of these variables one year later. Conversely, drug-use–specific spirituality was positively predictive of cigarette smoking and hallucinogen use, whereas non-drug-use spirituality failed to be found predictive of these variables. Our results provide new evidence that suggests that spirituality may have an effect on drug use among adolescents. The drug-use-specific measure of spirituality showed “risk effects” on drug use, whereas the other measure resulted in “protective effects,” as found in previous research. Knowledge of the risk and protective patterns and mechanisms of spirituality may be translated into future drug use prevention intervention programs.

Young adult e-cigarette users’ reasons for liking and not liking e-cigarettes: A qualitative study

Objective: To gain an in-depth understanding of what young adult electronic- or e-cigarette users like or dislike about e-cigarettes. We aimed to determine the reasons that may encourage young adults to use e-cigarettes or discourage them from using e-cigarettes. Design: Twelve focus group discussions were conducted with 62 current daily e-cigarette users (63% men) of mean age = 25.1 years (standard deviation = 5.5). Data were analysed following principles of inductive content analysis. Results: Results indicated 12 categories of reasons for liking e-cigarettes (e.g. recreation, smoking cessation) and 6 categories of reasons for not liking e-cigarettes (e.g. poor product quality, poor smoking experience). Conclusions: Young adults’ motives for using or not using e-cigarettes appear to be varied and their relative importance in terms of predicting e-cigarette use initiation, dependence, and cigarette/e-cigarette dual use needs to be carefully studied in population-based, empirical studies. The current findings suggest that e-cigarettes may serve social, recreational, and sensory expectancies that are unique relative to cigarettes and not dependent on nicotine. Further, successful use of e-cigarettes in smoking cessation will likely need higher standards of product quality control, better nicotine delivery efficiency and a counselling component that would teach smokers how to manage e-cigarette devices while trying to quit smoking cigarettes.

Breast cancer screening utilization among Eastern European immigrant women worldwide: a systematic literature review and a focus on psychosocial barriers

Many countries host growing Eastern European immigrant communities whose breast cancer preventive behaviors are largely unknown. Thus, we aimed to synthesize current evidence regarding secondary prevention via breast cancer screening utilized by that population.

Adolescent Neurocognitive Development, Self-Regulation, and School-Based Drug Use Prevention

Adolescence is marked by several key development-related changes, including neurocognitive changes. Cognitive abilities associated with self-regulation are not fully developed until late adolescence or early adulthood whereas tendencies to take risks and seek thrilling and novel experience seem to increase significantly throughout this phase, resulting in a discrepancy between increased susceptibility to poor regulation and lower ability to exercise self-control. Increased vulnerability to drug use initiation, maintenance, and dependence during adolescence may be explained based on this imbalance in the self-regulation system. In this paper, we highlight the relevance of schools as a setting for delivering adolescent drug use prevention programs that are based on recent findings from neuroscience concerning adolescent brain development. We discuss evidence from school-based as well as laboratory research that suggests that suitable training may improve adolescents’ executive brain functions that underlie self-regulation abilities and, as a result, help prevent drug use and abuse. We note that considerable further research is needed in order (1) to determine that self-regulation training has effects at the neurocognitive level and (2) to effectively incorporate self-regulation training based on neuropsychological models into school-based programming.