Patrick M. O’Malley

The Epidemiology of Alcohol, Marijuana, and Cocaine Use Among Mexican American, Puerto Rican, Cuban American, and Other Latin American Eighth-Grade Students in the United States: 1991–2002

OBJECTIVES We compared trends in and correlates of marijuana use, cocaine use, and heavy alcohol use for adolescents of Mexican American, Puerto Rican, Cuban, and other Latin American heritage in the United States. METHODS We used/examined data from nationally representative samples of eighth-grade Hispanic students who participated in the Monitoring the Future study during the years 1991-2002 (n=24235). RESULTS Drug use was significantly higher among boys and adolescents of almost all Hispanic ethnicities who did not live with both parents. In addition, drug use differed considerably according to ethnic group on language first spoken, parental education, urbanicity, and region. CONCLUSIONS A better understanding of the homogeneity and heterogeneity of drug use patterns within and between Hispanic groups should assist in the development of prevention programs.

How and Why the Understanding of Developmental Continuity and Discontinuity is Important

No story is a straight line. The geometry of human life is too imperfect and too complex, too distorted by the laughter of time and the bewildering intricacies of fate to admit the straight line into its system of laws. (Pat Conroy, 1995, p. 104)

Mediators and moderators of parental involvement on substance use: a national study of adolescents.

Current social developmental theories of drug use often incorporate mediation processes, but it is generally unknown whether these mediation processes generalize across ethnicity and gender. In the present study, we developed a mediation model of substance use based on current theory and research and then tested the extent to which the model was moderated by gender and ethnicity (African American, European American, and Hispanic American), separately for 8th and 10th graders. The respondents were adolescents from the 1994, 1995, and 1996 cohorts of the Monitoring the Future (MTF) project, which conducts yearly in-school surveys with nationally representative samples. Multi-group, structural equation modeling (SEM) results indicated much similarity across gender and ethnicity for school success and time spent with friends as partial mediators of risk taking and parental involvement on drug use (controlling for parental education). However, there were some differences in the magnitude of indirect effects of parental involvement and risk taking on substance use for 8th-grade African American girls. Discussion focuses on the potential success of prevention efforts across different ethnicities and gender that target parent–child relationship improvement and risk taking, and considers possible culture- and gender-specific issues.

How Substance Use Differs Among American Secondary Schools

The purpose of this study was to examine (1) the extent to which student drug use and related measures vary among American secondary schools, and (2) how substance use varies among schools by certain school characteristics. Data come from the Monitoring the Future project’s annual surveys of nationally representative samples of 8th-, 10th-, and 12th-grade students from 1991 to 2002.The results show that the preponderance of variance in drug use and related variables lies within schools; only a relatively small amount of variance is between schools. Although the variance lies primarily within schools, there remain important school-to-school differences in the extent to which students are exposed to drug use.The analyses of school characteristics show that schools do indeed differ in drug use by their students, particularly by school type, socioeconomic status, and race/ethnicity. Eighth and 10th grade (but not 12th grade) students in public schools are more likely to be cigarette smokers than students in private schools. Students in public middle schools are at higher risk for use of alcohol and marijuana; however, among 12th graders, students in Catholic schools are at higher risk. School size is generally unrelated to substance use, with few exceptions. For the most part, there is a negative association between school socioeconomic status and student substance use among 8th graders; but by 12th grade, the association tends to be positive or not significant. Racial/ethnic composition is significantly associated with student substance use, with majority African American schools typically showing the lowest rates of use at all grades.

Trends in use of marijuana and attitudes toward marijuana among youth before and after decriminalization: the case of California 2007-2013

BACKGROUND This analysis examines decriminalization as a risk factor for future increases in youth marijuana acceptance and use. Specifically, we examine marijuana-related behaviors and attitudes of 8th, 10th, and 12th graders in California as compared to other U.S. states during the years before and after California passed legislation in 2010 to decriminalize marijuana. METHODS Data come from Monitoring the Future, an annual, nationally representative survey of 8th, 10th, and 12th grade students. RESULTS In 2012 and afterwards California 12th graders as compared to their peers in other states became (a) 25% more likely to have used marijuana in the past 30 days, (b) 20% less likely to perceive regular marijuana use as a great health risk, (c) 20% less likely to strongly disapprove of regular marijuana use, and (d) about 60% more likely to expect to be using marijuana five years in the future. Analysis of 10th graders raises the possibility that the findings among 12th graders may reflect a cohort effect that was set into place two years earlier. CONCLUSION These results provide empirical evidence to support concerns that decriminalization may be a risk factor for future increases in youth marijuana use and acceptance.

Adolescent Substance Use: Epidemiology and Implications for Public Policy 241

This article discusses the epidemiology of adolescent substance use, including licit drugs and illicit drugs. The focus is on nationally representative samples of eighth-, tenth-, and twelfth-grade students from both public and private schools. Prevalence rates and recent trends are discussed for subgroups based on gender, geographic region, population density, parental education, and racial or ethnic groups. Some implications for public policy are presented.

Trends in Recall and Appraisal of Anti-Smoking Advertising Among American Youth: National Survey Results, 1997–2001

Public health efforts to reduce the harms related to tobacco use currently include a significant emphasis on anti-smoking media campaigns. This paper provides (a) data on the overall extent of exposure to anti-smoking media among American youth from 1997 to 2001, (b) an appraisal of general youth reactions to such advertising, and (c) an examination of how exposure levels and reactions vary by socio-demographic characteristics. Data were obtained from the Monitoring the Future study, an ongoing nationwide study of youth. Data were collected each year from nationally representative separate and nonoverlapping school samples of 8th, 10th, and 12th grade students (N = 29,724; 24,639; and 12,138, respectively). Self-reported levels of recalled exposure to both electronic and print anti-smoking advertising were measured, as well as the judged impact and perceived exaggeration of such advertising. Data indicate that significant increases in overall exposure to anti-smoking advertising occurred over the study time period. These increases were associated with (a) increases in the self-reported likelihood that anti-smoking advertising diminished the probability of individual smoking behaviors, and (b) increases in the perceived level to which anti-smoking advertising exaggerates the risks associated with smoking. Further, these trends were significantly associated with various characteristics—most notably, ethnicity, smoking behaviors, and residence in a state with an ongoing tobacco-control program having a media component.

School wellness policies and foods and beverages available in schools.

BACKGROUND Since 2006-2007, education agencies (e.g., school districts) participating in U.S. federal meal programs are required to have wellness policies. To date, this is the only federal policy that addresses foods and beverages sold outside of school meals (in competitive venues). PURPOSE To examine the extent to which federally required components of school wellness policies are associated with availability of foods and beverages in competitive venues. METHODS Questionnaire data were collected in 2007-2008 through 2010-2011 school years from 892 middle and 1019 high schools in nationally representative samples. School administrators reported the extent to which schools had required wellness policy components (goals, nutrition guidelines, implementation plan/person responsible, stakeholder involvement) and healthier and less-healthy foods and beverages available in competitive venues. Analyses were conducted in 2012. RESULTS About one third of students (31.8%) were in schools with all four wellness policy components. Predominantly white schools had higher wellness policy scores than other schools. After controlling for school characteristics, higher wellness policy scores were associated with higher availability of low-fat and whole-grain foods and lower availability of regular-fat/sugared foods in middle and high schools. In middle schools, higher scores also were associated with lower availability of 2%/whole milk. High schools with higher scores also had lower sugar-sweetened beverage availability and higher availability of 1%/nonfat milk, fruits/vegetables, and salad bars. CONCLUSIONS Because they are associated with lower availability of less-healthy and higher availability of healthier foods and beverages in competitive venues, federally required components of school wellness policies should be encouraged in all schools.

Alcohol, Tobacco, and Other Drug Use Prevention Programs in U.S. Schools: A Descriptive Summary

This report identifies the prevalence of state, local, and commercially developed substance abuse prevention programs in middle and high schools from 2001 to 2007, using survey data from nationally representative samples of 1,206 schools. Based on school administrators’ reports, schools and school districts offer students an average of 1.62 prevention programs during their school years from elementary through high school. Bivariate and multivariate regression analyses were conducted with school demographic characteristics public versus private, size, population density, region of the country, school race/ethnic composition, and socioeconomic status of the student body (SES) as predictors of total number of programs that students received and of the relative use of local, state, and commercial programs. Schools in the West had significantly fewer prevention programs than those in other regions of the country. Students in predominantly White and in higher SES schools received significantly more prevention programs than students in majority African American, majority Hispanic, or in lower SES affluent schools. The most frequently reported programs that students received were locally developed. D.A.R.E. was the most widely adopted prevention program. Findings from this study suggest that schools often develop their own curriculum to suit their students’ needs, and students are exposed to multiple prevention programs through their school years, making it difficult to examine the effectiveness of any single program in preventing and reducing substance use among students.

Trends in Competitive Venue Beverage Availability: Findings From US Secondary Schools

berry. Study supervision: Widdice, Bernstein, and Kahn. Financial Disclosure: Dr Brown receives honoraria for lectures related to HPV and vaccination from Merck and Co Inc. These honoraria are donated to charities. Dr Brown’s laboratory is funded in part by a grant from Merck and Co Inc. Indiana University and Merck and Co Inc have a confidential agreement that pays the university based on certain landmarks of vaccine development. Dr Brown receives a portion of these payments as income. Dr Brown serves on the Women’s Health Advisory Board at Merck and Co Inc. Dr Shew is an investigator for Merck and Co Inc–related vaccine trials. Dr Fortenberry received a 1-time honorarium for delivery of educational material, not related to the content of this article, from Merck and Co Inc, makers of a quadrivalent HPV vaccine. Dr Kahn serves as co-chair of 2 clinical trials of the quadrivalent HPV vaccine in HIV-infected individuals. The trials are funded by the National Institutes of Health but Merck and Co Inc is providing vaccine and immunogenicity testing for both. She also chairs a grant review committee for the Society for Adolescent Health and Medicine; the grant mechanism is funded through Merck and Co Inc.