The authors examined the relationship between global sleep quality and alcohol risk, including the extent to which global sleep quality moderated the relationship between alcohol use and drinking-related consequences. Global sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) and alcohol-related consequences were assessed using the Rutgers Alcohol Problem Index (RAPI). The sample consisted of 261 college students (61.3% female, 58.2% Caucasian) who completed online surveys. Using a four-step hierarchical multiple regression model, global sleep quality was found to predict alcohol consequences, over and above assessed covariates (demographics and weekly drinking). Further, global sleep quality emerged as a strong moderator in the drinking-consequences relationship such that among heavier drinkers, those with poorer global sleep quality experienced significantly greater alcohol-related harm. Campus health education and alcohol interventions may be adapted to address the importance of maintaining a healthy lifestyle, both in terms of healthful sleeping and drinking behaviors, which appear to play a strong synergistic role in alcohol-related risk.
Alcohol; Sleep; College students; Health education
The prevalence of smoking across racial/ethnic groups has declined over the years, yet racial health disparities for smoking persist. Studies indicate that non-Hispanic Black smokers attempt to quit smoking more often compared to non-Hispanic White smokers but are less successful at doing so. Research suggests that motives to quit smoking differ by race, however, less is known about the role of motives to smoke in explaining racial differences in attempts to quit smoking.
This study examined whether smoking motives accounted for the differential rates in quit attempts between non-Hispanic Black (n=155) and non-Hispanic White (n=159) smokers. Data were culled from a larger study of heavy-drinking smokers. The Wisconsin Index of Smoking Dependence Motives (WISDM) assessed motives to smoke.
As expected, Black and White smokers reported similar smoking patterns, yet Black smokers reported higher rates of failed attempts to quit smoking than White smokers. Findings indicated that Black, compared to White, smokers endorsed lower scores in the negative reinforcement, positive reinforcement, and taste WISDM subscales and scores these subscales mediated the relationship between race and quit attempts.
In this study, Blacks, compared to Whites, endorsed lower motives to smoke, which are generally associated with successful quit attempts, yet they experienced more failed attempts to quit smoking. This study demonstrates racial health disparities at the level of smoking motives and suggests that Black smokers remain vulnerable to failed quit attempts despite reporting lower motives to smoke.
Adult and peer factors may influence whether adolescents use alcohol and other drugs (AOD). This longitudinal study examined the direct effects of adult monitoring, perceived adult AOD use, and cultural values on adolescent AOD use.
Participants were 193 at-risk adolescents referred to a California diversion program called Teen Court for a first-time AOD offense. We assessed youth reports of past 30 day AOD use (any alcohol use, heavy drinking, marijuana use), demographics, changes in parental monitoring and family values (from baseline to follow-up 180 days later), as well as family structure and perceived adult substance use at follow-up.
Adolescents who reported that a significant adult in their life used marijuana were more likely to have increased days of drinking, heavy drinking, and marijuana use at follow-up. Higher levels of familism (importance the teen places on their family’s needs over their own needs) and being in a nuclear family served as protective factors for future alcohol use. Additionally, poor family management was associated with increased alcohol use and heavy drinking.
Findings highlight how family management and perceptions of adult marijuana use influence subsequent adolescent AOD use, and how an increase in familism over time is associated with a decrease in adolescent drinking. Tailoring interventions, by including the teen’s family and/or providing support to adults who use AOD may be crucial for improving interventions for adolescent AOD use.
Parental Monitoring; Adolescents; Substance Use
Although many studies have shown that cognitive effect expectancies are associated with drug use and drug reatment outcomes, few studies have compared effect expectancies with drug response following drug challenge. Healthy male and female volunteers (n=19, ages 21-35) who reported using cocaine 1-4 times per month completed the Cocaine Effect Expectancy Questionnaire (CEEQ: Schafer and Brown, 1991), were challenged with cocaine (0.9 mg/kg, i.n.), then completed a series of visual analog scales (VAS) and the Addiction Research Center Inventory (ARCI) at 15 min intervals for 3 hrs following cocaine administration. Significant positive correlations were found between global negative expectancies and peak responses on the VAS measures “Good,” “Happy,” “High,” “Stimulated,” and “Desire to Use Cocaine,” and on the LSD subscale of the ARCI post-cocaine administration, and between global positive expectancies and the MBG subscale of the ARCI, and on VAS items “Anxious” and “Good” post-cocaine administration. Global positive expectancies also were positively correlated with peak systolic blood pressure, and global negative expectancies with peak heart rate after cocaine administration. These results suggest that negative and positive effect expectancies both play a complex role in the subjective experience of cocaine effects, and thus likely in the progression of nonuse to recreational use, in the transition to abuse, and in individualized treatment strategies.
It is important to understand the individual differences that contribute to greater frequency or intensity of marijuana use, or greater frequency of experiencing marijuana-related problems. The current study examined several elements of behavioral and emotional self-regulation as predictors of the likelihood and intensity of both marijuana use and marijuana-related problems. As predicted, indices of behavioral self-regulation (self-control, sensation seeking) were better predictors of marijuana use, while indices of emotional self-regulation (affect, distress tolerance, and emotional instability) better predicted marijuana-related problems. Surprisingly, urgency was not related to use but was predictive of problems, and there were no significant interactions between behavioral and emotional self-regulation in predicting either use or problems. From these findings we conclude that while behavioral dysregulation may put individuals at risk for using marijuana, or using it more frequently, it is those individuals with difficulty in emotional self-regulation that are at risk for experiencing negative consequences as a result of their marijuana use. Clinically, these data are relevant; clinicians might focus more on addressing emotional regulation in order to lessen or eliminate the consequences of marijuana use.
Marijuana use; Marijuana problems; Self-regulation
To the extent that craving serves to compel excessive drinking, it would be of significant import to predict the intensity of an individual’s craving over the course of a drinking episode. Previous research indicates that regular alcohol use (measured by the AUDIT) and the number of drinks individuals have already consumed that evening independently predict craving to drink (Schoenmakers & Wiers, 2010). The current study aims to replicate those findings by testing whether these same variables predict craving to drink in a sample of 1,320 bar patrons in a naturalistic setting. In addition, we extend those findings by testing whether regular alcohol use and self-reported number of drinks consumed interact to predict craving, and whether gender independently predicts craving or interacts with other variables to predict craving. Results indicate that for men, AUDIT score alone predicted craving, whereas for women, AUDIT score and number of drinks consumed interacted to predict craving, with craving highest among women with either high AUDIT scores or relatively high consumption levels. Our findings have implications for targeted intervention and prevention efforts, as women who have a history of harmful alcohol use and consume several drinks in an evening might be at the greatest risk for continued alcohol consumption.
alcohol; gender; AUDIT; field; craving
gambling; internet use; video-gaming; eating; food; sex; shopping
Parents’ beliefs about their children's involvement in aberrant behaviors are variable and sometimes inaccurate, but they may be influential. This study is concerned with inconsistencies between parents’ estimates and their children's reports of marijuana use, and children's subsequent usage one year later. The self-fulfilling prophecy hypothesis suggests discrepancies between parents’ beliefs and children's behaviors could have detrimental or beneficial outcomes, depending on the inconsistency. This possibility was investigated with data from a panel survey of a nationally representative sample of parents and their adolescent children (N = 3131). Marijuana-abstinent adolescents in the first year (T1) of the survey were significantly more likely to initiate use over the next year if they were characterized by parents as users at T1; conversely, adolescent marijuana users at T1 were significantly less likely to continue usage in the second year if they were labeled by parents as abstinent at T1 (both p < .001). Odds that abstinent children whose parents believed they used marijuana would initiate use a year later (T2) were 4.4 times greater than those of abstinent respondents whose parents judged them abstinent. Odds of self-reported users quitting by T2 were 2.7 greater if parents believed they had not used at T1.
self-fulfilling prophecy; adolescents, marijuana; secondary analysis; panel survey; drug misuse; cannabis
Smoking both cigarettes and marijuana is increasingly common among young adults, yet little is known about use patterns, motivations, or thoughts about abstinence. In a U.S. sample, this study explored young adults’ severity of cigarette and marijuana co-use, quit attempts, and thoughts about use.
Young adults age 18-to-25 who had smoked at least one cigarette in the past 30 days completed an anonymous online survey.
Of 1987 completed surveys, 972 participants reported both past-month cigarette and marijuana use (68% male, 71% Caucasian, mean age 20.4 years [SD=2.0]). Frequency of use, temptations to use, measures of dependence, decisional balance, and past-year quit attempts were associated across the two substances (all p< .05), but not motivation to quit. Relative to marijuana, participants reported greater desire and a later stage of change for quitting cigarettes and were more likely to endorse a cigarette abstinence goal, yet they had lower expectancy of success with quitting cigarettes and with staying quit (all p<.001).
Cigarette and marijuana use, temptations to use, and pros/cons of using were related in this young adult sample. Differences in motivation and thoughts about abstinence, however, suggest that young adults may be more receptive to interventions for tobacco than marijuana use. Use patterns and cognitions for both substances should be considered in prevention and intervention efforts.
tobacco; cigarette; marijuana; young adulthood; Internet; survey
Despite an extensive theoretical literature on acute alcohol intoxication likely increasing the odds of aggression between intimate partners, there have been few temporal studies on the relation between alcohol use and increased odds of intimate partner violence (IPV). Moreover, the literature on the temporal relation between marijuana use and IPV is in its infancy. The existing temporal research has yet to examine in the same study the three distinct types of IPV that occur most often between partners: physical, psychological, and sexual. Thus, the present study examined the temporal relationship between acute alcohol use, marijuana use, and male perpetrated physical, psychological, and sexual dating violence.
College men who had consumed alcohol in the previous month and were in a current dating relationship participated (N=67). Men completed daily surveys that assessed their alcohol use, marijuana use, and violence perpetration (psychological, physical, and sexual) for up to 90 consecutive days.
On any alcohol use days, heavy alcohol use days (5 or more standard drinks), and as the number of drinks increased on a given day, the odds of physical and sexual aggression perpetration increased. The odds of psychological aggression increased on heavy alcohol use days only. Marijuana use days did not increase the odds of any type of aggression.
These findings contribute to a growing body of research on the temporal relation between acute alcohol use and IPV perpetration among college men. Combined with previous research, our findings suggest that dating violence intervention and prevention programs should target reductions in alcohol use.
Alcohol; marijuana; dating violence; aggression
Studies have shown that moderate alcohol use confers protection against some of the dominant predictors of long-term care placement, including diminished cognitive functioning, physical disability, and injury. But little is known about the association between alcohol use and the likelihood of placement in long-term care facilities. A nationally representative sample of 5,404 community-dwelling Canadians ages 50 years and older at baseline (1994/95) was obtained from the longitudinal National Population Health Survey. Alcohol use categories were developed based on the quantity and frequency of use in the 12 months before the interview. Cox proportional hazards models were used to estimate the association between alcohol use at baseline and subsequent placement in long-term care facilities after adjusting for covariates measured at baseline. During the 14-year follow-up period, 14% of lifetime abstainers, 10% of former drinkers, 7% of infrequent drinkers, 4% of moderate drinkers, and 3% of heavy drinkers were placed in long-term care facilities. Furthermore, the multivariate analysis revealed that abstainers, former drinkers, and infrequent drinkers were more than twice as likely to be placed in long-term care as moderate drinkers. Moderate drinking was protective against placement in long-term care facilities even after adjusting for an array of well-known confounders. The strong protective effect of moderate alcohol use on long-term care entry is likely due to a complex mix of physical, cognitive and psychosocial health factors.
Alcohol; older adult; long-term care placement
Beliefs about the effects of mixing caffeine and alcohol on hangover or sleep may play a role in motivation to consume these mixtures; therefore, information is needed about actual effects. We investigated whether intoxication with caffeinated vs. non-caffeinated beer differentially affected perceived sleep quality, sleepiness, and hangover incidence and severity the next morning.
University students (89%) and recent graduate drinkers were randomized to receive: (1) beer with the equivalent of 69 mg caffeine/12 oz glass of regular beer (n = 28) or (2) beer without caffeine (n = 36), in sufficient quantity to attain a BrAC of 0.12 g%. After an 8-hour supervised sleep period, participants completed measures of hangover, sleep quality, sleep latency and time asleep, and sleepiness.
While caffeinated beer improved perceived sleep quality, effect sizes were greater for morning alertness than for quality while sleeping, with no effect on sleep latency or total sleep time. No effects were seen on hangover incidence or severity.
Mixing caffeine and alcohol does not significantly impair amount of sleep or sleep latency, hangover, or sleepiness the morning after drinking to intoxication in this population.
caffeine; alcohol; energy drinks; hangover; sleep quality
Research on ethnic health disparities requires the use of psychometrically sound instruments that are appropriate when applied to ethnically diverse populations. The Short Inventory of Problems (SIP) assesses alcohol-related consequences and is often used as a measure to evaluate intervention effectiveness in alcohol research; however, whether the psychometric properties of this instrument are comparable across language and ethnicity remains unclear.
Multi-group Confirmatory Factor Analysis (MGCFA) was used to test for the invariance of the measurement structure of the SIP across White Non-Hispanic English speaking (N=642), Hispanic English speaking (N=275), and Hispanic Spanish speaking (N=220) groups.
The MGCFA model in which factor loadings, measurement intercepts, and item residuals were constrained to be equal between English speakers and Spanish speakers exhibited a reasonable fit to the data, χ2(221)=1089.612 p<.001, TLI=.926; CFI=.922, RMSEA=.059 (90%CI=.055–.062). The ΔCFI supported strict factorial invariance, ΔCFI=.01, across groups; no significant group differences were found between factor loadings, measurement intercepts, or item residuals between English speakers and Spanish speakers.
This study extends the existing confirmatory factor analysis results of the SIP by providing additional data to inform the utility of the SIP among Hispanics. Strict factorial invariance between Spanish and English speakers is necessary to: conclude the underlying constructs have the same meaning across groups; test for group differences in the latent variables across groups; and presume group differences are attributable only to true differences between groups. Thus, the SIP is strongly supported for evaluating the effectiveness of alcohol treatment among Hispanics.
Reducing tobacco use among adolescents in China represents a significant
challenge for global tobacco control. Existing behavioral theories developed in
the West – such as the Protection Motivation Theory (PMT) – may
be useful tools to help tackle this challenge. We examined the relationships
between PMT factors and self-reported cigarette smoking behavior and intention
among a random sample of vocational high school students (N
= 553) in Wuhan, China. Tobacco-related perceptions were assessed using
the PMT Scale for Adolescent Smoking. Among the total sample, 45% had
initiated cigarette smoking, and 25% smoked in the past month. Among
those who never smoked, 15% indicated being likely or very likely to
smoke in a year. Multiple regression modeling analysis indicated the
significance of the seven PMT constructs, the four PMT perceptions and the two
PMT pathways in predicting intention to smoke and actual smoking behavior.
Overall, perceived rewards of smoking, especially intrinsic rewards, were
consistently positively related to smoking intentions and behavior, and
self-efficacy to avoid smoking was negatively related to smoking. The current
study suggests the utility of PMT for further research examining adolescent
smoking. PMT-based smoking prevention and clinical smoking cessation
intervention programs should focus more on adolescents’ perceived
rewards from smoking and perceived efficacy of not smoking to reduce their
intention to and actual use of tobacco.
Protection Motivation Theory; Adolescents; Cigarette smoking; China
Multi-component parent-based interventions (PBIs) provide a promising avenue for targeting alcohol use and related consequences in college students. Parents of college-aged children can have a significant influence on their children’s alcohol use decisions. However, parents tend to underestimate their own child’s alcohol use and overestimate other similar parents’ approval of student drinking. These misperceptions could have important implications for parents’ own attitudes and alcohol-related communication with their student. Targeting these misperceptions through normative feedback could help promote greater and more in-depth alcohol-related communication. The present study examines the potential efficacy of web-based alcohol-related normative feedback for parents of college students.
A sample of 144 parents of college students received web-based normative feedback about students’ alcohol use and approval, as well as other same-college parents’ alcohol approval. Parents completed measures of perceived student alcohol use, student alcohol approval, other-parent alcohol approval, and intentions to discuss alcohol use both pre- and post-normative feedback.
Post-feedback, parents reported stronger intentions to talk to their student about alcohol, were less confident in their knowledge of their students’ alcohol use, and believed that their student drank in greater quantity and more frequently than pre-feedback. Parents also perceived other parents to be less approving of alcohol use after viewing normative feedback.
These findings provide preliminary support for the use of web-based normative feedback for parents of college students. Given these promising results, further research developing and testing this approach merits attention.
Normative feedback; Parent-based intervention; College drinking; Alcohol use
The personality trait of impulsivity is predictive of heavy drinking and consequences among college students. The current study examined how impulsivity—measured via positive urgency, negative urgency, and sensation seeking—and a person's beliefs about the role alcohol plays in the college experience relate to drinking and consequences in a sample of 470 college students (mean age = 19 years, 61.3% female, 59.8% white). In support of hypotheses, sensation seeking independently predicted greater drinking, and both positive and negative urgency predicted greater experience of alcohol-related negative consequences after controlling for consumption level. Moreover, alcohol beliefs moderated the relationship between impulsivity types and alcohol outcomes. Among students high (versus low) in sensation seeking, strong beliefs about alcohol's role in college life were related to significantly greater drinking, and among students high (versus low) in negative urgency, endorsing strong beliefs about alcohol's role in college life were related to greater levels of alcohol-related negative consequences. Overall, findings inform college prevention efforts by highlighting the need to distinguish unique facets of impulsivity and examine how they intersect with students’ beliefs about alcohol in college.
Sensation seeking; Urgency; Impulsivity; College drinking; Alcohol beliefs
With the popularity of Internet use among adolescents, there is concern that some youth may display problematic or addictive patterns of Internet use. Although excessive patterns of Internet use was considered for inclusion in the DSM-5 with pathological gambling and substance-use disorders in a category of addictive disorders, it was determined that more research was needed on Internet-use behaviors before such actions be further considered and possibly undertaken. The present study is the first to investigate whether at-risk/problematic Internet use (ARPIU) may moderate the strength of association between problem-gambling severity and gambling-related characteristics and health and well-being measures in adolescents. Survey data from 1884 Connecticut high-school student stratified by Internet use (ARPIU vs. non-ARPIU) were examined in bivariate analyses and logistic regression models. Gambling-related characteristics and health and well-being measures were mostly positively associated with problem-gambling severity in both Internet use groups. Interaction odds ratio revealed that the strength of the associations between problem-gambling severity and marijuana, alcohol and caffeine use were stronger amongst the non-ARPIU compared to the ARPIU group, suggesting that the relationships between these substance use behaviors and problem gambling may be partially accounted for by ARPIU. Future studies should examine the extent to which preventative interventions targeting both problematic Internet use and problem gambling may synergistically benefit measures of health and reduce risk-taking behaviors in adolescence.
Problem gambling severity; Internet; Behavioral addiction; Substance use
The mixing of alcoholic beverages with caffeine has been identified as a public health problem among college students; however, little is known about the consumption of such drinks among younger adolescents. We estimated the prevalence of caffeinated alcoholic beverage (CAB) use among a wide age range of underage drinkers, examined differences in traditional (i.e. self-mixed alcoholic beverages with soda, coffee and tea) and non-traditional CAB use (pre-mixed caffeinated alcoholic beverages or self-mixed alcoholic beverages with energy drinks or energy shots) among underage drinkers by age and other demographic characteristics, and examined differences in hazardous drinking behavior between CAB and non-CAB users.
We used an existing internet panel maintained by Knowledge Networks, Inc. to assess the use of pre-mixed and self-mixed CABs in the past 30 days among a national sample of 1,031 youth drinkers ages 13–20. We conducted logistic regression analyses to estimate the relationship between traditional and non-traditional CAB use and risky drinking behavior as well as adverse outcomes of drinking, while controlling for age, gender, race/ethnicity, income, and general risk-taking (seat belt use).
The overall prevalence of CAB use in the sample of underage drinkers was 52.4% (95% confidence interval [CI], 47.4%–57.4%). CAB prevalence was 48.4% among 13–15 year-old drinkers, 45.3% among 16–18 year-old drinkers, and 58.4% among 19–20 year-old drinkers. After controlling for other variables, we found a continuum of risk with non-traditional CAB use most significantly associated with binge drinking (odds ratio [OR] = 6.3), fighting (OR = 4.4), and alcohol-related injuries (OR = 5.6)
The problem of caffeinated alcoholic beverage use is not restricted to college-aged youth. The prevalence of CAB use among underage drinkers is higher than previously thought and begins in early adolescence. Adolescents who consume CABs, and particularly non-traditional CABs, are at increased risk of adverse outcomes.
Energy drink; Alcohol use; Alcohol drinking pattern; Adverse outcomes; Youth