Research of Note for May 2002

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This month’s Research Watch provides information about the effectiveness of drug prevention programs, the impact of role models on youth and new warnings about marijuana use.

Reducing Smoking, Drinking and Drug Use

The National Cross-Site Evaluation of High-Risk Youth Programs, U.S. Center for Substance Abuse Prevention, DHHS
Publication No. SMA-25-01. Available free from National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345. (800) 729-6686, TDD (800) 487-4889, (click for CSAP).

Drug-abuse prevention programs can help high-risk youth, according to this five-year study by the Center for Substance Abuse Prevention (CSAP). The report found that prevention programs for high-risk youth have been effective in reducing rates of alcohol, tobacco and marijuana use.

The study included more than 10,500 youth in 48 communities with high levels of poverty, crime and substance abuse. The results showed that prevention programs strongly influence boys’ behavior while they participate in the programs and for a few months afterward. The impact on girls is initially weaker, but increases over time and is longer-lasting.

The programs varied widely in design, and some were effective while others were not. Unfortunately, the report does not specify the range of effectiveness, or the proportion of programs that were effective. However, it concludes that the programs that were most successful showed a clear purpose and evidence-based strategy, focused on self-examination, maintained intensive participant contact and were offered in after-school settings.

For girls, programs that focused on behavior-related life skills were the most effective. Boys benefited most from programs that emphasized interaction with peers or adults.

Approximately 60 percent of the youths participated in prevention programs. Their reported first-time use of cigarettes, alcohol and marijuana was 12 percent lower when the program was completed, compared with those who were not in a program. Eighteen months later, the participants’ first time use was still 6 percent below that of other youth.

For youths who had already used tobacco, alcohol or marijuana, use of these substances was 10 percent lower for those who completed a prevention program compared with those who did not. Eighteen months later, however, participants’ substance abuse levels were 22 percent below the levels of the other youths.

The programs had a more immediate impact on boys, who were 29 percent less likely to use drugs at the end of the program, and 22 percent less likely six months later. However, this difference disappeared 18 months after a prevention program was completed.

In contrast, substance use was only 3 percent lower for girls who completed a program compared with girls who did not participate, but 18 months later this difference had increased to 9 percent.

The report confirmed a “web of influence” in the lives of these youth that included school, family, peers and community. For example, in strong families, parents influence their children’s choice of friends and their decisions about whether to smoke, drink or use drugs. Youth who do well in school tend to have friends who do not use these substances, and those youth are also less likely to use them. The report concluded that “family, peers, school, community and society protect against substance abuse.”

Role Models for Urban Youth

Role Models, Ethnic Identity, and Health-Risk Behaviors in Urban Adolescents
Antronette Yancey, M.D., M.P.H., Judith Siegel, Ph.D., Kimberly McDaniel, Ph.D. Archives in Pediatrics & Adolescent Medicine, Vol. 156, January 2002, pp. 55-61.

There’s a lot of talk about role models, but not much information on whom kids choose as their models in their lives. A new study of more than 700 12- to 17-year-old Los Angeles adolescents revealed some surprising findings.

Fifty-six percent of the youths named role models. There was no significant difference between boys and girls or younger and older youths. Those who had role models, especially someone they knew personally, tended to have higher self-esteem and higher grades. White youths who did not live with their fathers were less likely to abuse drugs or alcohol if they had role models.

Those who had role models had a stronger ethnic identity than those who did not, and youngsters who chose someone they knew as a role model had a stronger ethnic identity than those who chose a celebrity.

The youths were ethnically diverse, although more than half were Hispanic. Youths from families with higher incomes were more likely to have role models. As a result, whites were somewhat more likely to have role models than were their classmates.
Nearly three out of four chose a role model of the same ethnic group, and 86 percent chose a role model of the same sex.
Almost all the African-Americans chose a role model of the same race, compared to 79 percent of whites and 64 percent of Hispanics. Boys were more likely than girls to choose a role model of the same sex.

Who are the role models? A parent was named by 22 percent of the students, whereas 18 percent (almost all of whom were boys) named an athlete. Siblings and singers were each named by 10 percent. Unrelated friends and acquaintances were named by 7 percent of the boys and 14 percent of the girls. These included peers, adult friends, teachers, doctors, lawyers and youth workers.

The implications for youth workers are clear: Role models help youth feel better about themselves and do better in school. The availability of potential role models of the same sex and race is apparent. Unfortunately, in this study, very few of the role models mentioned were youth workers. More research is needed to find out why.

Smoking Marijuana: An Update

Marijuana: A Decade and a Half Later, Still a Crude Drug with Underappreciated Toxicity
Richard Schwartz, M.D. Pediatrics, Vol. 109, No. 2, February 2002, pp. 284-289. Available free from Schwartz at 115 Park St., SE, Ste. 203, Vienna, VA 22180.

Despite its widespread use, there is still much to be learned about the impact of smoking marijuana. In a new review of the research, published 15 years after an earlier review, Richard Schwartz speaks in the voice of an unbiased expert. However, he also reveals that his 34-year-old son was under treatment for drug abuse at the time his first research review was published, and after 10 drug-free years, his son has “finally attained some adult goals.”

That kind of personal experience influences objectivity. Nevertheless, the review cites major research studies and makes interesting points about marijuana use in the U.S.

Annual marijuana use among adolescents fell steadily between 1979 and the early half of the 1990s, but started to increase rapidly and peaked among eighth-graders in 1996. At the same time, perceptions of the risk of smoking marijuana changed; as concerns decreased, smoking increased.

A major concern about marijuana has been that it is a gateway drug, opening the door to other substance abuse. According to the latest research, marijuana smoking seems to precede tobacco smoking and alcohol abuse in girls, but not necessarily “hard” drugs such as heroin and cocaine in either boys or girls. 1 However, kids who smoke marijuana at an early age and who use it frequently are more likely to live an unconventional lifestyle: hanging out with delinquent and substance-abusing teens, dropping out of school, leaving home and becoming parents at an early age.

Memory problems are an obvious short-term effect from marijuana. Smokers can’t process newly learned information and store it for later use. Several studies indicate the loss of “executive functions” such as learning lists and doing homework, and that this continues when the individual is no longer high.

Marijuana also has a clearly negative impact on driving. In a road test, for example, reaction time increased 36 percent, which would result in driving an additional 139 feet before stopping if the person was driving 59 miles per hour.

Schwartz points out that marijuana websites make it easy to purchase marijuana seeds and growing instructions, as well as pipes and water pipes that cool and concentrate the smoke so that even middle-school smokers can get a “super high” compared with smoking a cigarette-sized joint. The websites also convey the view that marijuana use is safe and should be legalized. These websites, he says, may account for the recent increase in marijuana use and make it more difficult for youth workers and other adults who try to provide more accurate information to youth. Meanwhile, seedless marijuana that is stronger than ever is readily available in towns, suburbs and cities across the country.