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Biomedical subjects

Phyllis L Ellickson

Publications and source records attributed to Phyllis L Ellickson.

At least 19 recordsLinked to original sources

A discrete time hazards model of smoking initiation among West Coast youth from age 5 to 23.

OBJECTIVE: To identify factors associated with age of smoking initiation and distinguish vulnerable periods for initiation according to those factors. METHOD: Discrete time hazards analysis was used to model smoking initiation as a function of age (5-23), demographic and familial influence variables (measured at age 13), and their interactions in a cohort of 6255 youths who completed six assessments over a 10-year period from age 13 to 23 years. RESULTS: Half of the sample had initiated smoking by age 13, and the hazard for initiation was greatest between ages 13 and 15. In addition to differences associated with race/ethnicity, protective factors for smoking initiation included high parental education and having an intact family of origin. Having an older sibling and participant's exposure to smoking by an important adult were both risk factors, with the latter having a stronger effect for females and Blacks. For all effects, the strength of the association differed across the age range. CONCLUSIONS: The impact of demographic and family influence factors on smoking initiation varies over time. However, the maximum risk for initiation is during the early teen years, and the range of considerable vulnerability is during middle school and high school.

Actuarial Analysis↗

Time trends and demographic differences in youth exposure to alcohol advertising on television.

OBJECTIVE: To examine trends in youth exposure to alcohol advertising on television across different demographic groups. METHODS: We used television ratings data on alcohol advertisements to examine trends in exposure between September 1998 and February 2002. Further, we explored the differences in exposure across demographic groups by examining group-level alcohol ad exposure across specific networks, program types, and times of day. RESULTS: We found that boys were more exposed than girls and African-Americans are more exposed than whites. Moreover, the race differential appeared to be increasing over time, whereas the gender differential appeared to increase with age. Differences in viewing patterns across race and gender contributed to the observed differences in exposure to alcohol advertising on television. CONCLUSIONS: These results provide guidance in identifying comparative vulnerabilities in exposure to alcohol advertising on television, and can aid in the development of strategies to inoculate youth against those vulnerabilities.

Adolescent↗

Are drug experimenters better adjusted than abstainers and users?: a longitudinal study of adolescent marijuana use.

PURPOSE: Experimentation with substance use is normative during adolescence and prior research suggests that adolescents who refrain from experimentation may be psychologically maladjusted. This longitudinal study compared lifetime marijuana abstainers (n = 1177), experimenters (n = 873), and frequent users (n = 205) at grade 12 on psychosocial functioning during late adolescence and young adulthood. METHODS: Participants were recruited from middle schools in 1985 (grade 7) and assessed repeatedly, including in 1990 (grade 12) and 1995 (age 23). Self-report surveys assessed lifetime substance use at grade 12, and psychosocial functioning at grade 12 and age 23. Group differences after controlling for key demographics were estimated using multivariate logistic regression and analysis of covariance. RESULTS: Adolescent abstainers from marijuana often fared better (and in no case worse) than experimenters and frequent users both concurrently and later in life on school engagement, family and peer relations, mental health, and deviant behavior. Similar results were found in ancillary analyses using a definition of adolescent "abstainer" that also accounted for cigarette and alcohol use. CONCLUSIONS: Results refute the idea that adolescents who abstain from substance use are maladjusted, and suggest instead that they function better than experimenters later in life, during the transition to young adulthood.

Adolescent↗

High school drug use predicts job-related outcomes at age 29.

The present study examines the relationship between hard drug use in high school and occupational and job quality outcomes measured at approximately age 29. We use two different methods aimed at ruling out the possibility of spurious correlations between high school drug use and occupational outcomes: (1) directly controlling for pre-high school characteristics that may affect both high school drug use and later occupational characteristics (e.g., educational orientation, early drug use and deviant behavior); and (2) matching high school users with a subset of nonusers that have very similar characteristics and then estimating the difference in labor market outcomes for these two groups (i.e., propensity score matching). Overall, the results suggest that adolescent drug use is linked with poorer occupational and job quality outcomes as much as 10 years after high school. Interestingly, which job-related outcomes are affected by early hard drug use varies by gender. Females who use hard drugs as adolescents end up in lower skill, lower status jobs while males who use hard drugs as adolescents are more likely to end up in jobs with fewer benefits (e.g., health, retirement).

Adolescent↗

Does solitary substance use increase adolescents' risk for poor psychosocial and behavioral outcomes? A 9-year longitudinal study comparing solitary and social users.

This longitudinal study compared Grade 8 solitary cigarette smokers (n = 541), drinkers (n = 577), and marijuana users (n = 148) with adolescents who restricted their use of these substances to social settings (ns = 562, 1,426, and 388, respectively) on adolescent functioning and young adult outcomes. In Grade 8, solitary users held more positive beliefs about the consequences of substance use, earned poorer grades, engaged in more deviant behavior, and devoted less time to school and more time to social activities. By age 23, these solitary users had lower educational attainment, poorer self-rated health, and greater substance use problems. Results indicate the importance of better understanding and addressing the needs of this understudied group of high-risk youth.

Adaptation, Psychological↗

Socio-environmental influences on adolescents' alcohol outcome expectancies: a prospective analysis.

AIMS: To investigate the prospective influence of social influence and social bonding variables on the development of alcohol outcome expectancies among adolescents with and without drinking experience. DESIGN: Longitudinal data from students in the control schools of a field trial designed to evaluate a school-based drug prevention program. SETTING: A total of 19 middle schools in South Dakota, USA. MEASUREMENTS: An alcohol outcome expectancy scale administered to 1410 students in grades 8 and 9. After using confirmatory factor analysis (CFA) to develop an expectancies measure, multiple-group (grade 8 drinkers versus grade 8 non-drinkers) path analysis was used to model 9th grade alcohol expectancies. Grade 8 social influence and bonding variables were used as predictors, controlling for grade 8 expectancies. FINDINGS: At the bivariate level, peer and adult influences and social bonding variables were related consistently to alcohol outcome expectancies among drinkers and non-drinkers. A bivariate relationship between alcohol advertising and alcohol expectancies was found among drinkers only. In the multivariate model, greater alcohol use by important adults predicted independently increased alcohol positivity among drinkers; greater perceived approval of alcohol use by parents and peers predicted diminished perceived potency of alcohol among non-drinkers. Advertisement exposure and social bonding variables were not independent predictors of alcohol expectancies in the multivariate model. CONCLUSIONS: These findings suggest that attempts to alter adolescents' alcohol expectancies are likely to fail unless they address the influence of immediate social models on these beliefs.

Adolescent↗

Exploring the link between substance abuse and abortion: the roles of unconventionality and unplanned pregnancy.

CONTEXT: Several studies have found a relationship between abortion and prior substance use, suggesting that a reduction in substance use might help decrease abortion rates. However, such a conclusion requires a greater understanding of the processes linking abortion and prior substance use. METHOD: Path analysis of longitudinal data from 1,224 women was used to simultaneously test two pathways from adolescent substance use to abortion by age 29, one mediated by higher rates of unplanned pregnancy and the other independent of unplanned pregnancy rates. The model was then expanded to examine how these pathways change when unconventional attitudes and behaviors (such as rebelliousness and low religiosity) are taken into consideration. RESULTS: In the analysis that did not control for unconventionality, women who reported smoking cigarettes or using marijuana or hard drugs at age 18 had an increased likelihood of subsequent unplanned pregnancy and, as a result, higher rates of abortion. In addition, women who had used marijuana had an increased likelihood of abortion independent of unplanned pregnancy rates. In the final model, unconventionality strongly predicted both abortion and unplanned pregnancy. Moreover, it explained the associations between the use of hard drugs or marijuana and abortion that were due to higher unplanned pregnancy rates. CONCLUSIONS: Unconventionality mediates certain associations between substance use and abortion, perhaps because unconventional women are more likely both to use substances and to engage in behaviors that increase their risk of unplanned pregnancy. Hence, it seems unlikely that reducing substance use will result in substantially fewer abortions.

Abortion, Legal↗

National Youth Anti-Drug Media Campaign and school-based drug prevention: Evidence for a synergistic effect in ALERT Plus.

This analysis examined the possible synergistic effect of exposure to the National Youth Anti-Drug Media Campaign and a classroom-based drug prevention curriculum among 9th grade students participating in a randomized trial of ALERT Plus. A total of 45 South Dakota high schools and their middle-school feeder(s) were randomly assigned to an ALERT condition (basic prevention curriculum delivered in 7th and 8th grades), an ALERT Plus condition (basic curriculum with booster lessons added for 9th and 10th grades), or a control condition. Marijuana use in the past month was significantly less likely among ALERT Plus students reporting at least weekly exposure to anti-drug media messages. The National Youth Anti-Drug Media Campaign may have led to reductions in marijuana use among youth who simultaneously received school-based drug prevention.

Adolescent↗

Isolating the nexus of substance use, violence and sexual risk for HIV infection among young adults in the United States.

Adults aged 18 to 29 are at significant sexual risk for HIV infection. Substance use and violence are known to be associated with sexual risk in certain groups, but few studies have examined these relationships in the general population of young adults. No studies have tested whether the contributions of substance use and violence to sexual risk are independent, and few have looked at whether drug use associations with risk are specific to certain substances. Using structural modeling techniques, we examined data for 3,437 adults aged 23-24, testing for associations between three measures of sexual risk for HIV, various forms of substance use, victimization and partner violence. Alcohol use and victimization predicted high risk sex in independent samples of single and married/cohabiting adults. Marijuana use, problem drug use, and partner violence were inconsistently related to sexual risk across measures and subsamples. HIV-prevention interventions designed for young adults in the general population should target individuals who use alcohol frequently and who are victims of violence, and should address both factors, in addition to sexual risk behavior.

Adolescent↗

Mediation analysis of a school-based drug prevention program: effects of Project ALERT.

This study used mediation analyses, implemented in a longitudinal structural equation modeling framework, to examine the mechanisms by which a social-influence-based school drug use prevention program (Project ALERT) achieved its effects on past month cigarette use and alcohol misuse. Participants were 4277 South Dakotan middle-school students (2554 treatment and 1723 control) measured at baseline and 1 year later on past month cigarette use and alcohol misuse, as well as cigarette- and alcohol-related mediating variables targeted by the Project ALERT curriculum (i.e., resistance self-efficacy, positive and negative beliefs about use, and peer influence). Results for cigarettes showed that all hypothesized mediating variables were significant mediators of ALERT's effect on intentions to smoke and past month cigarette use, with peer influence being the strongest. Results for alcohol point to positive beliefs about the consequences of drinking as an important mediator for alcohol misuse. Taken together, the findings highlight an avenue for program improvement through increased impact on peer influence to use alcohol and drugs.

Adolescent↗

Scope of HIV risk and co-occurring psychosocial health problems among young adults: violence, victimization, and substance use.

PURPOSE: This study examines the co-occurrence of sexual risk with violence, victimization, risky substance use, and drug-related problems among young adults. METHODS: Data were collected from 3392 young adults drawn from California and Oregon as youth, as part of the RAND adolescent panel study. Logistic regression analyses were used to test differences in psychosocial health problems for participants at high, moderate, and low sexual risk, overall, and by gender. RESULTS: Nearly 80% of young adults exhibited some degree of sexual risk. Both moderate (56%) and high (22%) HIV risks were associated with multiple forms of drug use, drug-related problems, violence and victimization. Males and females had similar relative risk profiles, but females reported higher rates of victimization in the form of partner abuse and sexual coercion. Over 80% of those at high sexual risk exhibited psychosocial health problems in at least 2 other areas. CONCLUSIONS: Sexual risk-taking is widespread among young adults and typically co-occurs with other psychosocial health problems. Interventions designed for young adults at high sexual risk should take into account their additional psychosocial problems; broad media campaigns may be useful for those at moderate risk.

Adolescent↗

Saturated in beer: awareness of beer advertising in late childhood and adolescence.

PURPOSE: The purpose of this study was to examine exposure, response to, and awareness of beer advertising in 2 age groups, including awareness of a Budweiser advertisement (ad) that portrayed lizards and an animated ferret. METHODS: In the spring of 2000, 1,996 fourth graders and 1,525 ninth graders attending 1 of 60 South Dakota schools participated in an in-school survey. Several indicators of advertising awareness, exposure, and response were assessed: recognition, product naming, brand naming, and liking in response to stills drawn from 4 masked television beer ads, listing of beer brands, exposure, attention to, and skepticism toward television beer ads. RESULTS: Fourteen percent of 4th graders and 20% of 9th graders recognized at least 3 of 4 sample beer ads. Seventy-five percent of 4th graders and 87% of 9th graders recognized the Budweiser ferret ad; about one in three 4th graders could name the brand it advertised, whereas more than three in four 9th graders could do so. When asked to list as many beer brands as they could, almost 29% of 4th graders listed 3 or more beer brands and 82% of 9th graders did so. Ninth graders liked beer advertisements more and paid greater attention to them, but 4th graders were exposed to them more often. CONCLUSION: Television beer ads result in high levels of beer advertising awareness in children as young as age 9, and even higher awareness among 14-year-olds. Practices that expose or appeal to youth, including use of animated characters, should be avoided by beer advertisers.

Adolescent↗

Predictors of attempted quitting and cessation among young adult smokers.

BACKGROUND: This study compared young adult nonsmokers (n = 1216), light smokers (n = 406), and regular smokers (n = 360) on demographic, psychosocial, and behavioral characteristics, as well as identified predictors of attempted quitting and 6-month cessation among regular smokers. METHOD: Participants were recruited from middle schools in 1985 (age 13) and assessed repeatedly through 2001 (age 29). Mail surveys were used to obtain information on smoking status and hypothesized predictors of cessation at age 23, and quit attempts and cessation occurring between ages 23-39 among regular smokers. Logistic regression analysis was used to identify predictors of quit attempts and 6-month cessation. RESULTS: Among initial smokers, 76% attempted to quit and 26% quit for 6 months or longer between ages 23-29. Higher rates of substance use, illegal activity, poor mental health, and victimization were found among regular smokers than nonsmokers and lighter smokers at age 23. However, multivariate analyses indicated that these problems were less relevant to quitting than social transitions and interpersonal factors, demographics (e.g., race/ethnicity), and health status. CONCLUSIONS: Different risk and protective factors are relevant to understanding why smokers attempt to quit versus why they are able to quit for 6 months or longer. We discuss implications of these findings for cessation interventions and programs for young adults.

Adolescent↗

Measuring developmental changes in alcohol expectancies.

The goal of this study was to measure shifts in alcohol expectancies from childhood into adolescence while controlling for changes in the psychometric properties of the instrument. One thousand nine hundred ninety-three 4th-grade and 1,632 9th-grade students from South Dakota rated the likelihood that 23 outcomes would result from alcohol use. These expectancies were modeled using a 2-factor confirmatory factor analysis. After differences in the psychometric properties of the instrument were controlled, the cohorts were distinguished by a large difference in Alcohol Positivity, with older participants viewing alcohol's effects more positively. Additionally, older participants displayed greater Alcohol Potency, believing that alcohol has a larger impact on all outcomes. There were also significant differences in the interpretation of the alcohol expectancies items across cohorts.

Adolescent↗

Concurrent use of alcohol and cigarettes from adolescence to young adulthood: an examination of developmental trajectories and outcomes.

Concurrent use of alcohol and tobacco is common among adolescents, yet little is known about the developmental patterns of concurrent use, or the consequences associated with such patterns during young adulthood. Using data collected at six time points during 1985-1995 as part of an evaluation of a school-based substance abuse prevention program in California and Oregon, this study used latent growth mixture modeling to identify five distinct developmental trajectories of concurrent use of alcohol and tobacco from ages 13-23 in a cohort of 5873 individuals and compared these distinct groups with respect to demographic characteristics and young adult outcomes (at age 23 and age 29). Results suggest that while it is common during adolescence to drink but not smoke, it is very unusual to smoke and not drink. Compared to young people who smoked and drank consistently throughout their teens and early twenties, those who drank consistently but smoked only occasionally or dramatically decreased their smoking over time had lower rates of deviant behavior and predatory violence at age 23 and were less likely to have a history of arrest and substance use problems by age 29. This close examination of concurrent use of alcohol and cigarette use from ages 13-23 further accentuates the importance of curbing smoking behavior among adolescents before it becomes habitual.

Adolescent↗

Marijuana use and later problems: when frequency of recent use explains age of initiation effects (and when it does not).

Tobacco, alcohol, and marijuana are among the most commonly used drugs during adolescence. Initiation of marijuana use typically peaks at age 15, with risk of initiation continuing throughout adolescence. The goal of the current study was to prospectively examine the influence of age of marijuana initiation on four outcomes: physical health, mental health, illicit drug use other than marijuana, and marijuana-use related consequences at age 18. We controlled for several important predictors of adolescent drug use and its associated consequences, including demographics, social bonding variables, personality variables, and recent use of marijuana. Baseline survey data were collected in 1984 at grade 7 and follow up surveys were conducted at grades 8, 9, 10, and 12 (N = 2079). This initiates-only sample was 47% female, 66% White, 11% African American, 13% Hispanic, 5% Asian, and 5% other race or ethnicity. Findings indicated that age of initiation predicted marijuana consequences and other illicit drug use after controlling for demographic, social, and behavioral factors. However, once frequency of recent marijuana use was included in the models, age of initiation was only associated with other illicit drug use. Both primary and secondary prevention are needed to curb marijuana use and its associated harms.

Adolescent↗

Developmental considerations for substance use interventions from middle school through college.

This article summarizes a symposium organized by Dr. Elizabeth D'Amico and presented at the 2004 Annual Meeting of the Research Society on Alcoholism in Vancouver, Canada. The four presentations illustrate the importance of creating substance use interventions that are developmentally appropriate for youth. They represent innovative approaches to working with preteens, teenagers, and young adults. Dr. D'Amico's paper describes her research on the development of a voluntary brief intervention targeting alcohol use among middle school students. Findings indicated that by using school and community input, she was able to obtain a diverse a sample of youth across grades, sex, ethnicity, and substance use status. Dr. Ellickson's paper describes her research on Project ALERT, a school-based prevention program for middle school youth. Her findings indicate that Project ALERT worked for students at all levels of risk (low, moderate, and high) and for all students combined. Dr. Wagner's Teen Intervention Project was a randomized clinical trial to test the efficacy of a standardized Student Assistance Program for treating middle and high school students with alcohol and other drug problems. The study provided a unique opportunity to begin to examine how development may impact response to an alcohol or other drug intervention. Dr. Turrisi's paper examined processes underlying the nature of the effects of a parent intervention on college student drinking tendencies. Findings suggested that the parent intervention seems to have its impact on student drinking by reducing the influence of negative communications and decreasing the susceptibility of influences from closest friends. Dr. Kim Fromme provided concluding remarks.

Adolescent↗

Does alcohol advertising promote adolescent drinking? Results from a longitudinal assessment.

AIMS: To examine the relationship between exposure to different forms of alcohol advertising and subsequent drinking among US adolescents and assess whether exposure to an alcohol and drug prevention program mitigates any such relationship. DESIGN: Regression models with multiple control variables examined the relationship between exposure to alcohol advertising in grade 8 and grade 9 drinking for two groups of South Dakotan adolescents: (1) seventh-grade non-drinkers (n = 1206) and (2) seventh-grade drinkers (n = 1905). Interactions between the intervention program and the significant advertising predictors were tested. SETTING: Forty-one middle schools in South Dakota, USA. PARTICIPANTS: A total of 3111 seventh-graders followed through grade 9. MEASUREMENTS: Advertising variables were constructed for four types of alcohol advertising-television, in-store displays, magazines and concession stands. Other predictors tested included measures tapping social influences, social bonds, problem behavior, alcohol beliefs, television exposure and demographics. FINDINGS: For seventh-grade non-drinkers, exposure to in-store beer displays predicted drinking onset by grade 9; for seventh-grade drinkers, exposure to magazines with alcohol advertisements and to beer concession stands at sports or music events predicted frequency of grade 9 drinking. Although exposure to television beer advertising had a significant bivariate relationship with alcohol use for grade 7 non-drinkers, it was not a significant predictor of drinking for either group in multivariate analyses. Participation in the prevention program, ALERT Plus, reduced future drinking for both groups and counteracted the effect of in-store beer displays. CONCLUSIONS: Several forms of alcohol advertising predict adolescent drinking; which sources dominate depends on the child's prior experience with alcohol. Alcohol prevention programs and policies should help children counter alcohol advertising from multiple sources and limit exposure to these sources.

Adolescent↗