Using attitudes, age and gender to estimate an adolescent’s substance use risk
| DOI | https://doi.org/10.1108/JCS-06-2015-0020 |
| Date | 19 September 2016 |
| Published date | 19 September 2016 |
| Pages | 244-260 |
| Author | William B. Hansen,Jared L. Hansen |
| Subject Matter | Health & social care,Vulnerable groups,Children's services,Sociology,Sociology of the family,Children/youth,Parents,Education,Early childhood education,Home culture,Social/physical development |
Using attitudes, age and gender
to estimate an adolescent’s
substance use risk
William B. Hansen and Jared L. Hansen
William B. Hansen is the
President at Tanglewood
Research, Greensboro,
North Carolina, USA.
Jared L. Hansen is based at
Research and Development
Service, US Veterans
Administration, Salt Lake City,
Utah, USA.
Abstract
Purpose –The purpose of this paper is to present a strategy for estimating an individual’s risk of alcohol,
cigarette and cannabis use that relies on an assessment of an adolescent’s age, gender and attitude.
Design/methodology/approach –The authors assembled surveys from 35,987 11-17 year-olds from 36
databases to examine the relationship between attitude and behaviour.
Findings –Attitudes were strongly correlated with concurrent use of alcohol, drunkenness, smoking and
cannabis, with correlations of −0.555, −0.517, −0.552 and −0.476, respectively. Logistic regression
provided a means for using age, gender and attitudes to estimate an individual’s risk of engaging in
substance use behaviour. Developmental changes in attitudes were estimated by analysing changes in
scores associated with percentile rankings for each age and gender group. Projected year-to-year changes
in attitude were used as a heuristic for estimating future risk.
Research limitations/implications –Analyses relied on cross-sectional panel data. Analyses would
benefit from longitudinal data in which age-related changes in attitudes could be more precisely modelled.
Practical implications –Information about estimated current and future risk may prove useful for motivating
the adoption and implementation of effective prevention approaches by parents and care providers.
Originality/value –The authors present a novel method for estimating an individual’s risk of substance use
knowing attitude, age and gender.
Keywords Adolescents, Parents, Prevention, Alcohol, Cannabis, Clinicians, Cigarettes, Estimating risk,
Drunkenness
Paper type Research paper
Introduction
Substance use during adolescence remains a major source of risk for physical and mental health
outcomes. For the population in general, the relationship between age, gender and the
prevalence of adolescent substance use is well known. For example, since 1991 the Monitoring
the Future project has collected surveys annually from approximately 50,000 8th, 10th and 12th
grade students in the USA (Johnston et al., 2013, 2015). These surveys assess the most
common substances used by adolescents –alcohol, cigarettes and cannabis (Kandel, 2002) –
as well as a host of other illicit drugs, including cocaine, heroin and methamphetamine. A similar
survey is periodically conducted by the US Centres for Disease Control and Prevention, the
Youth Risk Behaviour Survey (Eaton et al., 2012) in which the 30-day prevalence of alcohol,
cigarettes and cannabis are assessed for students in grades 9-12. European countries also
participate in the European School Survey Project on Alcohol and Other Drugs (ESPAD), a
periodic student survey that assesses substance use prevalence (Hibell et al., 2012).
Received 13 June 2015
Revised 9 November 2015
31 December 2015
Accepted 3 January 2016
There are no financial conflicts of
interest in this research. This
research was funded in part by a
grant from the US National Institute
on Drug Abuse, Grant No.
1R43DA036258-01.
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VOL. 11 NO. 3 2016, pp. 244-260, © Emerald Group Publishing Limited, ISSN 1746-6660 DOI 10.1108/JCS-06-2015-0020
These surveys reveal that the prevalence of substance use increases with age and that boys are
slightly morelikely than girls to participate (Johnston et al., 2015). Ascan be seen in Table I, recent
results from the Monitoring the Future Study reveal that the 30-day prevalence rates of cannabis
use rose from 6.5 per cent of 8th grade students to 17.0 per centof 10th grade students to 22.9
per cent of 12th grade students. The 30-day prevalenceof drinking alcohol had a similar patternof
increased onset by grade (11.0, 27.6 and 41.5 per cent for grades 8, 10 and 12, respectively).
Self-reported drunkenness (3.6, 14.5 and 28.1 per cent for the same grades) and cigarette
smoking (4.9,10.8 and 17.1 per cent) followed a similar pattern.Similar results have been reported
for students participating in the Youth Risk Behaviour Survey (Eaton et al.,2012). The most recent
ESPAD report (Hibell et al., 2012) does not break down rates of use by age or grade.
Decades of these data have accumulated and demonstrate that the likelihood of engaging in
these substance use behaviours consistently increases with age and male gender, yet
knowledge of these general trends does not lend itself to estimating risk for individual
adolescents. Despite the replicability of these patterns, parents and health care providers may
not appreciate the risk an individual adolescent may face in the future of initiating use. Indeed, at
present, other than relying on age-based prevalence rates (such as those presented in Table I),
there is no published method that allows someone to estimate the substance use risk of an
individual child. Having access to child-specific information about current and future risks is
expected to be motivating and may be valuable for guiding decisions and prescribing solutions.
Information about risk is expected to be most effective at motivating parents to take preventive
action when presented in conjunction with tailored interventions and training. Strong evidence
shows that intervention during early adolescence is most effective for preventing the onset of
substance use (Cuijpers, 2002; Tobler et al., 2000).
Attitudes
The concept of attitudes was first introduced as a fundamental social psychological concept by
early theorists (Allport, 1935; Heider, 1946; Krech and Crutchfield, 1948) who sought to
characterise an individual’s motivation or disposition to behave. Since then, the history of how
attitudes are conceptualised and measured and the role they play in behaviour has continued to
be central to understanding people’s social behaviour (Briñol and Petty, 2012).
In its simplest formulation, attitudes may refer to liking or disliking, agreeing or disagreeing,
judging rightness or wrongness or making some other affective analysis about a topic. Many who
assess attitudes continue to think in this way, using scales in which survey participants are asked
to make summary judgments. However, from early in the history of theory and research on
attitudes, attitudes have also been characterised as complex phenomena reflecting the
accumulation of multiple components. For example, an early theory proposed that attitudes were
based on three components: affect, beliefs and behaviour (Hovland et al., 1960). In a similar vein
that emphasised the multi-component nature of attitudes, Heider (1958) proposed that
Table I Recently reported prevalence of substance use behaviours from two US surveys
Grade Age
a
Drinking (%) Drunkenness (%) Cigarettes (%) Cannabis (%)
Monitoring the Future
813 11 4 5 7
10 15 28 15 11 17
12 17 42 28 17 23
Youth Risk Behaviour Survey
914 30 14 3 18
10 15 36 18 4 22
11 16 43 25 8 26
12 17 48 35 11 28
Notes:
a
Both Monitoring the Future and the Youth Risk Behaviour Survey, grade in school is reported.
Average age for each grade level has been substituted
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