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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Public Health Statistics and Risk Assessment".

Deadline for manuscript submissions: closed (31 October 2020) | Viewed by 64631

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Dr. Aina M. Yañez

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Guest Editor

Departament d'Infermeria i Fisioteràpia, Universitat de les Illes Balears, 07122 Palma, Spain
Interests: adolescent health and personality factors; health promotion interventions; risk factors for cardiovascular disease; cognitive decline; global health

Dr. Alfonso Leiva Rus

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Guest Editor

Primary Care Research Unit of Mallorca, Balearic Islands Health Service, Mallorca, Spain.
Interests: primary care research; complex interventions; depression

Special Issue Information

Dear Colleagues,

Adolescence is a time when maturational changes take place and adolescents begin to make their own decisions and to develop behavioral patterns that differ from childhood. There is a special vulnerability to risk-taking behaviors including substance use and addictive behaviors.

It has been described that personal, genetic, and environmental factors could contribute to these risk behaviors. Personality and genetic factors could predispose one to certain behavioral addictions. Factors related to the environment, family, school, and peers influence adolescent choices and therefore their future physical and mental health.

Although tobacco and alcohol consumption are declining worldwide, in many countries cannabis consumption seems to have been stable for the last 15 years. Furthermore, new behavioral addictions, such as internet gambling or smartphone addiction, which have come with new technology irruption in the last decades, have become a new challenge for public health.

While a broad literature exists on risk factors for some individual addictions, less is known about some topics such as the interaction between addiction, substance use, and multiple risk-behaviors in adolescence. Neither adequately describes the influence of the context where the addiction takes place (ludic, social, etc.) or the pattern related to simultaneous or sequential use of different substances during adolescence and their relationship with the dynamic friendship networks.

A wide range of topics will be included in this Issue, related to risk and protective factors for addictive behaviors and substance use during adolescence, including risk perception, neurobiological risk factors, socioeconomic and cultural factors for smartphone addiction, internet addiction, internet gaming addiction, substance abuse (tobacco, alcohol cannabis), etc.

This Special Issue in the International Journal of Environmental Research and Public Health is dedicated to recent findings on “Risk Factors for Adolescent Substance Use and Addictive Behaviors” to make substantial contributions to knowledge in understanding why some adolescents engage in these high-risk health behaviors.

Dr. Aina M. Yañez
Dr. Alfonso Leiva Rus
Guest Editors

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Keywords

adolescent health
adolescent behavior
addictive behavior
substance use disorder
internet addiction
internet gaming disorders
family environment
personality factors
environmental factors
neurobiological factors

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Published Papers (11 papers)

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Research

14 pages, 880 KiB

Open AccessArticle

A Comparison of Cut Points for Measuring Risk Factors for Adolescent Substance Use and Antisocial Behaviors in the U.S. and Colombia

by Eric C. Brown, Pablo Montero-Zamora, Francisco Cardozo-Macías, María Fernanda Reyes-Rodríguez, John S. Briney, Juliana Mejía-Trujillo and Augusto Pérez-Gómez

Int. J. Environ. Res. Public Health 2021, 18(2), 470; https://doi.org/10.3390/ijerph18020470 - 8 Jan 2021

Cited by 1 | Viewed by 2916

Abstract

As the identification and targeting of salient risk factors for adolescent substance use become more widely used globally, an essential question arises as to whether U.S.-based cut points in the distributions of these risk factors that identify “high” risk can be used validly in other countries as well. This study examined proportions of youth at “high” risk using different empirically derived cut points in the distributions of 18 measured risk factors. Data were obtained from large-scale samples of adolescents in Colombia and the United States. Results indicated that significant (p < 0.05) differences in the proportions of “high” risk youth were found in 38.9% of risk factors for 6th graders, 61.1% for 8th graders, and 66.6% for 10th graders. Colombian-based cut points for determining the proportion of Colombian youth at “high” risk were preferable to U.S.-based cut points in almost all comparisons that exhibited a significant difference. Our findings suggest that observed differences were related to the type of risk factor (e.g., drug specific vs. non-drug specific). Findings from this study demonstrate the need for collecting large-scale national data on risk factors for adolescent substance use and developing country-specific cut points based on the distributions of these measures to avoid misidentification of youth at “high” risk. Full article

(This article belongs to the Special Issue Risk Factors for Adolescent Substance Use and Addictive Behaviors)

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16 pages, 1602 KiB

Open AccessArticle

The Influence of Parenting Style and Time Management Tendency on Internet Gaming Disorder among Adolescents

by I-Hua Chen, Zeng-Han Lee, Xiao-Yu Dong, Jeffrey Hugh Gamble and Hung-Wei Feng

Int. J. Environ. Res. Public Health 2020, 17(23), 9120; https://doi.org/10.3390/ijerph17239120 - 6 Dec 2020

Cited by 40 | Viewed by 12388

Abstract

The problem of adolescent online gaming addiction is related to individual-level characteristics and the influence of the family environment. The present study explores the potential role of adolescents’ time management tendency in mediating the relationship between parenting style and adolescent internet gaming disorder (IGD). Responses from a total of 357 Chinese high school students were collected for a Pathological Video-Game Use Questionnaire, Simplified Parenting Styles Scale, and Time Management Tendency Scale. Overall, participants reported moderate use of online games (Mean = 1.41; SD = 0.41), lower than the median value of 2 on a three-point scale. In terms of the mediating role of adolescents’ time management tendency, full meditation was observed for the relationship between the parenting style factor of “parents’ emotional warmth” for both mothers and fathers and internet gaming disorder. The results highlight the benefits of emotional warmth in supporting self-efficacy, self-control, and autonomy through the promotion of time management, which is an important protective factor for IGD and can serve as a mediating personality variable. Although non-significant in the complete model, over-protection and rejection by parents should also be cautiously considered as potential risk factors related to addiction. Full article

(This article belongs to the Special Issue Risk Factors for Adolescent Substance Use and Addictive Behaviors)

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11 pages, 910 KiB

Open AccessArticle

Maternal Education Level and Excessive Recreational Screen Time in Children: A Mediation Analysis

by Monserrat Pons, Miquel Bennasar-Veny and Aina M. Yañez

Int. J. Environ. Res. Public Health 2020, 17(23), 8930; https://doi.org/10.3390/ijerph17238930 - 1 Dec 2020

Cited by 24 | Viewed by 4325

Abstract

There is increasing recognition of the adverse health consequences of excessive recreational screen time (RST) in children and adolescents. Early interventions that aim to reduce RST are crucial, but there are some controversies about which individual and parental variables affect RST in children. The aim of this study was to determine the relationship of parental education level with RST in children and early adolescents and to identify mediators of these relationships. This cross-sectional study examined a sample of children (2–14 year-old) who attended routine childcare visits in primary health care centers in Spain (n = 402; 53.7% males; mean age: 7 ± 4 year-old). A self-reported questionnaire was given to the parents to assess sociodemographic data, parental education, the home media environment, and RST in children. Separate analysis was performed for two age groups (2–6 year-old and 6–14 year-old). Path analysis, an application of structural equation modeling, was used to analyze the data. Fitty three percent of the children had excessive RST (≥2 h/day). The maternal education level, eating lunch/dinner in front of a TV, presence of a background TV, and the amount of parental TV viewing had significant associations with excessive RST in both age groups. For the younger group, the maternal education level had direct and indirect effects on RST (total effect: β = −0.29, p < 0.01). For the older group, maternal education level only had a significant indirect effect on RST, and this was mediated by the presence of a background TV and the time of parental TV viewing (total indirect effect: β = −0.11, p < 0.01). A higher maternal education level appears to be associated with certain environmental factors or habits that prevent excessive RST. Full article

(This article belongs to the Special Issue Risk Factors for Adolescent Substance Use and Addictive Behaviors)

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13 pages, 336 KiB

Open AccessArticle

Association of Internet Addiction with Family Functionality, Depression, Self-Efficacy and Self-Esteem among Early Adolescents

by Hsiao-Ching Chen, Jiun-Yi Wang, Ying-Lien Lin and Shang-Yu Yang

Int. J. Environ. Res. Public Health 2020, 17(23), 8820; https://doi.org/10.3390/ijerph17238820 - 27 Nov 2020

Cited by 55 | Viewed by 9239

Abstract

Early adolescents usually have worse self-control and poor time management abilities. They are a higher-risk group for Internet addiction than older adolescents or adults. This study aims to explore the prevalence of Internet addiction and associated factors in early adolescents. Participants included 451 fifth and sixth-grade students in Central Taiwan. This study adopted a cross-sectional design and a structured questionnaire that consisted of demographics, Young’s Internet Addiction Test, the Centre for Epidemiological Studies-Depression scale, the General Self-Efficacy Scale and the Rosenberg Self-Esteem Scale. The participants were 50.8% male, and the mean age was 11.35, with a range of 10.33–12.92 years. A total of 33.7% of all participants were prone to Internet addiction. The results showed that participants who were male and had high money allowance, poor family atmosphere, parents who did not limit Internet usage time, high depression, low self-efficacy and low self-esteem were more prone to Internet addiction. A multiple logistic regression analysis revealed that being male, having parents who did not limit Internet usage time and higher degrees of depression were the associated factors of Internet addiction in early adolescents. The phenomenon of Internet addiction among early adolescents seems to be increasing. Improving family functionality and individual mental health may be effective ways to reduce Internet addiction. Full article

(This article belongs to the Special Issue Risk Factors for Adolescent Substance Use and Addictive Behaviors)

19 pages, 4334 KiB

Open AccessArticle

The Moderating Effects of Self-Referencing and Relational-Interdependent Self-Construal in Anti-Smoking Advertising for Adolescents

by Hsiang-Ming Lee, Ya-Hui Hsu and Tsai Chen

Int. J. Environ. Res. Public Health 2020, 17(22), 8481; https://doi.org/10.3390/ijerph17228481 - 16 Nov 2020

Cited by 6 | Viewed by 3233

Abstract

The tobacco epidemic is one of the most serious public health issues in the world. Tobacco use starts and becomes established primarily during adolescence, and nearly 9 out of 10 cigarette smokers first tried smoking by age 18, with 99% first trying by age 26. This study employed a 2 (advertising appeal: emotional vs. rational) by 2 (self-referencing: analytical vs. narrative) factorial design in Study 1; and a 2 (relational-interdependent self-construal: high and low) by 3 (social relational cue: self, friend, and family) factorial design in Study 2. The behavior intention of anti-smoking acted as the measured dependent variable. Samples of 192 (Study 1) and 222 (Study 2) were collected from one of the biggest high schools in northern Taiwan. The results showed advertising appeal and self-referencing had a significant interaction effect on behavior intention (p = 0.040). The results also showed rational appealing advertising is suitable for analytical self-referencing (p = 0.022) and emotional appealing advertising is suitable for narrative self-referencing (p = 0.067). However, the social relationship cue and relational-interdependent self-construal had no significant interaction effect on behavior intention, and only relational-interdependent self-construal significantly affected behavior intention (p < 0.001). Regardless of whether the relational-interdependent self-construal is high or low, when the anti-smoking advertising is from the family perspective to persuade adolescents not to smoke, both influence the adolescent more than the other two social relationship cues (self and friend). Full article

(This article belongs to the Special Issue Risk Factors for Adolescent Substance Use and Addictive Behaviors)

13 pages, 319 KiB

Open AccessArticle

Using Peer Crowd Affiliation to Address Dual Use of Cigarettes and E-Cigarettes among San Francisco Bay Area Young Adults: A Cross Sectional Study

by Nhung Nguyen, Louisa M. Holmes, Minji Kim and Pamela M. Ling

Int. J. Environ. Res. Public Health 2020, 17(20), 7643; https://doi.org/10.3390/ijerph17207643 - 20 Oct 2020

Cited by 3 | Viewed by 2879

Abstract

Given the emerging tobacco landscape, dual use of cigarettes and e-cigarettes has increased among young adults, but little is known about its associated factors. Peer crowds, defined as macro-level connections between individuals with similar core values (e.g., “Hip Hop” describing a group that prefers hip hop music and values strength, honor, and respect), are a promising way to understand tobacco use patterns. We examined associations between peer crowds and tobacco use patterns by using data from a cross sectional survey of 1340 young adults in the San Francisco Bay Area in 2014. Outcomes were the past 30-day use of: neither cigarettes nor e-cigarettes; cigarettes but not e-cigarettes; e-cigarettes but not cigarettes; and both cigarettes and e-cigarettes. Peer crowds included Hipster, Hip Hop, Country, Partier, Homebody, and Young Professional. Multinomial regression analysis indicated that peer crowds were significantly associated with different tobacco use patterns. Compared to Young Professionals, Hip Hop and Hipster crowds were more likely to dual use; Hipsters were more likely to use e-cigarettes only, and Country participants were more likely to smoke cigarettes only. These findings suggest that tobacco control campaigns and cessation interventions should be tailored to different young adult peer crowds and address poly-tobacco use. Full article

(This article belongs to the Special Issue Risk Factors for Adolescent Substance Use and Addictive Behaviors)

13 pages, 329 KiB

Open AccessArticle

Multidimensional Correlates of Parental Self-Efficacy in Managing Adolescent Internet Use among Parents of Adolescents with Attention-Deficit/Hyperactivity Disorder

by Yi-Ping Hsieh, Chia-Fen Wu, Wen-Jiun Chou and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2020, 17(16), 5768; https://doi.org/10.3390/ijerph17165768 - 10 Aug 2020

Cited by 9 | Viewed by 3064

Abstract

Given the growing concerns of problematic Internet use and online safety, it is critical to address parental self-efficacy in managing adolescent Internet use and to examine associated factors, especially in parents of adolescents with attention-deficit/hyperactivity disorder (ADHD). We examined the roles of adolescents’ hyperactivity/impulsivity, inattention and oppositional defiant disorder (ODD) symptoms, parents’ depressive symptoms, parenting behavior (parental care and indifference), and child behavior (Internet addiction) in relation to parental self-efficacy in managing adolescent Internet use. We recruited 237 Taiwanese parents of adolescents with ADHD (ages 11–18). Hierarchical linear regression was performed in four steps to test the study hypotheses. The results indicated that child’s age, ODD symptoms, and Internet addiction of adolescents were negatively associated, and parental care was positively associated with parental self-efficacy in managing adolescent Internet use. The final model was significant and explained 43% of the variance. The present study demonstrated that parenting and child behaviors contribute to parental self-efficacy in managing adolescent Internet use. Moreover, children’s ODD symptoms were identified as the risk factor for reduced parental self-efficacy. Full article

(This article belongs to the Special Issue Risk Factors for Adolescent Substance Use and Addictive Behaviors)

15 pages, 650 KiB

Open AccessArticle

Are School Substance Use Policy Violation Disciplinary Consequences Associated with Student Engagement in Cannabis?

by Megan Magier, Karen A. Patte, Katelyn Battista, Adam G. Cole and Scott T. Leatherdale

Int. J. Environ. Res. Public Health 2020, 17(15), 5549; https://doi.org/10.3390/ijerph17155549 - 31 Jul 2020

Cited by 7 | Viewed by 4430

Abstract

Schools are increasingly concerned about student cannabis use with the recent legalization in Canada; however, little is known about how to effectively intervene when students violate school substance use policies. The purpose of this study is to assess the disciplinary approaches present in secondary schools prior to cannabis legalization and examine associations with youth cannabis use. This study used Year 6 (2017/2018) data from the COMPASS (Cannabis use, Obesity, Mental Health, Physical Activity, Alcohol use, Smoking, Sedentary behavior) study including 66,434 students in grades 9 through 12 and the 122 secondary schools they attend in British Columbia, Alberta, Ontario, and Quebec. Student questionnaires assessed youth cannabis use and school administrator surveys assessed potential use of 14 cannabis use policy violation disciplinary consequences through a (“check all that apply”) question. Regression models tested the association between school disciplinary approaches and student cannabis use with student- (grade, sex, ethnicity, tobacco use, binge drinking) and school-level covariates (province, school area household median income). For first-offence violations of school cannabis policies, the vast majority of schools selected confiscating the product (93%), informing parents (93%), alerting police (80%), and suspending students from school (85%), among their disciplinary response options. Few schools indicated requiring students to help around the school (5%), issuing a fine (7%), or assigning additional class work (8%) as potential consequences. The mean number of total first-offence consequences selected by schools was 7.23 (SD = 2.14). Overall, 92% of schools reported always using a progressive disciplinary approach in which sanctions get stronger with subsequent violations. Students were less likely to report current cannabis use if they attended schools that indicated assigning additional class work (OR 0.57, 95% CI (0.38, 0.84)) or alerting the police (OR 0.81, 95% CI (0.67, 0.98)) among their potential first-offence consequences, or reported always using the progressive discipline approach (OR 0.77, 95% CI (0.62, 0.96)) for subsequent cannabis policy violations. In conclusion, results reveal the school disciplinary context in regard to cannabis policy violations in the year immediately preceding legalization. Various consequences for cannabis policy violations were being used by schools, yet negligible association resulted between the type of first-offence consequences included in a school’s range of disciplinary approaches and student cannabis use. Full article

(This article belongs to the Special Issue Risk Factors for Adolescent Substance Use and Addictive Behaviors)

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10 pages, 495 KiB

Open AccessArticle

Adolescents’ Alcohol Use in Botellon and Attitudes towards Alcohol Use and Prevention Policies

by Elena Gervilla, Zara Quigg, Mariàngels Duch, Montse Juan and Clarisse Guimarães

Int. J. Environ. Res. Public Health 2020, 17(11), 3885; https://doi.org/10.3390/ijerph17113885 - 30 May 2020

Cited by 8 | Viewed by 3963

Abstract

Alcohol is a common drug misused by young people worldwide. Previous studies have found that attitudes towards heavy consumption are stronger predictors than general norms concerning alcohol. This study aims to explore adolescents’ alcohol use and drunkenness, to understand adolescents’ attitudes towards alcohol use, drunkenness and prevention approaches, and to explore associations between attitudes and personal alcohol use and demographics. Methods: Cross-sectional face-to-face survey of 410 adolescents (61.2% women) who were socializing at night in the streets of Palma (Spain). Breath Alcohol Concentration (BrAC), self-reported measures of alcohol use and social variables were assessed. Results: 70.7% of respondents had a BrAC score higher than 0. The full sample reported having a mean of 3.9 drunk episodes in the last month, and a mean of 7.34 in Alcohol Use Disorders Identification Test (AUDIT). A total of 30.7% were under the minimum age limit for alcohol drinking in Spain and males showed higher BrAC than females. Bivariate analyses identified some differences in attitudes across participant demographics and personal alcohol use. In conclusion, we found high levels of alcohol use and drunkenness amongst adolescents, and adolescents’ attitudes towards drunkenness and prevention approaches were associated with their alcohol consumption as well as with age. Full article

(This article belongs to the Special Issue Risk Factors for Adolescent Substance Use and Addictive Behaviors)

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16 pages, 721 KiB

Open AccessArticle

Individual and Environmental Factors Associated with Tobacco Smoking, Alcohol Abuse and Illegal Drug Consumption in University Students: A Mediating Analysis

by Laura Delgado-Lobete, Rebeca Montes-Montes, Alba Vila-Paz, José-Manuel Cruz-Valiño, Berta Gándara-Gafo, Miguel-Ángel Talavera-Valverde and Sergio Santos-del-Riego

Int. J. Environ. Res. Public Health 2020, 17(9), 3019; https://doi.org/10.3390/ijerph17093019 - 27 Apr 2020

Cited by 31 | Viewed by 13808

Abstract

Substance abuse is a major and prevalent public health concern among university students. Tobacco smoking, risky alcohol behavior, and illegal drug consumption may lead to health problems and behavioral and academic issues. Several individual and environmental factors associate with substance abuse in this population, and the mediating effect of alcohol abuse in the relationship between tobacco smoking and drug consumption is yet to be explored. The purposes of this study were to evaluate the association of individual and environmental factors and substance use, and to analyze the relationship between tobacco smoking, alcohol abuse, and drug consumption, considering alcohol abuse as a possible mediator. A total of 550 Spanish undergraduate and postgraduate students completed several questionnaires regarding their smoking status, alcohol use, and drug consumption during the last six months. Bivariate and multivariate analyses were conducted to explore associations between factors. Direct, indirect and mediating effects were tested using a partial least squares approach (PLS-SEM). The results indicated that substance abuse is associated with being male, living with other students, and combined substance consumption. PLS-SEM showed a significant effect of tobacco smoking and alcohol abuse on drug consumption. Alcohol abuse plays a mediating role in the relationship between tobacco smoking and drug use. Full article

(This article belongs to the Special Issue Risk Factors for Adolescent Substance Use and Addictive Behaviors)

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10 pages, 904 KiB

Open AccessFeature PaperArticle

Breath Alcohol Concentration and Perception of Drunkenness: A Comparison between Adolescents and Young Adults Drinking Alcohol in Public Settings

by Elena Gervilla, Rafael Jiménez, Joella Anupol, Mariàngels Duch and Albert Sesé

Int. J. Environ. Res. Public Health 2020, 17(8), 2890; https://doi.org/10.3390/ijerph17082890 - 22 Apr 2020

Cited by 4 | Viewed by 2973

Abstract

Alcohol use is a persisting social and health problem in Spain that often takes place within the recreational context. This study aims to analyze objective and self-reported measures of alcohol use and to assess the potential role of social factors on alcohol intake in open-air public settings. A total of 1475 participants (47.4% women), including 27.8% adolescents organized into 355 natural groups of friends, were interviewed while they were socializing at night in the streets of Palma (Spain). Breath alcohol concentration (BrAC), self-reported measures of alcohol use, and social variables were assessed. Men showed statistically higher scores in BrAC than women. However, adolescents’ Alcohol Use Disorders Identification Test (AUDIT) scores were not statistically different by gender. Correlation between objective and self-reported measures was low. Interestingly, BrAC of drinkers was lower when some friends in the group were sober. Moreover, especially in young adults, variables related to the social environment were statistically significant factors to predict BrAC. In conclusion, we found a high prevalence of alcohol intake in young people in open-air public settings, low relationship of objective and self-reported measures, and social factors linked to alcohol use, although differences by age and gender must be considered. Full article

(This article belongs to the Special Issue Risk Factors for Adolescent Substance Use and Addictive Behaviors)

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