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This group-randomized trial assessed the effects of a universal prevention training curriculum for school administrators and teachers that focused on effective strategies to prevent adolescent substance use and related problems. Twenty-eight schools in three regions of Peru were randomly assigned to either an intervention or control condition (14 schools per condition). Repeated cross-sectional samples of 11 to 19-year-old students participated in four surveys from May 2018 to November 2019 (N = 24,529). School administrators and teachers at intervention schools participated in a universal prevention training curriculum focusing on the development of a positive school climate as well as effective policies related to school substance use. All intervention and control schools were offered Unplugged, a classroom-based substance use prevention curriculum. Outcome measures included: lifetime drug use; past-year and past-month tobacco, alcohol, marijuana, and other drug use; awareness of school tobacco and alcohol use policies; perceived enforcement of school policies; school bonding; perceived friends' use of tobacco, alcohol, marijuana and other drugs; and personal problems in general and problems related to substance use. Multi-level analyses indicated significant reductions in past-year and past-month smoking, friends' substance use, and problems related to substance use and in general at intervention relative to control schools. Significant increases were found in intervention vs. control schools related to students' awareness of school substance use policies, perceived likelihood of getting caught for smoking, and school bonding. These findings suggest that the universal prevention training curriculum and the school policy and climate changes it promoted reduced substance use and related problems in the study population of Peruvian adolescents.

Alcohol remains readily available to youth in most countries. We examined the associations between both the on- and off-premises commercial availability of alcohol to youth and their alcohol use, heavy episodic drinking, and alcohol-related harms. We conducted the study using data from a survey of a sample of 594 students in central Mexico between 12 and 17 years of age in 2016. Both the perceived availability of alcohol and the purchasing of alcohol at an off-premises establishment were positively related to past-30-day alcohol use and heavy episodic drinking, as well as to alcohol-related harms in the past year. Consumption at on-premises establishments was also positively associated with alcohol-related harms. Preventive efforts to reduce the availability of alcohol at off- and on-premises establishments, by such strategies as mystery shopper and responsible beverage service programs, are imperative.

We report the results of a quasi-experimental evaluation of a mystery shopper intervention in Zacatecas and Guadalupe, Mexico. Underage youth attempted to purchase beer at 50 Modelorama stores and 32 Oxxo stores (intervention groups), and at 19 comparison convenience stores in March, July, and August 2018. After each attempt, intervention store operators were informed if a sale was made. Modelorama operators also received training and were warned that repeated sales to minors could jeopardize their franchise. Average sales rates to minors were 63.8% at Modeloramas, 86.5% at Oxxo stores, and 98.2% at comparison stores. The findings suggest that mystery shopper interventions with training, feedback to store operators, and sanctions after repeated sales to underage youth may reduce sales to minors in low- and middle-income countries.

This study examined the usefulness of a survey on underage drinking in a rural American Indian community health clinic. One hundred ninety-seven youth (90 male, 107 female; age range 8-20 years) were recruited from clinic waiting rooms and through community outreach. The study revealed that the usefulness of the survey was twofold: Survey results could be used by clinic staff to screen for underage drinking and associated problems in youth served by the clinic, and the process of organizing, evaluating, and implementing the survey results accomplished several important goals of community-based participatory research. (Contains 4 tables.)

Introduction: We investigated whether greater concentrations of on‐ and off‐sale alcohol outlets were associated with crime and whether this association was moderated by COVID‐19 shelter‐in‐place orders (SIP) that restricted on‐premises consumption of alcohol. Methods: Crimes (2019–2020) and addresses of licenced alcohol outlets in a medium‐sized California city were geocoded within census block groups (N = 61). On‐ and off‐sale alcohol outlet density was calculated as licenced outlets/2.59 km2 (1 square mile). Multilevel negative binomial regression analyses were conducted to examine associations between alcohol outlet density and crime, and possible moderating effects of SIP, controlling for block group demographic characteristics and density of other retail businesses. Results: On‐sale outlet density was positively associated with total crimes and Part 2 crimes, while off‐sale outlet density was inversely associated with total crime and Part 2 crimes. Overall, SIP was not significantly associated with crime, but moderated the associations of on‐sale density with total crime and Part 1 crimes such that reductions in crime during SIP were observed in higher density areas. The association of off‐sale outlets with crime was not moderated by SIP policies. Discussion and Conclusion: On‐sale outlet density, but not off‐sale density, appears to be associated with increased crime. The results further indicate that restrictions in hours and service imposed by SIP policies reduced crime in high on‐sale outlet density areas. These findings reinforce the importance of regulating alcohol outlet density and hours of service, especially for on‐sale outlets, as a crime reduction strategy. [ABSTRACT FROM AUTHOR]

Despite efforts to limit underage access to alcohol, alcohol availability remains a challenge for youth drinking prevention. This article fills a gap in our understanding of alcohol consumption among youths by systematically investigating how and under what circumstances they obtain alcohol and the context within which they consume it. Qualitative interviews (n = 47) were conducted with teens to collect information about where and how they obtain alcohol and the contexts within which they drink. Respondents were knowledgeable about commercial and social sources and used this knowledge in their decision making regarding where to obtain alcohol. Teens used their social relationships to circumvent existing policies designed to limit underage access to alcohol. Findings indicate that the majority of teens' drinking occasions occur in their own or someone else's home.

Qualitative interviews were conducted with parents of teens to explore how parents store and monitor prescription drugs in the home. Most parents had prescription drugs in the house, but took few precautions against teens accessing these drugs. Strategies for monitoring included moving the drugs to different locations, remembering how many pills were left, and how medication containers were positioned. Reasons given for not securing drugs were that parents did not think that their teens would be interested in their prescription drugs and did not believe that they could be used to get high. This study highlights the need for parents to be educated about securing prescription drugs, the dangers of non-medical prescription drug use by teens, and which drugs might be used for non-medical purposes.

Results from a qualitative study with parents about underage drinking are presented. Semistructured interviews (n = 44) were conducted with parents of teens to investigate whether and why parents permit underage drinking. Parents had three primary reasons for allowing underage drinking: deliberate, spontaneous, and harm reduction. Deliberate reasons included passing on knowledge about drinking responsibly and appreciating alcohol. Parents also spontaneously decided to let their teen drink. Some of these spontaneous situations involved feeling pressure from other adults to let their teen drink. Another reason was a desire to reduce potential harm. Parents feared that forbidding underage drinking would harm their relationship with their teen and potentially lead to drunk driving. Prevention efforts aimed at parents should take into account parents' motivations to let teens drink.

This article reports on the development and psychometric properties of the Adolescent Sexual Expectancies Scale (ASEXS). Data were obtained from three annual longitudinal surveys of youth aged 10-17 at the first administration (N = 932 at Wave 3). Confirmatory factor analyses indicated that 4 correlated factors corresponding to Social Risk, Social Benefit, Health Risk, and Pleasure adequately represented the expectancy items. High alpha coefficients and stability across survey waves indicated good internal and test-retest reliability for these factors. Latent variable autoregressive analyses indicated that Social Risk expectancies predicted changes in sexual behavior over the course of the study. Multigroup analyses established that the measurement and predictive models were equivalent for males and females and across age groups. The ASEXS provides researchers with a useful measure for examining adolescents' expectancy beliefs about the consequences of sexual behavior.

The neighborhood context can interfere with parents' abilities to effectively monitor their children, but may be related to specific monitoring strategies in different ways. The present study examines the importance of mothers' perceptions of neighborhood disorganization for the specific monitoring strategies they use and how each of these strategies are related to youths' alcohol use and delinquency. The sample consists of 415 mother-child dyads recruited from urban and suburban communities in Western New York state. Youths were between 10 and 16 years of age (56% female), and were mostly Non-Hispanic White and African American (45.3 and 36.5%, respectively). Structural equation modeling shows that mothers who perceive greater neighborhood problems use more rule-setting strategies, but report lower levels of knowledge of their children's whereabouts. Knowledge of whereabouts is related to less youth alcohol use and delinquency through its association with lowered peer substance use, whereas rule-setting is unrelated to these outcomes. Thus, mothers who perceive greater problems in their neighborhoods use less effective monitoring strategies. Prevention programs could address parental monitoring needs based upon neighborhood differences, tailoring programs for different neighborhoods. Further, parents could be apprised of the limitations of rule-setting, particularly in the absence of monitoring their child's whereabouts.

Objective: Adolescents are more likely than young adults to use electronic nicotine delivery systems (ENDS), yet most of what is known is concluded from young adult ENDS use as young adults are easier to survey. Additionally, while evidence about the prevalence and trends of adolescent ENDS use comes from cross-sectional studies, ecological momentary assessment (EMA) studies provide greater detail about the ways in which adolescents vape and the environments that are favorable to adolescent vaping, providing important guidance for policy, prevention, and intervention. Method: We conducted a 2-week EMA study with 50 adolescents to assess behaviors, contexts, and characteristics of ENDS use. Given longitudinal research showing strong associations between ENDS use and use of other substances, we also examined tobacco cigarettes use, and daily concurrent use with tobacco cigarettes and marijuana. Results: There was little daily variability in motivations, willingness, and intentions, or in product characteristics. ENDS use varied by day and was more frequent on weekends, whereas cigarette use was less likely on weekends. We found daily variability in contexts and the characteristics of situations where adolescents used, which were largely social-normative, including whose device was used, which flavors were used, and where and with whom adolescents used ENDS. Unexpectedly, marijuana accompanied more than a quarter of ENDS use occasions. Conclusions: Socio-ecological context is important for explaining adolescent ENDS use and it is critical to developing adolescent ENDS prevention, intervention, and treatment resources. Prevention messaging may be most relevant and effective on weekends when youth exposure to advertising and peer influences are greatest. [ABSTRACT FROM AUTHOR]

Introduction: In 2016, California enacted a law (T21) prohibiting tobacco product sales to individuals under 21 years of age. Given tobacco use disparities among sexual minority (SM) youth, this study investigated whether California's T21 law was differentially associated with changes in tobacco use for SM and non-SM adolescents.Aims and Methods: Secondary analyses of California Healthy Kids Survey data from 2013-2014 to 2018-2019 for 7th, 9th, and 11th graders (N = 2 229 401).Results: Multilevel mixed-effects logistic regression analyses showed that SM students were more likely than non-SM students to report past-30-day and lifetime cigarette (odds ratio (OR) = 2.47; OR = 2.37), e-cigarette (OR = 1.21; OR = 1.10), smokeless tobacco use (OR = 1.95; OR = 1.56), and use of any tobacco product (OR = 1.94; OR = 1.61). Among SM youth, T21 was associated with significant reductions in lifetime e-cigarette use (OR = 0.66), and lifetime use of any tobacco products (OR = 0.75). These decreases generally were greater than or equivalent to those observed for non-SM youth. For 30-day e-cigarette and any tobacco use, SM youth showed no significant increases, whereas non-SM youth showed significant increases (OR = 1.06; OR = 1.11) following T21. T21 was associated with smaller increases in lifetime cigarette use (OR = 1.34), and larger increases for past-30-day and lifetime smokeless tobacco use (OR = 1.34; OR = 1.28) among SM students, to those observed for non-SM students.Conclusions: California's T21 policy may help reduce tobacco use disparities among SM students who are more at risk for tobacco use than their non-SM peers.Implications: Research on associations of T21 laws with tobacco use among sexual minority (SM) adolescents is lacking. The potential for unintended consequences of T21 for these adolescents raises concerns about increased health disparities. Importantly, our study generally found California's T21 was associated with reductions in tobacco use among SM students that were equivalent to or greater than those for non-SM students. Future research should investigate whether T21 laws and similar policies have differential effects for other marginalized groups and, if so, identify mechanisms that can be targeted in prevention efforts. [ABSTRACT FROM AUTHOR]

Objective: We investigated drinking behavior and sources of alcohol among Native American and White youths, as well as how underage drinking behavior and sources of alcohol may be related to environmental factors. Method: Survey data from a sample of 18,916 youths (8th, 10th, and 12th grades) from Montana were analyzed using hierarchical linear modeling. Survey data were supplemented with county-level economic and census data. Results: Native American youths were more likely than White youths to report drinking and heavy episodic drinking and initiate drinking at a younger age. Native Americans were less likely than Whites to get alcohol from home or from someone younger than age 21 but were more likely to get it from other social sources or through theft from a store. Living in a county with more Native Americans was inversely related to access to alcohol for both White and Native American youths, as well as reduced lifetime, 30-day, and heavy episodic drinking. Living in a county with more single-parent households was positively related to lifetime drinking, 30-day drinking, heavy episodic drinking, and increased access to alcohol through someone younger than age 21 or a stranger. Median income was negatively related to lifetime drinking and ease of access to alcohol and was positively related to accessing alcohol from home without permission, theft, or purchase with a fake ID. Conclusions: Because Native American and White youths have different drinking patterns and obtain alcohol from different sources, strategies to prevent alcohol problems in these groups should take these differences into consideration. (J Stud. Alcohol Drugs, 72, 53-60, 2011), DRINKING BY YOUNG PEOPLE IS ASSOCIATED with an array of problems. Each year, as many as 5,000 youths younger than the age of 21 in the United States die as [...]