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Aims To test, among US students: (1) whether perceived harmfulness of marijuana has changed over time, (2) whether perceived harmfulness of marijuana changed post-passage of state medical marijuana laws (MML) compared with pre-passage; and (3) whether perceived harmfulness of marijuana statistically mediates and/or modifies the relation between MML and marijuana use as a function of grade level. Design Cross-sectional nationally representative surveys of US students, conducted annually, 1991-2014, in the Monitoring the Future study. Setting Surveys conducted in schools in all coterminous states; 21 states passed MML between 1996 and 2014. Participants The sample included 1 134 734 adolescents in 8th, 10th and 12th grades. Measurements State passage of MML; perceived harmfulness of marijuana use (perceiving great or moderate risk to health from smoking marijuana occasionally versus slight or no risk); and marijuana use (prior 30 days). Data were analyzed using time-varying multi-level regression modeling. Findings The perceived harmfulness of marijuana has decreased significantly since 1991 (from an estimated 84.0% in 1991 to 53.8% in 2014, P < 0.01) and, across time, perceived harmfulness was lower in states that passed MML [odds ratio (OR) = 0.86, 95% confidence interval (CI) = 0.75-0.97]. In states with MML, perceived harmfulness of marijuana increased among 8th graders after MML passage (OR = 1.21, 95% CI = 1.08-1.36), while marijuana use decreased (OR = 0.81, 95% CI = 0.72-0.92). Results were null for other grades, and for all grades combined. Increases in perceived harmfulness among 8th graders after MML passage was associated with ~33% of the decrease in use. When adolescents were stratified by perceived harmfulness, use in 8th graders decreased to a greater extent among those who perceived marijuana as harmful. Conclusions While perceived harmfulness of marijuana use appears to be decreasing nationally among adolescents in the United States, the passage of medical marijuana laws (MML) is associated with increases in perceived harmfulness among young adolescents and marijuana use has decreased among those who perceive marijuana to be harmful after passage of MML. [ABSTRACT FROM AUTHOR]

Introduction: This study examines the role of e-cigarettes in the drug use patterns of adolescents. Of specific interest is whether adolescent e-cigarette users fall into a group of (1) youth who do not use traditional drugs of abuse or (2) polysubstance users.Methods: Using latent class analysis, we identify major "classes" of substance users on the basis of recent use of e-cigarettes, alcohol, marijuana, cigarettes, and prescription drugs. Analyses are conducted separately for adolescents in 8th, 10th, and 12th grades. Data come from 16 615 participants in the 2014 Monitoring the Future survey.Results: Youth who do not use traditional drugs of abuse account for about 50% of e-cigarette users in 8th grade, 35% in 10th grade, and 17% in 12th grade. These youth come from a large "low-level users" group found in each grade, characterized by low probability of use for all substances (e-cigarette probability in this group for 8th graders = .046; 10th graders = .071; 12th graders = .027). Other e-cigarette users come from a smaller, "poly-users" group found in each grade, characterized by high-to-moderate probabilities (.83-.21) of using e-cigarettes and other substances. Specific to 12th grade is a third, additional polysubstance group characterized by high likelihood of e-cigarette use (.93).Conclusions: The proportion of e-cigarette users who do not use traditional drugs of abuse is larger at younger ages. Longitudinal panel studies starting at 8th and 10th grades may best inform the current debate on whether e-cigarette use is a risk or protective factor for future transition to the use of other substances.Implications: The proportion of e-cigarette users who do not use traditional drugs of abuse is larger at younger ages. Longitudinal panel studies starting at 8th and 10th grades may best inform the current debate on whether e-cigarette use is a risk or protective factor for future transition to the use of other substances. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND The 2013-2014 school year involved preparation for implementing the new US Department of Agriculture ( USDA) competitive foods nutrition standards. An awareness of associations between commercial supplier involvement, food vending practices, and food vending item availability may assist schools in preparing for the new standards. METHODS Analyses used 2007-2012 questionnaire data from administrators of 814 middle and 801 high schools in the nationally representative Youth, Education, and Society study to examine prevalence of profit from and commercial involvement with vending machine food sales, and associations between such measures and food availability. RESULTS Profits for the school district were associated with decreased low-nutrient, energy-dense ( LNED) food availability and increased fruit/vegetable availability. Profits for the school and use of company suppliers were associated with increased LNED availability; company suppliers also were associated with decreased fruit/vegetable availability. Supplier 'say' in vending food selection was associated with increased LNED availability and decreased fruit/vegetable availability. CONCLUSIONS Results support (1) increased district involvement with school vending policies and practices, and (2) limited supplier 'say' as to what items are made available in student-accessed vending machines. Schools and districts should pay close attention to which food items replace vending machine LNED foods following implementation of the new nutrition standards. [ABSTRACT FROM AUTHOR]

Polysubstance use in adolescence is a known precursor to chronic substance misuse. Identifying risk factors for polysubstance use is necessary to inform its prevention. The present study examined the association of elevated levels of multiple mental health symptoms with adolescents' engagement in polysubstance use (past month use of alcohol, cigarettes, and marijuana). In a US national sample of 8th, 10th, and 12th grade students from Monitoring the Future surveys, we estimated probability of polysubstance use associated with high levels of depressive symptoms (DS), conduct problems (CP), or both. DS and CP, alone and particularly in combination, were associated with drastically elevated probability of polysubstance use. Adolescents with high levels of both DS and CP had the highest probability of polysubstance use. Among 8th and 10th graders, probability of polysubstance use associated with co-occurring mental health problems was significantly higher for girls than boys. [ABSTRACT FROM AUTHOR]

Abstract: Background: Simultaneous alcohol and marijuana (SAM) use raises significant concern due to the potential for additive or interactive psychopharmacological effects. However, no nationally representative studies are available that document prevalence, trends, or related factors in US youth SAM use. Methods: Nationally representative cross-sectional samples of 12th grade students surveyed in the Monitoring the Future project from 1976 to 2011 provided data on SAM use. Analyses were conducted in 2012. Results: In 2011, 23% of all US high school seniors reported any SAM use. Among seniors reporting any past 12-month marijuana use, 62% reported any SAM use and 13% reported SAM use most or every time they used marijuana. SAM use consistently followed trends for past 30-day alcohol use over time. SAM use showed significant variation by psychosocial and demographic characteristics and was strongly associated with higher substance use levels, but occurred across the substance use spectrum. Certain reasons for alcohol or marijuana use (to increase effects of another drug; I’m hooked) and situations of alcohol or marijuana use (park/beach, car, party) were strongly associated with SAM use. Conclusions: A sizable proportion of US high school seniors reported SAM use, and it appeared to occur frequently in social use situations that could impact both the public as well as youth drug users. SAM use appears to be a complex behavior that is incidental to general substance use patterns as well as associated with (a) specific simultaneous reasons (or expectancies), and (b) heavy substance use and perceived dependence, especially on alcohol. [Copyright &y& Elsevier]

Background: Consumption of sugar-sweetened beverages (SSBs) such as soft drinks has been associated with significantly increased energy intake and body weight. One strategy used to reduce soft drink consumption among adolescents has been reducing availability in schools; however, research is limited on associations between availability of soft drinks in school and student consumption. Purpose: This study examines associations between regular and diet soft drink availability in schools and student consumption using data from 329 secondary schools and 9284 students. Methods: Data were obtained from two sources: (1) nationally representative cross-sectional samples of students in Grades 8, 10, and 12 from U.S. public and private schools in 2010 and 2011 in the Monitoring the Future study and (2) administrators of the same schools in the Youth, Education, and Society study. Multilevel modeling conducted in 2012 examined associations between school availability and student consumption controlling for student sociodemographics and school characteristics. Results: In the total sample of more than 9000 students, regular and diet soft drink availability in school was not related to student consumption of these beverages in multivariate models. Yet, among African-American high school students, school regular and diet soft drink availability was significantly related to higher daily consumption (both before and after controlling for student and school factors). Conclusions: Although removal of soft drinks from schools may not result in significantly lower overall student consumption, such actions may result in significant decreases in soft drink consumption for specific student groups. [ABSTRACT FROM AUTHOR]

Background: The National Institute on Drug Abuse has called for increased research into the use of physical activity in substance abuse prevention, specifically research into physical activity type and context. Purpose: This paper examines the relationships between (1) secondary school student substance use and (2) exercise in general and school athletic team participation, and examines such relationships over time. Methods: Nationally representative cross-sectional samples of 8th-, 10th-, and 12th-grade students were surveyed each year from 1991 to 2009. Substance use measures included past 2-week binge drinking and past 30-day alcohol, cigarette, smokeless tobacco, marijuana, and steroid use. Analyses were conducted during 2009–2010. Results: Across grades, higher levels of exercise were associated with lower levels of alcohol, cigarette, and marijuana use. Higher levels of athletic team participation were associated with higher levels of smokeless tobacco use and lower levels of cigarette and marijuana use across grades and to higher levels of high school alcohol and steroid use. Exercise helped suppress the undesired relationship between team participation and alcohol use; exercise and athletic team participation worked synergistically in lowering cigarette and marijuana use. Observed relationships were generally stable across time. Conclusions: There appear to be substantive differences between exercise and team sport participation in relation to adolescent substance use. These findings from cross-sectional data suggest that interventions to improve levels of general physical activity should be evaluated to determine if they help delay or reduce substance use among youth in general as well as among student athletes. [Copyright &y& Elsevier]

Objective: The study describes the most common reasons for using vaporizers (such as e-cigarettes) among US adolescents and investigates how reasons for use differ by grade, lifetime cigarette use, frequency of vaporizer use, gender, race/ethnicity, and parent education.Method: Data were collected from 4066 students in the 8th, 10th, and 12th grades in 2015 as part of the Monitoring the Future study, a cross-sectional and nationally representative US survey.Results: Common reasons for vaporizer use reported by respondents who had ever used a vaporizer were experimentation (53.0%), taste (37.2%), boredom (23.5%), having a good time (22.4%), and relaxation (21.6%). Reasons differed little across grades or parent education; reasons differed by lifetime use of regular cigarettes, frequency of vaping, gender, and race/ethnicity.Conclusions: Overall, results suggest that decisions to vape are based on curiosity, taste, and pleasure, rather than for reasons such as quitting regular cigarettes or substituting for regular cigarette smoking. [ABSTRACT FROM AUTHOR]

Aims: Preference for risky activities is an important developmentally graded predictor of substance use. Population-level trends in adolescent risk preference, as well as the way in which risk preference may be a conduit to risk behavior, have never been documented. The present study examines population-level trends in risk preference among U.S. high school seniors for the 36 years from 1976 to 2011, as well as trends in the association between risk preference and substance use and other problem behaviors.Methods: Data were drawn from yearly nationally representative cross-sectional surveys of US high school seniors (N=91,860). Risk preference was measured consistently with two items. Marijuana and cocaine use, binge drinking, and conduct problems were assessed. Trends were tested using JoinPoint software.Results: The mean level of reported risk preference among US 12th graders has increased over time, especially in the 1980s. For example, the proportion of high school females who reported enjoying activities that were "a little dangerous" more than doubled, from 4.9% in 1976 to 10.8% in 1988. While risk preference reports among adolescent males leveled off in 1992, risk preference reports among females show a continued positive overall slope through 2011. The magnitude of the association between risk preference and marijuana use has increased over time.Conclusions: Reported preference for risky activities has increased among adolescents in the US, especially among young women. Reported risk preference is increasingly associated with a higher use of marijuana. Our findings argue for the importance of placing risk preference within a multi-level framework that attends to historical variation. [ABSTRACT FROM AUTHOR]

Background National trends in adolescent’s marijuana risk perceptions are traditionally used as a predictor of concurrent and future trends in adolescent marijuana use. We test the validity of this practice during a time of rapid marijuana policy change. Methods Two repeated cross-sectional U.S. nationally-representative surveys of 8th, 10th, and 12th-graders: Monitoring the Future (MTF) (1991–2015; N = 1,181,692) and National Survey on Drug Use and Health (NSDUH) (2002–2014; N = 113,317). We examined trends in the year-to-year prevalence of perceiving no risk of harm in using marijuana regularly, and prevalence of regular marijuana use within the previous month. A piecewise linear regression model tested for a change in the relationship between trends. Similar analyses examined any past-month use and controlled for demographic characteristics. Results Among MTF 12th-graders, the prevalence of regular marijuana use and risk perceptions changed similarly between 1991 and 2006 but diverged sharply afterward. The prevalence of regular marijuana use increased by ∼1 percentage point to 6.03% by 2015. In contrast, the proportion of 12th-graders that perceived marijuana as posing no risk increased over 11 percentage points to 21.39%. A similar divergence was found among NSDUH 12th-graders and other grades, for any past month marijuana use, and when controlling demographic characteristics. Conclusions An increase in adolescent marijuana use has not accompanied recent rapid decreases in marijuana risk perceptions. Policy makers may consider broader prevention strategies in addition to targeting marijuana risk perceptions. Further monitoring of predictors of marijuana use trends is needed as states legalize recreational marijuana use. [ABSTRACT FROM AUTHOR]