Relative risk of adolescent drug abuse: Part I Socio-demographic and interpersonal variables

Sections

ABSTRACT
Introduction
Operational definitions
Sampling
Research instruments used
Method of data collection
Data processing for socio-demographic and personality variables
Results
Test-retest reliability
Discussion

Details

Author: D. MOHAN,, P. K. RUSTAGI,, K. R. SUNDARAM, G.G. PRABHU
Pages: 1 to 8
Creation Date: 1981/01/01

Relative risk of adolescent drug abuse: Part I Socio-demographic and interpersonal variables

D. MOHAN,
P. K. RUSTAGI,
K. R. SUNDARAM
G.G. PRABHU
All India Institute of Medical Sciences (AIIMS), New Delhi, India

ABSTRACT

This study was carried out on a sample of 254 male senior high school students in New Delhi. The authors found that variables contributing significantly to drug use were age, heterosexual dating, drug abuse among family members and drug abuse among friends. However. drug use was not found to be significantly associated with family income. Father's occupation, family structure and place of residence. Since the sample studied was relatively small. additional confirmation is needed..

Introduction

This study introduces the concept of "relative risk" to the field of drug abuse. Relative risk attempts to identify those variables which may contribute towards drug-using behaviour. This measure of strength of association of the variable under study with drug-using behaviour is relatively easy to compute and comprehend. In this pilot project, male students of a senior high school were studied by means of a questionnaire [ [1]] . Socio-demographic, interpersonal and intra-psychic variables were assessed. The first two of these are discussed here. The findings on intra-psychic variables will be reported in part II.

Operational definitions

  1. Drug abuse: the use of any of the following substances without medical prescription: alcohol, tobacco, cannabis, hallucinogens, cocaine, amphetamines, barbiturates, methaqualone, minor tranquillizers and opiates [ 2] ;

  2. Non-user:one who had never used any of the above substances;

  3. Current user: one who had used any of the above substances during the past year;

  4. Life-time user: one who had ever used any of the above-mentioned substances (includes current users);

  5. Overall relative risk: result obtained after controlling relevant variables using the "subclassification approach" [ 3] .

Sampling

Male students in the ninth, tenth and eleventh classes of two English-medium schools situated in New Delhi, one for boys and the other co-educational, constituted the basis of this study. A sample of 254 students was obtained by stratified cluster sampling, taking each section of 30-40 students as a cluster.

Research instruments used

  1. A self-administered questionnaire designed to ascertain socio-demographic data and drug use;

  2. Multiphasic personality questionnaire;

  3. Eysenck personality inventory:

  4. An orientation questionnaire about drug use.

The last three items will be reported in part II of this study.

Method of data collection

The questionnaires were administered to small groups of students during school hours, in the absence of school personnel. Complete confidentiality was assured to the respondents. Students were instructed to write their roll numbers on the questionnaires.

Test-retest reliability was calculated on one randomly selected sample of 25 students by administering the same questionnaires three months later.

Data processing for socio-demographic and personality variables

Two comparisons were made for each variable by X2 calculation. One was between non-users and current users and the other between non-users and life- time users. A significant difference in one or both of these comparisons was the basis of selecting a variable for relative risk calculation. During relative risk calculation for each one of the variables so selected, other variables were controlled by the "subclassification approach" adapted from Mantel and Haenszel [ 3] . Significance level in all calculations was p 0.05.

Results

Prevalence of drug abuse

Table 1 shows that alcohol and tobacco were the most commonly used drugs; 78.6 per cent of current users or 21.8 per cent of the whole sample and 84,2 per cent of life-time users or 33.5 per cent of the whole sample restricted their drug abuse to these substances. Other drugs used were tranquillizers, cannabis, sedatives, narcotics and hallucinogens.

Table 1

Prevalence of drug use a

 

Current users

Life-time users

Drugs used

Number

Percentage

Number

Percentage

Tobacco only
7 2.8 16 6.3
Alcohol only
27 10.6 41 16.1
Tobacco and alcohol
21 8.3 28 11.0
Other drugs with or without alcohol and tobacco
15 5.9 16 6.3
Total
70 27.6 101 39.8

aNumber of non-users = 153 (60.2 per cent),

Drug abuse by age

The current drug abuse rate was significantly higher in older age groups but no significant association was observed between life-time use and age (see table 2).

Table 2

Drug abuse by age

 

Non-users

Current users

Life-time users*

 

Age

Number

Percentage

Number

Percentage

Number

Percentage

Total

12-13
19 70.4 1 3.7 8 29.6 27
14-15
88 61.5 39 27.3 55 38.5 143
16-18
43 57.3 26 34.7 32 42.7 75
Number of non-respondents
3   4   6   9
Non-users vs. current users
Non-users vs. life-time users
x 2 = 7.81
x 2 = 1.44
DF = 2
DF=2
p 0.05
NS

*Includes current users.

Drug abuse and heterosexual dating

Both current use and life-time use were significantly associated with heterosexual dating (see table 3).

Table 3

Drug abuse in relation to heterosexual dating

 

Non-users

Current users

Life-time users*

 

Heterosexual dating

Number

Percentage (Horizontal)

Number

Percentage (Horizontal)

Number

Percentage (Horizontal)

Total

Present
25 37.3 30 44.8 42 62.7 67
Absent
125 68.7 38 20.9 57 31.3 182
Number of non-respondents
3   2   2   5
Non-users vs. current users
Non-users vs. life-time users
X 2 = 17.26
X 2 = 18.83
DF = I
DF = I
p 0.001
p 0.001

*Includes current users.

Drug abuse amoung family members

Drug abuse by family members was reported significantly more frequently by current users and life time users than by non-users (see table 4)

Table 4

Drug abuse among family members

 

Non-users

Current users

Life-time users*

 
   

Percentage

 

Percentage

 

Percentage

 

Drug abuse among family members

Number

Horizontal

Vertical

Number

Horizontal

Vertical

Number

Horizontal

Vertical

Total

Present
81 50.6 31.9 57 35.6 81.4 79 49.4 78.2 160
Absent
72 76.6 28.4 13 13.8 18.6 22 23.4 21.8 94
Non-users vs. current users
Non-users vs. lifetime users
x 2 = 15.34
x 2 = 15.60
DF = I
DF = I
p 0.001
p 0.001

*Includes current users.

Drug abuse among friends

Table 5 shows that drug abuse among friends was reported significantly more frequently by current users and life-time users than by non users.

Table 5

Drug abuse among friends

 

Non-users

Current users

Life-time users*

 
   

Percentage

 

Percentage

 

Percentage

 

Drug abuse among friends

Number

Horizontal

Vertical

Number

Horizontal

Vertical

Number

Horizontal

Vertical

Total

Present
56 44.8 36.6 53 42.4 75.7 69 55.2 68.3 125
Absent
97 75.2 63.4 17 13.2 24.3 32 24.8 31.7 129
Non-users vs. current users
Non-users vs. lifetime users
X 2 = 27.85
X 2 = 23.28
DF = I
DF= I
p 0.01
p 0.001

*Includes current users.

Overall relative risk

Non-users, current users and life-time users were subclassified with respect to the above four variables, i.e., age, dating, friends' use and family use of drugs.

Overall relative risk values for each variable was computed after controlling the other three by the subclassification approach. Variables in descending order of magnitude of relative risk of current use were friends' use (2.49), followed by family use (1.97) and dating ( 1.86) (see table 6). In the case of all these three variables the relative risk of life-time use was less than that of current use. The relative risk of both current and life-time use for older age groups was not significant.

Table 6

Overall relative risk of drug abuse a

 

Current use

Life-time use

Variable

Relative Risk

X 2

p

Relative Risk

X 2

p

Older age
1.1 0.07
NS
1.18 0.76
NS
Dating
1.86 9.01 0.01 1.75 11.86 0.001
Family use
1.97 6.29 0.05 1.82 9.04 0.01
Friends' use
2.49 11.81 0.001 1.47 11.51 0.001

aFor calculation of relative risk with respect to age, only two sub-divisions were made, i.e. 12-15 years and 16-18 years.

Other variables

Neither current use nor life-time use was significantly associated with per capita income of the famiIy, father's education, father's occupation (professional/government office/business/other), family structure (nuclear/joint) and place of residence (home/hostel).

Test-retest reliability

Test-retest concordance at three months' interval was 100 per cent for drug abuse, 100 per cent for age, 96 per cent for heterosexual dating, 92 percent for family use, 96 per cent for friends' use, 75 per cent for per capita income, 100 per cent for father's occupation, 96 per cent for father's education, 100 per cent for family structure and 100 per cent for place of residence.

Discussion

In the present study, the most commonly used drugs were found to be alcohol and tobacco, which some people believe may lead to the abuse of harder drugs [ 4] . Many other investigators [5-11] have reported increases in drug abuse prevalence with increasing age and academic levels. In this study, when considered alone, older age was found to be significantly associated with drug abuse but on calculation of relative risk after controlling family use, friends' use and dating, the association was not found to be significant. The absence of any significant association in this study between drug abuse and socio-economic variables, i.e., per capita income, father's education and father's occupation, was an important negative finding. This was contrary to the findings reported in several studies from India [12-14] and elsewhere [9. 15-18]. One of the reasons for this observation could be the relatively narrow range of variation in the sample, most of the respondents having a relatively homogeneous background and socio-economic status and hence it needs confirmation on a larger and more representative sample. Nor was family structure (nuclear/joint) found to be significantly associated with drug abuse. This finding was not consistent with two other studies on the Indian student population [13, 14]. However, it is an important variable in the lndian setting and needs further exploration.

Whether a student stayed at home or in a hostel did not appear to be related to drug abuse. This finding was similar to one study [ 19] but not in line with some others [ 10, 14, 20].

Drug abuse was found to be more common in those who reported heterosexual dating behaviour. This supported the finding of a school study [ 13] and college study [ 14] conducted in Delhi. Relative risk of drug abuse associated with dating was l.86 for current use and l .75 for life-time use. Dating is a departure from traditional Indian social norms and reflects an imitation of Western countries. Higher risk of drug abuse associated with dating could be explained in terms of a higher level of extroversion or the existence of a "youth sub-culture" for which no evidence has yet been found. The psychological and sociological factors might be working synergistically in this sphere.

Like many studies conducted in lndia [8 , 10, 12, 21] and elsewhere [9, 17, 18, 22-24], the present survey also highlighted the importance of interpersonal variables associated with drug abuse. Relative risk of current use, associated with family use, was l .97, while that of life-time use was l.82. User family members in general and parents in particular may serve as models for adolescents, and not only reinforcers of behaviour [ 25] . Relative risk of current use associated with friends' use was 2.49 while that of life-time use was l.47. Though a cause and effect relationship can conclusively be established only in a prospective study, friends may influence a person to start using drugs by making the drugs available, providing an example or defining the nature of physiological experience. In conforming to peer pressure, many teenagers do things which they claim they actually disapprove of. Relative risk of current use was highest in association with friends' use, followed by family use and then dating. In the case of all these three variables, relative risk of life-time use was less than that of current use, which may indicate the role these factors play not only in initiating drug abuse but also in maintaining it. The difference between relative risk values was the greatest for friends' use, thus highlighting the importance of the peer group in continuing drug use.

High test-retest concordance (92 to 100 per cent) was observed for all socio-demographic and interpersonal variables except per capita income (75 percent), which in a sense was expected, as not all children would know their parents' exact income.

Associations found in this study could be used as leads for larger and more representative retrospective and prospective studies, wherein one might be able to establish cause and effect relationships and associations due to common causes. The usefulness of these associations would lie in their predictive and etiological implications, helping preventive planning.

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