Social and familial risk factors for drinking initiation and affective response to marijuana use

Abstract

Early initiation of substance use increases risks for abuse, injury, dependence, and death for young people around the globe . When substances are used for affect regulation, there is a risk of escalating use. This dissertation examines social and familial risk factors for initiation of alcohol use, and the affective response to marijuana use in naturalistic settings. In study #1, we explored the prospective association between television advertising for alcoholic beverages, changes in alcohol expectancies, and initiation of drinking over 12 months. We found that alcohol expectancies and the odds of drinking initiation increased over 12 months as a non-linear function of advertising exposure for boys. In study #2, we examined the association between adolescent freedoms and drinking initiation. We found that adolescents who were free to set their own bedtimes on weeknights had (odds ratio, 95% confidence interval) 1.53 (1.27, 1.86) higher odds of drinking initiation. We found that associations varied by sex for freedoms regarding companionship and weekend curfews. Notably, we found that boys who were granted the freedom to choose their own time to come home on weekends had 0.63 (0.47-0.85) times lower odds of drinking initiation within 12 months while girls had 1.30 (0.97-1 .73) times increased odds. In study #3 , we used both correlated data analysis methods and a case- crossover design to analyze data from an Ecological Momentary Assessment study examining changes in momentary affect following marijuana use. We found that negative affect was higher following marijuana use compared to backg round times, except for times when marijuana was being used to cope or conform. We found positive affect increased following marijuana use for persons with cannabis dependence but decreased otherwise. Further, we found that extremes of negative and positive affect were more likely to be experienced following marijuana use relative to background time periods. Our findings regarding alcohol advertising may inform efforts to ban alcohol advertising in countries including Finland and South Africa, while the findings relating to adolescent freedoms may improve parent education programs regarding underage drinking. Finally, improved understanding of the affective response to marijuana use may improve treatment programs.