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A Meta-analysis of Marijuana and Alcohol Use by Socio-economic Status in Adolescents Aged 10–15 Years

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Abstract

Objectives

A majority of population-based studies suggest prevalence of drug and alcohol risk behaviour increases during late adolescence to early adulthood. The purpose of this systematic literature review is to clarify if socio-economic status (SES) is a determinant of marijuana and alcohol risk behaviour in adolescents between the ages of 10–15 years.

Methods

We performed a meta-analysis to identify published or unpublished papers between January 1, 1980 and February 9, 2007 that reviewed marijuana and alcohol risk behaviour by SES in adolescents aged 10–15 years.

Synthesis

We found nine studies that fulfilled our inclusion criteria and passed the methodological quality review. The prevalence of marijuana and alcohol risk behaviour was 22% higher (RR = 1.22; 95% CI 1.14-1.31) in adolescents with low SES in comparison to adolescents with higher SES. Stratification by country of origin revealed that American and New Zealand studies had statistically significant variability in the reported effects as compared to European and UK studies.

Discussion

The evidence suggests that low SES has an inverse association with the prevalence of marijuana and alcohol risk behaviour in adolescents between the ages of 10–15 years. Higher rates of marijuana and alcohol risk behaviour among lower SES adolescents may impact emotional development, limit future educational and occupational achievement, and increase the likelihood for adult marijuana and alcohol addiction.

Conclusion

Lower SES adolescents have higher rates of marijuana and alcohol risk behaviour than higher SES adolescents.

Résumé

Objectifs

Selon la majorité des études fondées sur des populations, la prévalence des comportements à risque liés à la drogue et à l’alcool augmente entre la fin de l’adolescence et le début de l’âge adulte. Dans cette enquête bibliographique systématique, nous avons voulu déterminer si le statut socioéconomique (SSE) est un déterminant des comportements à risque liés à la marijuana et à l’alcool chez les jeunes de 10 à 15 ans.

Méthode

Nous avons effectué une méta-analyse afin de répertorier les articles publiés ou inédits, pour la période du 1er janvier 1980 au 9 février 2007, portant sur les comportements à risque liés à la marijuana et à l’alcool selon le SSE chez les jeunes de 10 à 15 ans.

Synthèse

Neuf études répondaient à nos critères d’inclusion et de qualité méthodologique. La prévalence des comportements à risque liés à la marijuana et à l’alcool était plus élevée de 22% (ratio des taux [RT] = 1,22; IC de 95% = 1,14-1,31) chez les jeunes de faible SSE comparés aux jeunes de SSE supérieur. Une stratification par pays d’origine a montré que les études américaines et néo-zélandaises présentaient des écarts significatifs dans les effets indiqués, comparées aux études menées en Europe et au Royaume-Uni.

Discussion

Selon ces données, il existerait une corrélation inverse entre un faible SSE et la prévalence de comportements à risque liés à la marijuana et à l’alcool chez les jeunes de 10 à 15 ans. Or, les taux plus élevés de ces comportements chez les jeunes de faible SSE peuvent avoir des répercussions sur leur développement affectif, limiter leurs horizons pédagogiques et professionnels et accroître la probabilité qu’ils soient dépendants de la marijuana et de l’alcool à l’âge adulte.

Conclusion

Les taux de comportements à risque liés à la marijuana et à l’alcool sont plus élevés chez les jeunes de faible SSE que chez les jeunes de SSE supérieur.

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References

  1. Crum RM, Helzer JE, Anthony JC. Level of education and alcohol abuse and dependence in adulthood: A further inquiry. Am J Public Health 1993;83:830–37.

    Article  CAS  Google Scholar 

  2. Droomers M, Schrijvers CTM, Stronks K, van de Mheen HD, Mackenbach JP. Educational differences in excessive alcohol consumption: The role of psychosocial and material stressors. Prev Med 1999;29:110.

    Article  Google Scholar 

  3. Midanik LT, Room R. The epidemiology of alcohol consumption. Alcohol Health Res World 1992;16:183–90.

    Google Scholar 

  4. Russell M, Cooper ML, Frone MR. The influence of sociodemographic characteristics on familial alcohol problems: Data from a community sample. Alcohol Clin Exp Res 1990;14:221–26.

    Article  CAS  Google Scholar 

  5. Davey Smith G, Blane D, Bartely M. Explanations for socio-economic differentials in mortality. Evidence from Britain and elsewhere. Eur J Public Health 1994;4:131–44.

    Article  Google Scholar 

  6. Schrijvers CTM, Stronks K, van de Mheen HD, Mackenbach JP. Explaining educational differences in mortality: The role of behavioral and material factors. Am J Public Health 1999;89:535–40.

    Article  CAS  Google Scholar 

  7. Townsend P, Davidson N. The Black Report. In: Townsend P, Davidson N, Whitehead M (Eds.), Inequalities in Health. London, UK: Penguin,1988.

    Google Scholar 

  8. Droomers M, Schrijvers CTM, Casswell S, Mackenbach JP. Occupational level of the father and alcohol consumption during adolescence; patterns and predictors. J Epidemiol Community Health 2003;57:704–10.

    Article  CAS  Google Scholar 

  9. Cooper ML, Peirce RS, Tidwell M-CO. Parental drinking problems and adolescent offspring substance use: Moderating effects of demographic and familial factors. Psychol Addict Behav 1995;9:36–52.

    Article  Google Scholar 

  10. Ellis DA, Zucker RA, Fitzgerald HE. The role of family influences in development and risk. Alcohol Health Res World 1997;21:218–26.

    CAS  PubMed  Google Scholar 

  11. Lowry R, Kann L, Collins JL, Kolbe LJ. The effect of socioeconomic status on chronic disease risk behaviours among US adolescents. JAMA 1996;276:792–97.

    Article  CAS  Google Scholar 

  12. Parker DA, Parker ES. Status and status inconsistency of parents on alcohol consumption of teenage children. Int J Addict 1980;15:1233–39.

    Article  CAS  Google Scholar 

  13. Wills TA, Pierce JP, Evans RI. Large-scale environmental risk factor for substance use. Am Behav Scientist 1996;39:808–22.

    Article  Google Scholar 

  14. Barnes GM, Farrell MP, Banerjee S. Family influences on alcohol abuse and other problem behaviors among black and white adolescents in a general population sample. In: Boyd GM, Howard J, Zucker RA. Alcohol Problems Among Adolescents. Current Directions in Prevention Research. Hillsdale, NJ: Lawrence Erlbaum, 1995.

    Google Scholar 

  15. Donovan JE, Jessor R. Adolescent problem drinking. Psychosocial correlates in a national sample study. J Stud Alcohol 1978;39:1506–24.

    Article  CAS  Google Scholar 

  16. Duncan TE, Duncan SC, Hops H. The effects of family cohesiveness and peer encouragement on the development of adolescent alcohol use: A cohort-sequential approach to the analysis of longitudinal data. J Stud Alcohol 1994;55:588–99.

    Article  CAS  Google Scholar 

  17. Green G, Macintyre S, West P, Ecob R. Like parent, like child? Associations between drinking and smoking behaviour of parents and their children. Br J Addict 1991;86:745–58.

    Article  CAS  Google Scholar 

  18. Tuinstra J, Groothoff JW, van den Heuvel WJA, Post D. Socioeconomic differences in health risk behaviour in adolescence: Do they exist? Soc Sci Med 1998;47:67–74.

    Article  CAS  Google Scholar 

  19. Wills TA, McNamara G, Vaccaro D. Parental education related to adolescent stress—coping and substance use: Development of a mediational model. Health Psychol 1995;14:464–78.

    Article  CAS  Google Scholar 

  20. Substance Abuse and Mental Health Services Administration (SAMHSA). Results From the 2005 National Survey on Drug Use and Health: National Findings. 2006. Available online at: https://doi.org/www.oas.samhsa.gov/NSDUH/2k5NSDUH/2k5results.htm (Accessed April 2, 2007).

    Google Scholar 

  21. Johnston LD, O’Malley PM, Bachman JG, Schlenberg JE. Monitoring the Future, National Survey Results on Drug Use, 1975–2005. Volume 1: Secondary School Students. 2006. Available online at: thefuture.org/ pubs/monographs/vol1_2005.pdf (Accessed April 2, 2007).

    Google Scholar 

  22. Johnston LD, O’Malley PM, Bachman JG, Schlenberg JE. Teen drug use continues down in 2006, particularly among older teens; but use of prescription type drugs remains high. 2006. Available online at: (Accessed April 2, 2007).

    Google Scholar 

  23. Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC). Web Based Injury Statistics Query and Reporting System (WISQARS). 2004. Available online at: (Accessed April 2, 2007).

    Google Scholar 

  24. Hingson R, Kenkel D. Social health and economic consequences of underage drinking. In: Bonnie RJ, O’Connell ME (Eds), Reducing Underage Drinking: A Collective Responsibility. Washington, DC: National Academies Press, 2004;351–82.

    Google Scholar 

  25. Levy DT, Miller TR, Cox KC. Costs of Underage Drinking. 1999. Available from: https://doi.org/www.udetc.org/documents/costunderagedrinking.pdf (Accessed April 2, 2007).

    Google Scholar 

  26. National Highway Traffic Safety Administration (NHTSA). Traffic safety facts 2002: Alcohol. 2003. Available online at: https://doi.org/www.nrd.nhtsa.dot.gov/pdf/nrd30/NCSA/TSF2002/2002alcfacts.pdf (Accessed April 2, 2007).

    Google Scholar 

  27. Smith GS, Branas CC, Miller TR. Fatal non-traffic injuries involving alcohol: A meta-analysis. Ann Emerg Med 1999;33:659–68.

    CAS  PubMed  Google Scholar 

  28. Dahl R, Hariri A. Frontiers of research on adolescent decision making — contributions from the biological, behavioral, and social sciences Background paper prepared for the Planning Meeting on Adolescent Decision Making and Positive Youth Development: Applying Research to Youth Programs and Prevention Strategies. National Research Council/Institute of Medicine Board on Children, Youth, and Families, Committee on Adolescent Health and Development, 2004.

    Google Scholar 

  29. Dahl RE. Adolescent brain development: A period of vulnerabilities and opportunities. Ann NY Acad Sci 2004;1021:1–22.

    Article  Google Scholar 

  30. Centers for Disease Control and Prevention. Youth risk behavior surveillance—United States, 2003. Surveillance Summaries 2004. MMWR 2004;53(No. SS-2) Errata in MMWR 2004;53:536. Errata in MMWR 2005;54:608.

    Google Scholar 

  31. Shiffman S, Balabanis M. Associations between alcohol and tobacco. In: Fertig JB, Allen JP (Eds.), Alcohol and Tobacco: From Basic Science to Clinical Practice. NIAAA Research Monograph No. 30. Washington, DC: U.S. Govt. Printing Office, 1995;17–36.

    Google Scholar 

  32. Cooper ML, Orcutt HK. Drinking and sexual experience on first dates among adolescents. J Abnorm Psychol 1997;106:191–202.

    Article  CAS  Google Scholar 

  33. Cooper ML, Pierce RS, Huselid RF. Substance use and sexual risk taking among black adolescents and white adolescents. Health Psychol 1994;13:251–62.

    Article  CAS  Google Scholar 

  34. Hingson R, Heeren T, Winter M, Wechsler H. Magnitude of alcohol related mortality and morbidity among U.S. college students age 18–24: Changes from 1998 to 2001. Annu Rev Public Health 2005;26:259–79.

    Article  Google Scholar 

  35. Brown SA, Tapert SF, Granholm E, Delis DC. Neuro-cognitive functioning of adolescents: Effects of protracted alcohol use. Alcohol Clin Exp Res 2000;24:164–71.

    Article  CAS  Google Scholar 

  36. Crews FT, Braun CJ, Hoplight B, Switzer RC, Knapp DJ. Binge ethanol consumption causes differential brain damage in young adolescent rats compared with adult rats. Alcohol Clin Exp Res 2000;24:1712–23.

    Article  CAS  Google Scholar 

  37. De Bellis MD, Clark DB, Beers SR, Soloff PH, Boring AM, Hall J, et al. Hippocampal volume in adolescent onset alcohol use disorders. Am J Psychiatry 2000;157:737–44.

    Article  Google Scholar 

  38. Swartzwelder HS, Wilson WA, Tayyeb MI. Age dependent inhibition of long term potentiation by ethanol in immature versus mature hippocampus. Alcohol Clin Exp Res 1995a19:1480–85.

    Article  CAS  Google Scholar 

  39. Swartzwelder HS, Wilson WA, Tayyeb MI. Differential sensitivity of NMDA receptor mediated synaptic potentials to ethanol in immature versus mature hippocampus. Alcohol Clin Exp Res 1995b;19:320–23.

    Article  CAS  Google Scholar 

  40. Tapert SF, Brown SA. Neuropsychological correlates of adolescent substance abuse: Four-year outcomes. J Int Neuropsychological Soc 1999;5:481–93.

    Article  CAS  Google Scholar 

  41. White AM, Swartzwelder HS. Age related effects of alcohol on memory and memory related brain function in adolescents and adults. In: Galanter M (Ed.), Recent Developments in Alcoholism, Vol. 17: Alcohol Problems in Adolescents and Young Adults: Epidemiology, Neurobiology, Prevention, Treatment. New York: Springer, 2005;161–76.

    Google Scholar 

  42. Boyle MH, Offord DR, Racine YA, Szatmari P, Fleming JE, Links PS. Predicting substance use in late adolescence: Results from the Ontario Child Health Study follow-up. Am J Psychiatry 1992;149:761–67.

    Article  CAS  Google Scholar 

  43. Poulin C, Elliot D. Alcohol, tobacco and cannabis use among Nova Scotia adolescents: Implications for prevention and harm reduction. CMAJ 1997;156:1387–93.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. Rey JM, Sawyer MG, Raphael B, Patton GC, Lynskey M. Mental health of teenagers who use cannabis: Results of an Australian survey. Br J Psychiatry 2002;180:216–21.

    Article  Google Scholar 

  45. King A. The health of youth: A cross-national survey. Denmark: WHO Regional Publications. European Series, 2000.

    Google Scholar 

  46. Currie C, Hurrelmann K, Settertobulte W, Smith R, Todd J (Eds.). Health and health behaviour among young people: Health behaviour in school-aged children: A WHO cross-national study (HBSC) international report. Denmark: WHO Regional Office for Europe, 2000.

    Google Scholar 

  47. Kosterman R, Hawkins JD, Guo J, Catalano RF, Abbott RD. The dynamics of alcohol and marijuana initiation: Patterns and predictors of firstuse in adolescence. Am J Public Health 2000;90:360–66.

    Article  CAS  Google Scholar 

  48. Frisher M, Crome I, Macleod J, Bloor R, Hickman M. Predictive factors for illicit drug use among young people: A literature review. Home Office On-line Report 05/07. Available online at: https://doi.org/www.homeoffice.gov.uk/rds (Accessed (Accessed February 2007).

    Google Scholar 

  49. Hamilton G, Cross D, Lower T, Resnicow K, Williams P. School policy: What helps to reduce teenage smoking? Nicotine & Tobacco Res 2003;5:507–13.

    Article  Google Scholar 

  50. Simpson DD, Joe GW, Barrett ME. Inhalant use by Mexican American youth: An introduction. Hispanic J Behavioral Sci 1991;13:246–55.

    Article  Google Scholar 

  51. van Reek J, Knibbe R, van Iwaarden T. Policy elements as predictors of smoking and drinking behaviour: The Dutch cohort study of secondary schoolchildren. Health Policy 1993;26:5–18.

    Article  Google Scholar 

  52. Best D, Rawaf S, Rowley J, Floyd K, Manning V, Strang J. Ethnic and gender differences in drinking and smoking among London adolescents. Ethnicity & Health 2001;6:51–57.

    Article  CAS  Google Scholar 

  53. Velleman RB, Templeton LJ, Copello AG. The role of the family in preventing and intervening with substance use and misuse: A comprehensive review of family interventions, with a focus on young people. Drug Alcohol Rev 2005;24:93–109.

    Article  Google Scholar 

  54. Ellickson PL, Hays RD, Bell RM. Stepping through the drug use sequence: Longitudinal scalogram analysis of initiation and regular use. J Abnorm Psychol 1992;101:441–51.

    Article  CAS  Google Scholar 

  55. Kirkcaldy BD, Siefen G, Surall D, Bischoff RJ. Predictors of drug and alcohol abuse among children and adolescents. Personality and Individual Differences 2004;36:247–65.

    Article  Google Scholar 

  56. Compton WM, Thomas YF, Conway KP, Colliver JD. Developments in the epidemiology of drug use and drug use disorders. Am J Psychiatry 2005;162:1494–502.

    Article  Google Scholar 

  57. Cote P, Cassidy JD, Caroll L, Frank JW, Bombardier C. A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine 2006;26(19):E445–E458.

    Article  Google Scholar 

  58. Fleiss JL. The statistical basis of meta-analysis. Statistical Methods in Medical Research 1993;2:121–45.

    Article  CAS  Google Scholar 

  59. Cappuccio FP, Elliot P, Allender PS, Pryer J, Follman DA, Cutler JA. Epidemiologic association between dietary calcium intake and blood pressure: A meta-analysis of published data. Am J Epidemiol 1995;142(9):935–41.

    Article  CAS  Google Scholar 

  60. Blenkinsop S, Boreham R, Erens B, Natarajan L, Schagen S, Shaw A. Drug use, smoking and drinking among young people in England in 2001. The Stationery Office, 2002.

    Google Scholar 

  61. Lintonen T, Rimpelä M, Vikat A, Rimpelä A. The effect of societal changes on drunkenness trends in early adolescence. Health Educ Res 2000;15:261–69.

    Article  CAS  Google Scholar 

  62. Wallace JM, Forman TA, Guthrie BJ, Bachman JG, O’Malley PM, Johnston L. The epidemiology of alcohol, tobacco and other drug use among black youth. J Stud Alcohol 1999;60:800–9.

    Article  Google Scholar 

  63. Miller DS, Miller TQ. A test of socioeconomic status as a predictor of initial marijuana use. Addict Behav 1997;22:479–89.

    Article  CAS  Google Scholar 

  64. Donato F, Monarca S, Chiesa R, Feretti D, Modolo MA, Nardi G. Patterns and covariates of alcohol drinking among high school students in 10 towns in Italy: A cross-sectional study. Drug Alcohol Depend 1995;37:59–69.

    Article  CAS  Google Scholar 

  65. Elgar FJ, Roberts C, Parry-Langdon N, Boyce W. Income inequality and alcohol use: A multilevel analysis of drinking and drunkenness in adolescents in 34 countries. Euro J Public Health 2005;3:245–50.

    Article  Google Scholar 

  66. Boys A, Farrell M, Taylor C, Marsden J, Goodman R, Brugha T, et al. Psychiatric morbidity and substance use in young people aged 13–15 years: Results for the child and adolescent survey of mental health. Br J Psychiatry 2003;182:509–17.

    Article  CAS  Google Scholar 

  67. Wilson N, Battistich V, Syme L, Boyce T. Does elementary school alcohol, tobacco, and marijuana use increase middle school risk? J Adolesc Health 2002;30(6):442–47.

    Article  Google Scholar 

  68. Simons-Morton B, Crump AD, Haynie DL, Saylor KE, Eitel P, Yu K. Psychosocial, school, and parent factors associated with recent smoking among early-adolescent boys and girls. Prev Med 1999;28:138–48.

    Article  CAS  Google Scholar 

  69. Wardle J, Jarvis MJ, Steggles N, Sutton S, Williamson S, Farrimond H, et al. Socioeconomic disparities in cancer-risk behaviors in adolescence: Baseline results from the Health and Behaviour in Teenagers Study (HABITS). Prev Med 2003;36:721–30.

    Article  CAS  Google Scholar 

  70. Gritz ER, Prokhorov AV, Hudmon KS, Chamberlain RM, Taylor WC, DiClemente CC, et al. Cigarette smoking in a multiethnic population of youth: Methods and baseline findings. Prev Med 1998;27:365–84.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Teaching and Research Health Unit, Saskatoon Health Region, 101-310 Idylwyld Drive North, Saskatoon, SK, S7L 0Z2, Canada

    Mark Lemstra PhD (Senior Research Epidemiologist and Associate Director)

  2. Population Health Research Unit, Saskatoon Health Region, Canada

    Norman R. Bennett MSc (Epidemiologist) & Ushasri Nannapaneni MA

  3. Saskatoon Health Region, Canada

    Cory Neudorf MD, MHSc, FRCPC (Chief Medical Health Officer)

  4. Public Health, Erasmus University, Netherlands

    Anton Kunst PhD (Associate Professor)

  5. Population Health Research Unit, Saskatoon Health Region, Canada

    Lynne M. Warren (Librarian), Tanis Kershaw BA (Hon) (Researcher) & Christina R. Scott BA

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  1. Mark Lemstra PhD
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  2. Norman R. Bennett MSc
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Correspondence to Mark Lemstra PhD.

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Lemstra, M., Bennett, N.R., Neudorf, C. et al. A Meta-analysis of Marijuana and Alcohol Use by Socio-economic Status in Adolescents Aged 10–15 Years. Can J Public Health 99, 172–177 (2008). https://doi.org/10.1007/BF03405467

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