Eric NwazueEnyinnaya Merengwa

Georgia SawyerMian B. Hossain 

Examining the relationship of past year delinquent behavior and the initiation of marijuana in the past

month among youths aged 12 to 17 in the US

Presented at the Annual Meeting of the APHANew Orleans

November 19, 2014

Presenter disclosureEric Nwazue

(1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months:

No relationships to disclose

Introduction Marijuana is derived from Cannabis

Sativa (hemp) plantKnown as pot, grass, reefer, weed,

hemp, & Mary Jane (MJ)Consumed by smoking dried leaves,

flowers, stems and seedsBrewed as tea or inhaled as vaporizerMixed with brownies, cookies and

lollipops (NIDA, 2014)Bioavailability could range from 10-45-90

days following use. Depends on body fat.

Active ingredient is delta-9-tetrahydrocannabinol (THC). Mind altering & implicated in addiction

Marijuana impacts every organ in the body

Produces adverse physical, mental, behavioral and neurological effects

Impairs memory and judgment, and distorts perception

Classified as a schedule 1 drug with no medical use and a high risk for abuse

Currently the most illicit drug used in the U.S

Background The challenges of adolescents are many.Violence, drug use and addiction

contribute significant problems of public health importance

Marijuana use and delinquent behaviors have been well documented. Incidence is rising:

8th graders – 7% (2013); 5.8% (2008)10th graders – 18% (2013); 13.8%

(2008)12th graders – 22.7% (2013); 19.4%

(2008). 6.5% now use daily, 5% in mid 2000 (MTF Report 2013)

Rising marijuana use reflects changing perceptions and attitudes

Current debate on legality has enhanced its popularity

2 states in U.S legalized for adult recreational use

21 states passed laws permitting use for medical treatment

Delinquent behaviors leading to initiation of marijuana use is sparsely documented

Study generates information to influence knowledge, attitude and practice

The objective of this study is to examine the association of past year delinquent behavior with the initiation of marijuana use in past month among youths aged 12-17.

Objective

Data and methodology The data for this research are taken

from 2012 National Survey on Drug Use and Health (NSDUH), which utilized multi-stage random probability sampling design.

The NSDUH 2012 collected information from residents of households and non-institutional group quarters and from civilians living in military bases through face to face in-home interviews utilizing computer-based instrumentation

A total of 55,268 interviews were completed aged 12 or older

The NSDUH excludes homeless persons who do not use shelters, military personnel on active duty, and people in jails and hospitals.

Data and methodology continued

Those who are over 17 years old

Those who ever smoked marijuana prior to past month.

Excluded in this analysis:

Hence, the current analysis consisted of 14,835 youths (out of 17,399 youths) aged 12-17.

Dependent variables:

Initiated using marijuana in past month (yes/no)

Variables

Primary independent variable of interest

Youths’ past year delinquent behavior, which is constructed from six questions: Youth gotten into a serious fight at

school/work taken part in group fights carried a handgun sold illegal drugs stolen/tried to steal anything worth

>$50 attacked someone w/intent to seriously

hurt

Socio-economic and behavioral indicators Gender (female/male) Age (12-13, 14-15 & 16-17 years) Race (whites, blacks, Hispanics & others) Family structure (both parent in HH, either

parent in HH & no parent in HH) Total family income (less than 20k, 20-49k,

50-74k, 75k and above) Youths’ social activities involvement score

(low, medium, and high) Youths’ drug prevention program participation

score (low, medium, and high).

Other independent variables

Past month initiation of marijuana use is defined as:

Youths who never smoked or used marijuana but initiated using marijuana for the first time in past month.

Definition of past month initiation of marijuana use:

Drug prevention program participation scores:

(Constructed from five questions)- During the past 12 months, youth participated in:

a problem solving, communication skills or self-esteem group

violence prevention program drug prevention program outside

school program to help drug abuse pregnancy or sexually transmitted

disease (STD) prevention program

Social involvement activities scores

(Constructed from four questions)- During the past 12 months, youth participated in how many:

number of school-based activities number of community-based

activities number of faith-based activities number of other activities

Adolescents’ social activities involvement score and drug prevention participation activities scores are constructed using factor analysis and categorized as low, medium and high.

Since past year marijuana initiation is dichotomous (yes/no), different unadjusted and adjusted logistic regression models are estimated for predicting marijuana initiation.

Sampling weights for complex survey design are considered in the analyses.

Analytical methods

Univariate Analyses Results (characteristics of study

sample)

Yes8.0%

No92.0%

Marijuana initiation in the past month among youths aged 12-17,

NSDUH 2012

Yes27.2%

No72.8%

Any delinquent behavior in the past year among youths aged 12-17,

NSDUH 2012

Male50.8%

Female49.2%

Distribution of gender, youths aged 12-17, NSDUH 2012

12-13 Years34%

14-15 Years34%

16-17 Years32%

Age distribution of youths aged 12-17, NSDUH 2012

Whites56%

Blacks14%

Hispanics21%

Others9%

Distribution of race/ethnicity, youths aged 12-17, NSDUH 2012

Both parent in HH

71%

Either parent in HH

26%

No parent in HH3%

Family structure of youths aged 12-17, NSDUH 2014

Bi-variate Analyses

Chi-square test of independence between

independent variables and the dependent variables

Independent variables Marijuana initiation in the past month

Past year delinquent behavior SGender NSAge category SRace SFamily income SFamily Structure SYouths’ social activities involvement score S

Youths’ drug prevention program participation scores

S

S: significant at least 95% levelNS: not statistically significant

Marijuana initiated in the past month0

5

10

15

20 16.8

4.7

Involved in delinquent behavior Not involved in delinquent behavior

Marijuana initiation in the past month among youths aged 12-17 by their delinquent behavior in the past year

Multiple logistic regression results

Marijuana use initiation Odds Ratio 95% Confidence IntervalDelinquent behavior     Yes 4.95*** 4.15, 5.89 No (Ref.) 1.00 -Gender     Female 1.09 0.92, 1.30 Male (Ref.) 1.00 -Age category     12-13 0.05*** 0.03, 0.07 14-15 0.31*** 0.26, 0.37 16-17 (Ref.) 1.00 -Race     Whites (Ref.) 1.00 - Blacks 0.66** 0.50, 0.86 Hispanics 0.81 0.63, 1.04 Others 0.67** 0.50, 0.90

Table 3. Odds Ratios and 95% confidence interval for logistic regression results for examining the association between youths’

delinquent behavior in past 12 months and youths’ marijuana initiation in the past month, NSDUH 2012.

Significance: * p<0.05; ** p<0.01; *** p<0.001

Marijuana use initiation Odds Ratio

95% Confidence Interval

Family income     Less than 20,000 1.03 0.78, 1.36 20,000-49,000 1.02 0.81, 1.29 50,000-74,000 0.99 0.77, 1.29 74,000+ (Ref.) 1.00 -Family structure     Both parents in the HH (Ref.) 1.00 - Either parents in the HH 1.55*** 1.27, 1.89 No parent in the HH 1.58* 1.03, 2.43Youths social involvement score     Low (Ref.) 1.00 - Medium 0.70*** 0.57, 0.86 High 0.44*** 0.36, 0.55Youths drug prevention participation score     Low (Ref.) 1.00 - Medium 0.78 0.59, 1.04 High 0.73** 0.59, 0.91Significance: * p<0.05; ** p<0.01; *** p<0.001

Results suggest that past year youths’ involvement in delinquent behavior enhances the likelihood of marijuana initiation process in past month.

Summary

Absence of parent in household plays a role in youths’ marijuana initiation process.

Youths living with no parent or one parent in the household are significantly more likely to have initiated marijuana use in the past month.

Lower level of involvement in social activities and lower level of drug prevention program participation plays a role in youths’ marijuana initiation process.

Youths less involved in social activities or participated less in drug prevention programs, are more likely to have initiated marijuana use in the in past month

Black youths are significantly less likely to initiate using marijuana compared to the whites.

Youths between ages 14-15 are significantly less likely to initiate marijuana use compared to youths aged 16-17.

Knowledge of these relationship might be useful in

Developing and implementing prevention measures for delinquent behavior and marijuana use among adolescents and

Determine appropriate timing for intervention programs

Driving policy initiative to address problems

Conclusion