Pregnancies averted among U.S. teenagers by the use of contraceptives.
CONTEXT: The personal and social costs associated with teenage pregnancy in the United States concern many policymakers and researchers, yet the role of contraception in preventing these pregnancies has not been adequately quantified. METHODS: Published estimates of contraceptive effectiveness were applied to 1995 National Survey of Family Growth data on sexual and contraceptive practices in order to estimate the number of pregnancies averted through the use of contraceptives by U.S. teenagers. Four scenarios of contraceptives access--from current levels of access to highly restricted access--and teenagers' sexual and contraceptive practices in response to such restrictions are used to project the potential impact on pregnancies among teenagers. RESULTS: Current levels of contraceptive use averted an estimated 1.65 million pregnancies among 15-19-year-old women in the United States during 1995. If these young women had been denied access to both prescription and over-the-counter contraceptive methods, an estimated one million additional pregnancies (ranging from 750,000 to 1.25 million) would have occurred, assuming some decrease in sexual activity. These pregnancies would have led to 480,000 live births, 390,000 abortions, 120,000 miscarriages, 10,000 ectopic pregnancies and 37 maternal deaths. CONCLUSIONS: Contraceptive use by teenage women prevents pregnancies and negative pregnancy-related health consequences that can disrupt the lives of adolescent women and that have substantial societal costs. Continued and expanded access to contraceptives for adolescents is a critically important public health strategy. (+info)
Marijuana use among minority youths living in public housing developments.
Youths residing in public housing developments appear to be at markedly heightened risk for drug use because of their constant exposure to violence, poverty, and drug-related activity. The purpose of this study was to develop and test a model of marijuana etiology with adolescents (N = 624) residing in public housing. African-American and Hispanic seventh graders completed questionnaires about their marijuana use, social influences to smoke marijuana, and sociodemographic and psychosocial characteristics. Results indicated that social influences, such as friends' marijuana use and perceived ease of availability of marijuana, significantly predicted both occasional and future use of marijuana. Individual characteristics such as antimarijuana attitudes and drug refusal skills also predicted marijuana use. The findings imply that effective prevention approaches that target urban youths residing in public housing developments should provide them with an awareness of social influences to use marijuana, correct misperceptions about the prevalence of marijuana smoking, and train adolescents in relevant psychosocial skills. (+info)
Provocative appeals in anti-smoking mass media campaigns targeting adolescents--the accumulated effect of multiple exposures.
This paper reports findings from a longitudinal study that evaluated the accumulated effect of three consecutive mass media campaigns using provocative and dissonance arousing appeals to prevent cigarette smoking by adolescents. In the spring of 1992, all eligible adolescents aged 14 and 15 in one intervention county (N = 4898) and one control county (N = 5439) in Norway were included in the study, and were followed until they were 17 and 18 years of age in 1995. Only students who completed questionnaires both in 1992 and 1995 were included in the analyses. Among the non-smokers at baseline, a significantly lower proportion of adolescents of both genders had started to smoke in the intervention county compared to the proportion in the control county. Among those who were smokers at baseline, significantly more girls in the intervention county had stopped smoking than in the control county, while no significant difference between the counties was detected among boys. Our findings suggest that provocative and dissonance arousing appeals that create affective reactions and lead to interpersonal communication should be given more attention in campaigns designed to influence adolescent smoking. However, such appeals may easily produce negative reactions and the normative context should be thoroughly considered when using such appeals in future interventions. (+info)
School and community influences on adolescent alcohol and drug use.
Social environment risk factors present in schools and communities have not been thoroughly investigated. This study cross-sectionally examined the social environments of schools and communities, and their influence on adolescent alcohol and drug use. Survey responses of eighth grade students (N = 2309), a random half of their parents (n = 943), community leaders (n = 118), school principals (n = 30), school counselors (n = 30) and chemical health providers (n = 14) were pooled to create indices of social environmental norms, role models, social support and opportunities for non-use of alcohol. Each index was examined for its association with prevalences from 30 schools of alcohol use onset, last-month alcohol use, heavy alcohol use and last-year marijuana use in univariate and stepwise regression analyses. Increases in the levels of norms, role models and opportunities for non-use predicted decreases in alcohol use prevalences. The explanatory power of the examined constructs in multivariate analyses was acceptably high (R2: 38-53%). These findings further support the notion that community-wide efforts need to be launched to affect changes in the normative, role model and opportunity structures of adolescents' social environments in order to curb adolescent alcohol and drug use. (+info)
Psychosocial correlates of health compromising behaviors among adolescents.
The objective of the present study was to examine psychosocial correlates of diverse health-compromising behaviors among adolescents of different ages. The study population included 123,132 adolescents in sixth, ninth and 12th grades. Psychosocial correlates of substance abuse, delinquency, suicide risk, sexual activity and unhealthy weight loss behaviors were examined. Risk-taking disposition was significantly associated with nearly every behavior across age and gender groups. Other consistent correlates included sexual abuse and family connectedness. Correlates of health-compromising behaviors tended to be consistent across age groups. However, stronger associations were noted between sexual abuse and substance use for younger adolescents, and risk-taking disposition and school achievement were stronger correlates for older youth. The results suggest the presence of both common and unique etiological factors for different health-compromising behaviors among youth. The results emphasize the importance of focusing on positive 'risk-taking' experiences for youth in prevention programs; being sensitive to possible sexual abuse experiences among both female and male adolescents in health-care consultations; integrating strategies for improved family connectedness into health promotion efforts; and making school relevant for all adolescents. (+info)
Underage drivers are separating drinking from driving.
OBJECTIVES: From 1985 to 1995, drivers younger than 21 years experienced a 50% drop in fatal crashes involving alcohol. This study addresses whether the decrease is explained by young drivers' drinking less or by their separating drinking from driving. METHODS: Nighttime roadside surveys were conducted in 3 communities to test drivers' breath and administer questionnaires on drinking practices. From 1992 to 1996, 34,898 drivers (21% of whom were younger than 21 years) were interviewed. RESULTS: Although drivers younger than 21 years were more likely to have consumed 6 or more drinks on at least 1 occasion during the previous month, a smaller percentage of younger drivers than of older drivers had blood alcohol concentrations of 0.01 or higher. CONCLUSIONS: Younger drivers are more likely than drivers older than 21 years to separate drinking from driving. (+info)
Estimating adolescent cigarette consumption in Japan.
We estimated the cigarette consumption among Japanese adolescents based on the data which was obtained from a 1990 nationwide school-based questionnaire survey of smoking prevalence among high school students. Cigarette consumption for adolescents was estimated using the data on current smokers' rate and cigarette consumption per day. Participants were 57,189 high school students (aged 13-18 years) including 4666 current smokers. The estimated adolescents' consumption was calculated at 3.5 to 4.3 billion units in 1990. The proportion of adolescents' consumption to the total sales was 1.1% to 1.3%. The corresponding tax amounted to between 21 and 25 billion yen in 1990. The difference between the total sales and the crude cigarette consumption for adults has increased gradually over 20 years. Logically, some part of this increase should be attributed to cigarettes consumed by adolescents. The increase in this difference seemed to keep pace with the increasing number of cigarette vending machines. These results indicate that a considerable amount of cigarettes were consumed by adolescents in 1990. (+info)
The impact of after-school peer contact on early adolescent externalizing problems is moderated by parental monitoring, perceived neighborhood safety, and prior adjustment.
Unsupervised peer contact in the after-school hours was examined as a risk factor in the development of externalizing problems in a longitudinal sample of early adolescents. Parental monitoring, neighborhood safety, and adolescents' preexisting behavioral problems were considered as possible moderators of the risk relation. Interviews with mothers provided information on monitoring, neighborhood safety, and demographics. Early adolescent (ages 12-13 years) after-school time use was assessed via a telephone interview in grade 6 (N = 438); amount of time spent with peers when no adult was present was tabulated. Teacher ratings of externalizing behavior problems were collected in grades 6 and 7. Unsupervised peer contact, lack of neighborhood safety, and low monitoring incrementally predicted grade 7 externalizing problems, after controlling for family background factors and grade 6 problems. The greatest risk was for those unsupervised adolescents living in low-monitoring homes and comparatively unsafe neighborhoods. The significant relation between unsupervised peer contact and problem behavior in grade 7 held only for those adolescents who already were high in problem behavior in grade 6. These findings point to the need to consider individual, family, and neighborhood factors in evaluating risks associated with young adolescents' after-school care experiences. (+info)