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      Adolescents’ perception of substance use and factors influencing its use: a qualitative study in Abu Dhabi

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          Summary

          Objective

          The objective of this article is to gain a deeper understanding of the attitudes and perceptions of adolescents in the United Arab Emirates regarding substance and to identify factors that, in their view, may influence the risk of substance use and suggest possible interventions.

          Design

          This was a qualitative study that used a focus group approach.

          Setting

          The study was carried out in Abu Dhabi, United Arab Emirates.

          Participants

          Male and female teenagers aged 13-18 years residing in the emirate of Abu Dhabi.

          Main outcome measures

          Adolescents’ awareness of substance use, patterns of use and associated harm; Adolescents' perceptions about the factors associated with substance use.

          Results

          Six focus groups were carried out, and a total of 41 adolescents (20 males and 21 females) participated. Data analysis identified three main themes: (1) adolescents’ awareness of substance use and associated harm; (2) gender role and image and (3) perceived factors affecting substance use among adolescents. Knowledge of substances and related consequences of use varied between groups but was compatible with participants’ age and school years. Factors that participants believed influenced substance use were classified into: (1) parent–adolescent relationship, (2) peer pressure, (3) substance accessibility, (4) religiosity and (5) others. Many factors were believed to increase the risk of substance use among adolescents such as peer pressure, inadequate knowledge of the harmful consequences of drug use, family-related factors (e.g. low monitoring and poor parent–adolescents relationship), affordability and availability of substances, boredom and affluence. On the other hand, religiosity was as a shield against substance use, especially alcohol. Other identified protective factors included carrying out schools- and communities-based educational campaigns, enhancing social workers’ ability to raise awareness and detect early signs of addiction and implementing CCTV systems in schools.

          Conclusions

          The study was successful in exploring adolescents’ awareness of substances and associated harm to health from their use. Also, it identifies a number of risk and protective factors based on the perceptions of a group of adolescents residing in the United Arab Emirates. Such factors can guide the planning, designing and implementing of prevention programmes that focus on raising awareness about the harms of substance use. The study findings would suggest that multifactorial prevention programmes that address social norms, gender role and image, and incorporate drug policy, religion, family and school would be more effective and may have better protective outcomes.

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          Most cited references20

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          Effective ingredients of school-based drug prevention programs. A systematic review.

          Drug prevention in schools is a top priority in most Western countries and several well-designed studies have shown that prevention programs have the potential of reducing drug use in adolescents. However, most prevention programs are not effective and there are no general criteria available for deciding which program is effective and which is not. In this systematic review of the literature, the current scientific knowledge about which characteristics determine the effectiveness of drug prevention programs is examined. Three types of studies are reviewed: meta-analyses (3 studies were included), studies examining mediating variables of interventions (6 studies), and studies directly comparing prevention programs with or without specific characteristics (4 studies on boosters, 12 on peer-versus adult-led programs, and 5 on adding community interventions to school programs). Seven evidence-based quality criteria were formulated: the effects of a program should have been proven; interactive delivery methods are superior; the "social influence model" is the best we have; focus on norms, commitment not to use, and intentions not to use; adding community interventions increases effects; the use of peer leaders is better; and adding life skills to programs may strengthen effects.
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            What predicts incident use of cannabis and progression to abuse and dependence? A 4-year prospective examination of risk factors in a community sample of adolescents and young adults.

            To determine risk factors of incident onset of use, abuse and dependence of cannabis in a community sample of adolescents and young adults. Risk factors were examined in a prospective longitudinal design across 4 years in a representative sample (N = 2,446) aged 14-24 at the outset of the study (EDSP). Patterns of DSM-IV defined cannabis use, abuse and dependence were assessed with the Composite International Diagnostic Interview (M-CIDI). Potential risk factors were assessed at baseline. Incident cannabis use, abuse and dependence at second follow-up (on average 42 months after baseline) were the main outcome measures in this study. Associations were analyzed with logistic and negative binomial regressions. Using 11 of a total of 56 variables examined, the predictive value of the final multiple logistic regression for incident cannabis use was moderately good (area under the ROC curve = 0.78). Cannabis use frequency was predicted in the final model by 18 variables, cannabis abuse by two variables in the younger subsample and nine factors in the older group, and dependence by eight variables (dependence: ROC curve area = 0.97). Incident cannabis use was predicted mainly by availability of drugs, peers' drug use, a more 'positive' attitude towards future drug use, and regular previous use of licit drugs, while cannabis dependence was predicted primarily by parental death before age 15, deprived socio-economic status, and baseline use of other illicit drugs. Different factors predict the onset or severity of cannabis use and the progression to abuse and dependence. In addition to well-documented risk factors such as peer group pressure, drug availability, and low self-esteem, findings suggest that family history (e.g. parental mental disorders, early parental death), and prior experiences with legal drugs play a significant role in the initiation of cannabis consumption and the transition to cannabis use disorders in adolescents and young adults. Findings suggest that early intervention and prevention might be improved by better targeted treatment.
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              Parental substance use as a modifier of adolescent substance use risk.

              A major question in national substance use prevention efforts is how much influence parents have on their children's substance use, answers to which could determine whether current school-based prevention programs that address peer pressure are sufficient or whether parents need to be involved. The present study examines whether parents act as gatekeepers by testing the moderator effects of parents' substance use on the relationships of friends' substance use to adolescent substance use (cigarettes, alcohol and marijuana). A longitudinal school-based trial for prevention of substance use in adolescents. Indianapolis, Indiana, USA. As part of a large substance use prevention trial, entering middle school students were surveyed prospectively at baseline, 6 months and 18 months (n = 1807 from 57 schools). A self-reported survey was used to measure behaviors, attitudes and social influences related to adolescent substance use. Results of logistic regression analyses and multiple group structural equation modeling showed that increasing numbers of parents and friends using substances were associated with greater risk of adolescent substance use, as were more substance offers and lower levels of refusal self-efficacy. Additionally, refusal self-efficacy mediated the effects of baseline use and substance offers on subsequent use. However, non-using parents had a buffering effect on friends' influences to use substances, such that friends' use did not affect adolescent use when parents were non-users, and the effects of substance offers on refusal self-efficacy were weaker. The findings suggest that parent substance use should be addressed in adolescent substance use prevention programs, and that continuing non-use by parents should be reinforced.
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                Author and article information

                Journal
                JRSM Open
                JRSM Open
                SHR
                spshr
                JRSM Open
                SAGE Publications (Sage UK: London, England )
                2054-2704
                2 March 2015
                February 2015
                : 6
                : 2
                : 2054270414567167
                Affiliations
                [1-2054270414567167]Department of Public Health and Research, National Rehabilitation Centre, Abu Dhabi, UAE
                Author notes
                [*]Layla Alhyas. Email: layla.alhyas@ 123456nrc.ae
                Article
                10.1177_2054270414567167
                10.1177/2054270414567167
                4349760
                25780594
                d6ea6366-6c38-44a3-a330-9183a09ba0f4
                © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License ( http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page( http://www.uk.sagepub.com/aboutus/openaccess.htm).

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                Research Papers

                adolescents,substance use,tobacco,alcohol,drugs,perceptions
                adolescents, substance use, tobacco, alcohol, drugs, perceptions

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