Parent-child communication, perceived sanctions against drug use, and youth drug involvement.

Kelly, Kathleen J. ; G., Maria Leonora, Comello ; Hunn, Liza C. P. 等

Trends show that drug use continues to be a critical public health concern among adolescents in the United States. The Monitoring the Future 2000 survey results (Johnston, O'Malley, & Bachman, 2001) show that although the use of some drugs has declined from peak levels in the mid-1990s, the use of other drugs (including marijuana, amphetamines, barbiturates, tranquilizers, alcohol, and hallucinogens other than LSD) is holding steady. Further, the Monitoring the Future 2000 data show an increase in the use of heroin and steroids by some students, and in the use of the club drug "ecstasy" by students at all levels. Moreover, the high-risk period is becoming longer, with the age at first use of alcohol dropping to about 12 years (Brody, Flor, Hollett-Wright, & McCoy, 1998; Tarter & Blackson, 1992). Because of these statistics, there continues to be a need to assess factors in the family environment that protect against drug use (Reis, 1996; U.S. Department of Health and Human Services, 1993).

There is a growing and robust body of research that indicates that the influence of parents is the most underutilized tool in preventing youth substance abuse (e.g., Califano, 2000; Jenkins & Zunguze, 1998; Office of National Drug Control Policy, 1997; Resnick et al., 1997). This influence is exerted through a number of avenues, such as parents' own values with respect to substance use, communication of those values, and monitoring/enforcement of family policies. Two recent longitudinal studies have found that parental disapproval of adolescent alcohol use deters later adolescent drinking (Ary, Tildesley, Hops, & Andrew, 1993; Reifman, Barnes, Dintcheff, Farrell, & Uhteg, 1998). Other studies have found that greater frequency of parental monitoring in the home is associated with somewhat less frequent cigarette, alcohol, and marijuana use among adolescents (Chilcoat & Anthony, 1996; Kafka & London, 1991; Resnick et al., 1997).

The Beck and Lockhart model of parental involvement in youth drinking and driving (Beck et al., 1997) says that the likelihood of alcohol misuse can be seen as a direct result of low levels of parental action, which is characterized by weak levels of monitoring and enforcement of family policies on drinking. The model predicts that the most immediate determinant of adolescent alcohol misuse is the frequency of parental monitoring and enforcement of family rules about underage drinking. Moreover, the researchers found that parents appear to have better success in helping their teens avoid high-risk alcohol situations if they supervise the activities given in their home and monitor their teens when they are away from home by "waiting up."

Considerable research has been devoted to forms of communication between parents and children. Several studies have reported that youth from families with frequent, open (bidirectional), and positive communication are less likely to become involved with drugs. These youth are also more likely to have abstinence-based norms than are youth from families in which this kind of dialogue is absent (Baumrind, 1991; Block, Block, & Keyes, 1988; Brody et al., 1998; Brody & Schaffer, 1982; Coombs, 1988; Kafka & London, 1991; Reis, 1996; Smetana, 1987). With respect to frequency, Gil, Vega, and Biafora (1998) found that White non-Hispanics and U.S.-born Hispanics with infrequent communication within their family were more likely to initiate drug use. Another study found that the fewer cautionary statements given to adolescents by their parents about substance use, the more likely those adolescents were to initiate substance use (Andrews, Hops, Ary, Tildesley, & Harris, 1993).

Discussions that involve both children's and parents' perspectives have been found to promote the development of conventional standards of conduct (Baumrind, 1991; Brody & Shaffer, 1982; Smetana, 1987). Active involvement in discussions in which children perceive that they have input into behavioral norms will decrease the likelihood that the children will view the norms as externally imposed; this, in turn, will increase the likelihood that they will behave in accordance with the norms (Langer, 1983; Lepper, 1981). Furthermore, Harbach and Jones (1995) found that the success of parents in communicating values about family, religion, education, and work was associated with lower risk of drug use. At-risk adolescents assigned less importance to these values than did other groups in the study.

Positive communication of parental values on substance use is another critical element in parent-child discussions. Parent-child communication within alcoholic families is often characterized as excessively critical, lacking warmth, and as inattentive to children's needs and feelings (Black, Bucky & Wilder-Padilla, 1986; Jones & Houts, 1992). Comparisons of adolescent drug users and nonusers document the importance of fathers who provide praise and encouragement and of mothers who provide advice and guidance to drug-abstaining youth (Coombs & Landsverk, 1988).

Given the central role of parent-child communication in prevention, this paper presents data on key aspects of family communication, including frequency, age at first discussion about drugs, and the people who have talked to a youth about drugs. Furthermore, the paper will explore the relationships between youth drug involvement, perceived family sanctions, and the number of people who have talked to a youth about the dangers of drugs.

METHOD

We present data gathered as part of a larger research project examining the effects of media campaigns on youth drug and alcohol use. Our analysis includes the portion of survey results that pertain to family communication issues and substance use.

Sample

The sample consisted of 82,918 students in grades 7 through 12 in 36 communities in the U.S. Communities were chosen based on criteria established by the larger media research project. In terms of location and size, the project specified that communities must be at least 30 miles from a large urban area and have a population of less than 30,000. U.S. census data were used to select communities matching the criteria of the study.

The sample was evenly distributed by gender and was largely White non-Hispanic (86.6%), followed by African American (4.6%), Latino (3.2%), other (2.8%), Native American (1.8%), and Asian or Pacific Islander (1.0%). A larger percentage of younger students were surveyed. This was probably due to the greater likelihood of school dropouts not being represented in the older grades.

Instrument

School districts in all communities agreed to administer the American Drug and Alcohol Survey [TM] (ADAS) to students in grades 7 through 12. The ADAS is a well-researched, commercially available survey that is widely used by communities nationwide to monitor substance use by youth and to assist in planning and evaluating prevention programs. It has been used in at least 45 studies (Rocky Mountain Behavioral Science Institute, 1998), and reliability and validity have been reported (Oetting & Beauvais, 1990; Oetting, Edwards, & Beauvais, 1985).

The ADAS includes questions about attitudes and behaviors regarding specific substances. For the purposes of the media research project, additional questions related to family and general communication about drugs were also included.

Substance use. Six measures of substance involvement were obtained: (a) alcohol involvement, (b) heavy alcohol involvement, (c) inhalant involvement, (d) marijuana involvement, (e) cigarette involvement, and (f) overall drug involvement. These involvement scales measure current substance use based on reported use patterns in the last 12 months and in the last month. In addition, some scales (for alcohol, inhalants, marijuana, and cigarettes) ask about how the substance is used and about self-identification as a user of the substance. For example, survey respondents are asked how they like to drink ("enough to feel it a little," "until I really get drunk," etc.); respondents are also asked if they consider themselves nonusers, light users, and so on, of cigarettes.

The involvement scales for alcohol, heavy alcohol, cigarettes, inhalants, and marijuana range from 0 (representing no current use) to 7 (representing addictive patterns of use). These scales have been tested with both majority and minority youth, with reliabilities ranging from .88 to .94 (Oetting & Beauvais, 1990).

The overall drug-involvement scale is a hierarchical typology of substance use that takes into account the level of current use and the combined use of various substances (Oetting & Beauvais, 1983). There are 34 different drug-involvement styles, ranging from no current use to current multiple-drug use; further, the styles can be collapsed into low-, medium-, and high-involvement categories (Oetting & Beauvais, 1990). As reported in the literature, the scores that correspond to the drug-involvement styles range from 1 (indicating the highest level of involvement) to 34 (indicating the lowest level of involvement).

Family sanctions. A family-sanctions scale was created by combining responses to two measures: (a) "How much do your parents care if you: use alcohol, use marijuana, use other drugs, and get drunk," and (b) "How much would your parents try to stop you from: using alcohol, using marijuana, using other drugs, and getting drunk." The possible responses for each question were "not at all," "not much," "some," and "a lot." By combining responses to these eight questions, a family-sanctions scale emerged, with the lowest possible score of 8 indicating a perception of low family sanctions and the highest possible score of 32 indicating a perception of high family sanctions against use. This scale can be broken down into four separate scales to determine family sanctions against a specific substance.

Communication about drugs. Students responded to questions regarding family communication about smoking cigarettes, getting drunk, sniffing something like glue or gas, using marijuana, and using other drugs. Students were asked whether their parents have ever talked to them about the dangers of these drugs; whether their parents have talked to them in the last year about the dangers of these drugs; and how old they were when their parents first talked to them about the dangers of these drugs. Those students who reported that their parents talked to them about drugs were asked what message(s) they received from their parents. Finally, students were asked whom they would most likely ask if they had questions about drugs, who has talked to them about the dangers of various drugs, and the total of all people who have ever talked to them about the dangers of drugs (verbal contacts).

RESULTS

General Communication

Adolescents were asked to indicate whom they would ask if they had questions about alcohol or other drugs. The top three responses were: a friend of the same age (31%), mother (27%), and father (22%). Other people identified were: sibling (14%), adult friend (13%), school counselor (7%), teacher (6%), and minister (3%). Six percent of the participants said they would not ask if they had a question about drugs.

However, when asked to identify all of the people who have talked to them about alcohol, getting drunk, and other specific substances, mother was identified most frequently, regardless of the substance. The second most frequently identified individual was father, and the third was a teacher.

The majority of adolescents reported that their parents have talked to them at some point about the dangers of alcohol (74%), getting drunk (72%), tobacco (69%), marijuana (67%), cocaine (64%), and sniffing something like gas or glue (56%). However, these percentages declined to 12-15% when adolescents were asked if their parents have talked to them in the last year about the dangers of these specific substances. Of those adolescents whose parents have talked to them about the dangers of various drugs, most reported that the first conversation took place between 10 and 12 years of age.

Family Sanctions

Figure 1 shows the relationship between adolescent drug use for all substances and perceived family sanctions. Overall, the relationship is curvilinear, peaking at a score of 17 and declining steadily thereafter. The figure shows that, in general, adolescents who perceive higher parental sanctions have lower involvement in drugs. However, given the curvilinear shape, it is intriguing that increasing drug involvement is also related to low but increasing levels of perceived family sanctions.

To further explore relationships, we analyzed the total number of people who have ever talked to the youth about a specific substance (verbal contacts) and its relationship to level of drug involvement. Figure 2 shows the same curvilinear relationship for all substances (alcohol, alcohol to get drunk, marijuana, cocaine, sniffing something like glue or gas, tobacco, and other drugs). Those adolescents with the lowest drug use reported that three people have talked to them about the dangers of specific substances, the exception being alcohol, which falls between three and four people. The data clearly illustrate that youth with the highest drug involvement are most likely both to have had no one talk to them and to have had the largest number of people talk to them about drugs.

More can be learned by looking at the association between family sanctions against specific substances and verbal contacts. Figures 3, 4, and 5 show selected data by substance-use level (low, medium, and high involvement). Regardless of the substance, youth with low drug involvement perceive higher levels of parental sanctions than do moderate- and high-involvement youth. These data also demonstrate the significance of the first person to talk to an adolescent, particularly among the high-involvement group: perceived sanctions increase dramatically for youth with high drug involvement once they have been talked to by one person. For the low-involvement group, perceived sanctions plateau with the fourth person.

DISCUSSION

Overall, the findings suggest that parent-child communication serves as a strong protective factor with respect to youth involvement with substances, and that parents may be a more potent influence than they might perceive themselves to be. This is supported by the findings that parents are considered credible sources of information about drugs and are most often identified as the people who have talked to a youth about drugs. Furthermore, the analysis shows that perceived sanctions increase dramatically once a youth is talked to by one person. Although these findings demonstrate the potential impact of parent-child discussions, there is clearly room for improvement, since only 12-15% of youth reported that their parents had talked to them in the past year about the dangers of drugs. Similarly, Kelly (1995), using nationwide focus groups, found that while most parents reported that they have had conversations with their children about the dangers of drugs, less than half of the adolescents reported such discu ssions.

Discussion serves to protect against drug involvement most likely as a result of increasing perceived sanctions against drug use. In general, as perceived sanctions go up, drug involvement goes down. However, given the curvilinear appearance of the data in Figure 1, it is interesting to note the relationship between increasing drug involvement with low but rising levels of perceived family sanctions, and then the steady decrease in drug involvement past a "critical point" of perceived sanctions. We suggest that the increasing drug involvement may reflect a tendency for youth to experiment or to seek attention if they perceive that their parents do not care a great deal about their substance-use habits. It may also reflect acknowledgment by youth of increasing parental concern as their drug use increases.

An equally intriguing finding concerned the total number of people who have ever talked to an adolescent about the dangers of drugs. The data show that youth with the lowest drug involvement had three to four people talk to them; in contrast, high-involvement youth were the group most likely to have had no one talk to them about drugs as well as the largest number of people talk to them about drugs. This should not imply that the optimum number of people to discuss drugs with an adolescent is three, or that more than three people talking to an adolescent will result in saturation and diminishing returns. Rather, we suggest that this result may point to the possibility that more people talk to a youth about the dangers of drugs if the youth is known to be using drugs or is at higher risk to begin use. Conversely, there would be little perceived need to talk with a youth if he or she does not associate with peers who use drugs and has strong attachment to school and family. Further, especially in the case of hi gh-involvement youth, the analysis suggests that an increasing number of verbal contacts about drugs appears to increase perceived family sanctions overall.

The findings have important implications for parents. The findings underscore the need for parents to have frequent, deliberate discussions about the dangers of drugs and to communicate clearly about sanctions against drug use. Parents should take the initiative in establishing a dialogue, since 6% of youth indicated that they would not ask if they had a question about drugs. Further, parents who are hesitant to talk to their children because they fear negative reactions or limited impact should take confidence in the power of perceived sanctions to protect against drug use, and the credibility of parents as sources of information about drugs (second only to a friend of the same age). However, this latter finding also highlights the need for parents to get to know their children's friends and perhaps ask their children about their friends' views on drugs.

In addition, the findings have special implications for high-involvement youth. The data show that perceived family sanctions increase most dramatically for this group once youth have been talked to by one person, and that high-involvement youth are most likely to have had no one talk to them as well as the largest number of people talk to them about drugs. Based on these findings, prevention specialists should of course encourage parents of at-risk youth to begin discussions. But prevention specialists should also consider the influence of adults outside the family as an important reinforcer of sanctions. This finding may suggest the desirability of community-based prevention programs (see Slater, Kelly, & Edwards, 2000, for an example) that would educate parents, teachers, and other youth-influential adults and community members about the importance of talking with youth about the dangers of drugs. A concerted effort may be vital in increasing perceptions of an abstinence-based norm.

The study is limited by the sample of rural, predominantly Caucasian youth. Further research with a broader spectrum of participants would provide a basis for more generalizable results. However, given the large sample size (N = 82,918), this analysis presents a compelling perspective of the relationships between drug involvement, sanctions, and communication that should be useful for community-based prevention efforts.

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This research was conducted as part of a larger study funded by the Center for Substance Abuse Prevention. The authors wish to acknowledge the Tri-Ethnic Center for Prevention Research at Colorado State University for providing access to survey data.

Kathleen J. Kelly, Maria Leonora G. Comello, and Liza C. P. Hunn, Department of Marketing, Colorado State University.

Reprint requests to Kathleen J. Kelly, Department of Marketing, College of Business, Colorado State University, Fort Collins, Colorado 80523. E-mail: [email protected]