1. Factors Related to Adolescent Alcohol Use Progression Matos TD, Robles RR, Reyes JC, Calderón J, Colón HM, Negrón-Ayala JL CENTER FOR ADDICTION STUDIES, SCHOOL OF MEDICINE, UNIVERSIDAD CENTRAL DEL CARIBE, BAYAMÓN, PUERTO RICO Matos TD, Robles RR, Reyes JC, Calderón J, Colón HM, Negrón-Ayala JL CENTER FOR ADDICTION STUDIES, SCHOOL OF MEDICINE, UNIVERSIDAD CENTRAL DEL CARIBE, BAYAMÓN, PUERTO RICO PO Box 60-327, Bayamón, PR 00960-6032Tel. (787) 288-0200 Fax. (787) 288-0242 email: tmatos@uccaribe.edu INTRODUCTION Despite increased awareness about the adverse health effects of alcohol, adolescents still experiment with alcohol use. According to data from the adolescent national survey Monitoring the Future, 13 to 15 years old are at high risk of beginning drinking. Some adolescents, who consume alcohol, later abuse and may develop alcohol dependence. In Puerto Rico, the percentage of adolescents who drink has increased during the 1990s. Alcohol drinking among female adolescents is increasing faster than among male adolescents. Intentions and favorable attitudes toward alcohol use predict experimentation; refusal self-efficacy may predict onset and escalation of drinking; peer and parent use seems to predict some progression beyond experimentation, but predictors of addictive drinking are not totally clear. Identifying factors of alcohol progression is an important issue because it has important implications for prevention and research. This study was funded by grant DA15301 of the National Institute on Drug Abuse (NIDA). Figure 1 shows changes in alcohol use. The percent of adolescents who started drinking was 20.2% at the first one-year follow up. That accounted for a net incidence of 16.3% (baseline 18.3% vs. 34.6% one-year follow up, p<.001). Only 3.9% of the adolescent report ceased the behavior and 14.4% continue the alcohol use. Changes in Alcohol Use at 1 Year Follow Up Total Never use- Ceased a InitiateContinue n%n%n%n%p Overall361100.023665.47320.25214.4 Sociodemographics variables Gender Males17448.311767.23821.81910.9 Females18651.711964.03518.83217.2 Age 12-13 years7219.96286.1811.122.8 14 years11531.97968.72017.41613.9 15 years9325.85458.12931.21010.8 16-17 years8122.44150.61619.82429.6*** Grade Elementary195.51684.2102.515.3 Middle school21161.514669.24420.92110.0 High School11332.96456.62421.22522.1** Table 1 Changes of Alcohol use by Sociodemographic variables a Only 14 subjects ceased alcohol use at follow up and non-significant differences were found with never use group. *p <.05; **p <.01;. ***p <.001. Changes of Alcohol Use at 1 Year Follow Up Total Never use- Ceased a InitiateContinue n%n%n%n%p Individual factors Cigarettes access (yes)8122.44016.92737.01426.9*** Cigarettes use (yes)41.110.400.035.8** Drug access (yes)5916.33012.71621.91325.0* Depression - CIDI (probable case)185.073.068.259.6* Suicide Ideation (yes)195.583.557.0612.2* Suicide Attempt (yes)133.862.722.9510.2* Conduct disorder (yes)195.393.868.247.7 Oppositional Defiant Disorder (yes)3610.0166.81115.1917.3* Violence (yes)9526.34117.42737.02751.9*** Look oldest (yes)11331.36527.52432.92446.2* Sex Behavior (yes)3510.1135.8912.51326.5*** Adolescents who look oldest, those involve in violence behavior and those reporting sexual activity were more likely to continue using alcohol versus those who report cigarettes access were more likely to initiate alcohol use at follow up. a Only 14 subjects ceased alcohol use at follow up and non- significant differences were found with never use group. *p <.05; **p <.01;. ***p <.001. Table 2 Changes of Alcohol use by Individual Factors Changes of Alcohol Use at 1 Year Follow Up TotalNever use- Ceased a InitiateContinue n%N%n%n%p Family Single parent (yes)20055.412753.84663.02751.9 Alcohol abuse: Mother (yes)328.9177.2912.3611.5 Family member drug use (yes)277.5104.2811.0917.3** Depression - CIDI (probable case)7219.93816.12128.81325.0* School School: cut classes (yes)12334.15824.63345.23261.5*** Out of school (yes)30.800.00 35.8*** Students using drugs (yes)257.0104.256.81020.0*** A lot of fights (yes)18250.710745.34257.53366.0* Friends Cigarettes use (yes)3710.2135.51115.11325.0*** Drug use (yes)339.1104.21013.71325.0*** Drug selling (yes)195.352.1811.0611.5*** The sample consists of 48.3% males and 51.7% females; 61.5% in middle school and 32.9% in high school. No gender differences were found in the case of alcohol use. However, more females than males report continue using alcohol. Older adolescents were more likely to initiate and continue using alcohol. (Table 1). Table 3 Changes of Alcohol use at 1 Year Follow Up by Family, School and Factors Table 3. Had a family member or a friend that use drugs or a friend that use cigarettes was associated to continue using alcohol. All school factors are related to continuing use of alcohol. a Only 14 subjects ceased alcohol use at follow up and non-significant differences were found with never use group. *p <.05; **p <.01;. ***p <.001. Alcohol at 1 Year Follow Up IndividualOR95% CIP Age 14 years3.01.27.5* 15 years4.51.711.9** 16-17 years3.91.410.5** Depression - CIDI (probable case)4.11.213.8* Oppositional Defiant Disorder (yes)3.71.49.7** Violence (yes)3.11.75.9*** Cigarettes access (yes)2.11.14.0* Family Depression - CIDI (probable case)2.21.14.4* Friends Drug use (yes)3.71.211.4* Note: OR= odds ratio; CI= confidence interval. *p <.05; **p <.01;. ***p <.001. Table 4. Logistic regression analysis results indicate that mother and child depressive symptoms, adolescent involve in violence act, adolescence had Oppositional Defiant disorder, friends’ drugs use and adolescent access to cigarettes were the factors significantly associated with adolescents initiating and continuing drinking. Table 4 Factors related to alcohol use at 1 Year Follow Up: logistic regression results: CONCLUSION Continued research examining the principal factors related to continuing use of alcohol among adolescents will aid to develop and implement innovative programs for this population. Prevention programs for children could simultaneously have depressive symptom, conduct disorder and involving in violence behavior are needed. Alcohol use among adolescents is a concern that should be addressed in diverse systems: school, physical and mental health providers, community and family. METHODS This study is using longitudinal data from an ongoing household study in Puerto Rico on the risk and resilience to drug use among adolescent offspring of drug using and non-drug using parents. Parents and their offspring were interviewed through an assessment protocol in their homes, using a computer-assisted personal interviewing program. A total of 361 adolescents who completed the first one-year follow up were used in the analyses. The adolescents were between ages 12 to 17and residing in poor neighborhoods. ANALYSIS Descriptive and bivariate analyses were used to calculate the changes in alcohol use and the association with a selected number of variables related to the study theoretical model. A multiple logistic regression model adjusted by gender, age, education, and living arrangement was conducted.