Taking it hard
Stress and Smoking: Associations with Terrorism and Causal Impact
Michael Pesko
Contemporary Economic Policy, forthcoming
Abstract:
This study analyzes the effects of the Oklahoma City bombing and 9/11 terrorist attacks on stress, smoking, and smoking quit attempts using 1,657,985 observations from the Behavioral Risk Factor Surveillance System. Regression discontinuity results suggest that, in the fourth quarter of 2001, stress increased by nearly an extra half day per 30 days (11.9%) among ever smoking adults. In the 2 years after 9/11, smoking prevalence increased by 1.1 percentage points (2.3%) among ever smoking adults, resulting in between 950,000 and 1,300,000 adult former smokers becoming smokers again because of terrorism. The net cost to the government was between $530 million and $830 million through the end of 2003. Adults reported disproportionate stress increases based on community military participation and education. Simultaneity between smoking and stress is addressed by an instrumental variables model, providing validity to the hypothesized causal pathway between terrorism, stress, and smoking. This model suggests that an extra day of stress per 30 days causes a 3.4 percentage point increase in smoking among ever smoking adults. Results help to quantify a hidden cost of terrorism and provide a better understanding of utility maximization during periods of high stress.
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Effects of State Medical Marijuana Laws on Adolescent Marijuana Use
Sarah Lynne-Landsman, Melvin Livingston & Alexander Wagenaar
American Journal of Public Health, August 2013, Pages 1500-1506
Objectives: Medical marijuana laws (MMLs) have been suggested as a possible cause of increases in marijuana use among adolescents in the United States. We evaluated the effects of MMLs on adolescent marijuana use from 2003 through 2011.
Methods: We used data from the Youth Risk Behavior Survey and a difference-in-differences design to evaluate the effects of passage of state MMLs on adolescent marijuana use. The states examined (Montana, Rhode Island, Michigan, and Delaware) had passed MMLs at different times over a period of 8 years, ensuring that contemporaneous history was not a design confound.
Results: In 40 planned comparisons of adolescents exposed and not exposed to MMLs across states and over time, only 2 significant effects were found, an outcome expected according to chance alone. Further examination of the (nonsignificant) estimates revealed no discernible pattern suggesting an effect on either self-reported prevalence or frequency of marijuana use.
Conclusions: Our results suggest that, in the states assessed here, MMLs have not measurably affected adolescent marijuana use in the first few years after their enactment. Longer-term results, after MMLs are more fully implemented, might be different.
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Kevin Callison & Robert Kaestner
Economic Inquiry, forthcoming
Abstract:
There is a general consensus among policymakers that raising tobacco taxes reduces cigarette consumption. However, evidence that tobacco taxes reduce adult smoking is relatively sparse. In this paper, we extend the literature in two ways: using data from the Current Population Survey Tobacco Use Supplements we focus on recent, large tax changes, which provide the best opportunity to empirically observe a response in cigarette consumption, and employ a novel paired difference-in-differences technique to estimate the association between tax increases and cigarette consumption. Estimates indicate that, for adults, the association between cigarette taxes and either smoking participation or smoking intensity is negative, small, and not usually statistically significant. Our evidence suggests that increases in cigarette taxes are associated with small decreases in cigarette consumption and that it will take sizable tax increases, on the order of 100%, to decrease smoking by as much as 5%.
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The impact of advertising regulation on industry: The cigarette advertising ban of 1971
Shi Qi
RAND Journal of Economics, Summer 2013, Pages 215-248
Abstract:
This article studies the impact of the 1971 TV/radio advertising ban on the cigarette industry. Data indicate that industry advertising spending decreased sharply immediately following the ban but recovered and actually exceeded the preban level within five years. A dynamic oligopoly model of advertising is developed to incorporate two potential explanations. The estimated model fully accounts for the puzzling trend, with 74% of the postban advertising spending increase explained by industry dynamics, and 26% explained by learning. Furthermore, this article uses the new concept of nonstationary oblivious equilibrium to handle intractable state space and accelerate equilibrium computation.
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Tobacco Control Policies, Birth Outcomes, and Maternal Human Capital
Sara Markowitz et al.
Journal of Human Capital, Summer 2013, Pages 130-160
Abstract:
Smoking during pregnancy can have significant adverse health effects for babies, yet many women smoke during pregnancy. In this paper, we examine whether state tobacco control policies lead to improved birth outcomes and to what extent the success of these policies depends on accumulated maternal human capital. We use data from the Pregnancy Risk Assessment Monitoring System in a time period when states significantly changed their tobacco control policies. Results show that the smoking policies are limited in their effectiveness. The largest improvements in birth outcomes from higher cigarette prices are among babies of women who have accumulated the least human capital.
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An expected utility maximizer walks into a bar...
Daniel Burghart, Paul Glimcher & Stephanie Lazzaro
Journal of Risk and Uncertainty, June 2013, Pages 215-246
Abstract:
We conducted field experiments at a bar to test whether blood alcohol concentration (BAC) correlates with violations of the generalized axiom of revealed preference (GARP) and the independence axiom. We found that individuals with BACs well above the legal limit for driving adhere to GARP and independence at rates similar to those who are sober. This finding led to the fielding of a third experiment to explore how risk preferences might vary as a function of BAC. We found gender-specific effects: Men did not exhibit variations in risk preferences across BACs. In contrast, women were more risk averse than men at low BACs but exhibited increasing tolerance towards risks as BAC increased. Based on our estimates, men and women's risk preferences are predicted to be identical at BACs nearly twice the legal limit for driving. We discuss the implications for policy-makers.
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Antonios Proestakis et al.
Journal of Neuroscience, Psychology, and Economics, June 2013, Pages 115-135
Abstract:
Many risky actions are carried out under the influence of alcohol. However, the effect of alcoholic intoxication over the willingness to take risks is complex and still remains unclear. We conduct an economic field experiment in a natural, drinking, and risk-taking environment to analyze how both actual and self-estimated blood alcohol concentration (BAC) levels influence subjects' choices over monetary lotteries with constant expected value. Our results reveal a negative impact of both actual and self-estimated BAC levels on risk taking. However, for male and young subjects, we find a positive relationship between BAC underestimation (a pattern of estimation error that mainly occurs at high BAC levels) and the willingness to choose riskier lotteries. Our findings suggest that a risk compensation mechanism is activated only when individuals' own intoxication level is consciously self-perceived to be high but not underestimated. We conclude therefore that human propensity to engage in risky activities under the influence of alcohol is not due to an enhanced preference for risky choices. In addition to the suggestion in the existing literature that such propensity is due to a weakened ability to perceive risks, our results indicate that an impaired self-perception of own intoxication level may also be an important factor.
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Testing the Effects of E-mailed Personalized Feedback on Risky Alcohol Use Among College Students
Zachary Bryant, Amber Henslee & Christopher Correia
Addictive Behaviors, October 2013, Pages 2563-2567
Objective: Although research utilizing the Internet to intervene with college student drinkers is growing, this study is the first to investigate the use of a theoretically-based and empirically supported personalized feedback form delivered via a single e-mail to college students.
Method: Students (n = 191) completed measures of their alcohol use, related consequences, and peer perceptions at baseline and 6-weeks after the intervention. Students were randomly assigned to receive either e-mailed personalized feedback or e-mailed generic feedback.
Results: Students who received e-mailed personalized feedback reported consuming significantly fewer drinks in a given week, as well as a fewer number of days being drunk in the previous 30 days. They also exhibited a significant reduction in the number of days they perceived their peers to have drunk alcohol and in the amount of alcohol they perceived their peers to consume per drinking occasion.
Conclusion: E-mailed personalized feedback appears to help students become more aware of normative drinking behavior and reduce the quantity of alcohol they consume. Furthermore, e-mailed personalized feedback may be a cost-effective manner in which to intervene with college student drinkers.
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Personality traits and illicit substances: The moderating role of poverty
Angelina Sutin, Michele Evans & Alan Zonderman
Drug and Alcohol Dependence, August 2013, Pages 247-251
Background: Illicit substances increase risk of morbidity and mortality and have significant consequences for society. Personality traits are associated with drug use; we test whether these associations vary by socioeconomic status.
Method: Participants (N = 412) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study completed the Revised NEO Personality Inventory and self-reported use of opiates and cocaine. 50% of participants were living below 125% of the federal poverty line. Mean-level personality differences across never, former, and current opiate/cocaine users were compared. Logistic regressions compared never versus current users and interactions between personality traits and poverty status tested whether these associations varied by socioeconomic status.
Results: High Neuroticism and low Agreeableness increased risk of drug use. The association between low Conscientiousness and drug use was moderated by poverty, such that low Conscientiousness was a stronger risk factor for illicit substance use among those with relatively higher SES. For every standard deviation decrease in Conscientiousness, there was a greater than 2-fold increase in risk of illicit substance use (OR = 2.15, 95% CI = 1.45-3.17). Conscientiousness was unrelated to drug use among participants living below 125% of the federal poverty line.
Conclusions: Under favorable economic conditions, the tendency to be organized, disciplined, and deliberate is protective against drug use. These tendencies, however, matter less when financial resources are scarce. In contrast, those prone to emotional distress and antagonism are at greater risk for current drug use, regardless of their economic situation.
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Stressful life events and adolescent drug use: Moderating influences of the MAOA gene
John Stogner & Chris Gibson
Journal of Criminal Justice, forthcoming
Purpose: Though stressful life events appear to impact the likelihood and frequency of substance use among adolescents, these effects are often varied and inconsistent. We suggest that the polymorphic MAOA gene may be partially responsible for variable susceptibility to environmental pressures and substance use. More specifically, we hypothesize that adolescents possessing low activity alleles for the MAOA genotype are more likely to respond to stressful life experiences by initiating substance use.
Methods: The genetic subsample of the National Longitudinal Study of Adolescent Health was analyzed (2,574 adolescents) using logistic regression models for each gender. Respondents' self-reports of eight key stressors were used to create a composite life stress scale which was allowed to interact with a variable that represented the number of low activity MAOA alleles.
Results: For males, a significant interaction emerged between stressful life experiences and the MAOA gene for alcohol (p = .029) and marijuana (p = .039) initiation. For females, the interaction was not significant in each model.
Conclusions: MAOA interacts with life stress to increase the likelihood of substance use initiation for males. Those with a low activity MAOA allele are more likely to initiate substance use than those with a high activity allele when exposed to stressful experiences.
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Huiping Zhang et al.
PLoS ONE, June 2013
Abstract:
The increased vulnerability to alcohol dependence (AD) seen in individuals with childhood adversity (CA) may result in part from CA-induced epigenetic changes. To examine CA-associated DNA methylation changes in AD patients, we examined peripheral blood DNA methylation levels of 384 CpGs in promoter regions of 82 candidate genes in 279 African Americans [AAs; 88 with CA (70.5% with AD) and 191 without CA (38.2% with AD)] and 239 European Americans [EAs; 61 with CA (86.9% with AD) and 178 without CA (46.6% with AD)] using Illumina GoldenGate Methylation Array assays. The effect of CA on methylation of individual CpGs and overall methylation in promoter regions of genes was evaluated using a linear regression analysis (with consideration of sex, age, and ancestry proportion of subjects) and a principal components-based analysis, respectively. In EAs, hypermethylation of 10 CpGs in seven genes (ALDH1A1, CART, CHRNA5, HTR1B, OPRL1, PENK, and RGS19) were cross validated in AD patients and healthy controls who were exposed to CA. P values of two CpGs survived Bonferroni correction when all EA samples were analyzed together to increase statistical power [CHRNA5_cg17108064: Padjust = 2.54×10-5; HTR1B_cg06031989: Padjust = 8.98×10-5]. Moreover, overall methylation levels in the promoter regions of three genes (ALDH1A1, OPRL1 and RGS19) were elevated in both EA case and control subjects who were exposed to CA. However, in AAs, CA-associated DNA methylation changes in AD patients were not validated in healthy controls. Our findings suggest that CA could induce population-specific methylation alterations in the promoter regions of specific genes, thus leading to changes in gene transcription and an increased risk for AD and other disorders.
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Mirte Kuipers et al.
Journal of Epidemiology & Community Health, July 2013; Pages 587-594
Background: Earlier research has shown that residents of Dutch deprived neighbourhoods drink less alcohol than people in other areas. We aimed to assess the role of individual and neighbourhood characteristics in a cross-sectional, nationwide, multilevel study.
Methods: Individual data of 30 117 Dutch adults, living in 1722 neighbourhoods across the Netherlands, were obtained from the 2004 to 2009 national health survey (POLS). Chronic heavy alcohol consumption was measured as ≥14 drinks/week for women and ≥21 for men, and episodic heavy drinking as ≥6 drinks/day at least once a week. Neighbourhood deprivation was dichotomous; deprived districts as selected by the Dutch government versus other areas. Multilevel logistic regression models of the association between deprivation and heavy drinking were corrected for age, gender, household composition, population density and potential predictors ethnicity, socioeconomic status (education, income), neighbourhood-level social cohesion and percentage Muslims.
Results: The prevalence of heavy drinking was lower in deprived neighbourhoods than in the rest of the Netherlands. This association was found for both chronic and episodic heavy drinking (OR=0.58 (0.47 to 0.72) and OR=0.57 (0.45 to 0.72), respectively). Adding ethnicity to the model reduced these associations by approximately one half. Socioeconomic composition did not contribute to the relationship. The proportion of Muslims explained a small part, while social cohesion explained even less of the association. Stronger associations were observed for women and older adults than for men and younger adults.
Conclusions: The lower prevalence of heavy drinking occurring in deprived areas is largely explained by the ethnicity of neighbourhood residents.
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Prenatal Alcohol Exposure and Educational Achievement in Children Aged 8-9 Years
Colleen O'Leary et al.
Pediatrics, forthcoming
Objective: This study examines the relationships between the dose, pattern, and timing of prenatal alcohol exposure and achievement in reading, writing, spelling, and numeracy in children aged 8 to 9 years.
Methods: Data from a randomly selected, population-based birth cohort of infants born to non-Indigenous women in Western Australia between 1995 and 1997 (n = 4714) (Randomly Ascertained Sample of Children born in Australia's Largest State Study cohort) were linked to the Western Australian Midwives' Notification System and the Western Australian Literacy and Numeracy Assessment statewide education testing program. The records for 86% (n = 4056) of the cohort were successfully linked with education records when the children were aged 8 to 9 years. The associations between prenatal alcohol exposure and achievement of national benchmarks in school numeracy, reading, spelling, and writing tests and nonattendance for the tests was examined. Logistic regression was used to generate adjusted odds ratios (aOR) and 95% confidence intervals (CI), adjusting for potential confounding factors. The referent group included children of mothers who previously drank alcohol but who abstained during pregnancy.
Results: Children were twice as likely not to achieve the benchmark for reading after heavy prenatal alcohol exposure during the first trimester (aOR 2.26; 95% CI 1.10-4.65) and for writing when exposed to occasional binge drinking in late pregnancy (aOR 2.35; 95% CI 1.04-5.43). Low-moderate prenatal alcohol exposure was not associated with academic underachievement.
Conclusions: The type of learning problems expressed depends on the dose, pattern, and timing of prenatal alcohol exposure.
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The aftermath of public housing relocation: Relationship to substance misuse
Hannah Cooper et al.
Drug and Alcohol Dependence, forthcoming
Introduction: Several cross-sectional studies have examined relationships between neighborhood characteristics and substance misuse. Using data from a sample of African-American adults relocating from US public housing complexes, we examined relationships between changes in exposure to local socioeconomic conditions and substance misuse over time. We tested the hypothesis that adults who experienced greater post-relocation improvements in local economic conditions and social disorder would have a lower probability of recent substance misuse.
Methods: Data were drawn from administrative sources to describe the census tracts where participants lived before and after relocating. Data on individual-level characteristics, including binge drinking, illicit drug use, and substance dependence, were gathered via survey before and after the relocations. Multilevel models were used to test hypotheses.
Results: Participants (N = 172) experienced improvements in tract-level economic conditions and, to a lesser degree, in social disorder after moving. A one standard-deviation improvement in tract-level economic conditions was associated with a decrease in recent binge drinking from 34% to 20% (p = 0.04) and with a decline in using illicit drugs weekly or more from 37% to 16% (p = 0.02). A reduction in tract-level alcohol outlet density of >3.0 outlets per square mile predicted a reduction in binge drinking from 32% to 18% at p = 0.05 significance level.
Discussion: We observed relationships between improvements in tract-level conditions and declines in substance misuse, providing further support for the importance of the local environment in shaping substance misuse. These findings have important implications for public housing policies and future research.
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Population-Level Administration of AlcoholEdu for College: An ARIMA Time-Series Analysis
Todd Wyatt, William DeJong & Elizabeth Dixon
Journal of Health Communication, forthcoming
Abstract:
Autoregressive integrated moving averages (ARIMA) is a powerful analytic tool for conducting interrupted time-series analysis, yet it is rarely used in studies of public health campaigns or programs. This study demonstrated the use of ARIMA to assess AlcoholEdu for College, an online alcohol education course for first-year students, and other health and safety programs introduced at a moderate-size public university in the South. From 1992 to 2009, the university administered annual Core Alcohol and Drug Surveys to samples of undergraduates (Ns = 498 to 1032). AlcoholEdu and other health and safety programs that began during the study period were assessed through a series of quasi-experimental ARIMA analyses. Implementation of AlcoholEdu in 2004 was significantly associated with substantial decreases in alcohol consumption and alcohol- or drug-related negative consequences. These improvements were sustained over time as succeeding first-year classes took the course. Previous studies have shown that AlcoholEdu has an initial positive effect on students' alcohol use and associated negative consequences. This investigation suggests that these positive changes may be sustainable over time through yearly implementation of the course with first-year students. ARIMA time-series analysis holds great promise for investigating the effect of program and policy interventions to address alcohol- and drug-related problems on campus.
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Dopamine Receptor (D4) Polymorphism Is Related to Comorbidity Between Marijuana Abuse and Depression
Leonardo Bobadilla, Jamie Vaske & Kia Asberg
Addictive Behaviors, October 2013, Pages 2555-2562
Abstract:
The rates of marijuana abuse are steadily increasing in the U.S. Data suggest that comorbid marijuana abuse and depression is associated with worse outcomes than either diagnosis. Genetic studies independently link the DRD4 gene polymorphism to substance use and to internalizing disorders, but no study has examined whether the DRD4 polymorphism is linked to comorbid marijuana use and depression in a population sample. This study examined associations between the DRD4 gene 48 bp VNTR polymorphism and comorbidity between marijuana use frequency and depression in a diverse, non-clinical adolescent sample (n=1,882; ages 14 to 18) from the National Longitudinal Study of Adolescent Health (Add Health). Multinomial regression analyses indicated that the odds of being comorbid for depressive symptoms and marijuana use is approximately 2.5 times greater for youths with the > 7R / > 7R genotype than youths who carry the < 7R / < 7R genotype, controlling for the effects of ethnicity, gender, age, violent victimization, and alcohol related problems. Findings provide genetic clues for psychopathology characterized by prominent externalizing and internalizing features.
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Karl Gauffin, Tomas Hemmingsson & Anders Hjern
Journal of Epidemiology & Community Health, forthcoming
Background: Alcohol use is the third most important global-health risk factor and a main contributor to health inequalities. Previous research on social determinants of alcohol-related disorders has delivered inconsistent results. We aimed to investigate whether socioeconomic position (SEP) in childhood predicts alcohol-related disorders in young adulthood in a Swedish national cohort.
Methods: We studied a register-based national cohort of Swedish citizens born during 1973-1984 (N=948 518) and followed them up to 2009 from age 15. Childhood SEP was defined by a six-category socioeconomic index from the Censuses of 1985 and 1990. HRs of alcohol-related disorders, as indicated by register entries on alcohol-related death and alcohol-related medical care, were analysed in Cox regression models with adjustment for sociodemographic variables and indicators of parental morbidity and criminality.
Results: Low childhood SEP was associated with alcohol-related disorders later in life among both men and women in a stepwise manner. Growing up in a household with the lowest SEP was associated with risk for alcohol-related disorders of HR: 2.24 (95% CI 2.08 to 2.42) after adjustment for sociodemographic variables, compared with the highest SEP group. Adjusting the analysis for parental psychosocial problems attenuated the association to HR 1.87 (95% CI 1.73 to 2.01).
Conclusions: The study demonstrates that low SEP in childhood predicts alcohol-related disorders in young adulthood. Alcohol abuse needs to be addressed in policies to bridge the gap of health inequalities.
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Danielle Boisvert et al.,
Journal of Criminal Justice, July-August 2013, Pages 262-272
Purpose: The current study seeks to examine the relationship between low self-control and cigarette smoking, alcohol use, and marijuana use in adolescence and adulthood using behavioral genetic methodology.
Methods: Using a subsample of twin pairs from the National Longitudinal Study of Adolescent Health (Add Health), the current study estimates the genetic and environmental overlap between low self-control and substance use (or problems associated with substance use) across four waves of data collection.
Results: The overall pattern of results suggests that genetic factors explain a moderate proportion of the variance in low self-control and substance use in both adolescence and adulthood. Furthermore, bivariate genetic analyses reveal that the correlation between low self-control and substance use is due, for the most part, to common genetic and nonshared environmental factors.
Conclusions: The current study adds to a growing body of biosocial research on self-control and its relationship to criminal and analogous behaviors. The implications of our findings for the general theory of crime are discussed.
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Diana Samek et al.
Behavior Genetics, July 2013, Pages 286-296
Abstract:
Previous research suggests adolescent alcohol use is largely influenced by environmental factors, yet little is known about the specific nature of this influence. We hypothesized that peer deviance and alcohol expectancies would be sources of environmental influence because both have been consistently and strongly correlated with adolescent alcohol use. The sample included 206 genetically related and 407 genetically unrelated sibling pairs assessed in mid-to-late adolescence. The heritability of adolescent alcohol use (e.g., frequency, quantity last 12 months) was minimal and not significantly different from zero. The associations among peer deviance, alcohol expectancies, and alcohol use were primarily due to shared environmental factors. Of special note, alcohol expectancies also significantly explained nonshared environmental influence on alcohol use. This study is one of few that have identified specific environmental variants of adolescent alcohol use while controlling for genetic influence.
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Joan Tucker, Jeremy Miles & Elizabeth D'Amico
Journal of Adolescent Health, forthcoming
Purpose: This study examines the reciprocal longitudinal associations between alcohol or other drug (AOD)-related media exposure and alcohol use among middle school students, and explores whether these associations differ by ethnicity or gender.
Methods: The analytic sample is 7th grade students who were recruited from 16 California middle schools and surveyed in the spring semester of two academic years. Students reported on their background characteristics, exposure to seven types of AOD-related media content (Internet videos, social networking sites, movies, television, magazine advertisements, songs, and video games) in the past 3 months, and alcohol use in the past 30 days. Structural equation modeling was used to examine cross-lagged associations between media exposure and alcohol use.
Results: Greater AOD-related media exposure in 7th grade was significantly associated with a higher probability of alcohol use in 8th grade (p = .02), and alcohol use in 7th grade was marginally associated with greater AOD-related media exposure in 8th grade (p = .07). These cross-lagged associations did not statistically differ by ethnicity (Hispanic vs. non-Hispanic white) or gender. Further, there was no evidence that certain types of media exposure were more strongly associated with alcohol use than others.
Conclusions: Results from this study suggest that AOD-related media effects and media selectively form a reciprocal, mutually influencing process that may escalate adolescent alcohol use over time. Addressing adolescents' exposure to AOD-related media content and its effects on behavior, such as through media literacy education, may hold promise for improving the efficacy of alcohol prevention efforts for middle school students.
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Leslie Hulvershorn et al.
Drug and Alcohol Dependence, August 2013, Pages 230-237
Background: Recent longitudinal studies demonstrate that addiction risk may be influenced by a cognitive, affective and behavioral phenotype that emerges during childhood. Relatively little research has focused on the affective or emotional risk components of this high-risk phenotype, including the relevant neurobiology.
Methods: Non-substance abusing youth (N = 19; mean age = 12.2) with externalizing psychopathology and paternal history of a substance use disorder and demographically matched healthy comparisons (N = 18; mean age = 11.9) were tested on a facial emotion matching task during functional MRI. This task involved matching faces by emotions (angry, anxious) or matching shape orientation.
Results: High-risk youth exhibited increased medial prefrontal, precuneus and occipital cortex activation compared to the healthy comparison group during the face matching condition, relative to the control shape condition. The occipital activation correlated positively with parent-rated emotion regulation impairments in the high-risk group.
Conclusions: These findings suggest a preexisting abnormality in cortical activation in response to facial emotion matching in youth at high risk for the development of problem drug or alcohol use. These cortical deficits may underlie impaired affective processing and regulation, which in turn may contribute to escalating drug use in adolescence.