Abstract
BackgroundAs the promotion of alcohol and tobacco to young people through direct advertising has become increasingly restricted, there has been greater interest in whether images of certain behaviours in films are associated with uptake of those behaviours in young people. Associations have been reported between exposure to smoking images in films and smoking initiation, and between exposure to film alcohol images and initiation of alcohol consumption, in younger adolescents in the USA and Germany. To date no studies have reported on film images of recreational drug use and young people's own drug use.MethodsCross sectional multivariable logistic regression analysis of data collected at age 19 (2002-4) from a cohort of young people (502 boys, 500 girls) previously surveyed at ages 11 (in 1994-5), 13 and 15 in schools in the West of Scotland. Outcome measures at age 19 were: exceeding the 'sensible drinking' guidelines ('heavy drinkers') and binge drinking (based on alcohol consumption reported in last week), and ever use of cannabis and of 'hard' drugs. The principle predictor variables were an estimate of exposure to images of alcohol, and of drug use, in films, controlling for factors related to the uptake of substance use in young people.ResultsA third of these young adults (33%) were classed as 'heavy drinkers' and half (47%) as 'binge drinkers' on the basis of their previous week's consumption. Over half (56%) reported ever use of cannabis and 13% ever use of one or more of the 'hard' drugs listed. There were linear trends in the percentage of heavy drinkers (p = .018) and binge drinkers (p = 0.012) by film alcohol exposure quartiles, and for ever use of cannabis by film drug exposure (p = .000), and for ever use of 'hard' drugs (p = .033). The odds ratios for heavy drinking (1.56, 95% CI 1.06-2.29 comparing highest with lowest quartile of film alcohol exposure) and binge drinking (1.59, 95% CI 1.10-2.30) were attenuated by adjustment for gender, social class, family background (parental structure, parental care and parental control), attitudes to risk-taking and rule-breaking, and qualifications (OR heavy drinking 1.42, 95% CI 0.95-2.13 and binge drinking 1.49, 95% CI 1.01-2.19), and further so when adjusting for friends' drinking status (when the odds ratios were no longer significant). A similar pattern was seen for ever use of cannabis and 'hard' drugs (unadjusted OR 1.80, 95% CI 1.24-2.62 and 1.57, 95% CI 0.91-2.69 respectively, 'fully' adjusted OR 1.41 (0.90-2.22 and 1.28 (0.66-2.47) respectively).ConclusionsDespite some limitations, which are discussed, these cross-sectional results add to a body of work which suggests that it is important to design good longitudinal studies which can determine whether exposure to images of potentially health-damaging behaviours lead to uptake of these behaviours during adolescence and early adulthood, and to examine factors that might mediate this relationship.
Highlights
In high income countries there is concern about the consequences of excessive alcohol consumption [1], especially in youth when these behaviours are common [1,2,3,4] and may track into adulthood [5,6]
Cannabis use in young people is associated with psychotic symptoms and dependence on other illicit drugs [10,11], there is debate over its health consequences [12]
We have previously reported a lack of association between exposure to smoking in films and smoking in these young adults [37]
Summary
In high income countries there is concern about the consequences of excessive alcohol consumption [1], especially in youth when these behaviours are common [1,2,3,4] and may track into adulthood [5,6]. The reduction of alcohol (mis)use, and binge drinking in particular, are priorities for the British Government [3] This reflects concerns about public drunkenness and anti-social behaviour on the one hand, and the longer term health effects of excessive drinking, such as increased mortality in heavy drinkers [8]. There is evidence from Scotland of an increase in the lifetime prevalence (ever use) of illicit drugs in recent decades, with ever-use of cannabis by young adulthood being much more common than ever-use of other drugs [9]. Cannabis use in young people is associated with psychotic symptoms and dependence on other illicit drugs [10,11], there is debate over its health consequences [12]. To date no studies have reported on film images of recreational drug use and young people’s own drug use
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