Student Drug Use Research Articles

Cross-sectional examination of the association of co-occurring alcohol misuse and traumatic brain injury on mental health and conduct problems in adolescents in Ontario, Canada

ObjectiveThis study describes the impact of traumatic brain injury (TBI) and hazardous drinking on mental health and behavioural issues among Ontario adolescents. In particular, we assessed the incremental co-occurrence of...

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The present study was carried out in the most populated city in Northern Nigeria that is believed to have the highest number of commercial motorcyclists and highest prevalence of psychoactive substance use in the country. Research on psychoactive substance use among motorcycle operators in Northern Nigeria is limited, despite the high level of morbidity these substances cause to them. This study aimed to study the prevalence of psychoactive substance use among motorcycle operators in Kano, North western Nigeria. The study was cross-sectional descriptive. Participants for the study were commercial motorcyclists registered with the local branch of Amalgamated Commercial Motorcycle Owner’s and Riders Association of Nigeria (ACOMORAN). Assessment was carried out with the use of socio-demographic questionnaire and World Health Organization Student Drug Use Questionnaire (SDUQ). Data obtained was analysed using Statistical Package for Social Sciences (SPSS), 17th edition. Three hundred and ninety four (394) subjects participated in the study. The results showed that the prevalence of overall psychoactive substance use was 19.3%. The prevalence of tobacco, stimulant (gadagi), and cannabis use were 19.3, 11.9 and 3.8% respectively, while the prevalence of inhalants and opiates use were 2.0 and 1.3%, respectively. There were no reported use of alcohol, benzodiazepines and cocaine. All the subjects were males, Moslems, within the age range of 22 and 60 years mean of 32.7 ± 6.6 years. They were mostly married (88.6%), and more than two third of them (70.1%) were from Kano. The study has highlighted the prevalence of substance use among commercial motorcyclists. It has important implication for policy makers to initiate primary preventive measures that could be focused towards the reduction of substance use among commercial motorcyclists in the community. Key words: Motorcycle operators, psychoactive substance, Northwestern Nigeria, Student Drug Use Questionnaire (SDUQ).

Looking beyond cigarettes: Are Ontario adolescents with asthma less likely to smoke e-cigarettes, marijuana, waterpipes or tobacco cigarettes?

ObjectivesThe purpose of this paper is to examine whether high school students in Ontario with asthma smoke cigarettes, waterpipes, marijuana or e-cigarettes more or less than those without asthma. MethodsThe 2013 Ontario Student Drug Use and Health Survey provides self-report data on tobacco cigarettes, waterpipes, marijuana and e-cigarette smoking and asthma rates from 109 high schools in Ontario, Canada. Individual and social characteristics were also collected. Multiple binary logistic regression models measures the association with the various types of smoking in relation to asthma. ResultsAdolescents with asthma have higher odds of smoking e-cigarettes or smoking any type including either cigarettes, waterpipes, marijuana or e-cigarettes. Respondents of lower socio-economic status had a higher odds of smoking marijuana or any type. Boys were more likely to smoke waterpipes, e-cigarettes or any type, while students in higher grades had a higher odds of smoking cigarettes, waterpipes, marijuana or any type. ConclusionsResults from this study suggest that adolescents with asthma have a higher odds of smoking e-cigarettes than those without asthma, but no relationship was found for cigarettes, waterpipes or marijuana. Findings present some new challenges as technology changes how adolescents can smoke. Public health campaigns should target adolescents, especially those with asthma, to raise their awareness of the risks of all types of smoking including e-cigarettes.

Possession of weapon and school violence among adolescents and their association with history of traumatic brain injury, substance use and mental health issues

PurposeAssessment of the association between illegal possession of weapon and assault on school property among adolescents with and without a history of traumatic brain injury (TBI) while assessing risk factors for these outcomes. MethodsData were derived from the Centre for Addiction and Mental Health’s 2013 Ontario Student Drug Use and Health Survey completed by students in grades 7–12 (ages 11–20). ResultsIn this sample of 5478 adolescents, 6.1% (95% CI: 5.0, 7.4) reported carrying a weapon (e.g., gun or knife) on school property, 10.8% (95% CI: 9.5, 12.3) were engaged in a physical fight and 6.4% (95% CI: 5.4, 7.6) reported having beat up or hurt someone on purpose at school, during last year. Youth who reported carrying a weapon, who were engaged in a physical fight and those who assaulted peers on school property during last year had statistically significantly higher odds of reporting a history of TBIs, being male, in first years of high-school, scored positive for elevated psychological distress, and were current regular alcohol (weapon possession only) and cannabis users. ConclusionPreviously it was thought that alcohol and drugs were the main contributors to school violence. Here we show that history of TBIs is yet another significant predictor of violence at school among adolescents. The results suggest that school vigilance and combined violence and TBI prevention, treatment and rehabilitation programs in this population are warranted.

Acculturation and substance use in a Mexican American college student sample

ABSTRACTAlthough the association between acculturation and substance use among Latino groups is important, it is often understudied, especially within specific Latino groups living in geographically distinct communities, such as the Mexican American population in South Texas. The researchers of this study aimed to better understand the effect of acculturation on substance use and alcohol dependence in a Mexican American college student population. This survey study investigated the correlation between acculturation and substance use and dependence by using the Vancouver Index of Acculturation (VIA), items related to substance use (nicotine, marijuana, and cocaine) in a Mexican American college student sample (N = 1,494), and the Short Alcohol Dependence Data Questionnaire (SADD; N = 715). The study was conducted in the Texas–Mexico border region. The results suggest that higher levels of acculturation do not predict increased drug use or alcohol dependence in the Mexican American college students. However, acculturation was found to be associated with lower use of cocaine and marijuana. The discussion examines commonalities and differences in drug use and dependence. Specifically, acculturation seems to have an inverse relationship to substance use and may serve as a protective factor to licit and illicit drug use among Mexican American college students.

Prevalence and Patterns of Drug Abuse among Students of Tertiary Institutions in Abeokuta, Ogun State, Nigeria

Background: In recent time, there has been a rise in the use of alcohol and psychoactive substances and the associated consequences among Nigerian students in tertiary institutions. Despite being a major public health concern, there are few studies that examined prevalence of alcohol and drug use among students of different tertiary institutions at the same point in time. Method: The self-administered WHO Student Drug Use Questionnaire was used to collect data on drug use among 1233 college students from the Federal College of Education, Moshood Abiola Polytechnic and University of Agriculture all in Abeokuta, Ogun State, Nigeria. Results: The lifetime prevalence of use of one or more drugs of abuse was 69.2%. The highest lifetime prevalence rates were for alcohol (34.3%), tobacco (14.4%), hypnosedatives (8.8%) and cannabis (6.2%). The majority of respondents who abused psychoactive drugs initiated the habit in primary and secondary school. Alcohol use was more common among male students and Christians. It was also associated with parental drug use, parental educational level and marital status. Conclusion: This study showed a high prevalence of drug abuse among the students. There is a need for more studies on drug use among college students with a view to mapping out appropriate preventive and intervention programmes in Nigeria.

Social factors associated with drug use in the Mexican school-age population: A comparison of two national surveys

Objectives: This study analyses changes in drug use in Mexican junior high and high-school students and identifies differences over two decades in the social factors (availability of drugs, perceptions of risk and social tolerance) associated with such use. Method: Data from two national surveys, conducted in 1991 and 2014, were analysed. Results: Data show that the proportion of students who had tried drugs doubled in 2014. In both surveys, substance use was significantly associated with a high perception of availability and use by friends and older siblings; in 2014, there was a decrease in the perception of risk for marijuana use and an increase in social tolerance toward illegal drugs. Conclusions: It can be inferred from this analysis that public policy to prevent drug use has not had the expected impact, at least not on the social factors considered here.

The search for healthy schools: A multilevel latent class analysis of schools and their students.

The objective of this study was to establish and investigate a taxonomy of school health among high school students in Ontario, Canada. Data analyzed were based on 3358 9th–12th graders attending 103 high schools who participated in the 2011 Ontario Student Drug Use and Health Survey. Based on 10 health-related indicators, multilevel latent class analysis was used to extract 4 student-level latent classes and 3 school-level latent classes. Unhealthy schools (19% of schools) had the lowest proportion of healthy students (39%) and the highest proportion of substance-using (31%) and unhealthy (18%) students. Healthy schools (66%) contained the highest proportion of healthy students (56%) and smaller proportions of substance-using (22%) and unhealthy students (8%). Distressed schools (15%) were similar to healthy schools in terms of the proportions of healthy and unhealthy students. Distressed schools, however, were characterized by having the largest proportion of distressed students (35%) and the lowest proportion of substance-using students (4%). Meaningful categories of schools with respect to healthy environments can be identified and these categories could be used for focusing interventions and evaluating school health programs.

School bus travel is associated with bullying victimization among Canadian male, but not female, middle and high school students

Previous research has found a link between active school transportation and bullying victimization among school-aged children. However, the link with other school travel modes (such as car, school bus, and public transportation) and bullying victimization is largely unknown. The purpose of this study was to investigate the association between school travel mode and report of bullying victimization among Canadian middle and high school students. The sample consisted of 5065 students aged 11–20 years (mean age: 15.2±1.9 years; 56% females) who participated in the 2013 Ontario Students Drug Use and Health Survey (OSDUHS). Overall, 24.7% of students reported school bullying victimization in the past year. Females (27.2%) were more likely than males (22.3%) to be victims of school bullying (p<0.01). After adjustment for age, ethnicity, subjective socioeconomic status and parental education, multivariable logistic regression analyses indicated that, compared to active school transportation, school bus travel to (adjusted odd ratio (OR)=1.83; 95% confidence interval (CI)=1.25–2.68) and from (OR=1.79; 95% CI=1.70–2.67) school was associated with greater odds of bullying victimization among males, but not females. However, the use of public transportation to get to school was associated with lower odds of bullying victimization compared to active transportation among females only (OR=0.59; 95% CI=0.36–0.97). These findings suggest that school travel mode should be considered when considering risks for bullying victimization. Bullying prevention efforts should target school buses to make children's commute a safe and enjoyable experience.

Use of social networking sites and alcohol consumption among adolescents

ObjectivesResearch indicates that screen time (e.g. TV viewing) is associated with alcohol consumption in adolescents; however, very little is known about the link between the use of social networking sites (SNSs) and alcohol intake in this age group. The purpose of this study was to examine the association between the use of SNSs and alcohol consumption among Canadian middle and high school students, and to test whether this link varies by sex and drinking frequency or intensity. Study designSchool-based cross-sectional study. MethodsSelf-reported data on time spent on SNSs, alcohol consumption and sociodemographic characteristics were obtained from 10,072 participants within the 2013 cycle of the Ontario Student Drug Use and Health Survey, a province-wide survey of students in grades 7–12 (11–20 years old). ResultsAdolescent females who reported daily use of SNSs (≤2 hours/day or >2 hours/day) were more likely than those who use them infrequently or do not use them at all to report both occasional and regular alcohol consumption in the past 12 months, while adolescent males who reported daily use of SNSs were more likely than those who use SNSs infrequently or do not use them at all to report regular alcohol use in the past 12 months. The use of SNSs was also associated with report of binge drinking (defined as drinking five or more drinks on one occasion) in the past 4 weeks in both males and females. ConclusionsResults provide evidence that the use of SNSs is associated with alcohol consumption among adolescents. Differences between males and females in the reported associations warrant further investigations.

Correlates for psycho-active substance use among boarding secondary school adolescents in Enugu, South East, Nigeria.

BackgroundPsycho-active substance use among adolescents is a national and global problem and its attendant effects on adolescents cannot be overemphasized.The objectives of this study are to determine the prevalence and pattern of psychoactive substance use among adolescents; the substances involved and the extent of the problem in this locale.MethodsThis is a cross-sectional study that assesses the pattern of psychoactive substance use among secondary school adolescents in Enugu, south East, Nigeria. The study was carried out among adolescents attending six secondary boarding schools in Enugu metropolis of Enugu State of Nigeria.The WHO Student Drug Use Questionnaire was adapted for this study.Data were analyzed using the Statistical Package for Social Sciences program (SPSS), version 17. Chi-square and multivariate regression were used as a test of significance for qualitative variables. A p-value less than 0.05 were accepted as significant for each statistical test.ResultsOut of 900, a total of 896 respondents, comprising 400 and 82 boys (482) (53.8 %) and 400 and 14 girls (414) (46.2 %) completed the questionnaires. This gave a response rate of 99.6 %.The study revealed that the prevalence of current use for psychoactive substances ranges from 0.4 to 34.9 % while that for life use ranges from 0.8 to 63.5 %. The least being cannabis and the most being kola nuts.Kola nut is the most widely used psychoactive substance both for current use, past year use and the respondents’ life time use. It shows a lifetime prevalence of 63.5 % and a current use prevalence of 34.9 %.More than half of the users of each of the psychoactive substances take it occasionally, using them on 1–5 days in a month. On the other hand, almost one-quarter of the users of each of the substances take it on 20 or more days in a month.ConclusionThe study revealed that the prevalence of current use for psychoactive substances ranges from 0.4 to 34.9 % while that for life use ranges from 0.8 to 63.5 %. The least being cannabis and the most being kola nuts.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0615-9) contains supplementary material, which is available to authorized users.

Assessing Substance Use and Mental Health in Adolescents With Chronic Conditions

Abstract BACKGROUND: Mental health disorders and substance use and abuse are significant issues affecting the health of adolescents. While prevalence of these issues have been studied widely in healthy youth, far less is known about these issues in adolescents with chronic disease. This population may experience adverse health effects from potential interactions between prescribed medications and recreational substances, and effects on adherence and response to treatment may be influenced by both mental health issues and substance use. OBJECTIVES: To determine the prevalence of substance use and mental health disorders in adolescentswith chronic conditions who were receiving care at a tertiary care paediatric centre. DESIGN/METHODS: Patients aged 12-18 with a diagnosed chronic illness, requiring ongoing care for greater than 6 months were recruited from outpatient clinics in Rheumatology , Nephrology and Haematology. Data collected included age, gender, diagnosis and duration, current medications, responses to questions drawnfrom the Ontario Student Drug Use Health Survey about alcohol and substanceuse.The GAIN-SS, a validated screening tool that screens for mental health and substance abuse was also administered, minus one questionwhich asks about suicidal thinking as the responses were collected anonymously. Data were analyzed using simple descriptive statistics and chi-square analysis. RESULTS: Data collection is ongoing. For the first 55 patients from who data has been collected, the mean age was15.3 years, with 69% being female, 29% male, and .02% other. Average grade of last completion was 9.2. Patients with SLE comprised 45% of the sample;15% hada diagnosis of Sickle Cell Disease, 13% Thalassemia, 13% chronic kidney disease, and the remaining participants a variety of other rheumatologic and haemato-logic diagnoses. On average, patients were currently taking 2.7 medications. Substance use was infrequent with 70% of participants reported never having drunk alcohol or only trying a sip, and 85% reporting never having tried cannabis. The opposite was true of mental health symptoms, with over 50% endorsing significant low mood overpast year, and a similar proportion endorsing significant problems with anxiety. 13% endorsed missing meals or self inducing vomiting as a way to control their weight. CONCLUSION: There are several possible reasons that this cohort had-lower than expected alcohol and substance use for their age. Their chronic illnessmay limitinteractions with peers,with whom initial teen alcohol and cannabis experimentation tends to occur. They may also have made con-cious decisions not to use because of their illness and treatments. Significantmood and anxiety symptoms that were endorsedwarrant further assessment and may have significant impact on their treatment and overall functioning. The data did not reveal that any of them were receiving phar-macologic treatment for either depression or anxiety. These results suggest that routine screening for mental health symptoms to inform further assessment is warranted in young people with chronic medical conditions.

Does socioeconomic status moderate the relationships between school connectedness with psychological distress, suicidal ideation and attempts in adolescents?

ObjectiveResearch has indicated that school connectedness acts as a buffer against depressive symptoms and suicidality. However, little is known about the role of socioeconomic status (SES) on these links. The present study examined the moderating role of subjective SES and parental education on the relationships between school connectedness and psychological distress, suicidal ideation and suicide attempts. MethodsData were gathered from 4955 participants within the 2013 cycle of the Ontario Students Drug Use and Health Survey, a province-wide repeated school-based survey of students in grade 7 to 12 across Ontario, Canada. ResultsResults indicated that higher subjective SES is associated with high levels of school connectedness. Subjective SES is also a significant moderator of the association between school connectedness and psychological distress, but not between school connectedness and suicidal ideation or attempts. At low subjective SES, there was no difference in risk of psychological distress between students with high and low levels of school connectedness. However, at higher subjective SES, students with high levels of school connectedness have lower odds of psychological distress than those with low levels of school connectedness. The associations between school connectedness and each of the mental health outcomes did not significantly vary with parental education. ConclusionsThese findings suggest that the beneficial effects of school connectedness on mental health problems may be more strongly related to adolescents' status beliefs rather than parental education. Future research is needed to better understand the mechanism through which subjective SES and school connectedness influence psychological distress.

Use of social networking sites and perception and intentions regarding body weight among adolescents.

SummaryObjectiveSocial networking sites (SNSs) not only offer users an opportunity to link with others but also allow individuals to compare themselves with other users. However, the link between the use of SNSs and the dissatisfaction with body weight is largely unknown. We investigated the associations between the use of SNSs and the perception of body weight and related behaviours among adolescent men and women.MethodsThe study sample consisted of 4,468 (48.5% women) 11–19‐year‐old Canadian students in grades 7 to 12 who participated in the 2013 Ontario Student Drug Use and Health Survey.ResultsOverall, 54.6% of students reported using SNSs for 2 h or less per day, 28.0% reported using them for more than 2 h d−1 and 17.4% reported infrequent or no use of SNSs (reference category). After adjustment for covariates, results showed that adolescent women who use SNSs for more than 2 h d−1 had greater odds of dissatisfaction with body weight (odds ratio = 2.02; 95% confidence interval [CI]: 1.30–3.16). More specifically, they were more likely to perceive themselves as overweight (relative risk ratio [RRR] = 2.20; 95% CI: 1.34−3.60) compared with those who reported infrequent or no use of SNSs. Conversely, men who use SNSs for 2 h or less per day presented a lower risk for perceiving themselves as overweight (RRR = 0.68; 95% CI: 0.47−0.98) but not those who use SNSs for more than 2 h d−1. Women who use SNSs for more than 2 h d−1 reported a greater likelihood of trying to lose weight (RRR = 2.52; 95% CI: 1.62−3.90).ConclusionsOur results showed that heavy use of SNSs is associated with dissatisfaction with body weight in adolescent women.

Trends and gender differences in alcohol and substance use among children and adolescents admitted to an addiction treatment center in Turkey: comparison of 2014 with 2011

Objective: The aim of this study was to evaluate the trends and gender differences in alcohol and substance use behaviors in youth admitted to an addiction treatment center in Istanbul. Methods: Participants were 2755 substance using children and adolescents who were treated at the Bakirkoy Mental Health and Neurologic Disorders Hospital between 2011 and 2014. The World Health Organization student drug use questionnaire’ was completed by trained clinicians. Results: There was an increase in the total number of youths admitted for substance use treatment (31.4% in 2011, 68.6% in 2014). A significant increase found in polysubstance use and in the number of females seeking treatment for substance use from 2011 to 2014. Alcohol, ecstasy, synthetics cannabinoids and heroin usage showed increase whereas inhalants, cannabis, prescribed medicines usage showed decrease in 2014. In 2014 while girls mostly consumed ecstasy, prescribed medicines and cocaine boys mostly used cannabis and synthetics. Conclusions: As new popular illicit drugs emerge in the market in the recent years, it is essential to reexamine the new trends in substance use and to reconsider prevention policies and treatment strategies.

Use of Social Networking Sites and Risk of Cyberbullying Victimization: A Population-Level Study of Adolescents.

Social networking sites (SNSs) have gained considerable popularity among youth in recent years; however, there is a noticeable paucity of research examining the association between the use of these web-based platforms and cyberbullying victimization at the population level. This study examines the association between the use of SNSs and cyberbullying victimization using a large-scale survey of Canadian middle and high school students. Data on 5,329 students aged 11-20 years were derived from the 2013 Ontario Student Drug Use and Health Survey. Logistic regression was used to examine the relationship between the use of SNSs and cyberbullying victimization while adjusting for covariates. Overall, 19 percent of adolescents were cyberbullied in the past 12 months. Adolescents who were female, younger, of lower socioeconomic status, and who used alcohol or tobacco were at greater odds of being cyberbullied. The use of SNSs was associated with an increased risk of cyberbullying victimization in a dose-response manner (p-trend <0.001). Gender was not a significant moderator of the association between use of SNSs and being cyberbullied. Results from this study underscore the need for raising awareness and educating adolescents on effective strategies to prevent cyberbullying victimization.

Ten-year trends in overweight/obesity among Ontario middle and high school students and their use in establishing baseline measures for government reduction targets.

Public health concern about increasing levels of child/youth overweight and obesity has resulted in initiatives to address this issue. In 2012, the Ontario Ministry of Health and Long-Term Care (MOHLTC) established a target to reduce childhood obesity by 20% within five years. In this paper, we examine trends and establish baseline levels of overweight/obesity to assess the impacts of population-level interventions. We analyzed 10 years (2003-2013) of data accumulated from six cycles of the Ontario Student Drug Use and Health Survey using logistic regression to assess trends in the prevalence of overweight/obesity among middle and high school students. The 2013 data are used to begin monitoring progress toward achieving the MOHLTC target. From 2003 through 2013, the prevalence of overweight/obesity among middle school students in the province remained stable overall and among all subgroups except 7th-grade females, who showed a significant linear decline. Among high school students, the prevalence of overweight/obesity showed a significant linear increase and an increase among 11th graders, females, and 10th- and 11th-grade females specifically. The prevalence remained stable but elevated among 9th- and 12th-grade females as well as among males in all grades. In 2013 (baseline for the MOHLTC target), 25.1% of students in grades 7-12 were overweight or obese, implying a presumed 2018 target of 20.1%. Ten-year trends in overweight/obesity indicate stability among males and significant linear increases in some female subgroups. Also, baseline data (2013) will facilitate the monitoring of future interventions aimed at achieving the 2018 MOHLTC target.

Social networking sites and mental health problems in adolescents: The mediating role of cyberbullying victimization

BackgroundPrevious research has suggested an association between the use of social networking sites (SNSs) and mental health problems such as psychological distress, suicidal ideation and attempts in adolescents. However, little is known about the factors that might mediate these relationships. The present study examined the link between the use of social networking sites and psychological distress, suicidal ideation and suicide attempts, and tested the mediating role of cyberbullying victimization on these associations in adolescents. MethodsThe sample consisted of a group of 11-to-20-year-old individuals (n=5126, 48% females; mean±SD age: 15.2±1.9 years) who completed the mental health portion of the Ontario Student Drug Use and Health Survey (OSDUHS) in 2013. Multiple logistic regression analyses were used to test the mediation models. ResultsAfter adjustment for age, sex, ethnicity, subjective socioeconomic status (SES), and parental education, use of SNSs was associated with psychological distress (adjusted odds ratio, 95% confidence interval=2.03, 1.22–3.37), suicidal ideation (3.44, 1.54–7.66) and attempts (5.10, 1.45–17.88). Cyberbullying victimization was found to fully mediate the relationships between the use of SNSs with psychological distress and attempts; whereas, it partially mediated the link between the use of SNSs and suicidal ideation. ConclusionFindings provide supporting evidence that addressing cyberbullying victimization and the use of SNSs among adolescents may help reduce the risk of mental health problems.

Associations between the use of social networking sites and unhealthy eating behaviours and excess body weight in adolescents

Unhealthy eating behaviour and excess body weight have been related to sedentary behaviour, particularly screen time, in adolescents; however, little is known about their associations with the use of social networking sites (SNS). We investigated the associations between time spent using SNS and unhealthy eating behaviours (including breakfast skipping, consumption of sugar-sweetened beverages (SSB) and energy drinks) and body weight in adolescents. Data on 9858 students (mean age: 15·2 (SD 1·9) years) in grades 7 through 12 were derived from the 2013 cycle of the Ontario Student Drug Use and Health Survey--a cross-sectional school-based survey of middle and high school students. The majority (81·5%) of students reported daily use of SNS and an additional 10·7% reported using them on an irregular basis. Multivariate logistic regression analyses revealed that the use of SNS was associated with increased odds of skipping breakfast (P trend<0·01) and consuming SSB (P trend<0·01) and energy drinks (P trend<0·01) in a dose-response manner with adjustments for age, sex, ethnicity, socio-economic status, tobacco, alcohol and cannabis use as well as BMI. However, there was no evidence of a significant association between use of SNS and BMI before or after adjusting for all the covariates and unhealthy eating behaviours. In conclusion, our results suggest associations between the use of SNS and unhealthy eating behaviours among youth. Given the popularity of SNS, more efforts are needed to better understand the impact of social networks on eating behaviours and risk of excess weight.

Energy Drinks, Alcohol, Sports and Traumatic Brain Injuries among Adolescents.

ImportanceThe high prevalence of traumatic brain injuries (TBI) among adolescents has brought much focus to this area in recent years. Sports injuries have been identified as a main mechanism. Although energy drinks, including those mixed with alcohol, are often used by young athletes and other adolescents they have not been examined in relation to TBI.ObjectiveWe report on the prevalence of adolescent TBI and its associations with energy drinks, alcohol and energy drink mixed in with alcohol consumption.Design, Settings and ParticipantsData were derived from the Centre for Addiction and Mental Health’s 2013 Ontario Student Drug Use and Health Survey (OSDUHS). This population-based cross-sectional school survey included 10,272 7th to 12th graders (ages 11–20) who completed anonymous self-administered questionnaires in classrooms.Main Outcome MeasuresMild to severe TBI were defined as those resulting in a loss of consciousness for at least five minutes, or being hospitalized for at least one night. Mechanism of TBI, prevalence estimates of TBI, and odds of energy drink consumption, alcohol use, and consumption of energy drinks mixed with alcohol are assessed.ResultsAmong all students, 22.4% (95% CI: 20.7, 24.1) reported a history of TBI. Sports injuries remain the main mechanism of a recent (past year) TBI (45.5%, 95% CI: 41.0, 50.1). Multinomial logistic regression showed that relative to adolescents who never sustained a TBI, the odds of sustaining a recent TBI were greater for those consuming alcohol, energy drinks, and energy drinks mixed in with alcohol than abstainers. Odds ratios were higher for these behaviors among students who sustained a recent TBI than those who sustained a former TBI (lifetime but not past 12 months). Relative to recent TBI due to other causes of injury, adolescents who sustained a recent TBI while playing sports had higher odds of recent energy drinks consumption than abstainers.Conclusions and RelevanceTBI remains a disabling and common condition among adolescents and the consumption of alcohol, energy drinks, and alcohol mixed with energy drinks further increase the odds of TBI among adolescents. These associations warrant further investigation.