Risk for Inhalant Initiation Among Middle School Students

Understanding Individual, Family, and Peer Risk and Protective Factors

Published In: Journal of Studies on Alcohol and Drugs, v. 74, no. 6, Nov. 2013, p. 835-840

Posted on RAND.org on November 01, 2013

by Allison J. Ober, Jeremy N. V. Miles, Brett Ewing, Joan S. Tucker, Elizabeth J. D'Amico

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Research Questions

  1. How common is inhalant use in middle school?
  2. What characteristics of youth are associated with inhalant use?
  3. When is the influence of adults, siblings, and peers strongest?
  4. What should be the focus of effective interventions?

OBJECTIVE: Because initiation of inhalants at an early age is associated with a range of health and behavioral problems, including an increased likelihood of inhalant dependence (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), we conducted discrete time survival analyses to determine the role of time-invariant and time-variant (over five waves) risk and protective factors as well as grade in inhalant initiation among middle school students. METHOD: The current study uses data from 3,215 students who were initially surveyed as sixth graders in 2008–2009 and were resurveyed in seventh and eighth grades. Students were part of a larger substance use prevention trial conducted in greater Los Angeles. The sample is racially/ethnically diverse (54% Hispanic/Latino, 16% Asian, 14% White, 3% African American) and 51% male. RESULTS Seventeen percent of youths initiated inhalants during middle school. Higher drug refusal self-efficacy, familism (i.e., values related to family), and parental respect were associated with decreased odds of inhalant initiation. Having a significant adult or older sibling who used substances was associated with increased risk of initiation, but adult influence declined linearly and by the end of seventh grade was no longer a risk factor. Self-rated popularity was associated with inhalant initiation in seventh grade only, and perceived substance use by peers was associated with inhalant initiation in sixth grade only. CONCLUSIONS: The influence of adults, siblings, and peers on inhalant use may be strongest in sixth and seventh grade. Interventions to prevent inhalant initiation should target sixth and seventh graders, address influence by family and peers, and provide skills training to improve drug refusal self-efficacy.

Key Findings

  • About 17 percent of youth begin using inhalants in middle school.
  • The influence of adults, siblings, and peers is strongest in 6th and 7th grade.
  • Having an older sibling who uses substances is the strongest family influence on inhalant use.
  • Prevention efforts should give adolescents a more realistic understanding of drug use among their peers.

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