Teens Who Smoke, Drink Alone at Higher Risk

Solitary use predicts future troubles, study finds

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By Steven Reinberg
HealthDay Reporter

THURSDAY, Dec. 7, 2006 (HealthDay News) -- Teens who often engage in unhealthy habits on their own, rather than with peers, may be in bigger trouble, a new study finds.

Researchers at the Rand Corp. found that teens who use alcohol, cigarettes and marijuana when they are alone are less likely to graduate from college, more likely to have substance abuse problems and report poorer physical health by age 23, compared with their peers who only use these substances in groups.

"We found that kids who used these substances while alone were not only at higher risk for problems during adolescences, but 10 years later when they were 23," said study author Joan Tucker, a behavioral scientist at Rand Corp.

"We need to take a closer look at this group of 'solitary users,'" Tucker said. "They are overlooked. When we think about adolescent substance users, we think of those kids who are using substances at parties or when they are hanging out with friends. But we found that there is a significant group that are using these substances by themselves."

Tucker noted that these teens are not loners but are socially active, using alcohol, tobacco or marijuana when they are with friends, but also when they are alone.

Her team's report is published in the December issue of Psychology of Addictive Behaviors.

In the study, Tucker's team collected data on over 6,500 teenagers from California and Oregon who were in a study to evaluate Project ALERT, a drug-prevention program developed by Rand for middle school children. Teens were asked about their substance use and a variety of other issues several times during middle school and high school, and again at age 23.

The researchers found that of the more than 3,300 people who completed the study, 16 percent of eighth graders had smoked cigarettes while alone, 17 percent drank while alone, and 4 percent had used marijuana while alone.

These solitary users admitted to more delinquent behavior, such as stealing and acting out at school, and were less likely to talk to their parents about personal problems than kids who indulged in bad habits more socially. They were also less involved with school, had lower grades and spent less time on homework and school activities.

However, "these are not the loner kids," Tucker said. In fact, most of these high-risk youngsters also spent significantly more time going to parties and dating than other substance-using youth. "They focus less on school and more on activities with their peers," Tucker said.

Moreover, these solitary substance abusers felt that substance use had positive effects on their behavior, helping them relax, have more fun and feel better, Tucker said. Also, they were less likely to think substance use is harmful.

But at 23, more of these solitary users had developed substance abuse problems and were involved in crimes, such as selling drugs and stealing, Tucker said. They also had more physical health problems. "So, across the board, they were faring worse in young adulthood," she said.

One expert believes that a combination of addiction and existing psychological problems account for these behaviors among this subset of youth.

"People who are more likely to be addicted are more likely to use solitarily as well as socially," said Bonnie Halpern-Felsher, an associate professor of pediatrics at the University of California, San Francisco. "In addition, kids who are at risk are more likely to use solitarily."

Halpern-Felsher thinks it is important that health-care providers ask adolescents about their smoking and drug use behaviors -- not only if they use drugs and alcohol but where. "It may be that asking these questions will help identify those teens at risk for other developmental problems," she said.

"It's not just the fact that they are using the substances, but what's going on behind it," Halpern-Felsher said. "Either they are lonely or there is depression or there is something going on at home. It could be that this is a marker for other behavioral and social problems that are going on," she said.

More information

There's more on teens and substance abuse at the U.S. National Institute on Drug Abuse.

SOURCES: Joan Tucker, Ph.D., behavioral scientist, Rand Corp., Pittsburgh; Bonnie Halpern-Felsher, Ph.D., associate professor, pediatrics, University of California, San Francisco; December 2006 Psychology of Addictive Behaviors

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