Addiction Risk Factors and Inhalant Use in 10- to 15-Year-Olds with Chronic Stress

Inhalant use (IU) is understudied, especially compared to other drugs like alcohol and tobacco. It can lead to “sudden sniffing death” even during first use, and current knowledge of IU is based almost entirely on retrospective reports. IU differs from other drugs in several ways; inhalants are legal for children to possess, are widely available for free, and are not one of many drugs carefully monitored by adults, including health professionals. Consequently, IU prevalence is greatest during early adolescence. In order to prevent IU, scientists need to understand whether targeting traditional risk factors for other addictive substances will work for IU. The current study tested whether a range of correlates of alcohol and tobacco use also correlate with IU.

Data from 607 10- to 15-year-olds were collected from two sources: (a) records at a summer camp designed for children with chronic stress, and (b) program evaluations of these children using the ALEXSA^© illustration-based, audio, computer-assisted self-report. Participants experienced a mean 2.2 (SD=1.31) chronic stressors, including family problems such as parent imprisonment (60.9%), social rejection (57.9%), academic performance (50.8%), poverty (49.4%), and psychiatric problems (42.7%). The sample was 55.0% female, 79.0% European-American, 12.1% African-American, 8.6% Hispanic (of any race); 44.7% received free school meals and 26.4% received special education services.  Lifetime tobacco and alcohol consumption was admitted by 40.3% and 21.3% of participants, respectively; 46.6% had 2 or more conduct disorder criteria; 9.2% admitted to IU.

Results show that IU was associated with alcohol use, tobacco use, conduct disorder criteria, level of depression, and every subscale of the following risk domains: disinhibition, self-management, sensation seeking, parental fortification, social contagion, and social cognition. Only gender, minority status, and number of stressors were not associated with IU. Taken together, results suggest that IU represents a manifestation of high liability to substance use disorders in youth ages 15 and younger, consistent with findings in older samples.

Increasing numbers of programs to prevent problem behaviors provide the greatest efficacies among the highest risk youth. The results from the current study suggest that IU represents an important outcome to target and evaluate in preventive interventions because of its threat to youth health, its apparent status as a prodrome of substance use disorder, and the potential for prevention programs to decrease its prevalence. Taking into account past research, adding unique components to prevention programs that specifically target inhalants may enhance efficacy for reducing use of this dangerous yet unique substance.