Estimating the Risk of Gateway Drug Behaviors: Using Attitudes to Model Risk of Future Use By Adolescents

I will present a strategy for estimating future risk of gateway drug behaviors (drinking alcohol, getting drunk, smoking cigarettes and using marijuana) that relies on an assessment of an adolescent’s attitude. Surveys from over 37,000 11 through 17 year-olds accumulated from 36 datasets were analyzed to examine the relationship between attitude and behavior. Attitude scores ranged from 0 (pro-drug use) to 10 (anti-drug use). Attitude scores were constructed from a composite of measures of normative beliefs, intentions, lifestyle incongruence, and parental monitoring and communication. The Cronbach alpha for the attitude scale was .883. Results reveal that the relationship between attitude and each gateway drug behavior could be modeled using age-specific cubic regression functions. Regression coefficients between attitude scores and alcohol, drunkenness, cigarettes and marijuana were, respectively, 0.538, 0.538, 0.559, 0.513, all of which were highly significant. Using predicted values for each level of attitude, econometric models were created for each behavior. The model is constrained so that risk of each gateway behavior increases with age. The model is further adjusted to match recent national survey results for patterns of prevalence. To estimate risk of future behavior, an individual’s base-year attitude is adjusted for each subsequent year of life to the age of 17 based on average age-to-age changes that were observed in the accumulated datasets. Results suggest that risk of future gateway drug behaviors can be estimated once an adolescent’s current attitude score is known. Risk estimates may be used to motivate parents and other care takers to adopt and implement effective prevention approaches designed to lower the risk of gateway drug use.