Examining the relationship of past year delinquent behavior and the initiation of marijuana in the past month among youths aged 12 to 17 in the US
Eric Nwazue
Enyinnaya Merengwa
Georgia Sawyer
Mian B. Hossain
Presented at the Annual Meeting of the APHA
New Orleans
November 19, 2014

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(1)The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months:
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No relationships to disclose

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Marijuana is derived from Cannabis Sativa
(hemp) plant
Known as pot, grass, reefer, weed, hemp, & Mary
Jane (MJ)
Consumed by smoking dried leaves, flowers, stems and seeds
Brewed as tea or inhaled as vaporizer
Mixed with brownies, cookies and lollipops
(NIDA, 2014)
Bioavailability could range from 10-45-90 days following use. Depends on body fat.

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Active ingredient is delta-9-tetrahydrocannabinol
(THC). Mind altering & implicated in addiction
Marijuana impacts every organ in the body
Produces adverse physical, mental, behavioral and neurological effects
Impairs memory and judgment, and distorts perception
Classified as a schedule 1 drug with no medical use and a high risk for abuse
Currently the most illicit drug used in the U.S

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The challenges of adolescents are many.
Violence, drug use and addiction contribute significant problems of public health importance
Marijuana use and delinquent behaviors have been well documented. Incidence is rising:
8 th graders – 7% (2013); 5.8% (2008)
10 th graders – 18% (2013); 13.8% (2008)
12 th graders – 22.7% (2013); 19.4% (2008). 6.5% now use daily, 5% in mid 2000 (MTF Report 2013)

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Rising marijuana use reflects changing perceptions and attitudes
Current debate on legality has enhanced its popularity
2 states in U.S legalized for adult recreational use
21 states passed laws permitting use for medical treatment
Delinquent behaviors leading to initiation of marijuana use is sparsely documented
Study generates information to influence knowledge, attitude and practice

Objective
The objective of this study is to examine the association of past year delinquent behavior with the initiation of marijuana use in past month among youths aged 12-17.

Data and methodology
 The data for this research are taken from 2012
National Survey on Drug Use and Health
(NSDUH), which utilized multi-stage random probability sampling design.
 The NSDUH 2012 collected information from residents of households and non-institutional group quarters and from civilians living in military bases through face to face in-home interviews utilizing computer-based instrumentation

Data and methodology continued
 A total of 55,268 interviews were completed aged 12 or older
 The NSDUH excludes homeless persons who do not use shelters, military personnel on active duty, and people in jails and hospitals .

Excluded in this analysis
:
 Those who are over 17 years old
 Those who ever smoked marijuana prior to past month.
Hence, the current analysis consisted of 14,835 youths (out of 17,399 youths) aged 12-17.

Variables
Dependent variables:
 Initiated using marijuana in past month
(yes/no)

Primary independent variable of interest
Youths’ past year delinquent behavior, which is constructed from six questions: Youth
 gotten into a serious fight at school/work
 taken part in group fights
 carried a handgun
 sold illegal drugs
 stolen/tried to steal anything worth >$50
 attacked someone w/intent to seriously hurt

Other independent variables
Socio-economic and behavioral indicators
 Gender (female/male)
 Age (12-13, 14-15 & 16-17 years)
 Race (whites, blacks, Hispanics & others)
 Family structure (both parent in HH, either parent in
HH & no parent in HH)
 Total family income (less than 20k, 20-49k, 50-74k, 75k and above)
 Youths’ social activities involvement score (low, medium, and high)
 Youths’ drug prevention program participation score
(low, medium, and high).

Definition of past month initiation of marijuana use:
Past month initiation of marijuana use is defined as:
Youths who never smoked or used marijuana but initiated using marijuana for the first time in past month.

Drug prevention program participation scores:
(Constructed from five questions)- During the past 12 months, youth participated in:
 a problem solving, communication skills or selfesteem group
 violence prevention program
 drug prevention program outside school
 program to help drug abuse
 pregnancy or sexually transmitted disease
(STD) prevention program

Social involvement activities scores
(Constructed from four questions)- During the past 12 months, youth participated in how many:
 number of school-based activities
 number of community-based activities
 number of faith-based activities
 number of other activities

Analytical methods
 Adolescents’ social activities involvement score and drug prevention participation activities scores are constructed using factor analysis and categorized as low, medium and high.
 Since past year marijuana initiation is dichotomous (yes/no), different unadjusted and adjusted logistic regression models are estimated for predicting marijuana initiation.
 Sampling weights for complex survey design are considered in the analyses.

Univariate Analyses Results
(characteristics of study sample)

Marijuana initiation in the past month among youths aged 12-17, NSDUH 2012
Yes
8,0%
No
92,0%

Any delinquent behavior in the past year among youths aged 12-17, NSDUH 2012
Yes
27,2%
No
72,8%

Distribution of gender, youths aged 12-
17, NSDUH 2012
Female
49,2%
Male
50,8%

Age distribution of youths aged 12-17,
NSDUH 2012
16-17
Years
32%
12-13
Years
34%
14-15
Years
34%

Distribution of race/ethnicity, youths aged 12-
17, NSDUH 2012
Hispanics
21%
Blacks
14%
Others
9%
Whites
56%

Family structure of youths aged 12-17,
NSDUH 2014
Either parent in
HH
26%
No parent in HH
3%
Both parent in
HH
71%

Bi-variate Analyses
Chi-square test of independence between independent variables and the dependent variables

Independent variables
Past year delinquent behavior
Gender
Age category
Race
Family income
Family Structure
Youths’ social activities involvement score
Youths’ drug prevention program participation scores
Marijuana initiation in the past month
S
S
S
S
NS
S
S
S
S: significant at least 95% level
NS: not statistically significant

Marijuana initiation in the past month among youths aged 12-17 by their delinquent behavior in the past year
16,8
18
16
14
12
10
4
2
0
8
6
4,7
Marijuana initiated in the past month
Involved in delinquent behavior Not involved in delinquent behavior

Multiple logistic regression results

Table 3. Odds Ratios and 95% confidence interval for logistic regression results for examining the association between youths’ delinquent behavior in past 12 months and youths’ marijuana initiation in the past month, NSDUH 2012.
Odds Ratio 95% Confidence Interval Marijuana use initiation
Delinquent behavior
Yes
No (Ref.)
Gender
Female
Male (Ref.)
Age category
12-13
14-15
16-17 (Ref.)
Race
Whites (Ref.)
Blacks
Hispanics
Others
4.95***
1.00
1.09
1.00
0.05***
0.31***
1.00
1.00
0.66**
0.81
0.67**
4.15, 5.89
-
0.92, 1.30
-
0.03, 0.07
0.26, 0.37
-
-
0.50, 0.86
0.63, 1.04
0.50, 0.90
Significance: * p <0.05; ** p <0.01; *** p <0.001

Marijuana use initiation Odds
Ratio
Family income
Less than 20,000
20,000-49,000
50,000-74,000
74,000+ (Ref.)
Family structure
Both parents in the HH (Ref.)
Either parents in the HH
No parent in the HH
Youths social involvement score
Low (Ref.)
Medium
High
Youths drug prevention participation score
Low (Ref.)
Medium
High
Significance: * p <0.05; ** p <0.01; *** p <0.001
1.03
1.02
0.99
1.00
1.00
1.55***
1.58*
1.00
0.70***
0.44***
1.00
0.78
0.73**
95% Confidence
Interval
0.78, 1.36
0.81, 1.29
0.77, 1.29
-
-
1.27, 1.89
1.03, 2.43
-
0.57, 0.86
0.36, 0.55
-
0.59, 1.04
0.59, 0.91

Summary
 Results suggest that past year youths’ involvement in delinquent behavior enhances the likelihood of marijuana initiation process in past month.

 Absence of parent in household plays a role in youths’ marijuana initiation process.
 Youths living with no parent or one parent in the household are significantly more likely to have initiated marijuana use in the past month.

 Lower level of involvement in social activities and lower level of drug prevention program participation plays a role in youths’ marijuana initiation process.
 Youths less involved in social activities or participated less in drug prevention programs, are more likely to have initiated marijuana use in the in past month

 Black youths are significantly less likely to initiate using marijuana compared to the whites.
 Youths between ages 14-15 are significantly less likely to initiate marijuana use compared to youths aged 16-17.

Conclusion
Knowledge of these relationship might be useful in
 Developing and implementing prevention measures for delinquent behavior and marijuana use among adolescents and
 Determine appropriate timing for intervention programs
 Driving policy initiative to address problems