IMPLICATIONS FOR PROGRAM PLANNING AND POLICY
Over the years, adolescent patterns of alcohol, tobacco, and other drug use have varied. Changes in social and legal standards of tolerance (and behavior), substance availability, prevention efforts, general societal circumstances (e.g., wars, economic depressions, and recessions), and an evolution of demographic profiles in communities have all contributed to increases (and decreases) in substance use among young people.
The Maryland Adolescent Survey (MAS) was developed as a resource for state and community agencies, policy makers, prevention educators, and other prevention professionals to provide up-to-date local information on the changing patterns in substance use. For the first time, the 1998 MAS collected data on whether or not the students feel safe in and around schools. Data gathered from the MAS provides important information about how safe our children feel as well as the extent of drug use, the age at first use, and the differences between groups (by grade, gender, and race/ethnicity), as well as trends in use over time for various substances.
The 1998 MAS results show that generally, the proportions of users of alcohol, tobacco, and other drugs decreased across all grades. This was most true for twelfth graders, in that, across the board, the number of twelfth graders who had used a substance in the 30 days prior to the survey decreased from that reported in 1996. For cigarettes, alcohol, and marijuana, trends in use across grade levels have declined since 1996 or remained constant.
It is important to note that there are relatively large segments of sixth, eighth, tenth, and twelfth grade youth who do not use one or any substance. The MAS indicates there are teens who have never smoked, not drank, and not tried marijuana or any other illegal drugs. Analysis of the MAS data reveal there are a number of factors associated with substance use and nonuse. These have been collectively identified as protective factors.
The Maryland State Department of Educations approach to creating and maintaining safe disciplined and drug-free schools and communities emphasizes the following protective factors:
The MAS includes a number of items assessing the degree to which populations of substance users differ from nonusers in terms of their exposure to these school based protective influences, in order to provide information on their relative effectiveness.
Although the MAS does not directly assess the extent to which schools have provided students and staff clear no use policies, the State Board of Education implemented guidelines in 1997 that defines a State code of discipline with standards of conduct and consequences for violations of the standards. In addition, local boards of education adopted regulations that create and maintain an atmosphere of order and discipline necessary for effective learning. Adding to this, the Maryland State Department of Education has guidelines for suspension reporting which enhance the consistency of statewide data collection.
In the 1998 survey, the MAS asked students about their safety in and around schools. Generally, more than half of surveyed students (eighth, tenth, and twelfth grades) indicated they never felt unsafe at school, never felt unsafe going to and from school, and never felt unsafe in their neighborhood. The importance of this information cannot be overemphasized when highlighted against the recent tragedies in schools around our country. We will continue to gather this data in order to provide current trends and demographic information to our planners and program implementers.
Effective drug and violence prevention programs provide information to our youth about drugs and offer skills to assist young people in resisting pressures to try drugs, to be disruptive, or to engage in other risky behaviors. In addition, effective programs provide opportunities to practice the skills so that the students will become comfortable using the skills whenever they wish. We cannot overemphasize the importance of parents and communities reinforcing the "no use" messages and resistance skills in order to create a seamless approach to prevention of drug abuse and violence. In order to build resiliency in Marylands student population, a safe and drug free schools curriculum is provided throughout grades K through 12. The MAS provides feedback for the prevention community on the effectiveness of their efforts in this area.
Substance Abuse Knowledge
For the past several administrations of the MAS, a number of questions evaluating respondents knowledge about illicit substances was included on the questionnaire. Results generally show that the effort by prevention educators to impart this information was successful. In 1998, sixth graders averaged almost 10.6 out of a possible 18 (59%) correct. By twelfth grade, the average score was approximately 14.9 (83%). There was a small decline in scores from 1996 to 1998 across all grades, with the greatest decline among tenth graders. This was the first decline in "knowledge" and should be an area of concern for our educators.
In addition, when "knowledge" is compared to behaviors reported through the MAS, there is even greater cause for concern. For instance, although over 90% of eighth, tenth, and twelfth graders indicated they knew you should take a drinking friends car keys to prevent them from driving, between one-third and one-half of eighth, tenth, and twelfth grade students indicated they had been a passenger with a drinking driver. Other measures from the survey also confirm the poor link between knowledge and behavior. Almost all (90.1%) twelfth graders knew that driving with an alcohol level of .02 (one drink) could cost them their drivers license. However, 27% indicated they drove while under the influence of alcohol.
For perceived risk of danger of the surveyed substances, users generally rate the dangerousness of substances considerably less than nonusers. The knowledge and skills curricula should be supplemented with programs that target the user population in order to eliminate the misperception that their behavior will not have detrimental effects on their future. In addition, the consistent "no use" message must permeate the collaborative efforts of our schools, communities, and families. We must collaborate and have an unwavering commitment to ensure that the policies are in place to prevent the illegal use of alcohol, tobacco, and other drugs and an equally energetic commitment to consistent and rigorous enforcement of those policies by our schools and communities.
Peer Pressure Resistance Skills and Practice
These data suggest that users and nonusers respond very differently to educational efforts designed to encourage resistance to peer pressure at the eighth, tenth, and twelfth grade level. Data also indicate that user status did not affect students willingness to apply the concepts until the eighth grade.
Another measure of students resistance to social pressure is the proportion of students friends who approve (or disapprove) of using some type of substance. Not surprisingly, users were twice as likely as nonusers to have friends who approved of using substances. Nonusers typically had twice as many friends who disapproved of using substances. Given that peer influence is greatest during the adolescent years, often outweighing parental influence, these findings are not surprising. Emphasis on peer pressure and choice of peers may need to be expanded within programs.
Programs need to continue to develop and/or improve messages that are specifically targeted to substance users. Users are likely to need additional information about the harmful effects of substances, additional peer resistance skills, and additional practice using these skills in order for users to become comfortable in saying no to those pressuring them to engage in risky behaviors.
Parent and Community Involvement
Survey data indicate substantial differences in parental involvement of users and nonusers of cigarettes, alcohol, and other drugs. Measures specific to parents waking their students up for school, worrying if their child was late from school, and worrying if they did not know where their child was shows that users are less likely than nonusers to have parental involvement at this level. In addition, more nonusers than users of substances had parents who had rules about the people they could be with. Nonusers were also more likely to have parents who talked to them about not using alcohol or other drugs. While schools cannot be directly responsible for parenting practices, they can and should continue their efforts to communicate relevant information on effective parenting practices through PTA meetings, parent events and programs, newsletters, and other means. An understanding of the necessity for setting clear rules, consistently enforcing them, providing consistent no use messages, role modeling, and age-appropriate behavior expectations reinforce the information and skills delivered in the school setting. Further, programs must focus on youths friendship networks and encourage parents to closely monitor their childrens peer relationships as well as their behaviors.
In addition to parental involvement, communities must also be involved in creating the consistency and reinforcing no use messages and in modeling appropriate behaviors for our youth. Data on cigarette acquisition indicate that almost half of all twelfth grade cigarette smokers purchased their cigarettes in a store. Of these youth, almost one-third were not asked to show proof of age. While the proportion of youth who were not asked to show proof of age has decreased since the 1996 survey, the findings suggest that additional efforts to enforce existing laws prohibiting the sale of cigarettes to minors are still required. Community leaders and local businesses can assist in denying access to tobacco products by encouraging employees to follow the law and request identification of those patrons who appear to be under age.
Identification/Intervention Through Staff Development
MAS data indicate that users of tobacco, alcohol, and other drugs begin using as early as age 10 or younger. In addition, 1998 data suggest that in certain sub-populations of youth, more youth are beginning to use substances at age 10 or younger, such as the males (begin smoking) and Hispanic youth (begin drinking beer, wine, or wine coolers). These data support the importance of early identification and intervention in preventing substance use. MAS results should be used to inform all elementary and secondary school staff, including bus drivers, maintenance personnel, secretaries, cafeteria workers, teachers, and administrators about the nature and extent of substance use in their schools so that they are aware of the magnitude of the problem and can be better prepared to assist in the prevention/intervention effort. Staff training should include information on the signs and symptoms of substance use as well as basic intervention techniques. In addition, staff should be provided referral resources so they can assist youth and their families as soon as problems become apparent. Resource information of this type may be provided by the local health department and/or staff development/drug education personnel within the school system.
Coordination of Support Programs
Students who have used alcohol or other drugs reported that they experienced a variety of problems associated with their substance use. Between 10% and 20% of eighth, tenth, and twelfth graders users were absent from school because of their alcohol or drug use while 7% to 18% of these youth had experienced poor school performance as a result of their substance use. Survey findings also indicate youth who use substances receive less parental supervision than their non-using peers and, at the twelfth grade level, as many as 15% had used three substances (cigarettes, alcohol, and marijuana) within a 30 day period.
As substance users, these students break school regulations as well as state laws (on average, between 5.8% and 8.2% of eighth, tenth, and twelfth graders who experienced problems as a result of their substance use were arrested). Because of their behaviors, substance users are likely to become known to school administrators, student services professionals (such as school nurses, counselors, pupil personnel workers, social workers, or psychologists), and others (such as the members of the student assistant teams). These students should have access to appropriate services and supports needed to reduce their use of substances. Coordination and collaboration between families, schools, and the appropriate helping community agencies are essential for successful interventions on behalf of these at-risk youth.
When data are compared over time, it is clear that the number of users for many of the surveyed substances have declined across grade levels. In some instances, however, there were slight increases in use and decreases in personal knowledge about the harmful effects of drugs, alerting program planners, policy makers, and prevention educators that these changes may be a precursor of future trends. Additionally, the data collected about how safe our children feel is important, not only to reinforce the belief that our schools are safe, but also to begin to look at data over time to ensure that our staff and students can teach and learn in a safe environment.
The information from the survey is instructive in validating current program approaches and suggesting areas in which greater effort is required to create and maintain safe, disciplined, and drug-free learning environments.