BACKGROUND AND OBJECTIVES Scientific understanding of the forces involved in the decades-long decline of adolescent alcohol use in the United States is limited. This study examines specific changes in US adolescent frequent binge drinking (FBD) by age (variation due to maturation), period (variation across time that does not covary across age), and cohort (variation common to adolescents born around the same time). METHODS We analyzed nationally representative, multicohort data from 8th, 10th, and 12th grade students sampled between 1991 and 2015 from Monitoring the Future (n = 1 065 022) to estimate age, period, and cohort effects on adolescents' FBD (defined as ≥2 occasions of ≥5 drinks in a row during the past 2 weeks). Age-Period-Cohort analyses were stratified by sex, race/ethnicity, and socioeconomic status (SES). Trends in the associations between demographics and FBD across historical time were examined. RESULTS Decreases in FBD during adolescence were attributable to period and cohort effects independent of age variations. Birth cohorts between 1985 and 1990 showed the greatest decline in FBD. The Age-Period-Cohort results were consistent across sex, race/ethnicity, and SES, with the exception of slower declines seen among African American adolescents compared with white adolescents since 2007. We also found convergence in FBD by sex and divergence by SES. CONCLUSIONS Recent declines in adolescent FBD have been driven by period and cohort effects. Attention is warranted for the slower declines in FBD seen among African American adolescents since 2007, a narrowing difference by sex, and a growing gap by SES.

BACKGROUND: Simultaneous alcohol and marijuana (SAM) use poses threats to health, particularly among adolescents. These risks would be exacerbated to the extent that high-intensity drinking (e.g., 10+ drinks in a row) and marijuana use (e.g., 1+ joints per day) are associated with a higher likelihood of SAM use. The current study examines the extent to which the intensity of alcohol use and of marijuana use are associated with adolescent SAM use prevalence, and whether associations remain after controlling for key covariates known to associate with both alcohol and marijuana use; it identifies alcohol and marijuana use intensity levels associated with the highest risk of adolescent SAM use. METHODS: Data come from nationally representative samples of US 12th graders who participated in the Monitoring the Future study from 2005 to 2014 (N = 24,203 respondents; 48.4% boys, 51.6% girls). RESULTS: SAM use during the past year was reported by 20% of 12th graders overall. SAM use prevalence was strongly and positively associated with alcohol and marijuana use intensity even after controlling for covariates. High school seniors at highest risk for engaging in SAM use were those who reported 10+ drinks and those smoking at least 1 joint/day. Approximately 60% of those who had 10-14 or 15+ drinks in a row during the past 2 weeks and 76%-80% of those who had 1 or 2+ joints per day on average during the past 30 days reported SAM use. CONCLUSIONS: Results suggest that high school seniors who consume high quantities of alcohol and marijuana are very likely to consume these substances so that their effects overlap.

Background Nearly 10% of U.S. 12th graders report high-intensity drinking (10+ or 15+ drinks in a row), but the extent to which these drinkers also engage in nonmedical use of prescription drugs (NMUPD) is largely unknown. This study examined the associations between different thresholds of past two-week high-intensity drinking and past-month NMUPD among U.S. 12th graders. Methods The sample consisted of eleven nationally representative cross-sections of 12th graders in the Monitoring the Future study (2005–2015) who answered questions on past two-week drinking behaviors and past-month nonmedical use of prescription opioids, sedative, stimulants, and tranquilizers (N = 26,502 respondents). Results High-intensity drinking during the past two-weeks was associated with an increased risk of past-month NMUPD. The odds of NMUPD were four times larger among 12th graders who indicated drinking 15 or more drinks on at least one occasion (AOR = 4.43, 95% CI = 3.18, 5.01) relative to those who had 0–4 drinks during the past two-weeks, after adjusting for relevant covariates. These associations were similar across different classes of prescription drugs and tended to be stronger among non-white respondents. A sub-analysis revealed simultaneous co-ingestion of alcohol and NMUPD was more prevalent among high-intensity drinkers. Conclusions More than 1 in every 4 U.S 12th graders who engage in high-intensity drinking (15+ drinks in a row) also report NMUPD. Given the greater likelihood of simultaneous co-ingestion of alcohol and prescription drugs among high-intensity drinkers, adolescent substance use interventions need to address the risks associated with mixing alcohol and prescription drugs.

AIMS To estimate (1) the prevalence of underage binge drinking, high-intensity drinking, and intoxication among young adults aged 19/20; (2) change in these behaviors across the transition out of high school and across historical time; and (3) associations between these behaviors and key covariates, including college status. Design, Setting, & Participants Longitudinal data from the U.S. nationally representative Monitoring the Future study included 1,657 respondents first surveyed as 12th graders (modal age 18) in 2005-2013 and again at modal age 19/20 in 2006-2014. MEASUREMENTS Self-reported measures of alcohol use, demographics, college attendance, and living situation. FINDINGS Binge drinking (5+ drinks on one occasion) was reported by 24.2% (95% confidence interval (CI) = 22.0, 26.5) of young adults aged 19/20; 10.3% (CI = 8.7, 11.9) reported high-intensity drinking of 10+ drinks; 4.2% (CI = 3.1, 5.2) reported 15+ drinks. Usual moderate/high intoxication when drinking was reported by 33.1% (CI = 30.6, 35.6); 29.6% (CI = 27.2, 32.0) reported usual sustained intoxication of 3+ hours. Significant variability (p < .001) in these behaviors from ages 18 to 19/20 was observed. Significant decreases (p < .05) across historical time in 5+ and 10+ drinking were found. Four-year college students not residing with parents had significantly higher odds of moderate/high intoxication, binge drinking, and high-intensity drinking compared with other groups (p < .001). CONCLUSIONS Young adult underage binge drinking (5+ drinks on one occasion), high-intensity drinking (10+ and 15+ drinks), and intoxication are relatively common in the USA, and show meaningful variability across the transition out of high school. Four-year college students and those who do not live with their parents are more likely to engage in high-intensity drinking than their peers. This article is protected by copyright. All rights reserved.

The purpose of the present paper was to examine the extent to which college students underestimate the quantity of alcohol they will consume during Spring Break (SB), and whether individual, interpersonal, and contextual factors may be related to underestimation of SB drinking and drinking consequences. College students participated in web-based surveys prior to and after SB (N = 603; 57% women). Overall, results indicated that individual factors (being male, being a member of a fraternity or sorority, previously experiencing more alcohol-related consequences, and intending to drink less during SB), interpersonal factors (reporting friends encourage getting drunk), and contextual factors (going on a SB trip with friends and receiving drinks from others) predicted underestimating peak drinks consumed during SB. Underestimating the peak number of drinks to be consumed on SB was associated with experiencing a greater number of alcohol-related consequences. Targeted interventions designed specifically to focus on underestimation of college student drinking and the impact of SB contextual and interpersonal factors may be an important area of study to reduce negative consequences of alcohol use during SB.

Background This descriptive study identified latent classes of longitudinal marijuana use from ages 18 through 50 among a national sample; examined covariate associations with class membership regarding use/non-use, use intensity, and use duration; and described associations between identified latent classes and age 50 health outcomes. Methods The study involved collection and primary analysis of data from 9831 individuals first surveyed as 12th graders in the national Monitoring the Future study and followed through modal age 50. Repeated measures latent class analysis was used to identify latent classes based on self-reported past 12-month marijuana use. Results Seven latent classes of marijuana use from ages 18 to 50 were identified including Non-users (44%), two classes characterized by shorter-term use patterns (totaling 28%), and four classes characterized by longer-term moderate or heavy use (totaling 28%). Use reduction appeared particularly likely during early and late 20s. Gender, parental education, alcohol/cigarette use, religious commitment, and marital status differentiated use/non-use, use intensity, and use duration after high school. In non-causal models controlling for covariates, longer-term marijuana use classes (where use extended into the late 20s or beyond) were associated with significantly higher odds of negative health outcomes at age 50. Conclusions Approximately 28% of the national sample reported longer-term moderate/heavy marijuana use, which was associated with negative health outcomes at age 50. The early and late 20s may be especially important periods for marijuana use prevention and intervention efforts, which may be strengthened by recognition of characteristics that appear to have significant associations with persistent use.

Objective Using a national sample of young adults, this study identified latent classes of alcohol use including high-intensity drinking (10+ drinks) from ages 18 to 25/26, and explored associations between time-invariant covariates measured at age 18 and class membership. Method Longitudinal data from the national Monitoring the Future study were available for 1078 individuals (51% female) first surveyed as 12th grade students in 2005–2008, and followed through modal age 25/26. Repeated measures latent class analysis was used to identify latent classes based on self-reported alcohol use: no past 30-day drinking, 1–9 drinks per occasion in the past 2 weeks, and 10+ drinks per occasion. Results Four latent classes of alcohol use from ages 18 to 25/26 were identified: (1) Non-Drinkers (21%); (2) Legal Non-High-Intensity Drinkers (23%); (3) Persistent Non-High-Intensity Drinkers (40%); and (4) High-Intensity Drinkers (16%). Membership in the High-Intensity Drinkers class was characterized by higher than average probabilities of high-intensity drinking at all ages, with the probability of high-intensity drinking increasing between ages 18 and 21/22. Both gender and race/ethnicity significantly differentiated class membership, whereas neither parental education (a proxy for socioeconomic status) nor college plans at 12th grade showed significant associations. Conclusions More than one in seven individuals who were seniors in high school experienced a long-term pattern of high-intensity drinking lasting into middle young adulthood. Young adult high-intensity drinking is often preceded by high-intensity drinking in high school, suggesting the importance of screening and prevention for high-intensity drinking during adolescence.

Purpose The purpose of this study is to examine driving-related consequences associated with levels of drinking intensity among a national sample of young adult drinkers. Methods Data come from a nationally representative sample of 12th graders sampled annually in 2005–2014 with subsamples surveyed at age 19/20 years. Multivariable logistic regressions examined associations of 12th-grade drinking intensity (0–4, 5–9, 10–14, and 15+ drinks in a row) with driving consequences at age 19/20 years. Results Twelfth-grade binge drinkers (compared with nonbinge drinkers) were more likely to experience negative driving consequences at age 19/20 years. Among binge drinkers, 15+ drinkers (compared with 5–9 drinkers) in 12th grade had increased the risk of negative drinking consequences at age 19/20 years. Conclusions These results suggest that while underage binge drinkers are at an increased risk for having driving consequences, those who engage in higher intensity drinking are at even greater risk for these consequences. High-intensity drinkers may require additional screening or intervention to reduce future driving-related consequences.

College students experience a variety of effects resulting from alcohol use and evaluate their experiences on a continuum from negative to positive. Using daily reports collected via cell phone, we examined the psychometric properties of alcohol use consequences and evaluations of those consequences. Participants were 349 undergraduate students (mean age 19.7 [SD = 1.26], 53.4% female). Data were analyzed using a multilevel factor analysis framework, incorporating binary items (consequences) and normally distributed items (evaluations). Our model converged on 2 factors-positive and negative-with similar loadings between- and within-persons. Intraclass correlation coefficients for positive consequences and their evaluations ranged from .30 to .40, whereas values for negative consequences were more variable. Intraclass correlation coefficients for negative evaluations were higher, suggesting evaluations were more trait-like compared to experience of consequences which may be context dependent. Generalizability coefficients on the whole were good to excellent, suggesting highly reliable scales at both person-mean and daily-mean levels. However, likely due to binary scale and infrequency, the generalizability coefficients for negative consequences at the daily level was somewhat low. Convergent validity was demonstrated by (a) positive associations between baseline Rutgers Alcohol Problem Index and Alcohol Use Disorders Identification Test scores with latent factors for daily positive and negative consequences, and (b) positive associations between daily drinking and daily consequences and evaluations of consequences. Overall, this measure demonstrated good psychometric properties for use in studies examining daily and lagged relationships between alcohol use and related consequences. (PsycINFO Database Record

Background Perceived risk of harm has long been a key preventive factor for adolescent marijuana use. However, in recent years, perceived risk has decreased markedly and marijuana use has increased only slightly, leading to new questions about their association. This study investigates the magnitude and stability of the US adolescent marijuana risk/use association from 1991 to 2016, overall and by gender and race/ethnicity. Methods Self-reported data on past 12-month marijuana use, perceived risk of regular marijuana use, gender, and race/ethnicity were obtained from 275,768 US 12th grade students participating in the nationally representative Monitoring the Future study. Time-varying effect modeling (TVEM) was used to examine the marijuana risk/use association over time. Results Both before and after controlling for gender and race/ethnicity, perceived risk was a strong protective factor against adolescent marijuana use. The magnitude of the great risk/use association strengthened for Hispanic students; remained generally stable over time for 12th graders overall, males, females, and White students; and weakened for Black students. The magnitude of the moderate risk/use association strengthened for 12th graders overall, males, females, White and Hispanic students, but did not continue to strengthen for Black students from 2005 onwards. In general, marijuana use prevalence decreased over time within all levels of perceived risk. Conclusions Perceived risk remains a strong protective factor for adolescent marijuana use, and the protective association for moderate risk (vs. no/slight risk) is actually increasing over time. Results suggest that accurate and credible information on the risks associated with marijuana use should remain a key component of prevention efforts.

Objectives. To examine a potential increase in marijuana initiation among US college students as compared with their age peers not in college before and after 2013, a watershed year for increasing tolerance of marijuana use in the United States. Methods. Data come from the Monitoring the Future study, which has followed longitudinal panels drawn from annual nationally representative, baseline samples of 12th-grade students starting with the class of 1976.We studied panel members aged 19 to 22 years who had never used marijuana by 12th grade between 1977 and 2015. Results. College as a risk factor for marijuana initiation has increased significantly since 2013. The increased probability of past-year marijuana use for those enrolled versus not enrolled in college was 51% in 2015, 41% in 2014, and 31% in 2013; it averaged 17% to 22% from 1977 to 2012 among youths who had never used marijuana by 12th grade. Conclusions. College has grown as a risk factor for marijuana initiation since 2013. Public Health Implications. College students are in position to usher in new increases in population marijuana use unless colleges soon address the issue with new or modified programs for marijuana prevention and intervention. (Am J Public Health. 2017;107:996-1002.

© 2017, BMJ Publishing Group. All rights reserved. Objective To examine what substances US youth vape. Methods Data come from Monitoring the Future, an annual, nationally representative survey of USA 12th-grade, 10th-grade and 8th-grade students. Respondents reported what substance they vaped the last time they used a vaporiser such as an e-cigarette. Results Among students who had ever used a vaporiser, 65-66% last used ‘just flavouring’ in 12th, in 10th and in 8th grade, more than all other responses combined. In all three grades, the percentage using ‘just flavouring’ was above 57% for males, females, African-Americans, Hispanics, Whites, and students both with and without a parent with a college degree. Nicotine use came in a distant second, at about 20% in 12th and 10th grade and 13% in 8th grade. Taking into account youth who vaped nicotine at last use increases national estimates of tobacco/nicotine prevalence in the past 30 days by 24-38% above and beyond cigarette smoking, which is substantial but far less than estimates that assume all vaporiser users inhale nicotine. Conclusions These results challenge the common assumption that all vaporiser users inhale nicotine. They (a) call into question the designation of vaporisers and e-cigarettes as ENDS (‘Electronic Nicotine Delivery System’), (b) suggest that the recent rise in adolescent vaporiser use does not necessarily indicate a nicotine epidemic, and (c) indicate that vaporiser users can be candidates for primary prevention programmes. Finally, the results suggest the importance of developing different rationales for the regulation of vaporiser devices as compared to the regulation of substances marketed for vaporiser use.

The results of studies on the role of appropriate wine consumption in the prevention of cardiovascular disease are inconsistent, suggesting that the general approach to the issue needs to be revisited before further research is conducted. A number of points for consideration are raised: (1) the necessity to characterize wine analytically, as the content in important components of wine, such as resveratrol, is influenced considerably by regional factors, such as climate and local oenological procedures; (2) the bioavailability of the components of wine, which appears to be adequate as a broad range of biological effects have been documented at low concentrations that can be achieved by moderate chronic wine consumption; (3) the lack of importance of wine color, as also white wine consumption affords benefit, thanks to its content in the antioxidants caffeic acid, tyrosol and hydroxytyrosol, which are also found in olive oil; (4) the recommendation by WHO to “investigate the possible protective effects of ingredients other than alcohol in alcoholic beverages”.

Background—Daily affect and substance use covary among college students, but little is known about these associations among young adults not in college.

High-intensity drinking (i.e., women/men consuming 8+/10+ drinks in a day) is prevalent and associated with negative consequences. Occasions of high-intensity drinking have markedly high risk; however, previous research has not examined the predictors of these high-risk drinking days. The current study was designed to examine to what extent positive and negative alcohol expectancies predict high-intensity drinking and whether high-intensity drinking on a given day was associated with drinking consequences and their evaluations that day. Frequently drinking college students (N = 342) participated in an intensive longitudinal study of drinking behaviors (N = 4645 drinking days). Days with greater positive and negative expectancies were associated with high-intensity drinking. Days with high-intensity drinking were associated with reporting more positive and negative consequences and with evaluating positive consequences more favorably and evaluating negative consequences less favorably, compared to drinking days without high-intensity drinking. Given this, prevention and intervention efforts may consider specifically targeting high-intensity drinking events as a unique phenomenon.

© The Author 2015. Introduction: This study examines the role of e-cigarettes in the drug use patterns of adolescents. Of specific interest is whether adolescent e-cigarette users fall into a group of (1) youth who do not use traditional drugs of abuse or (2) polysubstance users. Methods: Using latent class analysis, we identify major "classes" of substance users on the basis of recent use of e-cigarettes, alcohol, marijuana, cigarettes, and prescription drugs. Analyses are conducted separately for adolescents in 8th, 10th, and 12th grades. Data come from 16 615 participants in the 2014 Monitoring the Future survey. Results: Youth who do not use traditional drugs of abuse account for about 50% of e-cigarette users in 8th grade, 35% in 10th grade, and 17% in 12th grade. These youth come from a large "low-level users" group found in each grade, characterized by low probability of use for all substances (e-cigarette probability in this group for 8th graders = .046; 10th graders = .071; 12th graders = .027). Other e-cigarette users come from a smaller, "poly-users" group found in each grade, characterized by high-to-moderate probabilities (.83-.21) of using e-cigarettes and other substances. Specific to 12th grade is a third, additional polysubstance group characterized by high likelihood of e-cigarette use (.93). Conclusions: The proportion of e-cigarette users who do not use traditional drugs of abuse is larger at younger ages. Longitudinal panel studies starting at 8th and 10th grades may best inform the current debate on whether e-cigarette use is a risk or protective factor for future transition to the use of other substances. Implications: The proportion of e-cigarette users who do not use traditional drugs of abuse is larger at younger ages. Longitudinal panel studies starting at 8th and 10th grades may best inform the current debate on whether e-cigarette use is a risk or protective factor for future transition to the use of other substances.

BACKGROUND This study is the first to examine the developmental course of high-intensity drinking (i.e., consuming 10+ drinks in a row) across late adolescence and the transition to adulthood. METHODS National longitudinal data (N = 3,718) from Monitoring the Future were used to examine trajectories of 10+ high-intensity drinking from age 18 through 25/26 overall and across sociodemographic subgroups; results were compared with similar analysis of 5+ binge drinking trajectories. RESULTS Results document that 10+ drinkers consume not just a greater quantity of alcohol on a given drinking occasion, but also engage in 5+ drinking more frequently than drinkers who do not report having 10 or more drinks. Developmental patterns for 10+ and 5+ drinking were similar, with peak frequencies reported at age 21/22. Greater peaks in both 10+ and 5+ drinking were documented among men and among college attenders, compared with women and nonattenders, respectively. However, there was a steeper decline in 10+ drinking after age 21/22, indicating that risk for consumption of 10 or more drinks in a row is more clearly focused on the early 20s. Patterns of developmental change in both behaviors were driven largely by college students: No significant age-related change in 10+ drinking was observed among men and women who did not go to college, and no significant age-related change in 5+ drinking was observed among female nonattenders. CONCLUSIONS Findings underscore the importance of recognizing high-intensity drinkers as a unique high-risk group, and that college attendance is associated with particularly strong peaks in the developmental course of high-intensity drinking.

© 2013, © The Author(s) 2013. National data from Monitoring the Future were used to examine patterns and predictors of college attendance. Samples of American 12th-grade students from 1977 to 2003 were followed for 7 years (modal ages 18-25; N = 10,020). College attendance and graduation patterns varied considerably over historical time and based on family background. Substance use during high school predicted a greater likelihood of never attending (for cigarettes, illegal drugs), of graduating from a 2-year rather than a 4-year school (for cigarettes), and of dropping out versus graduating from a 4-year school (for cigarettes, marijuana, and other illegal drugs). High school binge drinking predicted lower college dropout, but only in models also controlling for cigarette, marijuana, and other illicit drug use. This study provides a needed overview of adolescent predictors of patterns of college attendance among American young adults over the past three decades.

BACKGROUND Alcohol use is a key risk factor for young adult mortality and disease, but limited research has focused on high-risk alcohol use among individuals moving from early young adulthood into building and maintaining an initial structure of adult life. This study estimated the prevalence of a range of alcohol use behaviors among US young adults aged 25/26, examined evidence for historical change in prevalence rates, and estimated associations between alcohol use and key demographic, substance use, and adult social role characteristics. METHODS Data were obtained from 3542 individuals selected for follow-up from the nationally representative 12th-grade student Monitoring the Future study. Respondents self-reported alcohol use behaviors at age 25/26 during calendar years 2005-2014. RESULTS Two fifths (39.9%) of young adults aged 25/26 reported being intoxicated at least once in the past 30 days; 25.6% reported usually experiencing a sustained high of 3 or more hours when drinking alcohol. Past-2-week binge drinking (5+ drinks in a row) was reported by 36.3% of respondents. Past-2-week high-intensity drinking (10+ drinks in a row) was reported by 12.4%. These age 25/26 alcohol use prevalence rates remained stable over the 10 years of data examined, in contrast to significant declines over historical time in alcohol prevalence rates among these same individuals at age 18. High-risk drinking was particularly associated with being male, white, unmarried, employed, a nonparent, and an alcohol user before finishing high school. CONCLUSIONS Among US young adults in their mid-20s, alcohol use was highly normative and frequently included participation in high-risk drinking behaviors. High-risk alcohol use prevention approaches developed specifically to reach young adults in their mid-20s are needed, as well as efforts to increase proactive clinician screening to identify young adults participating in high-risk alcohol use.