The aim of this study was to describe the transitions between tobacco (T), cannabis (C) and other illicit drugs (OIDs) initiations, to simultaneously explore several substance use theories: gateway theory (GT), common liability model (CLM) and route of administration model (RAM).Data from 2 French nationwide surveys conducted in 2005 and 2010 were used (16,421 subjects aged 18-34). Using reported ages at initiations, we reconstituted a retrospective cohort describing all initiation sequences between T, C and OID. Transition probabilities between the substances were computed using a Markov multi-state model that also tested the effect of 2 latent variables (item response theory scores reflecting propensity for early onset and further substance use) on all transitions.T initiation was associated with increased likelihood of subsequent C initiation, but the reverse relationship was also observed. While the most likely initiation sequence among subjects who initiated the 3 groups of substances was the 'gateway' sequence T x2192; C x2192; OID, this pattern was not associated with substance use propensity more than alternative sequences. Early use propensity was associated with the 'gateway' sequence but also with some alternative ones beginning with T, C or OID.If the gateway sequence appears as the most likely pattern, in line with GT, the effects of early onset and substance use propensities were also observed for some alternative sequences, which is more in line with CLM. RAM could explain reciprocal interactions observed between T and C. This suggests shared influences of individual (personality traits) and environmental (substance availability, peer influence) characteristics.
AbstractThis study examines attitudes to smoking among adolescents. Data for the study is derived from a large quantitative French cross-sectional survey of school students. Attitudes toward smoking were found to be associated with regularity and quantity of consumption, and the type of school attended. These associations are explained according to Becker’s concept of a ‘moral career’, for attitudes differ among occasional, regular and heavy smokers. The association with school type indicates advanced formal schooling enables students to offer sophisticated rationalisations for smoking, combining an acknowledgement of health-related risks of smoking, emphasis on personal benefits derived from smoking, and claims that smoking is a private matter.Key Words: Sociologysmokingadolescencedeviancemoral careerFrance
The general decrease in telephone survey response rates leads to potential selection and estimation biases. As nonrespondents can be broken down into noncontacts and refusals, different strategies can be deployed—increasing the number of call attempts before abandoning a number, and calling back refusals/abandonments to persuade them to participate. Using a two-stage random-digit-dialing sample of 8,645 individuals aged 15–49 for a survey on sexual and reproductive health (SRH), we compared the effects of the two strategies: including hard-to-contact respondents (more than twenty call attempts with no upper limit) and including respondents from two successive waves of call-back among initial refusals/abandonments. Comparisons were based on sociodemographic bias, differences in SRH behaviors, multivariate logistic modeling of SRH behaviors, post-calibration weighting, and cost estimation. The sociodemographic profile of hard-to-contact and call-back respondents differed from that of easy-to-interview respondents. Including hard-to-contact respondents decreased the socio- demographic bias of the sample, while including call-back respondents increased it. Several significant differences in SRH behaviors emerged between easy-to-interview and hard-to-contact respondents, but none between first-wave and call-back respondents. Nevertheless, the determinants of SRH behaviors in call-back and hard-to-contact respondents differed with respect to easy-to-interview respondents. The trade-off between bias and financial costs suggests that the best protocol would be to mix the two strategies but with only one call-back wave involving a limited number of call attempts to achieve a sufficient sample size with optimal quality.
