282688
Witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents
Roman Pabayo, PhD,
Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
Beth E. Molnar, ScD,
Institute on Urban Health Research, Bouvé College of Health Sciences, Northeastern University, Boston, MA
Ichiro Kawachi, MD, PhD,
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
Background: Witnessing violence has been linked to maladaptive coping behaviors such as smoking, alcohol consumption, and marijuana use. However, more research is required to identify mechanisms in which witnessing violence leads to these behaviors. Purpose: To examine the association between witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents; To identify whether depression was a mediator within this relationship; To determine if those who had adult support in school were less likely to engage in risky health behaviors. Methods: Data were collected from a sample of 1,878 urban students, from 18 public high schools participating in the 2008 Boston Youth Survey. In 2012, we used multilevel log-binomial regression models and propensity score matching to estimate the association between witnessing a violent death and the smoking, alcohol consumption, and marijuana-use. Results: Analyses indicated that girls who witnessed a violent death were more likely to smoke (RR=1.06, 95% CI=1.00,1.12) consume alcohol (RR=1.08, 95% CI=0.98,1.18) and use marijuana (RR=1.09, 95% CI=1.02, 1.17). Among boys, those who witnessed a violent death were significantly more likely to smoke (RR=1.23, 95% CI=1.14,1.33), consume alcohol (RR=1.30, 95% CI=1.17,1.44), and use marijuana (RR=1.35, 95% CI=1.23, 1.48). When depression was included, estimates were attenuated. Among girls who witnessed a violent death, having an adult at school for support was protective against alcohol consumption. When we used Propensity Score Matching, findings were similar among boys only. Conclusion: This study adds insight into how witnessing violence can lead to adoption of adverse health behaviors.
Learning Areas:
Epidemiology
Public health or related public policy
Social and behavioral sciences
Learning Objectives:
Describe the association between witnessing a violent death and smoking, alcohol consumption, and marijuana use among adolescents.
Identify depression as a potential mediator of this relationship.
Evaluate if those who had adult support in school were less likely to engage in risky health behaviors.
Keyword(s): Violence, Adolescent Health
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am a postdoctoral fellow who has been awarded a postdoctoral fellowship award by the Canadian Institutes of Health Research to conduct research on social determinants of health.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
