ADDRESSING YOUTH AND YOUNG ADULT SUBSTANCE USE IN FRANKLIN COUNTY
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- Horace Waters
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1 The Vermont Prevention Model: The Vermont Prevention Model highlights levels of intervention, or change, to improve health. ADDRESSING YOUTH AND YOUNG ADULT SUBSTANCE USE IN FRANKLIN COUNTY FACT: Young people who begin drinking before age 15 are 4 times more likely to develop alcoholism than those who begin drinking at age 21. FACT: In 2011,Vermont ranked #1 in the country for alcohol consumption among year olds, with 18% of that age group self-reporting alcohol use in the past month. The Vermont Prevention Model seeks to prevent and reduce the impact of substance use disorders through a variety of strategic approaches, from societal, broad-based policy approaches such as national and state law, to individual decisions. Alcohol, tobacco, marijuana, and other drugs permeate our culture. Policy and procedural changes at the national, state, and local level are an important part of the solution. The facts help explain why.
2 THE RETAIL ENVIRONMENT AND YOUTH ALCOHOL/TOBACCO USE (Taken from Small Change/Big Impact, a publication of Vermont Department of Health) Tobacco Facts and Figures The facts 1 speak for themselves: Tobacco ads do increase the number of underage smokers. The tobacco industry spends approximately $27.4 million on marketing in Vermont each year ($12.8 billion in the U.S.). Youth are three times as sensitive as adults to tobacco advertising. A May 2007 study found that retail cigarette advertising increased the likelihood that youth would begin smoking; cigarette promotions increased the likelihood that youth would move from experimentation to regular smoking. The study found that reducing or eliminating these retail marketing practices would significantly reduce youth smoking. Point-of-sale displays are the dominant channel for advertising cigarettes, and adolescents are routinely exposed to these messages. Roughly 75% of tobacco marketing dollars are spent on retail outlets. One study from 2010 explored the relationship between exposure to retail cigarette advertising and smoking initiation among adolescents. After 12 months, 18% of the adolescents in the study had begun smoking, but the number rose to 29% among students who visited convenience, liquor, or small grocery stores at least twice per week. These stores had significant numbers of tobacco advertisements and promotions. Both Price Chopper and Hannaford supermarkets in New York have changed their cigarette display case fronts from clear to opaque so consumers do not see the packaging. Prices are displayed in black and white with no promotional material. In November 2010, the FDA revealed proposed new warning labels on cigarette packages. These labels provide graphic reminders of tobacco s dangers, depicting a diseased lung, a man smoking through a tracheostomy tube and a woman holding a baby in a smoke-filled room. These images are required under a recent law that gives the FDA power to regulate tobacco products for the first time. By October 2012, manufacturers will not be able to distribute cigarettes in the U.S. without the graphic health warnings. 1 These facts and figures come from: Pediatrics: Official Journal of the American Academy of Pediatrics. 2010; Pollay R. The last straw? Cigarette advertising and realized market shares among youth and adults. Journal of Marketing. 1996; 60(2):1-16; Slater SJ et al., The impact of retail cigarette marketing practices on youth smoking uptake, Archives of Pediatrics and Adolescent Medicine. 2007; 161:
3 Alcohol Facts and Figures Alcohol advertising and marketing have a significant impact on youth decisions to drink. Greater exposure to alcohol advertising contributes to an increase in drinking among underage customers. Among 3,000 middle school students in South Dakota, exposure to in-store beer displays in grade 7 predicted onset of drinking by grade 9. In Maine, 69% of adolescents surveyed said that alcohol advertising appeals to underage youth. Respondents remembered point-of sale ads almost as much as they remembered television ads, 80% to 87%. Binge drinking in the past 30 days by college students is correlated with volume discounts, price specials and the total amount of alcohol advertising at retail outlets such as liquor stores, convenience stores and groceries near campuses. Training store clerks in best practice to prevent underage alcohol sales is also important. In the 2009 Youth Risk Behavior Survey, 5% of students in grades 8-12 who drank in the past 30 days reported that their usual source of alcohol was a store such as a convenience store, supermarket, gas station or liquor store. Further, 30% reported that they gave someone money to buy alcohol for them. Over half of those who purchased alcohol, or had alcohol purchased for them, reported usually drinking beer, malt beverages or wine coolers in the past 30 days. Additionally, the 2008 Young Adult Survey of Vermonters ages found that 30% of respondents thought it would be somewhat or very easy for persons ages 1820 to purchase alcohol in stores, and 60% thought it was somewhat or very likely that an obviously intoxicated person would be sold alcohol at a convenience store in their community. Based on data collected by the Vermont Department of Liquor Control (DLC), alcohol sellers who have been trained by DLC educators face-to-face at a liquor control seminar are more successful in not selling to underage buyers than those sellers trained in-house or not at all. The more people who are trained by the DLC educators, the higher the compliance rate for alcohol purchases. Vermont Department of Liquor Control seminar training should be the preferred method for educating anyone selling alcohol in order to decrease the availability of age-restricted products to underage youth.2 2 These facts and figures come from: Snyder LB, Milici FF, Slater M, Sun H, and Strizhakova Y, Effects of alcohol advertising exposure on drinking among youth, Archives of Pediatrics
4 Estimates indicate the alcohol market includes: 17.5% underage drinkers 20+% alcohol abusive/dependent drinkers (Archives of Pediatrics and Adolescent Medicine, 2006) STATES CAN MAKE A DIFFERENCE States can adopt policies that reflect evidence-based practices to influence the availability of and access to substances. States control alcohol availability through: Maintaining a minimum legal drinking age (MLDA); A statewide system of regulation, distribution, and enforcement; Social host laws that provide penalties for furnishing and enabling alcohol use by minors; Statewide restrictions on advertising and marketing; Traffic laws that establish limits on driving after the use of psychoactive substances; Laws that limit alcohol service to intoxicated patrons; Laws that limit alcohol and tobacco license-holders hours of operation. MUNICIPALITIES CAN MAKE A DIFFERENCE Towns can influence the availability of and access to substances through: Restrictions on advertising; Adopting open container ordinances that limit consumption in public places; Prohibiting alcohol, tobacco, and marijuana use in public parks; Limiting density of alcohol/tobacco outlets in concentrated areas; Establishing a vision statement that addresses substance use in municipal plans; Collaborating with community partners to address prevention, treatment, and enforcement of existing laws; Laws that limit hours of operation; Laws that restrict alcohol/tobacco licensees near schools. HEALTH CARE PROVIDERS INFLUENCE TEEN USE Evidence suggests that when doctors and nurses ask young people about their substance use, they help prevent or reduce use. For this reason, we encourage health and Adolescent Medicine. 2006; 160:18-24: Ellickson PL, Collins RL, Hambarsoomians K, and McCaffrey DR, Does alcohol advertising promote adolescent drinking? Results from a longitudinal assessment, Addiction. 2005; 100: Maine Youth Empowerment and Policy Project 2007; Kuo M, Wechsler H, Greenberg P, Lee H. The marketing of alcohol to college students: the role of low prices and special promotions, American Journal of Preventive Medicine. 2003; 25 (3):204-11
5 care providers to ask everyone about their use of substances at every visit and to offer encouragement and resources to stop using substances for those patience who divulge use. PARENTS MAKE A DIFFERENCE Parents and guardians are the first defense against adolescent substance use. Parents help their kids resist use when they: Talk with their kids and teens and listen. Set clear boundaries and expectations around substance use. Establish a policy with their children. Ask their children questions about where they are going and with whom. Refrain from engaging their children in their use (by asking them to serve them a beer, for example). Model responsible behavior around alcohol and other substances. Get help if they have a substance use problem. MARIJUANA LEGALIZATION AND USE Marijuana is legal as a prescribed medicine in Vermont, and it is decriminalized in small amounts. At the federal level, marijuana is neither legal nor approved as a medicine. Can you think of any other medicine that is also legal as a recreational drug? Adolescent marijuana use has been linked with: Lower school achievement Decrease in IQ Earlier onset of schizophrenia in people with a predisposition to the disease. Depression Adult dependency We hope Vermont will take plenty of time to observe what is happening in other states where cannabis has been legalized before making a decision whether to legalize and regulate its use in Vermont. Prepared by Franklin County Caring Communities, 67 Fairfield Street, St. Albans, VT Please contact Caring Communities at or info@fcccp.org for more information.
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