The Social Contexts of Drug Offers and Their Relationship to Drug Use of Rural Hawaiian Youth

Purpose: Several epidemiological studies have indicated that Native Hawaiian youth are initiated early into drug use (Lai & Saka, 2005), have high rates of drug use (Wong, Klingle, & Price, 2004), and suffer adverse psychosocial and behavioral consequences as a result of their use (Else, Andrade, & Nahulu, 2007; Ramisetty-Mikler, Caetano, Goebert, & Nishimura, 2004). The purposes of this study were to examine the differences in drug use between Hawaiian and Non-Hawaiian youth in rural communities, and to explore the relationship between drug offers and drug use of Native Hawaiian youth in these communities.

Method: Two hundred and forty nine youth (194 Native Hawaiian youth) from 7 different middle or intermediate schools on the Big Island of Hawai‘i completed a recently developed survey focused on drug offers of rural Hawaiian youth (the Hawaiian Youth Drug Offers Survey, or HYDOS; Okamoto, Helm, Giroux, Edwards, & Kulis, 2009). The HYDOS is comprised of 62 items, and measures the frequency of exposure to offers for alcohol, tobacco, and other drugs (from 0 = “Never” to 4 = “More than 10 times”). Descriptive statistics, t-tests, and chi-square analyses were conducted to examine the differences in drug offers and drug use between Hawaiian and non-Hawaiian youth. Logistic regression analyses with the Hawaiian subsample were used to explore the influence of peer pressure, family drug offers and context, and unanticipated drug offers on drug use, controlling for several demographic variables (i.e., age, grade, SES, family structure, and gender).

Results: In terms of recent drug use (i.e., within the past 4 weeks), the mean for both Hawaiian and non-Hawaiian youth ranged between 0 (indicating no use) and 1 (indicating use one time). Compared with non-Hawaiian youth, Hawaiian youth had significantly higher mean scores for the use of alcohol, t(162) = 3.85, p < .001, and marijuana, t(121) = 2.14, p < .05. Similarly, Hawaiian and non-Hawaiian respondents differed significantly in reporting any recent use of alcohol (31.6% versus 21.7%), c² (1, N = 245) = 7.63, p < .01, and marijuana (14.5% versus 3.6%), c² (1, N = 248) = 4.76, p < .05. After controlling for several demographic variables, the regression results demonstrated that family drug offers and context predicted recent alcohol use, peer pressure and family drug offers and context predicted recent cigarette use, and unanticipated drug offers and family drug offers and context predicted recent marijuana use. Odds ratios for these relationships ranged from 17.44 to 2.75.

Conclusions: Hawaiian youth in this study used alcohol and marijuana at rates approximately three times higher than their non-Hawaiian counterparts, suggesting that Hawaiian youth may be at increased risk for drug abuse and drug-related health and behavioral problems as they enter adolescence. Logistic regression results revealed that family drug offers and context predicted the use of the widest variety of substances for Hawaiian youth. The findings highlight the importance of incorporating family context in the content and/or delivery of drug prevention programs for rural Hawaiian youth.