J. DRUG EDUCATION, Vol. 43(1) 1-18, 2013
DRUG TAKING BELIEFS OF AUSTRALIAN ADOLESCENTS: A PILOT STUDY
GRACE SKRZYPIEC LAURENCE OWENS Flinders University, South Australia
ABSTRACT
In this study adolescents offered their insights and perspectives of factors associated with adolescent illicit drug taking intentions. The factors explored were identified using a cross-disciplinary approach involving the Theory of Planned Behavior (TPB) and criminological theories, and these formed the framework for data analysis. Interviews with 24 students aged 15-17 found that adolescents’ beliefs to drug taking attitudes, subjective norms, perceived behavioral control, moral norms, negative affect, and reputation enhancement involved a number a sub-themes that provided an in-depth understanding of the association of these components to intended drug use. The incorporation of these elements in drug education programs could be an effective approach in prevention interventions for adolescent drug use.
INTRODUCTION To identify factors related to drug taking and to understand why young people use drugs, some researchers (Conner & McMillan, 1999; Conner, Sherlock, & Orbell, 1998; Malmberg, Overbeek, Vermulsta, Monshouwer, Volleberghd, & Engelsa, 2012; McMillan & Conner, 2003; O’Callaghan & Joyce, 2006) have drawn upon the Theory of Planned Behavior (TPB) (Ajzen, 1991; Ajzen & Fishbein, 2005).
1 Ó 2013, Baywood Publishing Co., Inc. doi: http://dx.doi.org/10.2190/DE.43.1.a http://baywood.com
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This social psychological behavior theory postulates that “only a limited number of variables . . . need to be considered in order to predict, understand, change, or reinforce a given behavior” (Fishbein, 2008, p. 835). These studies were generally interested in testing the veracity of the TPB model with drug use. However, the TPB also provides a useful framework for developing interventions for behavior change (Fishbein, 2008) and education programs aimed at preventing, or changing, particular behaviors. According to Ajzen and Albarracin (2007), the TPB provides a suitable framework for modifying any behavior, provided the associated factors of the behavior in question are identified: “Fishbein and Ajzen proposed that we identify a particular behavior and then look for antecedents that can help to predict and explain the behavior of interest, and thus potentially provide a basis for interventions designed to modify it” (Ajzen & Albarracin, 2007, p. 4). A meta-analysis by Webb and Sheeran (2006), which examined 47 TPB intervention studies, found that changes in behavioral intentions engendered changes in behavior so “this model provides a worthwhile basis for developing interventions” (p. 261). Briefly, the TPB (Ajzen, 1991) postulates that there are three cognitive antecedents of one’s intentions to undertake any particular behavior and it proposes that the motivation to execute a particular behavior is related to this intention. As shown in Figure 1, behavioral intention is determined by three independent factors (which are not equal in their contribution), each of which has associated beliefs: 1. The attitude towards the behavior, which is a favorable or unfavorable evaluation of the behavior concerned. Behavioral beliefs are associated with, or may produce, a favorable or unfavorable attitude toward a behavior. Behavioral beliefs are beliefs about the likely outcome of the behavior and the evaluation of these outcomes. For example, if an individual evaluates the outcome of illicit drug use as negative, she/he will have an unfavorable attitude towards illicit drug use and is less likely to take drugs. 2. The subjective norm, which is a social factor associated with the perceived social pressure to undertake or relinquish the behavior. Normative beliefs result in perceived social pressure or subjective norms to undertake a behavior and include the normative expectations of others, which underlie a person’s motivation to comply with these expectations. For example, a young person may feel motivated to comply with her/his parent’s expectations to not use drugs or, alternatively, motivated to comply with the expectations of friends who are drug users and also take drugs. 3. Perceived behavioral control, which is the ease or difficulty perceived by the individual of executing the behavior. Control beliefs give rise to perceived behavioral control and are beliefs about the presence and power of factors that may facilitate or impede performance of the behavior. For example, some individuals may believe that it is easy to swallow a pill or smoke marijuana, but they might be unable to carry out the action because
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Figure 1. The Theory of Planned Behavior (TPB) (Ajzen, 1991).
they know it is illegal, or because they are under the supervision of parents or teachers. It is salient beliefs that are targeted in order to change or prevent a behavior when the TPB is utilized in interventions, and an understanding of these cognitive constructs as they relate to a particular behavior is, according to Fishbein (2008), the key to achieving these goals. While the TPB offers a theoretical framework for a study of any behavior, it is necessary to recognize that the aim of this research was to apply it to a specific context and population, namely the drug taking behavior of adolescent youth. According to Beck and Ajzen (1991), the application of the TPB in a context which involves dishonest or illegal actions, such as illicit drug use, requires careful investigation as factors not included in the TPB, such as moral norms, may influence this behavior. To address this proposition the criminological literature was scoured to identify possible additional factors from criminology theory. Since illicit drug use is prohibited, adolescents who take illicit drugs commit an offense, so it was considered appropriate to investigate theories that explained why people break this law. A theoretical paper by Agnew (1995), which identified the general motivators of antisocial behavior or crime, proved useful for this purpose. In his thesis, Agnew (1995) compared and contrasted major criminological theories to determine the key driving processes common to what he termed the “big three” theories (“control,” “differential association,” “strain”). He concluded that the theories were similar in all aspects except motivational processes, and that
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it was the explanation of “why” that is unique to each theory. The four motivational processes identified by Agnew that distinguished theories were: 1. 2. 3. 4.
the moral evaluation of crime; the rational evaluation of crime one’s level of negative affect; and one’s level of “freedom.”
The first process involves an individual’s moral assessment of the crime (in this case it would be a moral assessment of drug use) and if there is a positive evaluation this leads an individual to engage in that behavior (e.g., take drugs). This suggests that drug taking moral norms should be considered as another antecedent of drug taking intentions. The second process identified was associated with the rational evaluation of crime. This parallels the process postulated in the TPB, so no additional factors were considered necessary in relation to this motivational process. “Negative affect” was the third motivational process identified by Agnew (1995). This is more of an emotionally based concept that Agnew described as generated by “strain” or negative treatment by others, and which generally involves emotions of frustration and anger. According to Agnew (1992, 2003) “negative affect” has specific sources of beliefs associated with experiences of strain generated in situations where an individual is prevented from achieving positively valued goals, has positively valued stimuli removed (e.g., loss of a sibling, parent, or friend, moving to a new school, the divorce of one’s parents, or the loss of property), or is presented or threatened with noxious or negatively valued stimuli (e.g., child abuse and neglect, verbal threats and insults, criminal victimization, and adverse school experiences). The response to such circumstances is, according to Agnew (1995), not simply emotions of frustration and anger, but motivational emotions which “create pressure for corrective action” so that “the primary motivation . . . is not the anticipation of reinforcement; it is negative affect” (Agnew, 1995, p. 383; emphasis in original). This suggests that negative affect is a factor that exists independently of other motivators and is not merely a subset of attitudes. Studies which have found an association between drug use and strain provide empirical support for considering negative affect another antecedent of drug taking behavior (Agnew & White, 1992; Carson, Sullivan, Cochran, & Lersch, 2009). The last motivational process identified by Agnew (1995) is what he called “freedom” and it derives from control theory (Gottfedson & Hirschi, 1990). Agnew pointed out that control theorists would argue that the commission of crime is not due to negative affect or to favorable definitions of crime, but to an individual’s ability to exercise self-control, particularly with regard to adverse emotions such as frustration and anger. Agnew suggested that this mechanism could be measured “with many of the same questions used to measure the rational evaluation of crime” (Agnew, 1995, p. 385). This rational approach suggests a process akin to the TPB, which would involve attitudes and subjective norms and
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where “freedom” may be exercised through agency and self-efficacy, as described by the perceived behavioral control construct. Thus, the theoretically derived factors associated with drug taking intentions identified for this study (shown in Figure 2) included those postulated in the TPB, namely drug taking attitudes, subjective norms, and perceived behavioral control, as well as moral norms and negative affect gleaned from Agnew’s (1995) comparison of criminological theories. Furthermore, an additional factor—reputation enhancement—which emerged from the adolescent interviews (discussed below) was also added to this model. This research sought to investigate these factors in an elicitation study of drug taking behavioral intentions in order to develop
Figure 2. Proposed factors of drug taking intentions.
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an understanding of how they might be associated with drug use, from the perspective of adolescents. It is postulated that the inclusion of an adolescent perspective in a theory driven drug taking prevention intervention, or drug education program, would be better suited to adolescents who would be more likely to relate to cognitive elements described by their peers.
METHOD Twenty-four adolescents, comprising male and female known offenders, and non-offenders were interviewed individually about their drug taking beliefs. Known juvenile offenders were included in the study because they are much more likely than youths in the general population to have used illicit drugs during their lifetime (Prichard & Payne, 2005) and, therefore, would be well placed to offer informed beliefs about illicit drug use. They were students attending an alternative public school for troubled youth or residents in residential care homes located in various metropolitan suburbs of Adelaide, South Australia. Non-offenders were students at a secondary school located in a suburban area with a very low rate of adolescent crime (based on statistics obtained from the South Australian Office of Crime Statistics and Research). Young people from an Aboriginal school with non-offending students (according to the principal) also participated. Participation was voluntary and all respondents were paid a $30 reimbursement fee to cover any costs incurred due to the study. Participants Eleven of the participants were male and 12 were known offenders. The participants’ ages ranged from 15 to 17 (average = 16.3, SD = 0.82) years. Interviews were audio recorded, transcribed, and then thematically analyzed using QSR NVivo 8. Semi-structured Interviews A definition of drugs was not provided and participants were free to talk about drugs in a generic sense. A drug taking vignette was used and discussion was centered on what someone else would do in that circumstance. This averted the need to ask direct questions about a participant’s own behavior, and enabled discussions to be directed to a participant’s attitudes, opinions, and beliefs about drug taking without incrimination. The interview began with a simple vignette to initiate conversation and was followed by the drug taking scenario: “A group of kids are at a party. One of them offers a friend some drugs.” Participants were then asked a series of questions which explored their beliefs about drug taking.
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Data Analysis The transcripts were analyzed using an iterative “theoretical,” “semantic,” thematic analysis (Braun & Clarke, 2006) where the interpretation of data is based on a theoretical area of interest and where meaning is extracted from the words used by respondents. RESULTS AND DISCUSSION A number of sub-themes associated with each of the proposed antecedents of drug taking intentions were identified. Attitudes Attitudes formed the largest set of themes and the drug taking attitudes expressed by participants, whose quotes are labeled according to “M” male or “F” female, “NO” non-offender or “O” offender, and her/his age, were grouped as: 1. Evaluative: Drugs were assessed to be “bad.” Some participants were unequivocal that drugs were “bad,” “stupid,” and “disgusting.” 2. Experimental: Some participants felt that it was reasonable to experiment and give drugs a “try” as according to one participant: “You’ve got to try everything once everyone says, so that’s mostly why they’d do it—just try it’ (FNO, 17). Another participant suggested that “it’s sort of inevitable that teenagers and younger people are going to try drugs . . . probably everyone at some stage or another will probably experiment with that sort of stuff” (MNO, 17). However, several young people surmized that experimentation could lead to addiction as “it will become a habit, and it won’t be experimenting anymore” (FO, 16). 3. Health and Safety: Drugs were considered to have adverse physical effects and to be bad for one’s health as they “can damage your brain” (FNO, 17). The impact of drugs on health was explained by one person in terms of the short and long-term effects: If you have a cone of weed now and then it makes you feel better, but if you have it constantly, you kind of feel down. If you have the hard drugs, like speed or ecstasy, sort of stuffs up the brain . . . makes you feel real down . . . depressed. (MO, 17)
Of particular concern for some was that drug taking could be fatal as “Drugs kill fast for young people, because their body [sic] can’t take it” (FNO, 15). However, some felt that cannabis was safe compared to other drugs “because at least it doesn’t kill you” (MO, 15). 4. Fun: Drug taking was considered “fun.” Taking drugs at parties was considered by some as a necessity for a having a good time or to “have a slightly better time” (MO, 17). According to one participant “You need drugs or alcohol to have a good time. I guess it’s really about just having a good time” (FNO, 17). The type of
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enjoyment available from drugs was explained by another participant as: “taking drugs, you get that speed rush . . . that adrenalin rush, and you might as well go on a roller coaster as you’ll get the same feeling” (MNO, 15). Other participants categorically stated that taking drugs at parties and social events was not a requisite for having fun: “I don’t think drugs and alcohol are needed to have fun. Just being in an environment with the people that you want to be . . . and like, just socializing is fun” (FNO, 17). 5. Negative Consequences: In addition to harmful health effects, there were beliefs that drugs had other negative consequences such as uncontrolled behavior as “They can bring about violence. They can make you act differently . . . and uncontrollably” (FNO, 17) and “when people are on drugs they do silly things . . . like attacks, assaults, abuse, that sort of stuff” (FO, 16). The idea that drugs were particularly harmful for young people was a common belief: “it’s dangerous for young people . . . because of the stuff that it does to you . . . it just makes you all dizzy and you don’t know where you are . . . because you don’t know what you are doing” (MO, 16). A view that drugs would “mess up” one’s life was a strongly held belief by some participants. As one person expressed: “Drugs will just mess you up and you won’t have any good sense of direction after that” (FNO, 15). Participants found it easy to express their attitudes towards drug taking and their beliefs did not vary significantly between known offenders and non-offenders. There was a tendency however, for offenders to express both positive and negative beliefs of drug taking (particularly marijuana) and they were not as adamant about not using illicit drugs as non-offenders. Subjective Norms Respondents in the study talked freely about what they believed other people, such as parents and friends, thought about drug taking and three themes emerged from the analysis of the narratives. While peer norms and peer pressure were categorized as separate themes, these constructs are inexplicably linked. As the participants’ comments suggested, where drug taking is common practice (the norm) in a group of adolescents, there is pressure, either directly or indirectly, for an individual to join the group’s drug taking behavior. 1. Peer norms: Participants indicated that if a young person’s circle of friends approved of illicit drug use then this would be considered the group norm, as the following the quotes suggest: “If their friends have taught them that it’s okay, then they’re going to think it’s okay” (FNO, 16), and “It means like everyone’s doing it, so they’re gonna try to do it” (MO, 15). There was a belief among many of the participants that good friends would respect each other’s wishes about using or not using drugs. As one person explained: “If the friend that offered them the drugs was really a true friend, then they would respect the decision that the friend has made” (FNO, 17). However,
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pressure from peers could be implicitly related to an individual’s desire to fit in and be like everyone else, so a person wishing to be accepted would conform with the groups’ drug taking behavior, even if she or he was not explicitly pressured to do so. One person suggested that “It would be very hard to go out and not do it, when all of your friends are doing it” (FNO, 17) and another remarked that young people “are trying to feel like they fit into a group of people, and feel that if they take the drugs they’ll get respect . . . and fit in” (MNO, 17). 2. Peer Pressure: In the TPB, Ajzen and Fishbein (2005) theorized that subjective norms exert pressure on a person to undertake a particular behavior and such pressure was described by respondents as they expressed the strong influence of peers on drug taking. This was articulated by one participant who said: . . . say your friends are offering you drugs, and you’re in doubt saying “I don’t know. I don’t know. I don’t know if I should. I haven’t really tried it.” The friends that are offering drugs would say, “If you haven’t tried it how would you know what it’s like . . . see if it’s good . . . you should try it. Just try it man” . . . and pushing you towards taking the drugs . . . and then sooner or later, you give in . . . like most people give in to peer pressure. (MO, 17)
Similarly, One of their friends that they know, saying “here, have this here, have this here . . .” and the dude just keeps saying no and saying no, but then finally they give in . . . they’d keep pushing them to do it . . . and then that would make them end up taking it. (MO, 16)
The influence of peers on drug use is well documented in the literature (Branstetter, Low, & Furman, 2011; Heavyrunner-Rioux & Hollist, 2010), as are two processes, namely socialization and selection, that typify peer group influences (see Andrews, Tildesley, Hops, & Li, 2002). Socialization is the process whereby the peer group influences individuals to conform with its drug taking practices, while selection refers to individuals selecting peers with likeminded views of drug taking. The socialization influence is evident from the quotes already presented and in this quote by another participant which expresses the importance of friendships during adolescence: “It’s too hard to leave them and make new friends, so you just stay with them and you do what they do” (FO, 16). While not as common, the selection process was also referenced by a few of the participants as shown in the following quote: “My friends that I’ve known . . . now they’re dope smoking, needle pushing, drug addicts . . . and I have nothing to do with them anymore” (MO, 17). Some participants pointed out that during adolescence the views of parents were sometimes counteracted by peers, so that peer pressure outweighed parental guidance, as illustrated in the following statement: If your parents say no, and you come out, your friends are just like “Oh, it doesn’t matter what they think—you’re having fun anyway” . . . they’ll just
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contradict what your parents say . . . even if your parents get through to you, every now and again, your friends will change your mind somehow. (FNO, 17)
In this quote the participant has noted that parental advice is not without influence. Research has shown that a close relationship with parents acts as a protective factor against drug use (Wright & Cullen, 2001). 3. Parental influence: Generally, participants’ comments regarding parents were that they expected them to be angry and disappointed if they were to have knowledge that their child was using drugs. Most expected to receive some kind of punishment from them, as this quote shows: “Their parents would probably be fuming . . . they’d probably get grounded . . . probably get hit or yelled at” (FNO, 17). It was generally acknowledged, however, that parents “try their hardest to try and get their kids to stop by educating them” (MO, 16). Most of the participants believed that parents would view drug taking in a negative vein, as exemplified in this quotation: They [parents] wouldn’t be too impressed . . . if they found out their kid was taking drugs, like, their kid’s putting his life at risk, it’s affecting everyone around him . . . he’s making bad decisions that can only turn out worse. (MNO, 15)
“My mum would get like angry” (FNO, 15) was a sufficient reason some participants felt that they would not take drugs. However, it was reported that not all parents would disapprove of drug taking as indicated by these quotes: “Some of the adults don’t even care, but some who are strict, wouldn’t like it and wouldn’t let them do it in the house” (FO, 16), and “There are some adults who give the drugs to kids, so some people just don’t care for the kids, but there are some adults there who would care as well” (MO, 16). One respondent was aware that some parents also take drugs and would therefore not stop their children from using them: “Many [parents] would take drugs with them, if it’s in their environment and in their lifestyle already. I think they would just accept it. They wouldn’t try to stop them” (FNO, 17). Perceived Behavioral Control 1. Addiction: Participants’ reflections about perceived behavioral control with regard to drug taking centered generally on addiction: “it’s probably more an issue of trying to stop the addiction” (MO, 17), and “it could be that they’ve done it once and they want to keep going, because it’s an addiction” (FNO, 17). 2. Easy to get: Despite drugs being illegal, their availability was generally not considered an issue by study participants as “they’re easy to get your hands on, and quite popular” (FNO, 17); “getting asked to just go and have a smoke of marijuana,
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or whatever, is pretty common” (MNO, 17); and “I don’t know how, but it always seems to be available” (FNO, 17). 3. Self-efficacy: In terms of drug taking self-efficacy, participant discussions were not so much concerned with the relative ease or difficulty of taking drugs, but they generally centered on whether a young person wanted to take drugs or not, and how well they were able to stand by that decision. For example, “I think it would be more in themselves [sic] like they basically just don’t want to take it at all” (FNO, 17) and “if their friends were egging them on . . . but if they were strong in themselves as to what they believed in, and if they didn’t want to do it, then I don’t see there would really be any influence there” (FNO, 17). 4. Freedom: The essence of freedom and change in perceived behavioral control as young people grow and mature was well summarized by one participant who conceptualized it within a developmental framework: When you’re older, you know, your parents will let you out more . . . you’ve got more time, and you can stay out longer, and then when you’ve got your license, you can drive, and you know, you’re very independent, and you can make more decisions yourself. (FNO, 17)
For some adolescents in this study, perceived control was related to the young person’s sense that she or he was “free” to make decisions for her/himself and she or he was not bound by parental control and restrictions. This was borne out by participant statements such as: “They [parents] realize that it’s the child making the decision in the end anyway” (FNO, 17). The sense of freedom was related to whether parents were perceived to be strict. Some participants indicated that certain behaviors were out of the question as their parents were strict and being “grounded” would be the consequence of any transgressions. As one participant remarked, parents would think “I don’t want my kids to do this, so I’m gonna put strict rules on ’em,” aiming to curb behaviors such as drug taking. Moral Norms Analysis of the study narrative identified three moral themes of “righteousness,” an “outright rejection of drugs” and the “illegality” of illicit drugs. 1. Righteousness: Righteousness was associated with a sense that taking drugs was wrong and the way it was presented by participants fits well with Manstead’s (2000) description that moral norm “becomes independent of the immediate expectations and influence of others, virtually regardless of who those others might be” (p. 13). This was exemplified by one participant: “They go against their mates and do the right thing and not take them” (MNO, 15). 2. Outright rejection of drugs: Righteousness differed from an outright rejection of drugs, where the sentiment was more about having made a decision not to take drugs, with no mention being made of whether drug taking was right or
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wrong. For example, statements such as “NO (!), out of the question for me” (FNO, 15) and “I know it wouldn’t be for me” (MNO, 17) suggested that this was a subtle variation of this moral norm. 3. Illegality: The illegality of drug taking was also pointed out by some of the participants as a reason drug taking was considered the wrong thing to do, as shown in this quote: “I’ve grown up with that, that drugs are illegal my whole life, so it’s not anything different . . . I know that they are illegal and you can’t legally do it” (FNO, 17). However, the illegality of illicit drug use was not salient for most of the participants, as epitomized in this quote: “I reckon that [it’s illegal] would be floating through the person’s mind at the time, but it would probably be at the very back of the head” (MNO, 15). Some participants thought that illegality was not an important factor in the decision to take drugs. This was explained by one participant who used the following reasoning: “You can’t drink when you’re under age anyway, but that doesn’t stop a lot of people, so I don’t think that [drugs being illegal] would have anything to do with it” (FNO, 17). Negative Affect The idea of “relief,” “escape,” and poor self-image were linked to notions of negative affect. Participants showed an understanding of an association between negative affect and drug taking as they reflected on why young people might use drugs. Some respondents, who were not known offenders, had close friends or family members who were drug users and as they observed these significant others “getting into trouble” they surmised that it was due to elements of negative affect. One young person offered this insight about general criminal behavior: The hurt that they could have is child abuse from a younger age and they finally let out the anger—anger that they have kept in so long that they finally want to let it out and they let it out in the wrong way—which isn’t quite legal, but things seem to feel better after they have let that anger out. (FNO, 15)
1. Relief: Some of the participants linked drug taking to this negative affect, explaining that drugs offered “relief” from some of the harsh realities in life, as illustrated by the following quotes: “It’s maybe ’cause they’re like depressed . . . like they have problems in their lives . . . they think it’s wrong, but it gives them relief for a little while (FNO, 16), and “They’re only doing it because they think it’s a relief from their problems” (FNO, 17). 2. Escape: According to participants drug use also provided a means to “escape” from the stresses and pressures associated with adolescence and family life, as the following quotes suggest: Maybe it could relate back to troubles they have, whether it’s from at home in the family and their upbringing . . . if they have any anger in them, or just want to be rebellious, or things like that . . . or whether they just feel that life is just
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too hard, and is a real struggle, and drugs is [sic] a way of escaping. (MNO, 17) Because of their way of life is just . . . things are not going too well, so they just start using dope and stuff to relax them and take their mind off other stuff. (MO, 16) I think if your family environment is very happy, and you’re having fun, then you go out and you can experience the same thing . . . and you don’t need something to change that . . . but if your family environment isn’t, sometimes you need something to escape that, and to actually forget about it, and so you take drugs. (FNO, 17)
3. Poor self-image: A few participants made reference to one having a poor self-image as a factor in drug taking, and that refusing drugs would be easier if one was content with her or his self-image and self-esteem: “The reason for taking drugs might just be a lacking in someone’s self-esteem, or the way that they feel about themselves, and feel they need to enhance that” (MNO, 17); “It’d be easy to decline if you were happy with yourself” (FNO, 17); and “They feel inadequate and need to take the drugs” (MNO, 17). Reputation Enhancement It became evident during the interviews that some young people considered drug taking to be a “cool” behavior associated with a particular type of reputation. A link between having a “bad” reputation and offending has been found by Carroll, Houghton, Durkin, and Hattie (2009). Adolescents, they suggested, make a deliberate choice about how they wish to be viewed by others and they choose either conforming or non-conforming social goals on which to base their reputations. Delinquency, they argued, “is a deliberate choice, selected in order to achieve and maintain standing within a peer culture that values antiestablishment and tough behavior” (Carroll et al., 2009, p. 33). Reference was made by almost every respondent about behaviors such as graffiti, drug taking, stealing, and fighting being perceived as “cool” and associated with peer status by some individuals. For a few participants, a “cool” status among peers was considered desirable and its attainment could be indirectly linked to drug taking, as explained by one participant: If they want to be cool, they’ll use that to say “Oh, if you don’t take these [drugs] you won’t be cool and you won’t be hanging around us” . . . I mean they don’t actually say that, but that’s the message you get. (MO, 17)
However, while participants had an awareness that drug taking could be perceived as “cool,” it was not a sentiment that was generally endorsed and most of them were more likely to agree that: “It’s a cool thing to do—they think . . . (laughing) I don’t think that” (MNO, 17). The research of Carroll et al. (2009), and the views of participants, supports the supposition that reputation
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enhancement may be another element in adolescent drug use, and as such, it could be considered another possible antecedent of drug taking intentions. SUMMARY OF FINDINGS The findings indicated that there were different facets for each of the six theorized antecedents of drug taking intentions. Adolescent drug taking attitudes involved evaluative concepts that drugs were generally “bad” and varied beliefs about the experimental, health and safety, and fun aspects of drug taking as well as other negative consequences of drug use. In terms of subjective norms, adolescents were aware of peer norms and peer pressure associated with drug taking and parental influence with regard to chastizing or supporting adolescent drug use. Perceived behavioral control of drug taking centered mostly on avoiding addiction, but also included views that drugs were easy to get. Self-efficacy was determined by one’s resolve to not use drugs rather than with any perceived difficulty of use. Perceived behavioral control was also associated with the freedom attained with development as parents restricted their children less during the older adolescent years, making decisions to take drugs easier, although some parents were strict. Righteousness, an outright rejection of drugs, and illegality were the main aspects of moral norms associated with drug taking behavior, while negative affect was associated with having a poor self-image, with drugs providing relief and a means of escape from stressful life experiences. For some individuals drug taking was perceived as a “cool” behavior and one that provided reputation enhancement for social status amongst peers. Directions for Drug Education Programs According to the TPB, it is an understanding of these drug taking factors and the role they play in drug taking behavioral intentions, which would be used in the development of an adolescent drug taking education program or intervention. For example, drug taking is a behavior which is more likely to be endorsed by friends who use drugs themselves, so strategies for how young people could handle peer pressure should be included in any education program. A drug education module on peer pressure should include strategies which strengthen self-efficacy and control so that individuals feel able to make and stand-by decisions which are contrary to those of their peers. Negative affect is also an aspect of drug use that should be included in a program. Rather than fearing that this element would inform young people of a means to “escape” or find “relief” during troubled times, a negative affect module could be used to present alternative strategies for coping that would empower adolescents and direct them away from drug use. A similar approach could be employed to address recreational drug use. To determine how use is made of the drug taking FACTORS explored in this research we can draw from other researchers, such as Jemmott and Jemmott (see
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Jemmott, Jemmott, & Fong, 1992; Jemmott & Jemmott, 2007; Villarruel, Jemmott, & Jemmott, 2006), whose TPB research spans nearly two decades. Jemmott et al. (1992) began with elicitation studies, similar to the one described in this article, to identify the salient beliefs and factors associated with the behavior in question within the population of interest and developed an intervention based on this information. Jemmott and Jemmott (2007) specified that it was important that an intervention not only provide participants with information, but that participants’ skills and confidence should also be developed to enable them to undertake appropriate behaviors. Transference of this approach to a drug education program or drug use prevention intervention, would mean that strategies should be included to develop adolescents’ agency and self-efficacy to engage in behaviors that facilitate decisions to not use drugs. For example, methods should be developed to enable adolescents and assist them in dealing with peer pressure to take drugs, or to find other ways to “escape” and find “relief” from stressful life events, to avoid “experimenting” with illicit drugs or to seek other “cool” reputation enhancing behaviors. The type of activities that would be appropriate for the targeted age group was also a consideration by Jemmott and Jemmott (2007) who concluded that “adolescents would benefit most from short activities that involve active participation, concrete concepts, sufficient variation to keep their interest, and sufficient repetition to ensure integration of the most important beliefs” (p. 248). They recognized that participants were accustomed to watching television, so they utilized videos to depict various realistic situations to which students could easily relate. The specially produced videos evoked students’ feelings, attitudes, beliefs, and thoughts about the behavior in question and provided messages about prevention in an interesting and entertaining way. They also added a theme, “Be Proud! Be Responsible,” to reflect pride and responsibility, not just for oneself but for the family and community. Applied in this context, videos and role plays are possible, and use can be made of online resources and websites. While beliefs associated with the TPB antecedents can be identified and strategies developed to influence those beliefs, Fishbein (2008) stressed that the key to evoking effective influences on behavior was in designing successful communications for this purpose. In other words, in determining how messages could be most effectively received by adolescents. A starting point is to incorporate an adolescent perspective which would be driven more by the adolescent voice than an authoritarian adult point of view. In a review of school interventions, Yeager and Walton (2011) showed that it is possible to change behavior by targeting “students’ thoughts, feelings, and beliefs” (p. 1) using interventions which are not heavy-handed, which do not stigmatize students or identify them as being in need, which minimize resistance to the message, and which actively engage students in the intervention. While the intervention studies Yeager and Walton reviewed were aimed at improving school achievement, it is possible to transfer some of the strategies and methods that were used, particularly by incorporating the adolescent
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perspective. The tools developed in the interventions reviewed by Yeager and Walton (2011) were reliant on “a rich tradition of research on persuasion and attitude change to powerfully convey psychological ideas” (p. 276), so could readily be used to inform the design and development of a drug prevention program which conveyed the cognitive constructs of adolescent drug use intentions as described by them, and as reported in this study. Study Limitations Although it is likely that many of the findings would align with the general views of adolescents, caution should be exercised in generalizing the findings from this research as study participants were small in number and not representative of Australian adolescents. Furthermore, illicit drugs in this research were not demarcated and separated into different drug types such as marijuana, amphetamines, opiates, inhalants, and steroids, and it is possible that attitudes to using different types of drugs would vary among adolescents. For example, as some participants noted, marijuana is considered by some users as a “safe” drug, while some other drugs are considered dangerous (Muir, Mullen, Powell, Flaxman, Thompson, & Griffiths, 2009). There would be benefit in undertaking further research to understand adolescents’ beliefs in using different types of illicit drugs. CONCLUSION Based on findings from this study and other research (as discussed above), a school-based drug prevention program would be designed in a manner that utilized the best known communication strategies, with interactive activities that would best suit adolescents and which incorporated an adolescent perspective of drug taking attitudes, subjective norms, perceived control, negative affect, moral norms, and reputation enhancement, as described in this study. REFERENCES Agnew, R. (1992). Foundation for a general strain theory of crime and delinquency. Criminology, 30, 47-87. Agnew, R. (1995). Testing the leading crime theories: An alternative strategy focusing on motivational processes. Journal of Research in Crime and Delinquency, 32(4), 363-398. Agnew, R. (2003). The interactive effects of social control variables on delinquency. In C. L. Britt, & M. R. Gottfredson (Eds.), Control theories of crime and delinquency. Advances in criminological theory, vol. 12 (pp. 53-76). New Brunswick, NJ: Transaction Publishers. Agnew, R., & White, H. R. (1992). An empirical test of general strain theory. Criminology, 30, 475-499.
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Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211. Ajzen, I., & Albarracin, D. (2007). Predicting and changing behavior: A reasoned action approach. In I. Ajzen, D. Albarracin, & R. Hornik (Eds.), Prediction and change of health behavior: Applying the reasoned action approach (pp. 3-21). Mahwah, NJ: Lawrence Erlbaum Associates. Ajzen, I., & Fishbein, M. (2005). The influence of attitudes on behavior. In D. Albarracin, B. T. Johnson, & M. P. Zanna (Eds.), The handbook of attitudes (pp. 173-221). Mahwah, NJ: Erlbaum. Andrews, J. A., Tildesley, E., Hops, H., & Li, F. (2002). The influence of peers on young adult substance use. Health Psychology, 21(4), 349-357. Beck, L., & Ajzen, I. (1991). Predicting dishonest actions using the theory of planned behavior. Journal of Research in Personality, 25, 285-301. Branstetter, S. A., Low, S., & Furman, W. (2011). The influence of parents and friends on adolescent substance use: A multidimensional approach. Journal of Substance Use, 16, 150-160. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101. Carroll, A., Houghton, S., Durkin, K., & Hattie, J. A. (2009). Adolescent reputations and risk: Developmental trajectories to delinquency. New York, NY: Springer. Carson, D., Sullivan, C. J., Cochran, J. K., & Lersch, K. (2009). General strain theory and the relationship between early victimization and drug use. Deviant Behavior, 30, 54-88. Conner, M., & McMillan, B. (1999). Interaction effects in the theory of planned behavior: Studying cannabis use. British Journal of Social Psychology, 38, 195-222. Conner, M., Sherlock, K., & Orbell, S. (1998). Psychosocial determinants of ecstasy use in young people in the UK. British Journal of Health Psychology, 3, 295-317. Fishbein, M. (2008). A reasoned action approach to health promotion. Medical Decision Making, 28, 834-844. Gottfredson, M. R., & Hirschi, T. (1990). A general theory of crime. Stanford, CA: Stanford University Press. Heavyrunner-Rioux, A. R., & Hollist, D. R. (2010). Community, family, and peer influences on alcohol, marijuana, and illicit drug use among a sample of Native American youth: An analysis of predictive factors. Journal of Ethnicity in Substance Abuse, 9(4), 260-283. Jemmott, J. B., III., Jemmott, L. S., & Fong, G. T. (1992). Reductions in HIV riskassociated sexual behaviors among Black male adolescents: Effects of an AIDS prevention intervention. American Journal of Public Health, 82(3), 372-377. Jemmott, L. S., & Jemmott, J. B., III. (2007). Applying the theory of reasoned action to HIV risk-reduction behavioral interventions. In I. Ajzen, D. Albarracin, & R. Hornik (Eds.), Prediction and change of health behavior: Applying the reasoned action approach (pp. 243-264). Mahwah, NJ: Lawrence Erlbaum Associates. Malmberg, M., Overbeek, G., Vermulsta, A., Monshouwer, K., Volleberghd, W., & Engelsa, R. (2012). The theory of planned behavior: Precursors of marijuana use in early adolescence? Drug and Alcohol Dependence, 123, 22-28. Manstead, A. S. R. (2000). The role of moral norm in the attitude-behavior relation. In D. J. Terry, & M. A. Hogg (Eds.), Attitudes, behavior, and social context (pp. 11-30). Mahwah, NJ: Lawrence Erlbaum.
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McMillan, B., & Conner, M. (2003). Applying an extended version of the theory of planned behavior to illicit drug use among students. Journal of Applied Social Psychology, 33(8), 1662-1683. Muir, K., Mullan, K., Powell, A., Flaxman, S., Thompson, D., & Griffiths, M. (2009). State of Australia’s young people: A Report on the social, economic, health and family lives of young people. Canberra: Office for Youth. O’Callaghan, F. V., & Joyce, J. (2006). Cannabis: What makes university students more or less likely to use it? Journal of Applied Biobehavioral Research, 11(2), 105-113. Prichard, J., & Payne, J. (2005). Alcohol, drugs and crime: A study of juveniles in detention. Research and public policy series no 67, Canberra: Australian Institute of Criminology. Villarruel, A. M., Jemmott, J. B., III, & Jemmott, L. S. (2006). A randomized controlled trial testing an HIV prevention intervention for Latino youth. Archives of Pediatrics and Adolescent Medicine, 160(8), 772-777. Webb, T. L., & Sheeran, P. (2006). Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence. Psychological Bulletin, 132, 249-268. Wright, J. P., & Cullen, F. T. (2001). Parental efficacy and delinquent behavior: Do control and support matter? Criminology, 39, 677-705. Yeager, D. S., & Walton, G. M. (2011). Social-Psychological interventions in education: They’re not magic. Review of Educational Research, 81(2), 267-301.
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DRUG TAKING BELIEFS OF AUSTRALIAN ADOLESCENTS: A PILOT STUDY
GRACE SKRZYPIEC LAURENCE OWENS Flinders University, South Australia
ABSTRACT
In this study adolescents offered their insights and perspectives of factors associated with adolescent illicit drug taking intentions. The factors explored were identified using a cross-disciplinary approach involving the Theory of Planned Behavior (TPB) and criminological theories, and these formed the framework for data analysis. Interviews with 24 students aged 15-17 found that adolescents’ beliefs to drug taking attitudes, subjective norms, perceived behavioral control, moral norms, negative affect, and reputation enhancement involved a number a sub-themes that provided an in-depth understanding of the association of these components to intended drug use. The incorporation of these elements in drug education programs could be an effective approach in prevention interventions for adolescent drug use.
INTRODUCTION To identify factors related to drug taking and to understand why young people use drugs, some researchers (Conner & McMillan, 1999; Conner, Sherlock, & Orbell, 1998; Malmberg, Overbeek, Vermulsta, Monshouwer, Volleberghd, & Engelsa, 2012; McMillan & Conner, 2003; O’Callaghan & Joyce, 2006) have drawn upon the Theory of Planned Behavior (TPB) (Ajzen, 1991; Ajzen & Fishbein, 2005).
1 Ó 2013, Baywood Publishing Co., Inc. doi: http://dx.doi.org/10.2190/DE.43.1.a http://baywood.com
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This social psychological behavior theory postulates that “only a limited number of variables . . . need to be considered in order to predict, understand, change, or reinforce a given behavior” (Fishbein, 2008, p. 835). These studies were generally interested in testing the veracity of the TPB model with drug use. However, the TPB also provides a useful framework for developing interventions for behavior change (Fishbein, 2008) and education programs aimed at preventing, or changing, particular behaviors. According to Ajzen and Albarracin (2007), the TPB provides a suitable framework for modifying any behavior, provided the associated factors of the behavior in question are identified: “Fishbein and Ajzen proposed that we identify a particular behavior and then look for antecedents that can help to predict and explain the behavior of interest, and thus potentially provide a basis for interventions designed to modify it” (Ajzen & Albarracin, 2007, p. 4). A meta-analysis by Webb and Sheeran (2006), which examined 47 TPB intervention studies, found that changes in behavioral intentions engendered changes in behavior so “this model provides a worthwhile basis for developing interventions” (p. 261). Briefly, the TPB (Ajzen, 1991) postulates that there are three cognitive antecedents of one’s intentions to undertake any particular behavior and it proposes that the motivation to execute a particular behavior is related to this intention. As shown in Figure 1, behavioral intention is determined by three independent factors (which are not equal in their contribution), each of which has associated beliefs: 1. The attitude towards the behavior, which is a favorable or unfavorable evaluation of the behavior concerned. Behavioral beliefs are associated with, or may produce, a favorable or unfavorable attitude toward a behavior. Behavioral beliefs are beliefs about the likely outcome of the behavior and the evaluation of these outcomes. For example, if an individual evaluates the outcome of illicit drug use as negative, she/he will have an unfavorable attitude towards illicit drug use and is less likely to take drugs. 2. The subjective norm, which is a social factor associated with the perceived social pressure to undertake or relinquish the behavior. Normative beliefs result in perceived social pressure or subjective norms to undertake a behavior and include the normative expectations of others, which underlie a person’s motivation to comply with these expectations. For example, a young person may feel motivated to comply with her/his parent’s expectations to not use drugs or, alternatively, motivated to comply with the expectations of friends who are drug users and also take drugs. 3. Perceived behavioral control, which is the ease or difficulty perceived by the individual of executing the behavior. Control beliefs give rise to perceived behavioral control and are beliefs about the presence and power of factors that may facilitate or impede performance of the behavior. For example, some individuals may believe that it is easy to swallow a pill or smoke marijuana, but they might be unable to carry out the action because
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Figure 1. The Theory of Planned Behavior (TPB) (Ajzen, 1991).
they know it is illegal, or because they are under the supervision of parents or teachers. It is salient beliefs that are targeted in order to change or prevent a behavior when the TPB is utilized in interventions, and an understanding of these cognitive constructs as they relate to a particular behavior is, according to Fishbein (2008), the key to achieving these goals. While the TPB offers a theoretical framework for a study of any behavior, it is necessary to recognize that the aim of this research was to apply it to a specific context and population, namely the drug taking behavior of adolescent youth. According to Beck and Ajzen (1991), the application of the TPB in a context which involves dishonest or illegal actions, such as illicit drug use, requires careful investigation as factors not included in the TPB, such as moral norms, may influence this behavior. To address this proposition the criminological literature was scoured to identify possible additional factors from criminology theory. Since illicit drug use is prohibited, adolescents who take illicit drugs commit an offense, so it was considered appropriate to investigate theories that explained why people break this law. A theoretical paper by Agnew (1995), which identified the general motivators of antisocial behavior or crime, proved useful for this purpose. In his thesis, Agnew (1995) compared and contrasted major criminological theories to determine the key driving processes common to what he termed the “big three” theories (“control,” “differential association,” “strain”). He concluded that the theories were similar in all aspects except motivational processes, and that
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it was the explanation of “why” that is unique to each theory. The four motivational processes identified by Agnew that distinguished theories were: 1. 2. 3. 4.
the moral evaluation of crime; the rational evaluation of crime one’s level of negative affect; and one’s level of “freedom.”
The first process involves an individual’s moral assessment of the crime (in this case it would be a moral assessment of drug use) and if there is a positive evaluation this leads an individual to engage in that behavior (e.g., take drugs). This suggests that drug taking moral norms should be considered as another antecedent of drug taking intentions. The second process identified was associated with the rational evaluation of crime. This parallels the process postulated in the TPB, so no additional factors were considered necessary in relation to this motivational process. “Negative affect” was the third motivational process identified by Agnew (1995). This is more of an emotionally based concept that Agnew described as generated by “strain” or negative treatment by others, and which generally involves emotions of frustration and anger. According to Agnew (1992, 2003) “negative affect” has specific sources of beliefs associated with experiences of strain generated in situations where an individual is prevented from achieving positively valued goals, has positively valued stimuli removed (e.g., loss of a sibling, parent, or friend, moving to a new school, the divorce of one’s parents, or the loss of property), or is presented or threatened with noxious or negatively valued stimuli (e.g., child abuse and neglect, verbal threats and insults, criminal victimization, and adverse school experiences). The response to such circumstances is, according to Agnew (1995), not simply emotions of frustration and anger, but motivational emotions which “create pressure for corrective action” so that “the primary motivation . . . is not the anticipation of reinforcement; it is negative affect” (Agnew, 1995, p. 383; emphasis in original). This suggests that negative affect is a factor that exists independently of other motivators and is not merely a subset of attitudes. Studies which have found an association between drug use and strain provide empirical support for considering negative affect another antecedent of drug taking behavior (Agnew & White, 1992; Carson, Sullivan, Cochran, & Lersch, 2009). The last motivational process identified by Agnew (1995) is what he called “freedom” and it derives from control theory (Gottfedson & Hirschi, 1990). Agnew pointed out that control theorists would argue that the commission of crime is not due to negative affect or to favorable definitions of crime, but to an individual’s ability to exercise self-control, particularly with regard to adverse emotions such as frustration and anger. Agnew suggested that this mechanism could be measured “with many of the same questions used to measure the rational evaluation of crime” (Agnew, 1995, p. 385). This rational approach suggests a process akin to the TPB, which would involve attitudes and subjective norms and
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where “freedom” may be exercised through agency and self-efficacy, as described by the perceived behavioral control construct. Thus, the theoretically derived factors associated with drug taking intentions identified for this study (shown in Figure 2) included those postulated in the TPB, namely drug taking attitudes, subjective norms, and perceived behavioral control, as well as moral norms and negative affect gleaned from Agnew’s (1995) comparison of criminological theories. Furthermore, an additional factor—reputation enhancement—which emerged from the adolescent interviews (discussed below) was also added to this model. This research sought to investigate these factors in an elicitation study of drug taking behavioral intentions in order to develop
Figure 2. Proposed factors of drug taking intentions.
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an understanding of how they might be associated with drug use, from the perspective of adolescents. It is postulated that the inclusion of an adolescent perspective in a theory driven drug taking prevention intervention, or drug education program, would be better suited to adolescents who would be more likely to relate to cognitive elements described by their peers.
METHOD Twenty-four adolescents, comprising male and female known offenders, and non-offenders were interviewed individually about their drug taking beliefs. Known juvenile offenders were included in the study because they are much more likely than youths in the general population to have used illicit drugs during their lifetime (Prichard & Payne, 2005) and, therefore, would be well placed to offer informed beliefs about illicit drug use. They were students attending an alternative public school for troubled youth or residents in residential care homes located in various metropolitan suburbs of Adelaide, South Australia. Non-offenders were students at a secondary school located in a suburban area with a very low rate of adolescent crime (based on statistics obtained from the South Australian Office of Crime Statistics and Research). Young people from an Aboriginal school with non-offending students (according to the principal) also participated. Participation was voluntary and all respondents were paid a $30 reimbursement fee to cover any costs incurred due to the study. Participants Eleven of the participants were male and 12 were known offenders. The participants’ ages ranged from 15 to 17 (average = 16.3, SD = 0.82) years. Interviews were audio recorded, transcribed, and then thematically analyzed using QSR NVivo 8. Semi-structured Interviews A definition of drugs was not provided and participants were free to talk about drugs in a generic sense. A drug taking vignette was used and discussion was centered on what someone else would do in that circumstance. This averted the need to ask direct questions about a participant’s own behavior, and enabled discussions to be directed to a participant’s attitudes, opinions, and beliefs about drug taking without incrimination. The interview began with a simple vignette to initiate conversation and was followed by the drug taking scenario: “A group of kids are at a party. One of them offers a friend some drugs.” Participants were then asked a series of questions which explored their beliefs about drug taking.
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Data Analysis The transcripts were analyzed using an iterative “theoretical,” “semantic,” thematic analysis (Braun & Clarke, 2006) where the interpretation of data is based on a theoretical area of interest and where meaning is extracted from the words used by respondents. RESULTS AND DISCUSSION A number of sub-themes associated with each of the proposed antecedents of drug taking intentions were identified. Attitudes Attitudes formed the largest set of themes and the drug taking attitudes expressed by participants, whose quotes are labeled according to “M” male or “F” female, “NO” non-offender or “O” offender, and her/his age, were grouped as: 1. Evaluative: Drugs were assessed to be “bad.” Some participants were unequivocal that drugs were “bad,” “stupid,” and “disgusting.” 2. Experimental: Some participants felt that it was reasonable to experiment and give drugs a “try” as according to one participant: “You’ve got to try everything once everyone says, so that’s mostly why they’d do it—just try it’ (FNO, 17). Another participant suggested that “it’s sort of inevitable that teenagers and younger people are going to try drugs . . . probably everyone at some stage or another will probably experiment with that sort of stuff” (MNO, 17). However, several young people surmized that experimentation could lead to addiction as “it will become a habit, and it won’t be experimenting anymore” (FO, 16). 3. Health and Safety: Drugs were considered to have adverse physical effects and to be bad for one’s health as they “can damage your brain” (FNO, 17). The impact of drugs on health was explained by one person in terms of the short and long-term effects: If you have a cone of weed now and then it makes you feel better, but if you have it constantly, you kind of feel down. If you have the hard drugs, like speed or ecstasy, sort of stuffs up the brain . . . makes you feel real down . . . depressed. (MO, 17)
Of particular concern for some was that drug taking could be fatal as “Drugs kill fast for young people, because their body [sic] can’t take it” (FNO, 15). However, some felt that cannabis was safe compared to other drugs “because at least it doesn’t kill you” (MO, 15). 4. Fun: Drug taking was considered “fun.” Taking drugs at parties was considered by some as a necessity for a having a good time or to “have a slightly better time” (MO, 17). According to one participant “You need drugs or alcohol to have a good time. I guess it’s really about just having a good time” (FNO, 17). The type of
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enjoyment available from drugs was explained by another participant as: “taking drugs, you get that speed rush . . . that adrenalin rush, and you might as well go on a roller coaster as you’ll get the same feeling” (MNO, 15). Other participants categorically stated that taking drugs at parties and social events was not a requisite for having fun: “I don’t think drugs and alcohol are needed to have fun. Just being in an environment with the people that you want to be . . . and like, just socializing is fun” (FNO, 17). 5. Negative Consequences: In addition to harmful health effects, there were beliefs that drugs had other negative consequences such as uncontrolled behavior as “They can bring about violence. They can make you act differently . . . and uncontrollably” (FNO, 17) and “when people are on drugs they do silly things . . . like attacks, assaults, abuse, that sort of stuff” (FO, 16). The idea that drugs were particularly harmful for young people was a common belief: “it’s dangerous for young people . . . because of the stuff that it does to you . . . it just makes you all dizzy and you don’t know where you are . . . because you don’t know what you are doing” (MO, 16). A view that drugs would “mess up” one’s life was a strongly held belief by some participants. As one person expressed: “Drugs will just mess you up and you won’t have any good sense of direction after that” (FNO, 15). Participants found it easy to express their attitudes towards drug taking and their beliefs did not vary significantly between known offenders and non-offenders. There was a tendency however, for offenders to express both positive and negative beliefs of drug taking (particularly marijuana) and they were not as adamant about not using illicit drugs as non-offenders. Subjective Norms Respondents in the study talked freely about what they believed other people, such as parents and friends, thought about drug taking and three themes emerged from the analysis of the narratives. While peer norms and peer pressure were categorized as separate themes, these constructs are inexplicably linked. As the participants’ comments suggested, where drug taking is common practice (the norm) in a group of adolescents, there is pressure, either directly or indirectly, for an individual to join the group’s drug taking behavior. 1. Peer norms: Participants indicated that if a young person’s circle of friends approved of illicit drug use then this would be considered the group norm, as the following the quotes suggest: “If their friends have taught them that it’s okay, then they’re going to think it’s okay” (FNO, 16), and “It means like everyone’s doing it, so they’re gonna try to do it” (MO, 15). There was a belief among many of the participants that good friends would respect each other’s wishes about using or not using drugs. As one person explained: “If the friend that offered them the drugs was really a true friend, then they would respect the decision that the friend has made” (FNO, 17). However,
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pressure from peers could be implicitly related to an individual’s desire to fit in and be like everyone else, so a person wishing to be accepted would conform with the groups’ drug taking behavior, even if she or he was not explicitly pressured to do so. One person suggested that “It would be very hard to go out and not do it, when all of your friends are doing it” (FNO, 17) and another remarked that young people “are trying to feel like they fit into a group of people, and feel that if they take the drugs they’ll get respect . . . and fit in” (MNO, 17). 2. Peer Pressure: In the TPB, Ajzen and Fishbein (2005) theorized that subjective norms exert pressure on a person to undertake a particular behavior and such pressure was described by respondents as they expressed the strong influence of peers on drug taking. This was articulated by one participant who said: . . . say your friends are offering you drugs, and you’re in doubt saying “I don’t know. I don’t know. I don’t know if I should. I haven’t really tried it.” The friends that are offering drugs would say, “If you haven’t tried it how would you know what it’s like . . . see if it’s good . . . you should try it. Just try it man” . . . and pushing you towards taking the drugs . . . and then sooner or later, you give in . . . like most people give in to peer pressure. (MO, 17)
Similarly, One of their friends that they know, saying “here, have this here, have this here . . .” and the dude just keeps saying no and saying no, but then finally they give in . . . they’d keep pushing them to do it . . . and then that would make them end up taking it. (MO, 16)
The influence of peers on drug use is well documented in the literature (Branstetter, Low, & Furman, 2011; Heavyrunner-Rioux & Hollist, 2010), as are two processes, namely socialization and selection, that typify peer group influences (see Andrews, Tildesley, Hops, & Li, 2002). Socialization is the process whereby the peer group influences individuals to conform with its drug taking practices, while selection refers to individuals selecting peers with likeminded views of drug taking. The socialization influence is evident from the quotes already presented and in this quote by another participant which expresses the importance of friendships during adolescence: “It’s too hard to leave them and make new friends, so you just stay with them and you do what they do” (FO, 16). While not as common, the selection process was also referenced by a few of the participants as shown in the following quote: “My friends that I’ve known . . . now they’re dope smoking, needle pushing, drug addicts . . . and I have nothing to do with them anymore” (MO, 17). Some participants pointed out that during adolescence the views of parents were sometimes counteracted by peers, so that peer pressure outweighed parental guidance, as illustrated in the following statement: If your parents say no, and you come out, your friends are just like “Oh, it doesn’t matter what they think—you’re having fun anyway” . . . they’ll just
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contradict what your parents say . . . even if your parents get through to you, every now and again, your friends will change your mind somehow. (FNO, 17)
In this quote the participant has noted that parental advice is not without influence. Research has shown that a close relationship with parents acts as a protective factor against drug use (Wright & Cullen, 2001). 3. Parental influence: Generally, participants’ comments regarding parents were that they expected them to be angry and disappointed if they were to have knowledge that their child was using drugs. Most expected to receive some kind of punishment from them, as this quote shows: “Their parents would probably be fuming . . . they’d probably get grounded . . . probably get hit or yelled at” (FNO, 17). It was generally acknowledged, however, that parents “try their hardest to try and get their kids to stop by educating them” (MO, 16). Most of the participants believed that parents would view drug taking in a negative vein, as exemplified in this quotation: They [parents] wouldn’t be too impressed . . . if they found out their kid was taking drugs, like, their kid’s putting his life at risk, it’s affecting everyone around him . . . he’s making bad decisions that can only turn out worse. (MNO, 15)
“My mum would get like angry” (FNO, 15) was a sufficient reason some participants felt that they would not take drugs. However, it was reported that not all parents would disapprove of drug taking as indicated by these quotes: “Some of the adults don’t even care, but some who are strict, wouldn’t like it and wouldn’t let them do it in the house” (FO, 16), and “There are some adults who give the drugs to kids, so some people just don’t care for the kids, but there are some adults there who would care as well” (MO, 16). One respondent was aware that some parents also take drugs and would therefore not stop their children from using them: “Many [parents] would take drugs with them, if it’s in their environment and in their lifestyle already. I think they would just accept it. They wouldn’t try to stop them” (FNO, 17). Perceived Behavioral Control 1. Addiction: Participants’ reflections about perceived behavioral control with regard to drug taking centered generally on addiction: “it’s probably more an issue of trying to stop the addiction” (MO, 17), and “it could be that they’ve done it once and they want to keep going, because it’s an addiction” (FNO, 17). 2. Easy to get: Despite drugs being illegal, their availability was generally not considered an issue by study participants as “they’re easy to get your hands on, and quite popular” (FNO, 17); “getting asked to just go and have a smoke of marijuana,
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or whatever, is pretty common” (MNO, 17); and “I don’t know how, but it always seems to be available” (FNO, 17). 3. Self-efficacy: In terms of drug taking self-efficacy, participant discussions were not so much concerned with the relative ease or difficulty of taking drugs, but they generally centered on whether a young person wanted to take drugs or not, and how well they were able to stand by that decision. For example, “I think it would be more in themselves [sic] like they basically just don’t want to take it at all” (FNO, 17) and “if their friends were egging them on . . . but if they were strong in themselves as to what they believed in, and if they didn’t want to do it, then I don’t see there would really be any influence there” (FNO, 17). 4. Freedom: The essence of freedom and change in perceived behavioral control as young people grow and mature was well summarized by one participant who conceptualized it within a developmental framework: When you’re older, you know, your parents will let you out more . . . you’ve got more time, and you can stay out longer, and then when you’ve got your license, you can drive, and you know, you’re very independent, and you can make more decisions yourself. (FNO, 17)
For some adolescents in this study, perceived control was related to the young person’s sense that she or he was “free” to make decisions for her/himself and she or he was not bound by parental control and restrictions. This was borne out by participant statements such as: “They [parents] realize that it’s the child making the decision in the end anyway” (FNO, 17). The sense of freedom was related to whether parents were perceived to be strict. Some participants indicated that certain behaviors were out of the question as their parents were strict and being “grounded” would be the consequence of any transgressions. As one participant remarked, parents would think “I don’t want my kids to do this, so I’m gonna put strict rules on ’em,” aiming to curb behaviors such as drug taking. Moral Norms Analysis of the study narrative identified three moral themes of “righteousness,” an “outright rejection of drugs” and the “illegality” of illicit drugs. 1. Righteousness: Righteousness was associated with a sense that taking drugs was wrong and the way it was presented by participants fits well with Manstead’s (2000) description that moral norm “becomes independent of the immediate expectations and influence of others, virtually regardless of who those others might be” (p. 13). This was exemplified by one participant: “They go against their mates and do the right thing and not take them” (MNO, 15). 2. Outright rejection of drugs: Righteousness differed from an outright rejection of drugs, where the sentiment was more about having made a decision not to take drugs, with no mention being made of whether drug taking was right or
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wrong. For example, statements such as “NO (!), out of the question for me” (FNO, 15) and “I know it wouldn’t be for me” (MNO, 17) suggested that this was a subtle variation of this moral norm. 3. Illegality: The illegality of drug taking was also pointed out by some of the participants as a reason drug taking was considered the wrong thing to do, as shown in this quote: “I’ve grown up with that, that drugs are illegal my whole life, so it’s not anything different . . . I know that they are illegal and you can’t legally do it” (FNO, 17). However, the illegality of illicit drug use was not salient for most of the participants, as epitomized in this quote: “I reckon that [it’s illegal] would be floating through the person’s mind at the time, but it would probably be at the very back of the head” (MNO, 15). Some participants thought that illegality was not an important factor in the decision to take drugs. This was explained by one participant who used the following reasoning: “You can’t drink when you’re under age anyway, but that doesn’t stop a lot of people, so I don’t think that [drugs being illegal] would have anything to do with it” (FNO, 17). Negative Affect The idea of “relief,” “escape,” and poor self-image were linked to notions of negative affect. Participants showed an understanding of an association between negative affect and drug taking as they reflected on why young people might use drugs. Some respondents, who were not known offenders, had close friends or family members who were drug users and as they observed these significant others “getting into trouble” they surmised that it was due to elements of negative affect. One young person offered this insight about general criminal behavior: The hurt that they could have is child abuse from a younger age and they finally let out the anger—anger that they have kept in so long that they finally want to let it out and they let it out in the wrong way—which isn’t quite legal, but things seem to feel better after they have let that anger out. (FNO, 15)
1. Relief: Some of the participants linked drug taking to this negative affect, explaining that drugs offered “relief” from some of the harsh realities in life, as illustrated by the following quotes: “It’s maybe ’cause they’re like depressed . . . like they have problems in their lives . . . they think it’s wrong, but it gives them relief for a little while (FNO, 16), and “They’re only doing it because they think it’s a relief from their problems” (FNO, 17). 2. Escape: According to participants drug use also provided a means to “escape” from the stresses and pressures associated with adolescence and family life, as the following quotes suggest: Maybe it could relate back to troubles they have, whether it’s from at home in the family and their upbringing . . . if they have any anger in them, or just want to be rebellious, or things like that . . . or whether they just feel that life is just
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too hard, and is a real struggle, and drugs is [sic] a way of escaping. (MNO, 17) Because of their way of life is just . . . things are not going too well, so they just start using dope and stuff to relax them and take their mind off other stuff. (MO, 16) I think if your family environment is very happy, and you’re having fun, then you go out and you can experience the same thing . . . and you don’t need something to change that . . . but if your family environment isn’t, sometimes you need something to escape that, and to actually forget about it, and so you take drugs. (FNO, 17)
3. Poor self-image: A few participants made reference to one having a poor self-image as a factor in drug taking, and that refusing drugs would be easier if one was content with her or his self-image and self-esteem: “The reason for taking drugs might just be a lacking in someone’s self-esteem, or the way that they feel about themselves, and feel they need to enhance that” (MNO, 17); “It’d be easy to decline if you were happy with yourself” (FNO, 17); and “They feel inadequate and need to take the drugs” (MNO, 17). Reputation Enhancement It became evident during the interviews that some young people considered drug taking to be a “cool” behavior associated with a particular type of reputation. A link between having a “bad” reputation and offending has been found by Carroll, Houghton, Durkin, and Hattie (2009). Adolescents, they suggested, make a deliberate choice about how they wish to be viewed by others and they choose either conforming or non-conforming social goals on which to base their reputations. Delinquency, they argued, “is a deliberate choice, selected in order to achieve and maintain standing within a peer culture that values antiestablishment and tough behavior” (Carroll et al., 2009, p. 33). Reference was made by almost every respondent about behaviors such as graffiti, drug taking, stealing, and fighting being perceived as “cool” and associated with peer status by some individuals. For a few participants, a “cool” status among peers was considered desirable and its attainment could be indirectly linked to drug taking, as explained by one participant: If they want to be cool, they’ll use that to say “Oh, if you don’t take these [drugs] you won’t be cool and you won’t be hanging around us” . . . I mean they don’t actually say that, but that’s the message you get. (MO, 17)
However, while participants had an awareness that drug taking could be perceived as “cool,” it was not a sentiment that was generally endorsed and most of them were more likely to agree that: “It’s a cool thing to do—they think . . . (laughing) I don’t think that” (MNO, 17). The research of Carroll et al. (2009), and the views of participants, supports the supposition that reputation
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enhancement may be another element in adolescent drug use, and as such, it could be considered another possible antecedent of drug taking intentions. SUMMARY OF FINDINGS The findings indicated that there were different facets for each of the six theorized antecedents of drug taking intentions. Adolescent drug taking attitudes involved evaluative concepts that drugs were generally “bad” and varied beliefs about the experimental, health and safety, and fun aspects of drug taking as well as other negative consequences of drug use. In terms of subjective norms, adolescents were aware of peer norms and peer pressure associated with drug taking and parental influence with regard to chastizing or supporting adolescent drug use. Perceived behavioral control of drug taking centered mostly on avoiding addiction, but also included views that drugs were easy to get. Self-efficacy was determined by one’s resolve to not use drugs rather than with any perceived difficulty of use. Perceived behavioral control was also associated with the freedom attained with development as parents restricted their children less during the older adolescent years, making decisions to take drugs easier, although some parents were strict. Righteousness, an outright rejection of drugs, and illegality were the main aspects of moral norms associated with drug taking behavior, while negative affect was associated with having a poor self-image, with drugs providing relief and a means of escape from stressful life experiences. For some individuals drug taking was perceived as a “cool” behavior and one that provided reputation enhancement for social status amongst peers. Directions for Drug Education Programs According to the TPB, it is an understanding of these drug taking factors and the role they play in drug taking behavioral intentions, which would be used in the development of an adolescent drug taking education program or intervention. For example, drug taking is a behavior which is more likely to be endorsed by friends who use drugs themselves, so strategies for how young people could handle peer pressure should be included in any education program. A drug education module on peer pressure should include strategies which strengthen self-efficacy and control so that individuals feel able to make and stand-by decisions which are contrary to those of their peers. Negative affect is also an aspect of drug use that should be included in a program. Rather than fearing that this element would inform young people of a means to “escape” or find “relief” during troubled times, a negative affect module could be used to present alternative strategies for coping that would empower adolescents and direct them away from drug use. A similar approach could be employed to address recreational drug use. To determine how use is made of the drug taking FACTORS explored in this research we can draw from other researchers, such as Jemmott and Jemmott (see
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Jemmott, Jemmott, & Fong, 1992; Jemmott & Jemmott, 2007; Villarruel, Jemmott, & Jemmott, 2006), whose TPB research spans nearly two decades. Jemmott et al. (1992) began with elicitation studies, similar to the one described in this article, to identify the salient beliefs and factors associated with the behavior in question within the population of interest and developed an intervention based on this information. Jemmott and Jemmott (2007) specified that it was important that an intervention not only provide participants with information, but that participants’ skills and confidence should also be developed to enable them to undertake appropriate behaviors. Transference of this approach to a drug education program or drug use prevention intervention, would mean that strategies should be included to develop adolescents’ agency and self-efficacy to engage in behaviors that facilitate decisions to not use drugs. For example, methods should be developed to enable adolescents and assist them in dealing with peer pressure to take drugs, or to find other ways to “escape” and find “relief” from stressful life events, to avoid “experimenting” with illicit drugs or to seek other “cool” reputation enhancing behaviors. The type of activities that would be appropriate for the targeted age group was also a consideration by Jemmott and Jemmott (2007) who concluded that “adolescents would benefit most from short activities that involve active participation, concrete concepts, sufficient variation to keep their interest, and sufficient repetition to ensure integration of the most important beliefs” (p. 248). They recognized that participants were accustomed to watching television, so they utilized videos to depict various realistic situations to which students could easily relate. The specially produced videos evoked students’ feelings, attitudes, beliefs, and thoughts about the behavior in question and provided messages about prevention in an interesting and entertaining way. They also added a theme, “Be Proud! Be Responsible,” to reflect pride and responsibility, not just for oneself but for the family and community. Applied in this context, videos and role plays are possible, and use can be made of online resources and websites. While beliefs associated with the TPB antecedents can be identified and strategies developed to influence those beliefs, Fishbein (2008) stressed that the key to evoking effective influences on behavior was in designing successful communications for this purpose. In other words, in determining how messages could be most effectively received by adolescents. A starting point is to incorporate an adolescent perspective which would be driven more by the adolescent voice than an authoritarian adult point of view. In a review of school interventions, Yeager and Walton (2011) showed that it is possible to change behavior by targeting “students’ thoughts, feelings, and beliefs” (p. 1) using interventions which are not heavy-handed, which do not stigmatize students or identify them as being in need, which minimize resistance to the message, and which actively engage students in the intervention. While the intervention studies Yeager and Walton reviewed were aimed at improving school achievement, it is possible to transfer some of the strategies and methods that were used, particularly by incorporating the adolescent
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perspective. The tools developed in the interventions reviewed by Yeager and Walton (2011) were reliant on “a rich tradition of research on persuasion and attitude change to powerfully convey psychological ideas” (p. 276), so could readily be used to inform the design and development of a drug prevention program which conveyed the cognitive constructs of adolescent drug use intentions as described by them, and as reported in this study. Study Limitations Although it is likely that many of the findings would align with the general views of adolescents, caution should be exercised in generalizing the findings from this research as study participants were small in number and not representative of Australian adolescents. Furthermore, illicit drugs in this research were not demarcated and separated into different drug types such as marijuana, amphetamines, opiates, inhalants, and steroids, and it is possible that attitudes to using different types of drugs would vary among adolescents. For example, as some participants noted, marijuana is considered by some users as a “safe” drug, while some other drugs are considered dangerous (Muir, Mullen, Powell, Flaxman, Thompson, & Griffiths, 2009). There would be benefit in undertaking further research to understand adolescents’ beliefs in using different types of illicit drugs. CONCLUSION Based on findings from this study and other research (as discussed above), a school-based drug prevention program would be designed in a manner that utilized the best known communication strategies, with interactive activities that would best suit adolescents and which incorporated an adolescent perspective of drug taking attitudes, subjective norms, perceived control, negative affect, moral norms, and reputation enhancement, as described in this study. REFERENCES Agnew, R. (1992). Foundation for a general strain theory of crime and delinquency. Criminology, 30, 47-87. Agnew, R. (1995). Testing the leading crime theories: An alternative strategy focusing on motivational processes. Journal of Research in Crime and Delinquency, 32(4), 363-398. Agnew, R. (2003). The interactive effects of social control variables on delinquency. In C. L. Britt, & M. R. Gottfredson (Eds.), Control theories of crime and delinquency. Advances in criminological theory, vol. 12 (pp. 53-76). New Brunswick, NJ: Transaction Publishers. Agnew, R., & White, H. R. (1992). An empirical test of general strain theory. Criminology, 30, 475-499.
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Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211. Ajzen, I., & Albarracin, D. (2007). Predicting and changing behavior: A reasoned action approach. In I. Ajzen, D. Albarracin, & R. Hornik (Eds.), Prediction and change of health behavior: Applying the reasoned action approach (pp. 3-21). Mahwah, NJ: Lawrence Erlbaum Associates. Ajzen, I., & Fishbein, M. (2005). The influence of attitudes on behavior. In D. Albarracin, B. T. Johnson, & M. P. Zanna (Eds.), The handbook of attitudes (pp. 173-221). Mahwah, NJ: Erlbaum. Andrews, J. A., Tildesley, E., Hops, H., & Li, F. (2002). The influence of peers on young adult substance use. Health Psychology, 21(4), 349-357. Beck, L., & Ajzen, I. (1991). Predicting dishonest actions using the theory of planned behavior. Journal of Research in Personality, 25, 285-301. Branstetter, S. A., Low, S., & Furman, W. (2011). The influence of parents and friends on adolescent substance use: A multidimensional approach. Journal of Substance Use, 16, 150-160. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101. Carroll, A., Houghton, S., Durkin, K., & Hattie, J. A. (2009). Adolescent reputations and risk: Developmental trajectories to delinquency. New York, NY: Springer. Carson, D., Sullivan, C. J., Cochran, J. K., & Lersch, K. (2009). General strain theory and the relationship between early victimization and drug use. Deviant Behavior, 30, 54-88. Conner, M., & McMillan, B. (1999). Interaction effects in the theory of planned behavior: Studying cannabis use. British Journal of Social Psychology, 38, 195-222. Conner, M., Sherlock, K., & Orbell, S. (1998). Psychosocial determinants of ecstasy use in young people in the UK. British Journal of Health Psychology, 3, 295-317. Fishbein, M. (2008). A reasoned action approach to health promotion. Medical Decision Making, 28, 834-844. Gottfredson, M. R., & Hirschi, T. (1990). A general theory of crime. Stanford, CA: Stanford University Press. Heavyrunner-Rioux, A. R., & Hollist, D. R. (2010). Community, family, and peer influences on alcohol, marijuana, and illicit drug use among a sample of Native American youth: An analysis of predictive factors. Journal of Ethnicity in Substance Abuse, 9(4), 260-283. Jemmott, J. B., III., Jemmott, L. S., & Fong, G. T. (1992). Reductions in HIV riskassociated sexual behaviors among Black male adolescents: Effects of an AIDS prevention intervention. American Journal of Public Health, 82(3), 372-377. Jemmott, L. S., & Jemmott, J. B., III. (2007). Applying the theory of reasoned action to HIV risk-reduction behavioral interventions. In I. Ajzen, D. Albarracin, & R. Hornik (Eds.), Prediction and change of health behavior: Applying the reasoned action approach (pp. 243-264). Mahwah, NJ: Lawrence Erlbaum Associates. Malmberg, M., Overbeek, G., Vermulsta, A., Monshouwer, K., Volleberghd, W., & Engelsa, R. (2012). The theory of planned behavior: Precursors of marijuana use in early adolescence? Drug and Alcohol Dependence, 123, 22-28. Manstead, A. S. R. (2000). The role of moral norm in the attitude-behavior relation. In D. J. Terry, & M. A. Hogg (Eds.), Attitudes, behavior, and social context (pp. 11-30). Mahwah, NJ: Lawrence Erlbaum.
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McMillan, B., & Conner, M. (2003). Applying an extended version of the theory of planned behavior to illicit drug use among students. Journal of Applied Social Psychology, 33(8), 1662-1683. Muir, K., Mullan, K., Powell, A., Flaxman, S., Thompson, D., & Griffiths, M. (2009). State of Australia’s young people: A Report on the social, economic, health and family lives of young people. Canberra: Office for Youth. O’Callaghan, F. V., & Joyce, J. (2006). Cannabis: What makes university students more or less likely to use it? Journal of Applied Biobehavioral Research, 11(2), 105-113. Prichard, J., & Payne, J. (2005). Alcohol, drugs and crime: A study of juveniles in detention. Research and public policy series no 67, Canberra: Australian Institute of Criminology. Villarruel, A. M., Jemmott, J. B., III, & Jemmott, L. S. (2006). A randomized controlled trial testing an HIV prevention intervention for Latino youth. Archives of Pediatrics and Adolescent Medicine, 160(8), 772-777. Webb, T. L., & Sheeran, P. (2006). Does changing behavioral intentions engender behavior change? A meta-analysis of the experimental evidence. Psychological Bulletin, 132, 249-268. Wright, J. P., & Cullen, F. T. (2001). Parental efficacy and delinquent behavior: Do control and support matter? Criminology, 39, 677-705. Yeager, D. S., & Walton, G. M. (2011). Social-Psychological interventions in education: They’re not magic. Review of Educational Research, 81(2), 267-301.
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