title: Is the Association between Neighborhood Drug Prevalence and Marijuana use Independent of Peer Drug and Alcohol Norms? Results from a Household Survey of Urban Youth.
abstract: To inform policy debates surrounding marijuana decriminalization and add to our understanding of social and structural influences on youth drug use, we sought to determine whether there was an independent association between neighborhood drug prevalence and individual-level marijuana use after controlling for peer drug and alcohol norms. We analyzed cross-sectional data from a household survey of 563 youth aged 15-24 in Baltimore, Maryland. The study population was 88 % African-American. Using gender-stratified, weighted, multilevel logistic regression, we tested whether neighborhood drug prevalence was associated with individual-level marijuana use after controlling for peer drug and alcohol norms. Bivariate analyses identified a significant association between high neighborhood drug prevalence and marijuana use among female youth (AOR = 1.76, 95% CI = 1.26, 2.47); the association was in a similar direction but not significant among male youth (AOR = 1.26, 95% CI = 0.85, 1.87). In multivariable regression controlling for peer drug and alcohol norms, high neighborhood drug prevalence remained significantly associated among female youth (AOR = 1.59, 95% CI = 1.12, 2.27). Among male youth, the association was attenuated toward the null (AOR = 0.95, 95% CI = 0.63, 1.45). In the multivariable model, peer drug and alcohol norms were significantly associated with individual-level marijuana use among female youth (AOR = 1.54, 95% CI = 1.17, 2.04) and male youth (AOR = 2.59, 95% CI = 1.65, 4.07). This work suggests that individual-level marijuana use among female youth is associated with neighborhood drug prevalence independent of peer norms. This finding may have important implications as the policy landscape around marijuana use changes.
authors.affiliation: Center for Child & Community Health Research, Department of Pediatrics, Johns Hopkins School of Medicine, Mason F. Lord Building, Center Tower-Suite 4200, 5200 Eastern Avenue, Baltimore, MD, 21224, USA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Leifheit
authors.forename: Jenita
authors.initials: J
authors.lastname: Parekh
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Matson
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Moulton
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Ellen
authors.forename: Jacky M
authors.initials: JM
authors.lastname: Jennings
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D015142:Baltimore / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology* / Q000523:psychology; D010379:Peer Group; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult