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The effects of peer and romantic partner substance use

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Title:
The effects of peer and romantic partner substance use how using behaviors and injunctive norms influence alcohol, tobacco and marijuana use in late adolescence
Creator:
Firisck, Dylan Michael
Publication Date:
Language:
English
Physical Description:
ix, 87 leaves : ; 28 cm

Subjects

Subjects / Keywords:
Teenagers -- Alcohol use ( lcsh )
Teenagers -- Tobacco use ( lcsh )
Teenagers -- Substance use ( lcsh )
Marijuana abuse ( lcsh )
Peer pressure in adolescence ( lcsh )
Interpersonal relations in adolescence ( lcsh )
Interpersonal relations in adolescence ( fast )
Marijuana abuse ( fast )
Peer pressure in adolescence ( fast )
Teenagers -- Alcohol use ( fast )
Teenagers -- Substance use ( fast )
Teenagers -- Tobacco use ( fast )
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bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

Notes

Bibliography:
Includes bibliographical references (leaves 79-87).
General Note:
Department of Psychology ; Clinical Psychology Program
Statement of Responsibility:
by Dylan Michael Firisck.

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University of Colorado Denver Collections
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Auraria Library
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All applicable rights reserved by the source institution and holding location.
Resource Identifier:
757517651 ( OCLC )
ocn757517651
Classification:
LD1193.L645 2011m F57 ( lcc )

Full Text
/I
THE EFFECTS OF PEER AND ROMANTIC PARTNER SUBSTANCE USE: HOW
USING BEHAVIORS AND INJUNCTIVE NORMS INFLUENCE ALCOHOL, TOBACCO
AND MARIJUANA USE IN LATE ADOLESCENCE
by
Dylan Michael Firsick
B.A., Biola University, 2009
A thesis submitted to the
University of Colorado Denver
in partial fulfillment
of the requirements for the degree of
Masters of Arts
Clinical Psychology
2011


This thesis for the Master of Arts
degree by
Dylan Michael Firsick
has been approved
by
Elizabeth S. Allen
Richard Allen
Date


Firsick, Dylan Michael (M.A., Clinical Psychology]
The Effects of Peer and Romantic Partner Substance Use: How Using Behaviors
and Injunctive Norms Influence Alcohol, Tobacco and Marijuana Use in Late
Adolescence
Thesis directed by Professor Elizabeth S. Allen
ABSTRACT
Adolescence is a developmental period in which individuals are particularly
vulnerable to social influence. Research has consistently found peer group attitudes and
behaviors to be strong predictors of adolescent behavior especially regarding substance
use (Etcheverry & Agnew, 2008; Kristjansson et al., 2010; Morgan & Grube, 1991,
Urberg et al., 1997; Wang et al., 2009; Wills et al., 2004]. As individuals progress
through adolescence, peer relationships may begin to become secondary to romantic
partner relationships; however, recent authors have identified a gap in the academic
literature pertaining to romantic partner influence as compared to peer group influence
during adolescence (Collins, Welsh & Furman, 2009; Furman & Collins, 2008; Haynie et
al., 2005; Kierkus, 2009; Miller et al, 2010; van der Zwaluw et al., 2009). The present
study investigated romantic partner and close peer use and approval of use as
predictors of both use versus non-use, and frequency of use, for alcohol, tobacco and
marijuana for college students in late adolescence. In a sample of 186 college student
participants aged 18-22, romantic partner frequency of use and approval of use were
found to significantly predict individual use, in many instances above and beyond the
influence of close peers. Romantic partner variables were significant in all analyses
predicting both use versus non-use and frequency of use among users for alcohol;
however, the significance of this predictor was inconsistent for tobacco and marijuana.
Gender and problem use behavior were also examined as moderators among peer and
partner variables; however, these interactions were not found to be consistently
significant. These results demonstrate the important role that romantic partner
influence may have on individual substance use during the transition from adolescence
to adulthood and evidences the need for further research into this area.
This abstract accurately represents the content of the candidates thesis. I
recommend its publication.
Signed
Elizabeth S. Allen


DEDICATION
This thesis is dedicated first to my father, Joe Firsick, who taught me the value of
hard work and whose faith in my abilities has never faltered regardless of the
endeavor. Secondly I would like to dedicate this thesis to my mother, Barbara,
for her love and encouragement throughout my academic pursuits.


ACKNOWLEDGEMENT
I would like to acknowledge my thesis committee for their time and expertise in
assisting me throughout the development of this thesis. I would like to
specifically thank my thesis chair, Elizabeth Allen, for believing in me and
dedicating so much time to this project from the beginning. I would also like to
thank my cohort within the masters program at the University of Colorado
Denver. Finally I would like to thank my girlfriend Amy Lentell and all my friends
and family for their love and support.


TABLE OF CONTENTS
Tables...........................................................ix
CHAPTER
1. INTRODUCTION................................................1
Romantic Partner Influence-A Gap in the Literature..........1
Rationale for the Study.....................................3
Social Change During Adolescence............................5
Attachment Theory...........................................6
Conformity and Peer Group Influence.........................7
Social Theories and Romantic Relationships During Adolescence.10
Hypotheses................................................ 15
2. METHOD.....................................................17
Participant Characteristics................................17
Procedures.................................................18
Measures...................................................12
National Survey of Drug Use and Health.....................21
Injunctive Norms........................................21
Frequency of Use........................................22
vi


Romantic Partner Status
23
Problem Use Behaviors....................................... 23
Cannabis Problem Use Questionnaire-Adolescent (CPQ-a).... 24
Rutgers Alcohol Problem Index (RAPI)..................... 25
Analyses Used to Test Hypotheses.............................25
Power Analysis...............................................27
3. RESULTS..................................................... 29
Zero-Value Inflation........................................ 29
College Student Sample.......................................30
Close Peer and Romantic Partner Frequency of Use.............33
Users Versus Non-Users....................................33
Frequency of Use Among Users............................. 37
Close Peer and Romantic Partner Injunctive Norms.............39
Users Versus Non-Users....................................40
Frequency of Use Among Users..............................43
Gender Interactions..........................................46
Users Versus Non-Users....................................46
Frequency of Use Among Users..............................47
Problem Use Interaction.....................................48
vii


Alcohol Problem Use
,49
Marijuana Problem Use...................................50
4. DISCUSSION..................................................52
Transition from Close Peer to Romantic Partner Influence...52
Romantic Partner Using Behavior Predicts Individual Use......54
Injunctive Norms Within Romantic Relationships Predict Individual
Use.....................................................56
Influence Variations Across Substances.....................58
Moderation Effects.........................................63
Implications and Future Research...........................66
Initiation Vs. Maintenance Effects......................66
Future Direction..........................................67
APPENDIX
A. Questionnaires............................................69
REFERENCES...........................................................79
viii


LIST OF TABLES
Table
1. Descriptive Statistics.............................................31
2. Romantic partner and close peer frequency of use use vs. non-use.35
3. Romantic partner and close peer frequency of use users only......38
4. Romantic partner and close peer approval of use use vs. non-use..41
5. Romantic partner and close peer approval of use users only......44
IX


CHAPTER 1
INTRODUCTION
Romantic Partner Influence-A Gap in the Literature
The present study was concerned with social influence in relation to
alcohol, tobacco and marijuana use during late adolescence. Traditionally,
romantic relationships have been neglected in the scientific literature related to
the adolescent period of development. Social factors such as parent and peer
influence and attachment have historically been the primary focus (Berndt &
Ladd, 1989; Bowlby, 1973;Erikson, 1956; Hirschi, 1969; Huebner & Betts, 2002;
Kierkus & Baer, 2002). While peer group influence has been examined in
relation to such issues as substance use and the development of delinquent
behaviors, much less focus has been placed on the influence romantic partners
have on these same areas. In recent years this issue has been brought to light,
with many researchers pointing out the gap that exists in the literature, and
indeed investigating the role romantic partner influence plays during
adolescence [Collins, Welsh & Furman, 2009; Furman & Collins, 2008; Haynie et
al., 2005; Kierkus, 2009; Miller et al, 2010; van der Zwaluw et al., 2009). These
1


studies have shown both the importance of romantic partner involvement in
adolescent development and the need for further investigation.
Collins (2003) points out that certain myths regarding romantic
relationships in adolescence have contributed to the neglect of this subject
matter. The long-standing idea that relationships during adolescence are simply
too transitory to have any significant influence has been the primary reason that
this area has been overlooked. Many researchers also believed that adolescent
romantic relationships merely reflected larger social interactions such as those
between peer groups and parents. Thus previous research has chosen to focus
on these areas, causing romantic partner relationships to either become
consolidated, as part of peer group interactions, or to be studied later in life
through marital research. Further studies have found, however, that adolescent
romantic relationships are not as transitory as previously thought and that
unique contributions can be found from investigating romantic partner
influence. Carver, Joyner and Udry (2003) found that in late adolescence, 60% of
17 and 18 year olds reported having a relationship of 11 months or longer.
Additionally romantic partner involvement has been found to be increasingly
prevalent through out adolescence, with individuals becoming more involved
with mix-gendered groups and eventually participating in more frequent
2


romantic relationships as they approach young adulthood (Connoly, Furman, &
Konarski, 2000; Furman & Wehner, 1997; Laursen & Williams, 1997;).
Individuals who had experienced a romantic relationship increased from 36%
among 13-year-olds to 70% among 17-year-olds (Carver, Joyner & Udry, 2003).
Given the frequency with which adolescent romantic relationships occur and the
vulnerability to peer influence that characterizes this stage of development,
further research is needed to understand how these unique relationships impact
the adolescent experience.
Rationale for the Study
The present study investigated romantic partner relationships and
adolescent behavior. Specifically, romantic partner and peer group influence
was examined in relation to adolescent substance use. The neglect of this area in
past research has created a gap in the literature encompassing adolescent
development. This study aimed to address this gap by specifically targeting
romantic partner and peer group influence and examining the contributions of
each. Peer group substance use and approval of use have been consistently
found to influence adolescent using behaviors (Burlew et al., 2009; Kristjansson
et al., 2010; Moffitt, 1993; Wang et al., 2009; Wills et al., 2004). Although limited,
3


recent studies have shown that romantic partner use and approval of use may
also influence adolescent using behaviors, similar to the effects of peer group
influence (Etch ever ry & Agnew, 2008, 2009; Lonardo, Giordano, Longmore, &
Manning, 2009; van der Zwaluw et al., 2009). The present study is unique in that
it examined both using behaviors of romantic partners and peers as well as the
injunctive norms surrounding use within these relationships. Injunctive norms
are defined as attitudes relating to certain behaviors among an individual's peer
groups. These "norms" can be approving or disapproving in nature and are
directed at any given behavior or action, in this case, substance use. The present
study aimed to target these approval levels in relation to romantic partners and
close peers. Furthermore, whereas other studies have investigated romantic
partner involvement for specifically alcohol or tobacco use (Etcheverry &
Agnew, 2008; van der Zwaluw et al., 2009), the present study investigated
alcohol, tobacco and marijuana use, together, as these substances have been
found to be the most commonly used among adolescent and young adult
populations (NSDUH, 2007).
4


Social Changes During Adolescence
Adolescence is a period of marked change in the life of an individual.
Physical changes during this period are often the most salient as one enters
puberty, begins rapid physical growth and obvious adult features begin to
emerge (voice deepening, height increase, genital development). Puberty is a
hallmark of early adolescence as hormonal changes are beginning and increasing
levels of testosterone and estrogen are released for males and females
respectively (Collins, Welsh and Furman, 2009; Halpern, 2003; McClintock&
Herdt, 1996). This shift in hormones can account for the obvious physical
changes that occur during this period. Physical development, however, only
accounts for a portion of the entire adolescent experience. Adolescence is also
characterized by social changes and the search for identity and autonomy.
The child entering adolescence is still very much dependent on his or her
parent for emotional and physical support. As the individual develops through
adolescence, emotional support begins to be found in peer groups and social
relationships and not exclusively from parents. Adolescence is characterized by
the individual's desire to separate from parents and establish one's own identity
(Erikson, 1950). This concept of identity formation is a central tenant of
adolescent literature and is important in understanding not only adolescent
5


behaviors but also the roles peer group and romantic partner involvement play
in terms of influencing behaviors (Cotterell, 1996; Hirschi, 1969; Kierkus, 2009;
Moffitt, 1993; Monahan, Steinberg & Cauffman, 2009,). During this period, the
adolescent begins to find their own identity separate from their parents;
however, involvement in close relationships still has beneficial qualities.
Attachment Theory
Bowlby's attachment theory offers good insight into this concept.
Attachments early in life with one's parents are the basis for relationships in
adolescence and adulthood. Although the focus of attachment begins to shift in
adolescence, attachment relationships themselves are still desirable and begin to
be found more in peer groups than in parent interaction (Bowlby, 1973,
Cotterell, 1996, p. 6). In early adolescence, these attachments are focused on
same-sex peer groups. By the end of adolescence another significant shift is
occurring, and the individual is now seeking romantic partner involvement for
closeness and to meet emotional needs, shifting away from primarily same-sex
peer group relationships and incorporating more mixed-gender group
relationships. Connolly, Furman and Konarski (2000) showed the shifts that
occur in group associations during adolescence. Social networks in the ninth
6


grade were generally comprised of same-sex peers. However, as the individuals
progressed into later adolescence, peer groups expanded to include mixed-
gender peers. Subsequently, the social networks of eleventh graders had
expanded and more opposite-sex peers were included; romantic relationships
also began to increase. These findings are consistent with Carver, Joyner and
Udry, (2003) which found that individuals in late adolescence were much more
likely to be involved in a romantic relationship. Specifically, Connolly, Furman
and Konarski, (2000) found that same-sex peer networks predicted opposite-sex
associations, which subsequently predicted romantic relationship later in
adolescence. These findings are significant because they demonstrate the
influential role that both same-sex and opposite-sex peers play throughout
adolescence. Early in life, parental attachment serves as a foundation and
prototype for relationships in the future. Similarly, early adolescent peer
relationships form a foundation for romantic relationships in late adolescence
and adulthood.
Conformity and Peer Group Influence
To understand the effects of romantic partner influence during
adolescence, it is useful to first examine the effects of peer group and close friend
7


influence. The reason for this is two fold; first, peer group affiliation and
involvement typically occurs earlier in the adolescent period, prior to romantic
relationships. Secondly, the types of peer groups an individual chooses to
associate with has been found to significantly impact their behavior. Early
studies of conformity by Asch (1956) and Sherif (1963) showed the substantial
effect that group opinion and actions can have on individual behavior and
conformity. Individuals are much more likely to change their own viewpoints or
behaviors to fall in line with those of the group with which they associate. This
idea becomes particularly relevant in the study of peer group influence during
adolescence, in which the individual is vulnerable to the influence of others.
Desire for peer acceptance and approval have been shown to be strongest in
early to middle adolescence, but begins to wane toward early adulthood
(Monahan, Steinberg & Cauffman, 2009).
Behaviors such as adolescent substance use and delinquency have been
found to be some of the most vulnerable to peer influence. When an individual is
exposed to deviant peers, their own behavior is more likely to become deviant as
a result (Church, Wharton & Taylor, 2009). In terms of substance use specifically,
peer use, peer approval of use and peer respect predicted higher rates of
adolescent use (Kristjansson et al., 2010; Wang et al. 2009). Wills et al. (2004)
8


discussed social reward dependence as a potential explanation for the influence
of peer support. Social reward dependence emphasizes the tendency for an
individual to seek approval and support from their social groups. Moffitt (1993)
also discussed this behavior in the context of social mimicry, which states that as
social groups begin to form during adolescence, individuals mimic each other in
order to attain acceptance and approval. Moffett describes the desire to be
socially accepted as a primary cause of delinquent behavior in adolescence.
Research has consistently found that group association, relationship
closeness, peer approval and peer using behavior are significant predictors of
both initiating and maintaining substance use behaviors in adolescence (Eiser et
al., 1987; Etcheverry & Agnew, 2008; Kristjansson et al., 2010; Morgan & Grube,
1991; Newman, 1987; Urberg et al., 1997; Wang et al., 2009; Wills et al., 2004).
A common theme that connects these studies involves the perceived closeness of
peers. The influence of the group as a whole is important; however, the closeness
of the relationship (i.e. best friend) has been found to be a stronger predictor of
use. Morgan and Grube (1991) found that the strength of influence on smoking,
alcohol use and the use of illicit drugs was consistent with the level of closeness
of the relationship. Additionally this study found that best friend using behavior
alone was not the only predictor of use but that approval of use was also a
9


significant predictor. Etcheverry and Agnew (2008) confirm this finding stating
that the injunctive norms surrounding smoking behaviors (i.e. approval or
disapproval) were significant predictors of use. These findings are particularly
relevant to the present study in that peer influence was investigated in terms of
close peers rather than simply the influence of the peer group at large.
Furthermore, the injunctive norms surrounding use were measured in addition
to peer using behaviors as both of these variables have been found to be
significant predictors of substance use.
Social Theories and Romantic Relationships During Adolescence
From a theoretical standpoint these findings are consistent with both
social learning theory (Akers, 1977; Bandura, 1977) and social identity theory
(Abrams et al., 1990; Cotterrell, 1993; p. 131). Kobus (2003) gives a
comprehensive review of these and other social influence theories as they relate
to smoking behaviors in adolescence. Her review reveals a common theme
linking these theories together, primarily that "each theory either states directly
or suggests indirectly that the norms and behaviors of teenagers' peers are
important determinants of behavior." In social learning theory, behaviors are
first acquired through the observation of others, the individual then begins
10


engaging in such behaviors and the subsequent rewards or punishments that
result either encourage or discourage future behavior. Social learning theory is
similar to Moffitt's (1993) account of social mimicry involved in delinquent
behaviors in general. Social identity theory emphasizes the role that group
affiliation and identification play in the maintenance of certain behaviors. As an
individual begins to view him or herself as belonging to a specific group, they
begin to assimilate the behaviors of that group. Furthermore as the individual is
assessed and compared to other group members, positive appraisal that is
received for incorporating this group identity subsequently promotes and
encourages behavior. Kobus also relates this to Festingers (1954) social
comparison theory.
Both the theoretical perspectives and empirical results that have been
laid out in the preceding sections serve to construct the basic foundation for the
current study. The using behaviors and approval levels of close peers were
investigated as to their influence on adolescent use. The using behaviors of peers
act as observable examples of behavior, consistent with social learning theory.
The approval or disapproval of use from the adolescent's peer groups act to
encourage or discourage use, consistent with social identity theory and social
comparison. The unique aspect of the current study is the integration of
11


romantic partner influence in addition to that of close peers. As previously
stated, peer group influence is strongest from early to middle adolescence
(Monahan, Steinberg & Cauffman, 2009), but begins to wane toward early
adulthood. Subsequently, romantic partner involvement exists during early and
middle adolescence but increases in prevalence from late adolescence to early
adulthood (Carver et al. 2003). As involvement with romantic partners becomes
more frequent, adolescents spend increasing amounts of time with these
individuals, subsequently becoming closer and more involved. Romantic
partners become the source for physical and emotional support and take on a
more influential role in the life of the adolescent (Connoly, Furman, & Konarski,
2000; Laursen & Williams, 1997). For this reason the present study will target
the late adolescent and early adult developmental periods.
It is logical then to reason that as peer influence declines and romantic
partner influence increases toward late adolescence, the influential roles that
peers played in dictating adolescent behavior would be usurped by the influence
of romantic partners. In terms of substance use specifically, romantic partner
influence on using behaviors has been supported in previous studies examining
cigarette use, alcohol use and delinquency (Capaldi, Kim & Owen, 2008;
Etcheverry & Agnew, 2008, 2009; Haynie et al. 2005; Kierkus, 2009; Miller et al.,
12


2009; van der Zwaluw et al., 2009). The present study investigated the using
behavior and injunctive norms surrounding use of both close peers and romantic
partners as predictors of substance use in late adolescence. In addition,
variations among influence were investigated by gender and problem using
behaviors.
Romantic partner influence may be different across gender, both in terms
of substance use and delinquent behaviors, due to various relationship dynamics
and gender roles that may exist among romantic partners. For example,
traditional power roles within relationships would suggest that females may
have less power than males, while males have more influence. For reasons such
as this, past research has hypothesized a stronger male influence on female
romantic partners in regards to substance use behavior. The results of studies
examining this question, however, have not been unanimous, with some findings
supporting a stronger partner influence among females while others support a
stronger influence among males (Kierkus, 2009; Lonardo, 2009). Haynie et. al.,
(2005) found partial evidence for a stronger influence from male romantic
partners on females in predicting delinquent behavior but this "primacy of male
influence" hypothesis was not consistently supported. Most studies examining
partner influence have focused on delinquency in general and not specifically
13


substance use. Van der Zwaluw et al. (2009) examined alcohol use and reported
a stronger partner influence among females. The most consistent pattern of
results for gender interactions in theses studies, however, is one of ambiguity.
Some support is generally found for stronger male influence over female
partners in predicting both delinquency and substance use but these results are
not consistent and a definitive direction of gender interactions is not strongly
supported. Thus, further investigation is warranted and the current study
targeted gender as a moderator among romantic partner frequency of use and
approval of use, in predicting individual substance use behavior. Because of the
ambiguity of the prior results on this topic, there is no formal hypothesis of the
directionality of the finding (i.e., will females or males show evidence of greater
romantic partner influence?), simply that gender may moderate the relationship
between romantic partner and own use variables.
In addition to gender as a moderating variable, the present study
explored problem substance use behavior in the areas of alcohol and marijuana
as a moderator of close peer and romantic partner influence. As noted above,
past research has found close peer using behavior influences individual
substance use. Little research, however, has examined the changes in social
influence that may occur among adolescents who have developed a consistent
14


pattern of use and have experienced incidents of problem use behavior (i.e.
failing to meet social, occupational or educational expectations, using more than
originally intending to, being unable to cutback on use). The present study
utilized problem use behavior as a moderator to target differences in close peer
and romantic partner influence among problem users. It was not clear, based on
past research, if individuals displaying problem use behaviors would be more or
less influenced by close peers and romantic partners as compared to normative
users. Thus, a definitive direction was not hypothesized. Rather, problem use
behavior was hypothesized to moderate close peer and romantic partner
influence for alcohol and marijuana use.
Hypotheses
Hypothesis 1: Romantic partner substance use will predict adolescent use
above and beyond the effects of peer using behaviors. Specifically, both romantic
partner and peer using behaviors are hypothesized to be significant predictors
of adolescent use, however romantic partner influence is predicted to account
for a unique portion of variance that is left unaccounted for by peer use. This
would imply a unique contribution from romantic partner using behavior on
adolescent use.
15


Hypothesis 2: Romantic partner injunctive norms surrounding use will
predict adolescent use above and beyond the effects of close peer injunctive
norms. That is, the approval of substance use from close peers and romantic
partners will be directly related to adolescent use of alcohol, tobacco and
marijuana and romantic partner approval will account for a portion of the
variance left unaccounted for by close peer approval. This would imply a unique
contribution from romantic partner injunctive norms on adolescent use.
Hypothesis 3: It is hypothesized that the influence of romantic partner
substance use and approval of use will be different between males and females.
Specifically, gender will moderate the relationship between own using behaviors
and romantic partner approval/use levels (i.e., the using behaviors and approval
levels of male romantic partners will predict female substance use differently
than female romantic partner use and approval predicts male substance use.)
Hypothesis 4: Alcohol and marijuana problem use will moderate the
relationship between own using behavior and romantic/peer use and approval.
That is, it is hypothesized that romantic partner and close peer using behavior
and approval of use will predict frequency of use differently for problem users
than for individuals with less severe using behaviors.
16


CHAPTER 2
METHOD
Participant Characteristics
The participants for the current study were recruited from introductory
psychology classes at the University of Colorado Denver. As discussed earlier,
prior research has found the late adolescent period of development to be the
time in which romantic relationships become the most salient. This period is
generally comprised of the late teenage years and early twenties (Smetana et al.,
2006). Thus the present study targeted adolescents between the ages of 18 and
22. Given the target age group, recruiting from an undergraduate college
population provided ample opportunity to study individuals currently in the late
adolescent stage of development. A total sample of 245 college student
participants was collected. This sample was then filtered to meet the 18-22 year-
old age criteria (Mage= 19.3) giving a final sample size of N= 186. Of this sample
55 (29.6%) were male and 131 (70.4%) were female. The ethnic breakdown of
the sample was as follows: 58.6 % Caucasian, 13.4% Hispanic, 11.3 % Asian, 5.4
% African American, 2.7% Native American, 1.1 % Pacific Islander and 7.5% as
17


other. The participants were all students at the University of Colorado Denver
and enrolled in an Introduction to Psychology course. Participants received extra
credit for their participation in the study. It is important to note here that some
concern has traditionally been expressed when using college student samples
(Kazdin, 2010, p 58). Issues of selection bias, external validity and samples of
convenience are generally raised. While it may be true that certain subject
matters which impact a wide range of individuals (e.g. therapy modalities,
depression or anxiety treatment studies) should have a much wider sample than
what would be represented in a college population, the current study is
concerned specifically with behaviors that occur in the late adolescent and
young adult developmental periods. Given that attending college is a common
social expectation of individuals in late adolescence and early adulthood,
recruiting from a college student population was ideal for the purposes of this
study.
Procedures
The present study was concerned with examining the substance using
behaviors of adolescents, their romantic partners and their close peers.
Additionally the injunctive norms surrounding peer and romantic partner
18


relationships were also studied. Self-report measures were used to obtain the
targeted data. In terms of social influence, peer relationships are often defined in
different ways given the purpose and aims of any particular study. As mentioned
previously, close friend influence has been found to be a stronger predictor of
substance use than general peer group influence (Morgan & Grube, 1991). Based
on previous findings and given the aims of the current study to investigate peer
influence on adolescent use, close friendships were targeted. Participants were
asked to consider their "three closest friendships when answering the items
pertaining to peer influence. As a result responses targeted the individual's best
friendships and were not left open to interpretation regarding the individual's
peer group at large. Additionally, when responding to the romantic partner
items, participants were specifically asked to consider the definition that a
romantic relationship is constituted as "ongoing, voluntary interactions marked
by expressions of affection and possible current or anticipated sexual behavior.
This definition was adapted from Collins, Welsh and Furman (2009) and was
selected so as to not limit the participant's interpretation of romantic
relationships to relationships that are committed or long lasting. Additionally
previous studies have failed to give a common definition of romantic
relationships, instead leaving the interpretation of the term up to the individual
19


participants (van der Zwaluw et al., 2009; Miller et al, 2009; Etcheverry &
Agnew, 2008, 2009). The present study sough to create a uniform definition so
that each participant would consider the same type of interactions when
responding to items referencing their current or most recent romantic partner.
Participants were recruited in their introductory psychology courses and
directed to an online survey website. Through this site they were able to
complete the measures for the study and submit their responses anonymously.
An online interface was used to allow for increased accessibility for participants
given that research has found 87% of adolescents use the internet for
communication purposes (Collins, Welsh & Furman, 2009, Lenhart et al., 2005).
Additionally this form of data collection also served to reduce errors in data
recording, and provided a further sense of confidentiality for the participant,
effectively reducing social desirability and providing for more accurate
responses. All data was collected at a single time point.
20


Measures
National Survey of Drug Use and Health
The items targeting frequency of substance use and the injunctive norms
surrounding use were adapted from the 2007 National Survey of Drug Use and
Health (NSDUH). The NSDUH is an annual government funded survey that
targets the use of illicit drugs, alcohol, and tobacco in the United States. The
study samples both adolescents and adults from all fifty states (N=67,870). The
items used in the present study were adapted from the "youth experience"
subsection, which examines certain variables related to youth substance use and
influencing variables such as peer and parent approval. From 2006-2008 the
NSDUH conducted a reliability study finding that substance use variables had
kappa (k) reliability coefficients above .82 indicating near perfect agreement
(NSDUH Results, 2008).
Injunctive Norms. Injunctive norms were defined as the perceived approval or
disapproval of using alcohol, tobacco or marijuana from the individuals close
peers and romantic partners (Etcheverry & Agnew, 2008). Participants
completed a total of six items, targeting close peer and romantic partner
21


approval for alcohol, tobacco and marijuana use separately (e.g. How do you
think your romantic partner would feel about you using marijuana nearly
everyday? 1= strongly disapprove, 2= somewhat disapprove, 3= somewhat
approve, 4= strongly approve).
Frequency of Use. Substance use in the present study was defined as an
individual's frequency of use within the last 30 days for alcohol, tobacco and
marijuana. Data was collected in terms of number of days used (e.g. What is your
best estimate for the number of days you smoked a cigarette during the past 30
days? 0= did not smoke in past 30 days, 1= 1-2 days, 2= 3-5 days, 3= 6-9 days, 4=
10-19 days, 5= 20-29 days, 6= all 30 days). As described later, this variable was
used in two different ways for analyses: (1) coding all "0" responses as non-use,
and collapsing 1 through 6 into a "use" category; (2) focusing only on the 1-6
responses to estimate frequency of use for users. Participants were also asked to
indicate the frequency of use for both romantic partners and close friends (e.g.
What is your best estimate of the number of days your close friends smoked part
or all of a cigarette during the past 30 days? 0= Did not smoke Cigarettes, 1= 1 or
2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4= 10-19 days, 5= 20-29 days, 6 = all 30
days)
22


Romantic Partner Status
As mentioned above, participants were first given the definition that
romantic relationships are considered "ongoing, voluntary interactions marked
by expressions of affection and possible current or anticipated sexual behavior".
Participants were then asked "Are you currently in a romantic relationship?"
Participants indicating "No were then asked, "In the last 12 months have you
been involved in a romantic relationship?" Participants were asked to indicate if
their current romantic partner is a member of the same gender or the opposite
gender. Only participants who reported a current or within past 12 month
heterosexual romantic relationship were given the romantic partner frequency
of use and approval of use items. Participants then responded to the items
targeting their perceptions of their romantic partner's frequency and approval of
alcohol, tobacco and marijuana use.
Problem Use Behaviors
Problem use behaviors were examined for alcohol and marijuana use.
Two measures were used for this purpose; the Adolescent Cannabis Problem
23


Questionnaire-Adolescent (CPQ-a) and the Rutgers Alcohol Problem Index
(RAPI). These measures provide good general evaluations of an individual's
functioning as a product of their substance use.
Cannabis Problem Questionnaire-Adolescent The CPQ-a is a problem use
questionnaire designed specifically for cannabis use with adolescent
populations. For this study, the 30 "core" true/false items that apply to all
respondents were utilized, eliminating 28 supplementary items (targeting
specific areas such as parent and romantic partner issues, school functioning and
employment). The CPQ-a score total has been found to represent three factor
domains; financial/psychosocial consequences, physical impact, and acute
negative consequences (Martin et al., 2006). Each of these three factors had
adequate reliability with alpha coefficients ranging from .72-.88. The present
study used the core item score total as an indicator of problem use. The CPQ-a
items used in the present sample were found to be adequately reliable with an
alpha coefficient of .78. In terms of validity, total CPQ-a scores and number of
DSM-1V cannabis dependence symptoms have been found to correlate at .80
(Martin et al., 2006) giving this measure the ability to act as an indicator of
potential substance dependence criteria.
24


Rutgers Alcohol Problem Index. The RAPI was designed to be used as a
short, self report measure of problem drinking behaviors in clinical and
nonclinical adolescent populations. The measure consists of 23-items examining
the impact of drinking behaviors on social, emotional and academic domains.
The measure has been found to have an internal consistency of .80 or higher in
both clinical and nonclinical samples (White et al., 1988). In the sample for the
present study, RAPI items were highly intercorrelated at an alpha level of .95.
Additionally it has been found to have high correlations with DSM criteria for
alcohol dependence and abuse (White et al., 1988).
Analyses Used to Test Hypotheses
Hypothesis 1 stated that romantic partner substance use would predict
adolescent use above and beyond the effects of close peer using behaviors.
Specifically, both romantic partner and peer using behaviors are hypothesized to
be significant predictors of adolescent use, however romantic partner influence
is predicted to account for a unique portion of variance that is left unaccounted
for by peer use. This would imply a unique contribution from romantic partner
using behavior on adolescent use. These effects were investigated using OLS
25


multiple regression and binary logistic regression analyses. Hierarchical data
entry was utilized in order to examine the effects of frequency of partner use
above and beyond the frequency of close peer use. It is hypothesized that as
close peer and romantic partner using behavior increases, so too will the
frequency of adolescent use. These analyses were conducted separately for
alcohol, tobacco and marijuana use.
Hypothesis 2 examined the roles of close peer and romantic partner
approval and disapproval of substance use as they influenced individual
frequency of use. These injunctive norms for friend and partner were also
analyzed using OLS multiple regression and binary logistic regression equations.
It was hypothesized that these will both be significant predictors of use, and that
romantic partner approval would predict adolescent use above and beyond the
effects of close peer approval. As in the analysis of hypothesis 1, these variables
were examined for the effects on alcohol, tobacco and marijuana use. Again
hierarchical data entry was utilized to identify the unique influence of romantic
partner approval beyond the effects of close peer approval.
Hypothesis 3 examined the variation in romantic partner influence on
frequency of use for males as compared to females. Specifically, the using
behaviors and approval levels of male romantic partners will predict female
26


substance use differently than female romantic partner use and approval will
predict male substance use. Thus the influence of romantic partner use and
approval of use were examined for interactions by gender. That is, the
interaction effects for gender X frequency of partner use and gender X partner
approval were used to examine the variance among influence for male verses
female variables across the three substance domains.
Hypothesis 4 stated that close peer and romantic partner influence would
predict substance use differently among individuals with problematic using
behaviors. Scores from the CPQ-a and RAPI were used as moderator variables to
examine the interactions across romantic partner and peer influence variables. It
is hypothesized that romantic partner and close peer using behavior and
approval of use will predict frequency of use differently for problem users than
for individual's with less severe using behaviors.
Power Analysis
Of the regression equations that will be conducted in the present study,
the largest analysis will contain 3 predictor variables. With a power level of .80,
an alpha level of .05, three predictor variables and an estimated medium effect
size, a sample of at least 150 participants would be needed. Thus a sample of 186
27


participants was collected, providing adequate power for medium and large
effects to be detected (Miles & Shevlin, 2001; Faul et al., 2009).
28


CHAPTER 3
RESULTS
Zero-Value Inflation
The first set of statistical analyses in the present study investigated a
series of peer and romantic partner variables. Given the nature of substance use
behavior in a general population, a spectrum of using behaviors was expected
with a large number of individuals having never used a given substance. This
phenomenon is often called zero-value inflation due to the fact that in a
normative sample of the general population a large number of individuals will be
"zero" users having either never used a particular substance or having not used
in the targeted timeframe (in this case, alcohol, tobacco or marijuana use in the
last 30 days). In terms of statistical analysis this type of data distribution can
present unique challenges. Although data may be evenly distributed across the
varying levels or frequencies of use, the high zero-value inflation causes a strong
positive skew to occur. Assumptions of normality are fundamental in parametric
analyses and when high zero-inflated distributions occur, these assumptions are
29


violated (Atkins & Gallop, 2007], Although certain complex analyses exist
specifically for this type of data (Poisson, Hurdle or Negative Binomial
Regression) these models were inadequate in terms of fit and utility for the
present study. In order to address the zero-value inflation that was present in
the data two different sets of analyses were run for peer and romantic partner
influence variables. The first incorporated a binary logistic regression equation
to examine the effects of the independent variables between users and non-
users. The second analysis utilized OLS multiple regression equations to further
investigate the effects of the independent variables across the varying levels of
user-only data. In this way the zero-value inflation was overcome.
College Student Sample
Full descriptive information is presented in Table 1.
30


Table 1: Descriptive Statistics
N= 186 Mean Age (18-22) Gender 19.3
Male 55 29.6%
Female Ethnicity 131 70.4%
Caucasian 109 58.6%
Hispanic 25 13.4%
African American 10 5.4%
Asian 21 11.3%
Other 21 11.3%
Variables Substances Range
Alcohol Tobacco Marijuana
Individual Freq of Use (N=186)
Used Last 30 days?
Yes 115 52 65
No 71 134 121
Average Use (S.D.)- Users Only Close Peers Freq of Use (N=l 86) 2.43 (1.33) 3.33 (1.88) 3.15(1.94) 1:1-2 Days -6: All 30 Days
Used Last 30 days ?
Yes 149 108 110
No 37 78 76 1: 1-2 Day-6: All
Average Use (S.D.)- Users Only 3.13 (1.39) 4.01 (1.99) 3.81 (1.65) 30 Days
Current or Recent Romantic Relationship?
Yes: 136, No: 50
Romantic Partner Freq of Use (N=136)
Used Last 30 days?
Yes 101 42 58
No 35 94 78
1: 1-2 Day-6: All
Average Use (S.D.)- Users Only 3.01(1.31) 3.69(2.01) 3.31 (1.83) 30 Days
Close Peer Approval of Use (N=186)
Mean (S.D.) 2.3 (.89) 1.89 (.91) 2.11 (1.14) 1 -4
Romantic Partner Approval of Use (N= =136)
Mean (S.D.) 2.13 (.88) 1.47 (.81) 1.87(1.06) 1 -4
31


_____________Measures____________________________________________________________Range
Rutgers Alcohol Problem Index
(N= 114)
Mean (S.D.) 32.54 (10.84) 23 92
Cannabis Problem Questionnaire Adolescent
(N=53)
Mean (S.D.)_______________________35.02(4.18)_________________________________30-60
32


In the present study's sample of late adolescent college students (N=186),
alcohol was most prevalent at 62% (n=115) having used at least once in the last
30 days, followed by marijuana at 35% (n=65) and cigarette use at 28% (n=52).
These frequency rates were nearly identical with the alcohol and tobacco
frequency rates found among college students in the 2009 National Survey of
Drug Use and Health (NSDUH). Among 18-22-year-old college students, the
NSDUH found that 63.9% currently used alcohol, 27.1% currently used tobacco
and 20.2% currently used marijuana. Marijuana was used somewhat more
frequently in the present study's sample. The differences among marijuana using
rates may reflect variations in marijuana use legality as a product of
geographical location. The current study's location (Denver, Colorado)
represents one of the few locations in the United States in which medical
marijuana use is legal. This difference in medical marijuana use legality and
accessibility may have contributed to the higher marijuana using rates.
Close Peer and Romantic Partner Frequency of Use
Use Versus Non-Use.
Close peer and romantic partner frequency of use were examined as
predictors of individual frequency of use. Binary logistic regression analyses
33


were run for each of the three outcome variables; use verse non-use for Alcohol,
Tobacco and Marijuana. It was hypothesized that romantic partner influence
would predict own use beyond the influence of close peers. The results for close
peer and romantic partner frequency of use as predictors of use versus non-use
are summarized in Table 2 for each substance domain.
34


Table 2: Romantic Partner and Close Peer Frequency of Use Use Vs. Non-Use
95% Cl for Odds Ratio
B SE (B) Lower Odds Ratio Exp (B) Higher
Step 1
Cigarette (n=136)
Constant -2.63 0.46
Close Peer Frequency 0.46 0.09 1.32 1.58*** 1.88
Alcohol (n=136)
Constant -1.65 0.52
Close Peer Frequency of Use 0.75 0.15 1.58 2.12*** 2.84
Marijuana (n=136)
Constant -2.87 0.29
Close Peer Frequency of Use 0.66 0.11 1.56 1.93*** 2.40
Step 2
Cigarette
Constant -2.76 0.48
Close Peer Frequency 0.42 0.09 1.27 1.53*** 1.83
Romantic Partner Frequency 0.11 0.1 0.922 1.12 1.26
Alcohol
Constant -2.55 0.64
Close Peer Frequency of Use 0.58 0.16 1.30 1.80*** 2.47
Romantic Partner Freq of Use 0.55 0.16 1.25 1.73*** 2.38
Marijuana
Constant -3.49 0.58
Close Peer Frequency of Use 0.58 0.12 1.42 1.78*** 2.23
Romantic Partner Freq of Use 0.38 0.12 1.15 1.47** 1.86
Note: (Cigarettes) Step 1: R2 = .29 (Nagelkerke), Model x2(l)=31.85, pc.OOl. Step 2: AR2 = .30
(Nagelkerke) Model*2(1)=1.33, p=0.25. (Alcohol): Step 1: R2 = .31 (Nagelkerke), Modelx2W=
33.18, p<.001, Step 2: AR2= .41 (Nagelkerke), Modelx2W = 12.68 p<.001. (Marijuana) Step 1: R2
= .42 (Nagelkerke), Model*2(1)= 50.56 p<.001, Step 2: AR2=A9 (Nagelkerke), Model x2(l) =
10.82 p<.001. *p<.05, **p<.01, ***p<.001
35


In the first step of the equation close peer frequency of use was the only
predictor variable and was a significant predictor of use for all three substances.
In the second step of the equation, romantic partner frequency of use was added.
The results for alcohol and marijuana use confirmed that romantic partner
frequency does indeed contribute to the predictive power of the model and
specifically accounts for a portion of the variance predicting use versus non use,
left unaccounted for by close peer use (Hypothesis 1). The odds ratios of these
variables can be found in table 1 and indicate that, for alcohol use, an individual
becomes 1.8 times more likely to use for every unit increase in close peer
frequency of use and 1.73 times more likely to use for every unit increase in
romantic partner frequency of use. Similar effects are shown for marijuana use
in that an individual becomes 1.78 times more likely to use for every unit
increase in close peer frequency of use and 1.47 times more likely to use for
every unit increase in romantic partner frequency of use.
In comparing cigarette use versus non-use, romantic partner influence
was not significant when examined in conjunction with close peer influence. The
odds ratio for close peer frequency of use predicting use versus non-use was
similar to the results found for alcohol and marijuana. Individuals become 1.53
36


times more likely to use for every unit increase in cigarette use of their close
peers. Romantic partner frequency of use was, however, found to be a significant
predictor when entered into the equation as the lone predictor of use with an
odds ratio of 1.31. This result indicates that for cigarette users, romantic partner
frequency is an important predictor, however a considerable amount of shared
variance exists between these two variables (r (134) = .39, p < .01). This
becomes evident when close peer frequency is added to the equation resulting in
romantic partner frequency no longer retaining statistical significance.
Frequency of Use Among Users
To further investigate the effects of close peer and romantic partner
frequency of use, multiple regression equations were run among users only.
These results are illustrated in Table 3.
37


Table 3: Romantic Partner and Close Peer Frequency of Use Users Only
B SE(B) 0 t
Step 1
Cigarettes (n=43)
Constant 2.81 0.83 3.41
Close Peer Freq of Use 0.28 0.15 0.29 1.94f
Alcohol (n=98)
Constant 1.48 0.36 4.10
Close Peer Freq of Use 0.47 0.08 0.52 5.93***
Marijuana (n=55)
Constant 0.61 0.7 0.87
Close Peer Frequency of Use 0.69 0.13 0.59 5.28***
Step 2
Cigarettes
Constant 2.68 0.86 3.13
Close Peer Freq of Use 0.27 0.15 0.27 1.78
Romantic Partner Freq of Use 0.08 0.12 0.1 0.68
Alcohol
Constant 1.18 0.37 3.20
Close Peer Freq of Use 0.36 0.09 0.4 4.18***
Romantic Partner Freq of Use 0.2 0.08 0.24 2.5*
Marijuana
Constant 0.29 0.73 0.4
Close Peer Freq of Use 0.66 0.13 0.56 4.99***
Romantic Partner Freq of Use 0.14 0.1 0.16 1.39
Note: (Cigarettes) Step 1 :R2= .08, Step 2: AR2= .09(p = .50), (Alcohol) Step 1: R2= .27, Step 2:
AR2= -31(p < .05), (Marijuana) Step 1: R2 = .35, Step 2: AR2 = .37, (p = .17) *<.05, **<.01,
***<.001, t.051-.06
38


For cigarette users, neither variable significantly predicted use. For marijuana
users, close peer frequency of use was a significant predictor of individual use in
step 1 (|3 = .59 p < .001) and step 2 ([3 = .56, p < .001). However, romantic
partner frequency of use was not a significant predictor of degree of marijuana
use among users when entered along side close peer frequency (but it should be
noted that when entered as a single predictor, it emerged as a trend; ((3= .26, p =
.058).
In contrast to cigarette and marijuana use, romantic partner frequency of
alcohol use was a significant predictor of individual alcohol use, above and
beyond close peer frequency of alcohol use. Specifically, in the first step of the
model peer frequency was significant ((3 = .52, p < .001) as the lone predictor. In
step 2 both close peer frequency = .40, p < .001) and romantic partner
frequency ((3 = .24, p < .05) significantly predicted individual use.
Close Peer and Romantic Partner Injunctive Norms
In addition to frequency of use, the present study was interested in
examining the injunctive norms (i.e. approval levels) present in close peer and
romantic partner relationships as they influence substance use behavior. As the
dependent variable remained frequency of own use, the analyses again were
39


first conducted predicting any use versus non-use, and then degree of use among
those who reported any amount of use.
Use Versus Non-Use.
In the binary logistic regression analyses predicting use versus non-use
the injunctive norms within close peer and romantic partner relationships were
found to be significant. These results are displayed in Table 4.
40


Table 4: Romantic Partner and Close Peer Approval of Use Use Vs. Non-Use
95% Cl for Odds Ratio
B SE (B) Lower Odds Ratio Exp(B) Higher
Step 1
Cigarettes (n=136)
Constant -2.90 0.54
Close Peer Approval 1.00 0.23 1.75 2.72*** 4.23
Alcohol (n=136)
Constant -4.22 0.56
Close Peer Approval 0.6 0.24 1.14 1.82* 2.9
Marijuana (n=136)
Constant -3.94 0.62
Close Peer Approval 1.53 0.24 2.89 4.64*** 7.43
Step 2
Cigarettes
Constant -3.44 0.62
Close Peer Approval 0.76 0.25 1.32 2.13* 3.46
Romantic Partner Approval 0.71 0.29 1.14 2.03* 3.6
Alcohol
Constant -1.18 0.66
Close Peer Approval 0.33 0.27 0.83 1.4 2.35
Romantic Partner Approval 0.67 0.28 1.14 1.99* 3.45
Marijuana (n=136)
Constant -4.21 0.67
Close Peer Approval 1.35 0.27 2.33 3.92*** 6.59
Romantic Partner Approval 0.36 0.28 0.83 1.43 2.47
Note: (Cigarettes) Step 1: R2 = .22 (Nagelkerke), Model *2(1)=23.47, pc.001. Step 2: AR2 .28
(Nagelkerke) Model*2(1)=6.32, p < .01. (Alcohol) Step 1: R2 = .07 (Nagelkerke), Model*2 (1)=
6.75, p<.05, Step 2: AR2 = .13 (Nagelkerke), Model*2(1)=6.55, p < .05, (Marijuana) Step 1: R2 =
.52 (Nagelkerke), Model*2(1)= 65.93, pc.001, Step 2: AR2 = .53 (Nagelkerke) Model*2(1)=1.65,
p = .20. *p<.05,**p<.01, ***p c.001
41


Predicting cigarette use versus non-use, both norms from close peers and
romantic partners significantly contributed to the probability of an individual
smoking. In step 1 of the model, close peer approval significantly predicted
smoking, with the odds of an individual smoking increasing 2.72 times for each
unit of approval. Once romantic partner approval was added, both variables
were shown to be significant. In the combined model, odds ratios were 2.03 and
2.13 for partner and peer approval respectively. In predicting alcohol use versus
non-use, close peer approval was significant in step 1, with an odds ratio of 1.82.
Romantic partner approval was added to the model in step 2, and was significant
with an odds ration of 1.99. Hypothesis 2 was thus confirmed in comparing
cigarette and alcohol users to non-users. However, this pattern of romantic
partner approval significantly predicting use versus non-use was not found for
marijuana. Close peer approval was significant both alone and when
accompanied by romantic partner approval across steps 1 and 2. Romantic
partner approval, however, was not statistically significant, when entered into
the equation in conjunction with close peer approval., It should be noted that,
when examined as the lone predictor of marijuana use, romantic partner
approval was a significant predictor with an odds ratio of 2.78. This influence
however did not exist once close peer approval was added again showing the
42


large portion of shared variance that exists between these two variables (r (134)
= .62,p<. 01).
Frequency of Use Among Users
Multiple regression equations were used to further investigate the
injunctive norms of close peer and romantic partner relationships across
frequency of use (Table 5).
43


Table 5: Close Peer and Romantic Partner Approval of Use Users Only
B SE (B) P t
Step 1
Cigarettes (n=43)
Constant 3.43 0.85
Close Peer Approval 0.35 0.31 0.173 1.12
Alcohol (n=98)
Constant 2.42 0.41
Close Peer Approval 0.43 0.15 0.28 2.80**
Marijuana (n=55)
Constant 0.38 0.73
Close Peer Approval 1.2 0.23 0.59 5.34***
Step 2
Cigarettes
Constant 3.34 0.86
Close Peer Approval 0.19 0.37 0.09 0.50
Romantic Part Approval 0.27 0.31 0.16 0.85
Alcohol
Constant 2.03 0.44
Close Peer Approval 0.25 0.18 0.16 1.4
Romantic Part Approval 0.37 0.18 0.23 2.09*
Marijuana
Constant 0.35 0.72
Close Peer Approval 0.86 0.29 0.42 3.02**
Romantic Part Approval 0.44 0.24 0.26 1.87
Note: (Cigarettes) Step 1: R2= .03, Step 2: AR2= .05 (p = .38), (Alcohol) Step 1: R2= .08, Step
2: AR2= .12 (p < .05), (Marijuana) Step 1: R2 = .35, Step 2: AR2 = .39, (p = .08),
*< .05, ** <.01, *** <.001
44


Certain trends were exhibited in these user-only analyses that were not found in
the user vs. non-user comparisons. Most notably, neither close peer nor
romantic partner approval were consistent predictors for every substance but
differed across analyses. In step 1 of the alcohol user only equation, close peer
approval was a significant predictor of frequency of use (P = .28, P < .01).
However, once romantic partner approval was added in step 2, peer approval
was no longer significant while romantic partner approval was (P = .23, P < .05),
indicating that once added to the equation, romantic partner approval accounted
for a significant portion of the variance among frequency of use, beyond what
close peer approval accounted for. The pattern found for alcohol use frequency,
however, was not seen in predicting marijuana use. Close peer approval was a
significant predictor of marijuana use both as a single predictor (P = .59, p <
.001) in step 1 and in conjunction with romantic partner approval in step 2 (P =
.42, p < .01). Similar to the results of the use versus non-use analysis, romantic
partner approval was significant as a single predictor (P = .53, p < .001) however
this influence was no longer present once examined along side close peer
approval in step 2 of the model. The results for cigarette use differed
substantially in comparison to marijuana and alcohol use. Neither romantic
45


partner nor close peer approval of use were significant predictors of cigarette
use.
Gender Interactions
OLS and binary logistic regression equations were run to examine the
interaction effects of the romantic partner variables with gender. The SPSS
macro MODPROBE was utilized to investigate any interaction effects.
MODPROBE is an addition to the SPSS statistical package created by Andrew
Hayes and Jorg Matthes (Hayes & Matthes, 2009). This macro allows for
interaction effects in regression equations to be examined for significance and
further probed across degree of the moderating variable. This Macro was used to
investigate the dichotomous moderator variable of gender.
Users Versus Non-Users. The first set of interaction equations targeted romantic
partner frequency of use X gender and romantic partner approval of use X
gender between users and non-users for all three substances (n= 136). Separate
binary logistic regression analyses were run for each interaction effect and each
substance. The results were consistent with much of the past literature showing
that these gender interactions did not follow a consistent pattern and were
46


relatively inconclusive in differentiating between users and non-users for each
substance. The interaction between romantic partner approval X gender for
alcohol use did show a significant interaction (unstandardized b= 1.27, p < .05)
with an odds ratio of 3.56, suggesting that as gender changes from male to
female, romantic partner approval becomes more influential when predicting
use versus non-use. This effect was further probed specifically at the two levels
of the moderator (male and female). The interaction revealed that for males (b=
.18, p = .63) romantic partner approval did not significantly predict use versus
non-use. For females however (b= 1.45, p < .001), romantic partner approval
was a significant predictor of an individual using alcohol. Based on this
interaction, romantic partner approval was a stronger predictor for females than
males. This finding, however, was the exception and not the norm as the other
interaction effects for partner variables by gender were not significant.
Frequency of Use Among Users. In a second set of OLS regression analyses, the
same romantic partner interaction variables were examined across users only,
for each of the three substances. The same analyses were run to probe
interactions among variables. Again results were mixed however, a significant
interaction was found for romantic partner frequency of use X gender
47


interaction for alcohol users (n= 98). A significant interaction was found in the
user only partner frequency X gender interaction for alcohol (b= -.45, p < .01). In
this analysis the influence of partner frequency decreased from males (h= .75, p
< .001) to females (b= .30, p < .001). Although significant for both, the results
showed a stronger influence among male users than female. Again this was the
only significant interaction for the romantic partner variables among the three
substances. The significant p-values of these interactions underscores the
important influence these romantic partner variables have on individual
substance use behavior. However, in light of the mixed findings of these
interactions (i.e., romantic partner approval of use appearing more important
for females use versus non use, but romantic partner frequency of use appearing
more important for male frequency of use), direct influences regarding the
moderating effect of gender remain ambiguous.
Problem Use Interactions
The purpose of these analyses was to investigate variations in romantic
partner and close peer influence among individuals with problem use behaviors.
Hypothesis 4 stated that romantic partner and close peer using behavior and
approval of use would predict frequency of use differently for problem users
48


than for individual's with less severe using behaviors. The CPQ-a and RAPI are
designed to measure various life problems associated with using alcohol and
marijuana.
Alcohol Problem Use. Interactions were run for close peer and romantic partner
frequency of use and approval of use X RAPI score using the MODPROBE macro
for OLS regression analyses to predict individual using behaviors (N=114). By
dividing a continuous moderating variable by its own standard deviation, this
macro provides values of how the independent variable predicts the dependent
variable at the mean and one S.D. above and below the mean of the moderator.
In this way the interaction itself can be examined based on low, medium and
high levels of the moderator without the need to categorize continuous variables
or devise arbitrary cutoff scores. The independent variables were first centered
and entered into the equation. Of the interactions, only peer approval of use X
RAPI score showed a significant interaction (h = .05, p < .01). Close Peer approval
predicting own use was investigated at low, moderate and high levels of RAPI
problem behaviors. At the lowest levels of problem use, peer approval was not a
significant predictor of own use. However at moderate and high problem
behavior levels, peer approval became a stronger predictor (at moderate, RAPI, b
49


= .42, p < .01; at high, RAPI b = .94, p < .001). Thus, close peer approval of alcohol
use was a stronger predictor of own alcohol use for individuals with moderate
and high alcohol problem behaviors than for individuals without. Although
noteworthy, this was the only significant interaction found among the peer and
partner influence variables and the RAPI scales.
Marijuana Problem Use. Similar interaction effects were run for peer and
romantic partner variables in conjunction with CPQ-a scores to investigate the
influence of problem use behaviors related to marijuana use (N=63). The
independent variables were centered and the MODPROB macro for multiple
regression analyses was used to examine the interaction effects. Neither peer
factors (peer frequency of use and peer approval of use) nor romantic partner
factors (romantic partner frequency of use and approval of use) were found to
have significant interactions with CPQ-a scores. That is, the influence of peer and
romantic partner variables did not become stronger (or weaker) predictors of
use as a product of increasing problem use behaviors associated with marijuana.
In summary, a significant interaction effect was found for close peer
approval of alcohol use X RAPI score in predicting individual frequency of use.
This result, however, is somewhat inconclusive when considered in light of the
50


other interaction results. It did not seem to be the case, in this sample, that peer
and romantic partner influence variables become stronger predictors of use as
individual problem use behaviors increase. The one significant interaction that
was found does imply that close peer approval of use may become a stronger
predictor of individual use as problem behaviors increase; however, when
considering the pattern of non-significant results from the other interaction
analyses this finding should interpreted with caution.
51


CHAPTER 4
DISCUSSION
Transition from Close Peer to Romantic Partner Influence
The primary purpose of this study was to investigate the influence
romantic partners and close peers have on the substance using behaviors of
individuals during late adolescence and young adulthood. Social networks have
long been studied for their influence over the behaviors and decisions made by
an individual. Social pressures exist through out the lifetime but are often most
salient during adolescence and early adulthood in which individuals are seeking
to establish their own identity but are simultaneously seeking the acceptance
and approval of those in their social groups. Developmental psychology outlines
this path throughout the lifespan in which first, infancy and childhood are made
up of complete dependence and reliance on parental structure and support.
Adolescence is next characterized by an increased autonomy and establishment
of social networks. Finally during adulthood the individual seeks out a mate and
begins creating a family of his or her own. As individuals develop personal
autonomy and rely more heavily on social support and acceptance during
52


adolescence, the behaviors and attitudes of peer groups influence the
individual's own behaviors and decisions. This influence becomes particularly
relevant in terms of developing delinquent behaviors and substance use, in
which peer behavior and approval have been found to consistently predict the
adolescent's own initiation and maintenance of similar behavior (Church,
Wharton and Taylor, 2009; Kristjansson et al., 2010; Wang et al., 2009; Wills et
al., 2004) The peer group relationships that are formed during adolescence are
often the first sources of social pressure an individual may experience. However,
as individuals progress through adolescence, peer relationships become
somewhat less important and the pursuit of romantic relationships takes
priority (Carver et al., 2003; Connoly, Furman, & Konarski, 2000; Laursen &
Williams, 1997). Romantic partners now become a source of support for the
individual and the partner's own behavior and approval becomes an important
predictor of individual behavior.
As discussed previously, romantic partner influence during adolescent
development has not been studied to the extent that peer influence has. The
present study targeted the issue of romantic partner influence during late
adolescence in order to address the gap in literature that exists pertaining to this
source of social influence during development. As made evident by this study
53


and past research, romantic partner variables are important sources of influence
and warrant further study (Collins, Welsh & Furman, 2009; Furman & Collins,
2008; Haynie et al., 2005; Kierkus, 2009; Miller et al, 2010; van der Zwaluw et al.,
2009). With this purpose in mind, the present study sought to investigate
romantic partner influence as a predictor of alcohol, tobacco and marijuana use
during late adolescence.
Romantic Partner Using Behavior Predicts Individual Use
Hypothesis 1 stated that romantic partner use would predict individual
use above and beyond the influence of close peers. The analyses predicting use
versus non-use status in Table 1 show that for alcohol and marijuana use,
romantic partner frequency of use was significant above and beyond the
influence of close peer frequency of use. However, this was not found for
cigarette use, in which only close peer frequency was significant and not
romantic partner. In the users only analyses (Table 3), the romantic partner use
variable again predicted use beyond the influence of the close peer use variable
for alcohol users, but not for marijuana or cigarette users. Additionally in the
user only analysis, neither close peer nor romantic partner variables were
significant predictors for cigarette users. Once the first set of analyses were
54


completed, romantic partner frequency of use was examined as an individual
predictor without the influence of close peer frequency of use for the substances
in which it was not significant in the initial analyses. The results of these
secondary regression equations found that for cigarette and marijuana use
among users only, romantic partner frequency of use was not significant in
conjunction with close peer use, but was significant when isolated as an
individual predictor.
These results are important for a number of reasons, the first being that
hypothesis 1 was confirmed. Romantic partner frequency of use was found to be
significant in predicting alcohol and marijuana use versus non-use as well as
frequency of alcohol use across users only. Furthermore, in these analyses
romantic partner use accounted for a significant portion of the variance among
users beyond the influence of close peer frequency. Close peer and romantic
partner use and approval variables are very closely related (correlations ranging
from .39 to .62 across substances) and the instances in which romantic partner
use was not significant when paired with close peer use, but was significant as a
solo predictor, demonstrate the shared variance that exists. Despite this overlap,
romantic partner influence often, but not always, still emerged with unique
predictive variance. These findings confirm previous research regarding the
55


importance of peer influence during adolescent but also underscore the message
that has been stated by many recent authors that romantic relationships during
adolescence can play influential roles in the decisions and behaviors of the
individual.
These findings are also consistent with principles from developmental
psychology suggesting that while close peer influence continues to be an
important influence, romantic partner influence has become just as, and in many
instances, even more important than that of close peers. The evidence for the
importance of romantic partner influence is further strengthened by the results
for hypothesis 2 in which the injunctive norms of the individuals peer and
romantic partner relationships were examined.
Injunctive Norms Within Romantic Relationships Predict Individual Use
Injunctive norms are the basic feelings and attitudes pertaining to certain
behaviors or beliefs that exist among the individuals in a group or relationship.
These attitudes or beliefs can be directed toward any number of things but in the
present study refer specifically to the injunctive norms surrounding substance
use in close peer and romantic relationships. Hypothesis 2 targeted the influence
that exists among romantic partner relationships and stated that the approval or
56


disapproval of substance use from close friends and romantic partners would be
directly related to adolescent use of alcohol, tobacco and marijuana, and that
romantic partner approval would predict adolescent use above and beyond the
effects of close peer approval. Table 3 shows the results of these analyses again
in predicting use versus non-use. Close peer approval significantly predicted use
for cigarettes and marijuana. Romantic partner approval significantly predicted
use, beyond the influence of close peers, for cigarettes and alcohol but not
marijuana. The influence of romantic partner approval changed in the user only
analyses (table 5) in which it was only a significant predictor of use among
alcohol users. Only close peer approval significantly predicted use among
marijuana users while neither romantic partner nor close peer approval
predicted frequency of use among cigarette users. These analyses provide partial
confirmation for hypothesis 2, in that strong support was found for the influence
of romantic partner approval as a predictor of use versus non-use beyond the
effects of close peer approval. This influence, however, begins to wane when
predicting frequency of use among users-only, in which romantic partner
approval was only significant for alcohol use. These findings provide additional
evidence regarding the role that romantic partner influence plays in the
substance using behavior of individuals in late adolescence.
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It is important to note that while the confirmation of hypotheses 1 and 2
in the present study represent contributions to the theoretical understanding of
changes that occur in social influence during the late adolescent period,
adolescence itself is a construct that may be bound by regional or societal
interpretation. In North America and Western European countries, adolescence
is characterized and understood as a period of emerging autonomy, self-
formation, association with peer groups, and increasing engagement in romantic
relationships and interactions. A limitation of this study exists, therefore, in
terms of generalizability to people that may have a different cultural view of the
"adolescent" period of development. Thus a direction for future research would
be to evaluate potential cultural differences in defining this developmental
period and target peer and partner influence in societies with different
interpretations of what the construct of "adolescence" is and what changes occur
during this period.
Influence Variations Across Substances
The primary findings of the present study focus on the confirmation of
hypotheses 1 and 2 in which romantic partner frequency and approval of use
were found to be significant predictors of adolescent substance use and in many
58


instances accounted for additional variance in use beyond the effects of close
peer use and approval. It is important to discuss, however, the variations that
were found among peer and partner variables across the three substance
domains of alcohol, tobacco and marijuana. As three of the most widely used
substances during the adolescent period, the results of this study provide
important insight regarding the differences among social factors pertaining to
the initiation and maintenance of substance using behaviors. As alcohol and
tobacco are legalized substances that are highly prevalent in society today, these
two were theorized to be highly prevalent in a sample of adolescent college
students. Marijuana was theorized to be frequently used among college students
but to take a third place to alcohol and tobacco use. Alcohol was found to be the
most frequently use substance (62%) while cigarette use was much less
prevalent than had been initially expected (28%). Marijuana use, however,
proved to be somewhat more prevalent than expected (35%), possibly, as noted
earlier, due to greater accessibility to marijuana in the Denver area.
Within the current sample, the lower prevalence of tobacco in
comparison to alcohol and marijuana use that were found in the present study
are consistent with general trends of cigarette use throughout the United States
in the last decade. From 2002- 2009 cigarette use in the general population
59


declined from 26.0% to 23.3 % and from 45.3% -40.8% in young adults ages 18-
25 (NSDUH, 2009). This decline is likely due to increased education around the
harmful effects of cigarette use that has occurred in recent years.
Alcohol rates in the current study closely matched the NSDUH survey
results for college student use across the United States. These rates have
remained consistent since 2002. College alcohol use, however, presents unique
using behaviors of its own. The NSDUH found that while 63.9% of college
students were recent alcohol users, 40.3% of students were also binge drinkers
(NSDUH, 2009). This pattern of drinking frequency and particularly binge
drinking is an important aspect of college age substance use and is increasingly
prevalent among college students. While the current study did not directly target
binge-drinking behavior, this is an area that warrants further investigation due
to its prevalence among this particular age group.
The results of the present study found that close peer and romantic
partner variables fluctuated in terms of influence and predictive power across
substances. Romantic partner frequency and approval of use were generally
better predictors when comparing use versus non-use rather than frequency
among users only. Two potential issues likely contributed to the variance among
peer and partner variables found in the present study. The first issue refers to
60


the underlying mechanisms that make up substance use initiation and
maintenance. When investigating substance using behaviors, one must consider
that influence and motivations to use change as a product of an individual's
increased and prolonged using behavior. While the results from the current
study imply that romantic partner frequency of substance use influences the
individual's own frequency of use, it is likely that this influence changes as use in
general is increased and/or maintained over time. This is due to the effects of
physical tolerance that occur as a product of prolonged substance use. Thus,
even if an individual initiates use of a particular substance as a product of
romantic partner influence, the individuals own physiological responses will,
eventually, create other motivators to use. Physical dependence becomes a
factor and tolerance builds, causing the individual to use more to achieve the
same sensation. As a result, physical addiction becomes a primary motivator to
use. Additionally psychological dependence can become a factor and the
individual may increase in frequency of use as a coping mechanism or in seeking
to attain pleasurable sensations. In both situations, physical and psychological
motivators are causing the individual to use. Although the romantic partner's
own substance use, and subsequent approval of use, may have influenced the
individual's initiation or increase in substance use frequency, these may not be
61


the same variables that facilitate continual use. The present study has shown
that romantic partner use and approval significantly influence the using
behavior of the individual. However, when examining these effects at a more
specific level among users only, many other confounding variables may come
into play. This research has extended the work and theories of recent authors
pertaining to the importance of romantic partner variables in the lives of
adolescent and young adult populations. The next step, however, is to investigate
the deeper levels of romantic partner influences and one area is how these
factors change as product of long-term substance use over time.
A second noteworthy issue when interpreting the findings of the present
study pertains to the user-only sample sizes. The total sample for the study was
136 participants, which provided adequate power to detect medium to small
effects with a power level of .80, and alpha level of .05 for two predictor
variables (Miles & Shevlin, 2001). This design was utilized in the binary logistic
regression analyses that compared users to non-users. However, in the user only
analyses, the sample sizes became much smaller due to the fact that not every
participant had used the given substance. This was most evident among
cigarette users, which had the smallest sample size of the three substances
(n=52), and also provided the most inconsistent results for the peer and
62


romantic partner variables among users. This issue of sample size among users
only, which restricted the power of these analyses relative to the use vs non-use
analyses, represents one potential limitations of the current study. As an
extension of the present findings, future research specifically addressing user
only analyses with large sample sizes for each substance would provide further
details regarding close peer and romantic partner influences on substance use
behavior.
Moderation Effects
A secondary aim of the current study was to investigate potential
differences in romantic partner variables across gender. It was initially
hypothesized that romantic partner frequency and approval of use would
predict individual using behaviors differently for males than females. Given
certain societal norms and traditional gender roles in relationships, it was
theorized that females would be more susceptible to influence from their male
romantic partners than males would be from their female partners. The results,
however, did not show a consistent pattern of interactions among romantic
partner variables and gender. Of the analyses that were run for the three
substances, only two interactions were significant. The first found that romantic
63


partner approval X gender for alcohol use was significant when predicting use
versus non-use. This interaction found that romantic partner approval of use
was a stronger predictor of use for females than for males. The second
significant interaction effect however contradicted the results of the first. In
examining romantic partner frequency of use X gender for alcohol users only,
partner influence was a stronger predictor of frequency of use for males than for
females. These finding are interesting in their own right because they suggests
that a potential difference exists in the way that romantic partners influence
substance use between men and women. These finding were also consistent
with study hypotheses at a general level, suggesting that gender interactions
may exist among romantic partner variables; however, the contradictory nature
of the findings make it difficult to interpret a definitive direction of these effects.
As a final aim of the present study, peer and romantic partner variables
were investigated for interaction effects among levels of problem use behavior
pertaining to alcohol and marijuana use. It was hypothesized that close peer and
romantic partner frequency and approval of use would predict individual use
differently for users exhibiting more problematic use behaviors. Of the
interactions that were run, only peer approval of use X alcohol problem
64


behaviors was significant. Individual problem behaviors were based on total
Rutgers Alcohol Problem Index scores. The interaction showed that close peer
approval of use was a stronger predictor of use for individuals at the medium
and high problem use levels. This finding is of interest primarily because of its
contrast with other results in the study. As mentioned previously, romantic
partner and close peer variables were found to be significant more often when
predicting use versus non-use rather than frequency of use among users only.
These findings suggest that the influence of social variables may weaken as
individual use increases and is maintained over time. The finding in the peer
approval X RAPI interaction, however, contradicts this theory and suggests that
peer approval may become stronger as problem use increases. Based on this
contradiction further study is needed. It is important to interpret this finding
with caution as it was the exception and did not represent a pattern in the data.
The other problem use interactions were not significant and did not support the
idea that peer or romantic partner influence increases with severity of use. This
finding does however suggest the further study is warranted and additional
research would be needed to accurately determine these interaction effects.
65


Implications and Future Research
The present study has shown that romantic partner influence is an
important component and predictor of substance use during late adolescence
and young adulthood. The study had addressed an aspect of adolescent research
that has been neglected in the past and has highlighted the importance and value
in targeting romantic partner interactions and relationships during this
developmental period. Although demonstrating the influential role that romantic
partners play in predicting an individual's substance using behaviors, this study
has also raised additional questions and revealed many potential areas for
further study. The findings from the present study suggest that more focus
should be placed on the romantic relationships that adolescents engage in. As
individuals seek to find intimate companions and romantic relationships, the
types of people they choose to date may very well influence their decisions
regarding substance use. Peer groups and close peer relationships are an
important component regarding substance use, but as the results of the present
study have shown, romantic partners and dating companions also possess the
ability to influence an individual's behavior.
Initiation Vs. Maintenance Effects. The issue of selection in terms of
romantic partners and the subsequent influence that results from these
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relationships must now be addressed. In an effort to understand the
mechanisms of romantic partner influence, the deeper issue that must be further
pursued is in regards to how romantic partners are chosen. The present study
has shown that romantic partner behaviors can predict decisions individuals
make regarding substance use. However, further research should examine
whether or not individuals were already using when they chose other substance
using partners or if the romantic relationship facilitated the individual's use in
the first place. If the using adolescent primarily chooses substance using
romantic partners, the romantic partner influence, both in terms of injunctive
norms and using behavior, may act more as a maintenance factor, thereby
facilitating the continual use of the adolescent. If on the other hand, the
adolescent engages in use as a product of being in a relationship with a
substance user, the influence is now one of initiation into use.
Future Direction. The findings from the present study are significant in
their own right and establish the importance of romantic partner influence on
adolescent substance use that has been previously neglected in adolescent
research. These findings offer a good starting point, but much more remains to
be studied. In order to completely understand romantic partner influence, many
of the questions presented above need to be addressed. One unique difference
67


between romantic partners and close peers is that as individuals enter
adulthood and begin engaging in more frequent romantic encounters and
relationships, many different partners can become potential sources of
influence. The present study has shown that dating experiences and romantic
partners may influence an individual more than peer relationships do,
particularly in late adolescence and early adulthood. This study has established
the importance of romantic partner attitudes and using behaviors as predictors
of adolescent substance use. The next step in understanding these social factors
should be to investigate romantic partner influence over time. It is important to
uncover those variables that promote initiation to use versus those which
maintain substance-using behaviors. Understanding these differences may be
key to effectively treating adolescent substance users as well as helping
individuals avoid substance use behavior all together.
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APPENDIX A
QUESTIONNAIRES
Cannabis Problem Questionnaire-Adolescent (CPQ-a)
Below you will find a list of questions that relate to difficulties that other people who use
cannabis sometimes complain of.
Read each question carefully and answer either YES or No
Some questions specifically ask about problems associated with using cannabis, while
others ask about general problems that may have occurred.
In the last 3 months:
1. Have you tended to smoke more on your own than you used to?
1) yes 2) no
2. Have you worried about meeting people you don't know when you are stoned?
1] yes 2) no
3. Have you spent more time with smoking friends than other kinds of friends?
1) yes 2) no
4. Have your friends criticized you for smoking too much?
1) yes 2) no
5. Have you had any debts as a result of needing to buy cannabis?
1) yes 2) no
6. Have you pawned any of your belongings to buy cannabis?
1) yes 2) no
7. Have you found yourself making excuses about money?
1) yes 2) no
8. Have you found yourself worried about the amount of money you have been
spending on cannabis?
1) yes 2) no
9. Have you been caught out lying about money?
1) yes 2) no
10. Have you been in trouble with the police due to your smoking?
1) yes 2) no
11. Have you been in juvenile detention or prison?
1) yes 2) no
12. Have you been physically sick after smoking?
1) yes 2) no
13. Have you passed out after a smoking session?
1) yes 2) no
14. Have you had pains in your chest or lungs after a smoking session?
1] yes 2) no
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15. Have you had a persistent chest infection or cough?
1) yes 2) no
16. Have you felt paranoid or antisocial after a smoking session?
1) yes 2) no
17. Have you had any accidents requiring hospital admission after smoking?
1) yes 2) no
18. Have you lost any weight without trying to?
1) yes 2) no
19. Have you been neglecting yourself physically?
1) yes 2) no
20. Have you felt depressed for more than a week?
1) yes 2) no
21. Have you felt so depressed you felt like doing away with yourself?
1) yes 2) no
22. Have you given up any activities you once enjoyed because of smoking?
1) yes 2) no
23. Have you had less energy than in the past?
1) yes 2) no
24. Have you found it hard to get the same enjoyment from your usual interests?
1) yes 2) no
25. Has your general health been poorer than usual?
1) yes 2) no
26. Have you driven while stoned?
1) yes 2) no
27. Have you worried about getting out of touch with friends or family?
1) yes 2) no
28. Have you been concerned about a lack of motivation?
1) yes 2) no
29. Have you felt less able to concentrate than usual?
1) yes 2) no
30. Have you worried about feelings of personal isolation or detachment?
1) yes 2) no
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Rutgers Alcohol Problem Index (RAPI, 23-item version)
Different things happen to people while they are drinking ALCOHOL or because of their
ALCOHOL drinking. Several of these things are listed below. Indicate how many times each
of these things happened to you WITHIN THE LAST YEAR.
HOW MANY TIMES HAS THIS HAPPENED TO YOU WHILE YOU WERE DRINKING
OR BECAUSE OF YOUR DRINKING DURING THE LAST YEAR?
1. Not able to do your homework or study for a test
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
2. Got into fights with other people (friends, relatives, strangers)
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
3. Missed out on other things because you spent too much money on alcohol
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
4. Went to work or school high
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
5. Caused shame or embarrassment to someone
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
6. Neglected your responsibilities
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
7. Relatives avoided you
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
8. Felt that you needed more alcohol than you used to in order to get the same effect
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
9. Tried to control your drinking (tried to drink only at certain times of the day or in
certain places, that is, tried to change your pattern of drinking)
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
10. Had withdrawal symptoms, that is, felt sick because you stopped or cut down on
drinking
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
11. Noticed a change in your personality
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
12. Felt that you had a problem with alcohol
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
13. Missed a day (or part of a day) of school or work
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
14. Wanted to stop drinking but couldn't
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
15. Suddenly found yourself in a place that you could not remember getting to
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
16. Passed out or fainted suddenly
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
17. Had a fight, argument or bad feeling with a friend
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
18. Had a fight, argument or bad feeling with a family member
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
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19. Kept drinking when you promised yourself not to
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
20. Felt you were going crazy
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
21. Had a bad time
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
22. Felt physically or psychologically dependent on alcohol
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
23. Was told by a friend, neighbor or relative to stop or cut down drinking
0 = None 1 = 1-2 times 2 = 3-5 times 3 = More than 5 times
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Items Adapted from the National Survey of Drug Use and Health, 2007
Adolescent Frequency of Use
Cigarettes
1. What is your best estimate of the number of days you smoked part or all of a
cigarette during the past 30 days?
0= Did not smoke Cigarettes, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4=
10-19 days, 5= 20-29 days, 6 = all 30 days
2. Who are you usually with when smoking cigarettes?
1= I am usually alone, 2= my close friends, 3= my romantic partner, 4= both my
close friends and my romantic partner 5= neither my close friends or my
romantic partner
3. Between your close friends and your romantic partner, who do you believe
influences your cigarette use more?
1= Close Friends
2= Romantic Partner
3= Both Equally
4=Neither
Marijuana
4. What is your best estimate of the number of days you used marijuana during the
past 30 days?
0= did not use Marijuana, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4= 10-19
days, 5= 20-29 days, 6 = all 30 days
5. Who are you usually with when using Marijuana?
1= 1 am usually alone, 2= my close friends, 3= my romantic partner, 4= both my
close friends and my romantic partner 5= neither my close friends or my
romantic partner
6. Between your close friends and romantic partner who do you believe influences
your marijuana use more?
l=Close Friends
2= Romantic Partner
3= Both Equally
4= Neither
Alcohol
7. What is your best estimate of the number of days you drank alcohol during the
past 30 days?
0= Did not use Alcohol, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4= 10-19
days, 5= 20-29 days, 6 = all 30 days
8. Who are you usually with when drinking alcohol?
1= 1 am usually alone, 2= my close friends, 3= my romantic partner, 4= both my
close friends and my romantic partner, 5= neither my close friends or my
romantic partner
9. Between your close friends and romantic partner who do you believe influences
your alcohol use more?
73


1= Close Friends
2= Romantic Partner
3= Both Equally
4=Neither
10. In the last 30 days, how many drinks did you usually have in a typical day of
drinking?
0= Did not drink Alcohol, 1= 1-3 drinks, 2= 4-6 drinks, 3= 7-10 drinks, 4= 10-13
drinks, 5= 14-20 drinks, 6= more than 20 drinks
11. In your lifetime, what is that maximum number of alcoholic drinks you have
consumed in a 24-hour period?
0= 0 drinks, 1= 1-3 drinks, 2= 4-6 drinks, 3= 7-10 drinks, 4= 10-13 drinks, 5=
14-20 drinks, 6= more than 20 drinks
12. On how many days, in the last 30 days, did you consume 5 (for males)/ 4 (for
females) or more alcoholic drinks in a two-hour period?
0= 0 days, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4= 10-19 days, 5= 20-29
days, 6 = all 30 days
Close Friend Frequency of Use
Cigarettes
1. What is your best estimate of the number of days your close friends smoked
part or all of a cigarette during the past 30 days?
0= Did not Use Cigarettes, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4= 10-
19 days, 5= 20-29 days, 6 = all 30 days
Marijuana
2. What is your best estimate of the number of days your close friends used
marijuana during the past 30 days?
0= Did not Use Marijuana, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4= 10-
19 days, 5= 20-29 days, 6 = all 30 days
Alcohol
3. What is your best estimate of the number of days your close friends drank
alcohol during the past 30 days?
0= Did not Drink Alcohol, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4= 10-19
days, 5= 20-29 days, 6 = all 30 days
4. In the last 30 days, how many drinks did your close friends typically have in a
day of drinking?
0= Did not Drink Alcohol, 1= 1-3 drinks, 2= 4-6 drinks, 3= 7-10 drinks, 4= 10-13
drinks, 5= 14-20 drinks, 6= more than 20 drinks
5. What is your best estimate of the number of drinks your close friends have ever
had in a 24 hour period
0= 0 drinks, 1= 1-3 drinks, 2= 4-6 drinks, 3= 7-10 drinks, 4= 10-13 drinks, 5=
14-20 drinks, 6= more than 20 drinks
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6. On how many days, in the last 30 days, did your close friends consume 5 or
more alcoholic drinks (if they are male friends) or 4 or more alcoholic drinks (if they are
female friends) in a two-hour period?
0= 0 days, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4= 10-19 days, 5= 20-29
days, 6 = all 30 days
Romantic Partner Frequency of Use
For the following questions, a romantic relationship is defined as an ongoing, voluntary
interaction marked by expressions of affection and possible current or anticipated sexual
behavior.
1. Are you currently in a romantic relationship?
1= yes, 2= no
2. If No, during the last 12 months were you involved in a romantic relationship?
1= yes, 2= no
3. What is/was the duration of your current or most recent romantic relationship?
1= 0-1 month, 2= 1-3 months, 3= 4-7 months, 4= 8-12 months, 5= more than a
year
4. How old is your Romantic Partner?
5. Which statement best describes your current romantic relationship status?
1= Not currently involved in a romantic relationship
2= Involved in many romantic relationships
3= Involved in 2 or 3 romantic relationships
4= Involved in only one romantic relationship
5= Involved in a committed romantic relationship (both partners have agreed to
being romantically involved with only one another)
6. On the following scale, please indicate how serious you consider your current
romantic relationship to be, if involved in multiple romantic relationships, consider the
one most important to you.
1= Very casual
2= Somewhat casual
3= not casual but not serious
3=Somewhat serious
4= Very Serious
7. Which best applies to your current or most recent romantic partner?
1= a member of the opposite sex
2= a member of the same sex
For the following questions, consider your current romantic relationship. If you are in
multiple romantic relationships, consider the one most important to you.
75


Cigarettes
8. What is your best estimate of the number of days your romantic partner
smoked part or all of a cigarette during the past 30 days?
0= Did not smoke Cigarettes, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4=
10-19 days, 5= 20-29 days, 6 = all 30 days
Marijuana
9. What is your best estimate of the number of days your romantic partner used
marijuana during the past 30 days?
0= Did not use Marijuana, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4= 10-
19 days, 5= 20-29 days, 6 = all 30 days
Alcohol
10. What is your best estimate of the number of days your romantic partner drank
alcohol during the past 30 days?
0= Did not drink Alcohol, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4= 10-19
days, 5= 20-29 days, 6 = all 30 days
11. In the last 30 days, how many drinks did your romantic partner usually have in
a typical day of drinking?
0= Did not drink Alcohol, 1= 1-3 drinks, 2= 4-6 drinks, 3= 7-10 drinks, 4= 10-13
drinks, 5= 14-20 drinks, 6= more than 20 drinks
12. What is your best estimate of the maximum number of alcoholic drinks your
romantic partner has consumed in a 24-hour period?
0= 0 drinks, 1= 1-3 drinks, 2= 4-6 drinks, 3= 7-10 drinks, 4= 10-13 drinks, 5=
14-20 drinks, 6= more than 20 drinks
13. In the last 30 days, how many times did your romantic partner consume 5 or
more alcoholic drinks (if they are male) or 4 or more alcoholic drinks (if they are
female) in a two-hour period?
0= 0 days, 1= 1 or 2 days, 2= 3 to 5 days, 3= 6 to 9 days, 4= 10-19 days, 5= 20-29
days, 6 = all 30 days
Close Friend Approval of Use
1. How do you think your close friends would feel about you smoking one or more
cigarettes a day?
1= strongly disapprove, 2= somewhat disapprove, 3 somewhat approve, 4=
strongly approve
2. How do you think your close friends would feel about you having one or more
drinks of an alcoholic beverage a day?
1= strongly disapprove, 2= somewhat disapprove, 3 somewhat approve, 4=
strongly approve
3. How do you think your close friends would feel about you using marijuana at
least once a day?
1= strongly disapprove, 2= somewhat disapprove, 3 somewhat approve, 4=
strongly approve
76


Romantic Partner Approval of Use
1. How do you think your romantic partner would feel about you smoking one or
more cigarettes a day?
1= strongly disapprove, 2= somewhat disapprove, 3 somewhat approve, 4=
strongly approve
2. How do you think your romantic partner would feel about you having one or
more drinks of an alcoholic beverage a day?
1= strongly disapprove, 2= somewhat disapprove, 3 somewhat approve, 4=
strongly approve
3. How do you think your romantic partner would feel about you using marijuana
at least once a day?
1= strongly disapprove, 2= somewhat disapprove, 3 somewhat approve, 4=
strongly approve
77


Descriptive Items
Gender
1= Male, 2= Female
Age
Ethnicity
1= African American
2= Hispanic
3= Caucasian
4= Asian
5= Native American/ Alaskan Native
6= Native Hawaiian/ Pacific Island
7= Other
78


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