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Official websites use. Share sensitive information only on official, secure websites. Address correspondence to Jason T. With an eye toward future primary prevention efforts, this study explores perceptions of inhalant utility among young adolescents in the United States. Three main themes emerged concerning the perceived utility of inhalant use: 1 Inhalant use as a means of mental escape, 2 Inhalant use as a social tool, and 3 Inhalant use as a parental relations tool. Additionally, participants discussed an interaction hypothesis regarding inhalant use and popularity. Implications for future research are suggested and limitations described. Keywords: inhalants, adolescence, focus group, utility, function, drug use, middle school, sniffing, huffing. Department of Education, Inhalants are associated with negative mental health outcomes, such as affective disorders, antisocial personality disorders, depression Jacobs and Ghodse, ; Kelder et al. Inhalant use is especially problematic among younger adolescents. Similarly, whereas annual use of inhalants reaches its peak in 8th grade, the annual use of hallucinogens, heroin, ecstasy, steroids, oxycontin, alcohol, tobacco, marijuana, cocaine, and uppers peaks in 12th grade. The popularity of inhalants among younger adolescents may be due to inhalants being inexpensive and available in a wide array of legal products—many of which are found in a typical home. Moreover, the relatively brief duration of the inhalant high permits their covert use with less chance of detection by parents or other authorities Dinwiddie, ; Kurtzman et al. Perceptions of inhalant injuries are also different from other drugs. Moreover, motivations underlying inhalant use are anomalous. Motivations behind inhalant use must be explored if intervention efforts are to be successful at preventing use. Many prevention efforts focus on the physical harms of using inhalants. However, most theories of health behavior acknowledge that a decision to use is based on the ratio of perceived harms to perceived benefits. The Theory of Reasoned Action Ajzen and Fishbein, also emphasizes the importance of understanding whether adolescents believe that using inhalants will lead to positive outcomes and reduce the likelihood of negative ones. If future primary prevention efforts are to curtail inhalant use, young adolescents will have to be convinced that the harms of inhalant use outweigh the benefits. Consideration of the functional underpinnings of illicit drug use may prove important given the substantial literature linking substance-related expectancies to consumption Christiansen and Goldman, ; Stacy, Newcomb, and Bentler If individuals develop expectations for the outcomes of inhalant use, it is reasonable to assume that these expectations may make inhalant use a salient behavior to meet a given need or function. Although research exploring the perceived outcomes of inhalant use is scant, Boys and colleagues Boys and Marsden, ; Boys et al. Our review of the literature uncovered scant research focusing on why young adolescents use inhalants. MacLean interviewed inhalant users in Australia; however only a portion of the interviewees was under Exploring the perceived utility of inhalant use can provide key information for those seeking to prevent young adolescents from future inhalant use. Our goal is to explore perceived functionality so that before inhalant use can become habitual, young adolescents can be convinced that any perceived utility is either ill-conceived or greatly outweighed by harms. A focus group approach was selected as the method of data collection applied as a goal of generating new insights and hypotheses regarding the nature of inhalant use among middle school students. This technique is most useful in hypothesis-generating contexts and seems ideal for present purposes Crano and Brewer, A key strength of focus groups is their capacity to provide insights into the sources of complex behaviors and motivations Krueger, ; Morgan and Krueger, Focus groups are particularly useful when seeking to identify and explore contexts not currently understood by researchers and to produce insights and data that may not arise out of other means of data collection Balch et al. This study is a qualitative descriptive investigation. It makes use of data gathered in nine focus groups conducted in Tucson, Arizona. Several middle schools in Tucson were called toward the end of the school year and invited to participate. Contact was made with 16 different schools. The majority of schools that were unable to participate reported interest, but stated it was too late in the school year. Five of the schools agreed to participate. In these five schools, administrators informed teachers of the study, who in turn informed their students about participating in the study. Twenty-two participants were from secular schools, while 25 were from religion-based charter schools. Parental consent forms were sent home with all students of participating schools. Only students returning signed consent forms were permitted to participate in the focus groups. No more than two focus groups were conducted in any school. Focus groups were conducted on school grounds, without any teachers present. When feasible, moderators were instructed to divide groups by either age or gender. If there were sufficient participants for one female and one male focus group of similar age, groups were divided by gender. If a choice had to be made between splitting by gender or age, a choice was made to have the group consisting of adolescents of different genders but similar age. This tack was perceived as the best method for creating homogeneous groups Thorne and Henley, Of the nine focus groups conducted, one consisted of only males and one of exclusively females of the same grade. The remaining seven groups consisted of males and females of the same grade. To assure procedural consistency among the groups, a moderator guide was created Krueger, The first author moderated five of the nine groups, and four different research assistants moderated the others. At the start of the focus groups, moderators instructed participants that some personal questions would be asked. I promise they will be confidential—that means just between you and me. I will not tell your parents, your teachers, or anyone else about them unless you give me permission. Once confidentiality was discussed, all participants were assigned a number. Participants were asked to refer themselves and their fellow participants by the assigned numbers rather than their names for the remainder of the groups. This was done to increase feelings of anonymity and reduce chances of breach in confidentiality. After the assigning of identification numbers, moderators instructed participants to spread themselves throughout the room. Brief pre-discussion questionnaires were distributed and participants were asked to write their numbers—not their names—on top of the questionnaire. The questionnaire included items assessing age, gender, ethnicity, past inhalant use, and inhalant susceptibility. Table 1 summarizes the demographic characteristics of the sample. Thirteen participants Seven of these participants were from religion-based charter schools and six were not. Although the same reasons for inhalant use came up regardless of the number of past users in the focus group, it would have been ideal to hold separate groups for users and nonusers. A low number of users at each location made such a plan unfeasible. Moreover, holding separate groups based on use status could easily have led to students identifying the users within their schools. This would have breached the confidentiality assured to participants. Once pre-discussion questionnaires were completed and collected, moderators were instructed to give each participant a small table tent with their number inscribed on it. The purpose of the table tents was to assist the participants in calling each other by their numbers rather than their names. Focus groups were scheduled for 45—60 min. While schedule of focus groups with adults can range up to 2 hr, Krueger recommends that focus groups with youth be kept to this shorter time frame. As the goal of this study was to understand the perceived utility of inhalant use, central discussion questions included the following: 1 Why do you think some people use inhalants? To ensure construct validity, the term inhalant was defined prior to these questions being asked. The following follow-up questions were asked in groups in which participants brought up the use of inhalants as a social tool: a From a popularity standpoint, what do you think would happen to someone who used inhalants? Following the suggestions given by Morgan , the groups were audiotaped rather than videotaped. Although video recording has some benefits, they are far outweighed by the possible constraints video recording may place on focus group—especially in discussions of personal and socially disapproved behavior. All focus group audiotapes were transcribed and double-checked for accuracy. Five research team members individually read through each transcript. This was done to avoid relying too much on the judgment of one or two analysts Stewart and Shamdasani, Once researchers read through the transcripts, emerging thematic units were discussed. After several discussions, consensus on the most prevalent themes was reached. A coding guide was created based upon these thematic categories. Next, two coders independently read the transcripts. The coding guide directed the coders to label each thematic occurrence. The two coders were in complete agreement on Three main themes emerged concerning the perceived utility of inhalant use: 1 Inhalant use as a means of mental escape, 2 Inhalant use as a social tool, 3 Inhalant use as a parental relations tool. Throughout this section, quotes from participants are being given along with their age, gender, ethnicity, and user status. Comments voiced by one focus group participant can, and likely to, influence responses advanced by other group members. Therefore, comments made by participants of a specific age, gender, ethnicity, and user status should not be generalized throughout other members of a specific demograpy. Nonetheless, such information may serve as a catalyst for future exploratory research, and as such is provided. Discussion of inhalant use as a means of mental escape occurred in every focus group. Regardless of the moderator or the composition of the group, the comments revolved around a similar theme, i. These comments also arose whether the focus group was made up of all nonusers, or mainly nonusers with either one to two users. So it relieves the pressure. You can use it to get out of yourself. But you feel good when you are high. In eight of the nine focus groups, discussion arose concerning the perceived social utility of inhalants. The one group that did not discuss the social utility of inhalant use consisted entirely of self-reported non-users. Each of these two subcategories will be reviewed individually. Across groups, regardless of the moderator or school-type, discussion content was strikingly similar. Participants described situations where a desire for social acceptance, or some other form of social reward, motivated inhalant use. And the only way he would feel comfortable around them is if he actually did inhalants with them. A substantial number of comments arose concerning this theme. Participants described situations in which inhalant use was a necessary tool for maintaining friendships. So, if you finally have friends and they start doing drugs and stuff and they say they want you to start doing it. When moderators further probed perceptions regarding the use of inhalants leading to social acceptance and popularity, focus group participants described what can best be labeled as an interaction hypothesis: Inhalant use will lead to increased popularity for some but not for others. Every group that discussed the use of inhalants as a social tool mentioned this hypothesis. Depends on who is doing the judging. And depending on what neighborhood it is in. With the hope of obtaining a greater understanding of perceptions of inhalant use, participants were asked to compare the social utility of inhalants to that of marijuana. Inhalants are easy to get … pot is harder to get. In one-third of the focus groups, discussion arose concerning inhalant use as a tool for dealing lack of parental attention. Although comments revolving around this theme were limited, they arose spontaneously without any prompting from moderators. If their parents are like at work all of the time. Other participants explicitly discussed the perception that inhalants can be used to get parental attention. Just doing something wrong so their parents will pay attention to them. So you are going like for a while with bad things and drugs and inhalants. And say something and then I will be able to talk to them and give me attention. Approximately 30 years ago, Bearden, Woodside, and Jones proposed a need to understand why drug users associated specific outcomes with drug use. This recommendation is equally valid today. Whether or not the focus group consisted of nonusers, or a couple of users, participants associated inhalant use with positive outcomes. Some might assume that reasons for inhalant use are similar to that of other drugs. However, prevention campaigns can be extremely costly and it would be irresponsible not to investigate the specific motives for inhalant use. Accordingly, the focus groups study serves as a step toward understanding why some young adolescents decide to use inhalants. Results suggest that our young adolescent samples perceived three main utilities for inhalant use: 1 Inhalant use as a means of mental escape, 2 inhalant use as a social tool, and 3 inhalant use as a parental relations tool. Although the use of focus group methodology does not allow for statistical projection to other populations, two factors increase our confidence in the generalization of findings. First, similar themes emerged across groups regardless of group moderator. Moreover, the utilities advanced by our young adolescent sample are similar to rationales put forth by users of tobacco, marijuana, and alcohol. In every focus group, regardless of the moderator or whether any of the participants were users, comments arose regarding the use of inhalants as a means of mental escape. Accordingly, prior studies have found escape to be a central motive for general drug Brooke, ; Segal, , alcohol Martens, Cox, and Beck, a , b and marijuana use Moreover, MacLean also found inhalant users in Australia advancing a similar reason for continued use. In addition to exploring the generalization of these findings, future research should explore the origins of these perceptions. How do young adolescents who never used inhalants arrive at consensus regarding potential positive outcomes? Future research should not only explore the most prevalent sources of information but also how sources of information based on risk status differ. Further, as most health theories posit a decision to use inhalants is, among other things, determined by the ratio of harms to benefits, future research should also explore perceptions of the harms associated with the use of inhalants as an escape mechanism. If these findings are deemed general-izable, a two-pronged primary-prevention approach may include negating the perceived benefits of inhalants while informing young adolescent of the harms associated with their inhalant use. To this end, we suggest that inhalant-focused prevention programs informing young adolescents that the perceived benefits of inhalant use will be accompanied by social as well as physical harms may prove to be an effective tool to counter the inhalant use. Toohey, Dezelsky, and Baffi postulated that prevention efforts were needed to focus on therapeutic effects of marijuana use. Further exploring and replicating the findings reported herein has the potential to inform prevention specialists as to whether a similar approach is warranted for inhalants prevention. Additional caution is also warranted: Just as Toohey et al. In all the groups but one, participants perceived inhalants as having a social utility. This finding mirrors results of other researchers investigating the perceived utilities of other drugs which revealed similar motivations. MacLean reports socializing as one of the seven reasons why users claim to keep using inhalants. Cooper reported social motives as one of the four central reasons for alcohol use. Moreover, both Parks and Kennedy and Gamma, Jerome, Liechti, and Sumnall found that ecstasy users reported a social motivation for using the drug. It is noteworthy that even though our focus groups mainly consisted of nonusers, their perceptions of the benefits were remarkably similar to the reason advanced by users. Other studies did not report discussion centering on popularity, per se, but our findings may be expected, given that our participants are young adolescents. Surprisingly, participants less frequently spoke of situations in which they were pressured to use inhalants, compared to situations in which young adolescents, believing that inhalants will increase social acceptance, initiate use as a means to an end. The vast majority of participants shared the perception that inhalant use could work as a magic bullet for certain groups of adolescents, such as use inhalants, have more friends. As the majority of participants were nonusers, future research should explore the source of these perceptions. Paramount will be the future studies that explore the specific mechanisms by which young adolescents come to believe that inhalant use will foster social acceptance. It is imperative that future studies are conducted. It would be inappropriate to propose specific interventions or policy changes based on this exploratory research. However, we will discuss the potential implications of this study. These observations are not advanced as suggestions for immediate implementation, but to highlight the importance of future and more generalized research in this area. Specifically, if the current findings are generalized, implications for future interventions abound. For example, if young adolescents perceive inhalants will enhance their popularity, then interventions can either convince adolescents that inhalant use will not lead to popularity or that popularity is not as desirable as they might believe. Focusing exclusively on negating the benefits will be less effective than negating apparent positive benefits while simultaneously increasing perceptions of harm. By harm we by no means suggest focusing only on the physical harm. It may prove efficacious to inform adolescents that using inhalants as a social tool can potentially backfire and lead to extreme social alienation or ostracism. Every group that discussed the use of inhalants as a social tool mentioned this interaction hypothesis. As with the previously discussed utilities, future research must explore the origins of these perceptions. Future exploratory research can also focus on the different factors that may dictate whether inhalant use will lead to social acceptance or alienation. In the focus groups discussed here, age and neighborhood were two factors proposed to predict the perceived social outcomes of inhalant use. These factors may not be the same nationwide. Exploring these perceptions may result in useful information for future primary prevention efforts. Moreover, if the interaction hypothesis is generalizable, understanding which young adolescents would benefit socially from inhalant use can be useful for future primary prevention programs specifically aimed at these individuals as they may be at the highest risk for future use. Moreover, assessing the generalization of these findings can inform future primary prevention efforts on the advisability of presenting inhalant use as a means of affecting social relations. Young adolescents may be fully aware that inhalant use can serve a social utility for some. Prevention messages will not be effective if this is ignored as such messages will not be perceived as credible Siegel and Burgoon, If young adolescents believe that inhalant use will increase social acceptance for some but not for others, presenting information to the contrary may be ignored at best, and at worst may hinder future prevention efforts Tormala and Petty, Similar perceptions were held across focus groups. Not only did participants believe that inhalant use would work as a tool for social acceptance for some kids, and not for others, but they believed that this occurred even though inhalants are looked upon negatively, by many, in comparison to marijuana. Exploratory research should continue to investigate this paradox. Additionally, the generalization of these findings should be explored. Are such perceptions limited to young adolescents residing in Tucson? If widespread, these perceptions can be incorporated into future primary prevention efforts. Negative stereotypes of inhalants may already exist, and these perceptions can prove an effective anti-inhalant tool. This was the most nebulous theme that emerged. Inhalant use as a parental relations tool was not a common discussion thread like inhalant use as a social tool or as a means of mental escape, but further research into this area is nonetheless warranted. First, the use of marijuana as an act against authority has been reported in the past Bloomquist, ; Farnsworth and Weiss, This suggests the finding is less likely to be spurious. Do young adolescents perceive inhalant use as a form of revenge? If so, the rationale behind this belief must be explored. Further, if young adolescents genuinely believe that inhalant use can lead to increased parental attention, it will be important for future prevention to consider how to negate this perceived utility. Such an approach may convince young adolescents that inhalant use as a means of obtaining parental affection is undesirable or self-defeating. This might be easier than convincing adolescents that inhalent use will not lead to parental uproar. This study represents the first step toward understanding the outcomes young adolescents associate with inhalant use. Future research should continue along two important paths: 1 Further exploration, and 2 assessing generalizability. Most major theories of health behavior associate perceived benefits with increased use. Further, Siegel, Alvaro, and Burgoon , albeit investigating tobacco use, discovered that nonusers, at-risk nonusers, and users differed only minimally on the perceptions of the harms of tobacco use. However, large differences were noted when it came to the perceived benefits of use. A similar situation may exist with inhalant use. Unfortunately, the design of the current study does not allow these comparisons to be made. As discussed earlier, comments made by nonusers and users intentionally were not compared as comments made by one group member undoubtedly influenced the comments made by others. Nonetheless, future studies that can make such comparisons are warranted. Future research must explore the malleability of beliefs held by users, nonusers, and at-risk nonusers. These perceptions must continue to be explored among various groups and contexts. Moreover, collecting quantitative data on the number of young adolescents who believe inhalant use is foolish and will not lead to social escalation might provide the basis for prevention efforts that seek to correct perceptions about what is normative. Inhalants may not be seen as all good or bad. If primary prevention efforts ignore what appears to be a potentially complex narcotic, young adolescents may respond by ignoring prevention efforts. For example, a campaign or educational program attempting to convince young adolescents that all of their peers have negative attitudes toward inhalant use will ring false bell; however, emphasizing the relative scarcity of positive peer attitudes toward inhalants might prove useful. Furthermore, exploring the interaction between inhalant use and popularity might lead to the creation of intervention efforts perceived as having greater credibility among the young adolescent population. The most effective prevention approaches will likely be as dynamic and multi-dimensional as the individuals we hope to persuade. Focus group methodology is useful in developing hypotheses that may prove fruitful in future and more focused investigations. However, reported beliefs may be generalizable or they may be unique to the location where the groups were conveyed. These findings are advanced with the caveat that additional research, using various methodologies, is vital. William D. Crano, Principal Investigator. The opinions and interpretations expressed within are those of the researchers and not necessarily the funding agency. Pertains to the handling of information that a participant has disclosed during the procedure of the study with the expectation that the information will not be divulged to others in ways that are inconsistent with the understanding of the original disclosure without permission. Drug expectancies follow the research investigating the impact of expectations on behavior such that memories or perceptions of using a drug leads to the expectations of a specific outcome during and after drug use. A focus group is a form of qualitative research in which a group of people are asked about their attitude toward a concept, idea, product, or advertisement. Questions are asked in an interactive group setting where participants are free to talk with other group members and is facilitated by a moderator. Inhalants are ordinary household products that are inhaled or sniffed to get high. Common inhalants are model airplane glue, nail polish remover, cleaning fluids, hair spray, gasoline, the propellant in aerosol whipped cream, spray paint, air conditioner fluid freon , cooking spray, and correction fluid. An educated guess of the value of one variable, for example X, as another variable, for example Y, increases or decreases in one situation, while in another situation, the changes in X do not effect Y. For example, the probability that an adolescent will use inhalants will increase if the adolescent perceives that he or she will become popular for doing so when using inhalants in front of a social group that believes using inhalants is a popular thing to do. The probability that the adolescent will use inhalants will not increase if the adolescent does not perceive the activity to be popular among another social group. Jason T. Siegel , Ph. He is a Behavioral Scientist whose research focuses on improving the health and well being of adolecents and adults. Eusebio M. Alvaro , Ph. His research centers on studying persuasion in the context of health promotion, disease prevention, and clinical medicine. Neil M. Patel , Ph. Crano is the Director of the Institute of Health Psychology and Prevention Science at Claremont Graduate University, where his research is focused on prevention of adolescent substance abuse. As a library, NLM provides access to scientific literature. Subst Use Misuse. Published in final edited form as: Subst Use Misuse. The publisher's version of this article is available at Subst Use Misuse. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.
The first aim of our study was to identify the sociodemographic and risk behaviour characteristics of young people (16–24 years) with positive attitudes towards.
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This study explores perceptions of inhalant utility among young adolescents in the United States. The study makes use of data gathered via nine focus groups.
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