The purpose of the current study was to examine the relationship between adolescent substance use and psychosocial distress indicators among 30,851 adolescents aged 11 to 16 in four countries (Philippines, China, Chile, and Namibia). Global School-Based Student Health Survey data from these countries provided information about frequency and lifetime use of alcohol, tobacco, and other drugs as well as items about early adolescents' feelings of loneliness, worry, hopelessness, suicide, and number of close friends. Overall, there were significant relationships between adolescent substanceuse behaviors and a measure of "global" psychosocial distress for both boys and girls in all four countries and for four of the five items of psychosocial distress (often lonely, often worry, sad/hopeless, and having a suicide plan). The association between substance use and psychosocial distress was also consistent in both genders and across the four countries. These results have important implications for professionals who work with adolescent populations.

Research has shown that adolescent users of tobacco are much more likely to progress to use of illicit drugs than are nonusers of tobacco. This article suggests potential psychosocial reasons for the progression based on principles of learning theory, Theory of Reasoned Action, Health Belief Model, and Cognitive Dissonance. In addition, a neuropharmacologic causal mechanism is discussed. The existence of tobacco's gateway function has important implications in the nation's efforts to reduce illicit drug use and adolescent smoking.

The objective of this study was determine if the inclusion of Canadian-style graphic images would improve the degree to which adolescents attend to, and subsequently are able to recall, novel warning messages in tobacco magazine advertising. Specifically, our goal was to determine if the inclusion of graphic images would (1) increase visual attention, as measured by eye movement patterns and fixation density, and (2) improve memory for tobacco advertisements among a group of 12 to 14 year olds in the western United States. Data were collected from 32 middle school students using a head-mounted eye-tracking device that recorded viewing time, scan path patterns, fixation locations, and dwell time. Participants viewed a series of 20 magazine advertisements that included five U.S. tobacco ads with traditional Surgeon General warning messages and five U.S. tobacco ads that had been modified to include non-traditional messages and Canadian-style graphic images. Following eye tracking, participants completed unaided- and aided-recall exercises. Overall, the participants spent equal amounts of time viewing the advertisements regardless of the type of warning message. However, the warning messages that included the graphic images generated higher levels of visual attention directed specifically toward the message, based on average dwell time and fixation frequency, and were more likely to be accurately recalled than the traditional warning messages.

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Background: Physicians can play an important role in smoking prevention and control. This study will identify smoking prevalence among physicians in Yerevan, Armenia. It will also explore how the smoking behaviors of physicians, their perceived ability to influence patient smoking behavior, and their knowledge about health outcomes related to smoking influence their interaction with patients.