Skip to main content
Top
Published in: BMC Pediatrics 1/2019

Open Access 01-12-2019 | Research article

The vulnerability to alcohol, tobacco, and drug use of adolescents in Hong Kong: a phenomenological study

Authors: Yim Wah Mak, Doris Leung, Alice Yuen Loke

Published in: BMC Pediatrics | Issue 1/2019

Login to get access

Abstract

Background

In Hong Kong, the use of alcohol, tobacco, and other drugs (ATOD) is associated with strong peer influences; frequently absent parents; academic pressures; and a lack of interpersonal skills to cope with stress and conflict. It is posited that this social context alters the nature of the adolescent risk of using ATOD. The study aimed to explore how social interactions in their local context shape experiences of adolescents who smoke or use alcohol with their parents and other significant people (e.g., teachers, peers) in their lives.

Results

The participants consistently indicated that the communication of risk was fundamentally influenced by the attachment between the primary parent(s) and the child. In secure attachments, parents could positively discourage ATOD use by instilling fear or expressing regret or disappointment over its use. However, some parents expressed an overly permissive attitude about ATOD use, or stated that they had a limited ability to influence their child, or that the harm arising from their child’s use of ATOD would be minimal. Under these conditions, the authors posited that the potential influence of peers to disrupt parental attachments was stronger.

Conclusions

Descriptive phenomenology was adopted in this study and Colaizzi’s method was used to analyse the collected data. Focus group interviews were conducted with 45 adolescents, 11 parents, and 22 school teachers and social workers in two districts in Hong Kong. A secure attachment between a parent and a child enhances the child’s sense of self-efficacy in avoiding addictive behaviours such as ATOD use. In contrast, insecure parent-child attachments may trigger children to resist social norms, and disrupt their parental attachments. In these instances, parents may inadvertently convey the message that their children do not need protection from the risks of using ATOD. The key findings suggest that reinforcing secure parental attachments, as well as emphasizing how messages of vulnerability to ATOD are conveyed, may counter balance pressures (including peer influence) to use these substances. Further research is needed to uncover mechanisms of communication that add to the vulnerability of adolescents to using ATOD, and to the negative long-term consequences from ATOD use.
Literature
1.
go back to reference Hawkins JD, Catalano RF, Miller JY. Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention. Psychol Bull. 1992;112:64–105.CrossRef Hawkins JD, Catalano RF, Miller JY. Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention. Psychol Bull. 1992;112:64–105.CrossRef
2.
go back to reference Whitesell N, Asidigian N, Kaufman C, Big Crow C, Shangreau C, Keane E, et al. Trajectories of substance abuse among young American adolescents: patterns and predictors. J Youth Adolescence. 2014;43:437–53.CrossRef Whitesell N, Asidigian N, Kaufman C, Big Crow C, Shangreau C, Keane E, et al. Trajectories of substance abuse among young American adolescents: patterns and predictors. J Youth Adolescence. 2014;43:437–53.CrossRef
3.
go back to reference Maggs J, Patrick M, Feinstein L. Children and adolescent predictors of alcohol use and problems in adolescents and adulthood in the National Child Development Study. Society of the Study of Addiction. 2008;103(Suppl 1):7–22.CrossRef Maggs J, Patrick M, Feinstein L. Children and adolescent predictors of alcohol use and problems in adolescents and adulthood in the National Child Development Study. Society of the Study of Addiction. 2008;103(Suppl 1):7–22.CrossRef
4.
go back to reference Chan G, Kelly A, Toumbourou J, Hemphill S, Young R, Haynes M, et al. Predicting steep escalations in alcohol use over the teenage years: age-related variations in key social influences. Addiction. 2013;108:1924–32.CrossRef Chan G, Kelly A, Toumbourou J, Hemphill S, Young R, Haynes M, et al. Predicting steep escalations in alcohol use over the teenage years: age-related variations in key social influences. Addiction. 2013;108:1924–32.CrossRef
5.
go back to reference Kostelecky KL. Parental attachment, academic achievement, life events and their relationship to alcohol and drug use during adolescents. J Adolescence. 2005;28:665–9.CrossRef Kostelecky KL. Parental attachment, academic achievement, life events and their relationship to alcohol and drug use during adolescents. J Adolescence. 2005;28:665–9.CrossRef
6.
go back to reference van der Vorst H, Engles R, Meeus W, Dekovic M, Vermulst A. Parental attachment, parental control, and early development of alcohol use: a longitudinal study. Psychol Addict Behav. 2006;20(2):107–16.CrossRef van der Vorst H, Engles R, Meeus W, Dekovic M, Vermulst A. Parental attachment, parental control, and early development of alcohol use: a longitudinal study. Psychol Addict Behav. 2006;20(2):107–16.CrossRef
7.
go back to reference Mathijssen J, Janssen M, Bon-Martens M, van Oers H, de Boer E, Garretsen H. Alcohol-segment specific associations between the quality of the parent-child relationship and adolescent alcohol use. BMC Public Health. 2014;14:872–80.CrossRef Mathijssen J, Janssen M, Bon-Martens M, van Oers H, de Boer E, Garretsen H. Alcohol-segment specific associations between the quality of the parent-child relationship and adolescent alcohol use. BMC Public Health. 2014;14:872–80.CrossRef
8.
go back to reference Dickerson DL, Brown RA, Johnson CL, Schweigman K, D’Amico EJ. Integrating motivational interviewing and traditional practices to address alcohol and drug use among urban American Indian/Alaska Native youth. J Subst Abuse Treat. 2016;65:26–35.CrossRef Dickerson DL, Brown RA, Johnson CL, Schweigman K, D’Amico EJ. Integrating motivational interviewing and traditional practices to address alcohol and drug use among urban American Indian/Alaska Native youth. J Subst Abuse Treat. 2016;65:26–35.CrossRef
9.
go back to reference Parsai M, Voisine S, Marsiglia FF, Kulis S, Nieri T. The protective and risk effects of parents and peers on substance use, attitudes, and behaviors of Mexican and Mexican American female and male adolescents. Youth Soc. 2008;40:353–76.CrossRef Parsai M, Voisine S, Marsiglia FF, Kulis S, Nieri T. The protective and risk effects of parents and peers on substance use, attitudes, and behaviors of Mexican and Mexican American female and male adolescents. Youth Soc. 2008;40:353–76.CrossRef
10.
go back to reference Abar C, Abar B, Turrisi R. The impact of parental modeling and permissibility on alcohol use and experienced negative drinking consequences in college. Addict Behav. 2009;34:542–7.CrossRef Abar C, Abar B, Turrisi R. The impact of parental modeling and permissibility on alcohol use and experienced negative drinking consequences in college. Addict Behav. 2009;34:542–7.CrossRef
11.
go back to reference Lam WK, Cance JD, Eke AN, Fishbein DH, Hawkins SR, Williams JC. Children of African-American mothers who use crack cocaine: parenting influences on youth substance use. J Pediatr Psychol. 2007;32:877–87.CrossRef Lam WK, Cance JD, Eke AN, Fishbein DH, Hawkins SR, Williams JC. Children of African-American mothers who use crack cocaine: parenting influences on youth substance use. J Pediatr Psychol. 2007;32:877–87.CrossRef
12.
go back to reference Gilman SE, Rende R, Boergers J, Abrams D, Buka SL, Clark KA, et al. Parental smoking and adolescent smoking initiation: an intergenerational perspective on tobacco control. Pediatr. 2009;123:e274–81.CrossRef Gilman SE, Rende R, Boergers J, Abrams D, Buka SL, Clark KA, et al. Parental smoking and adolescent smoking initiation: an intergenerational perspective on tobacco control. Pediatr. 2009;123:e274–81.CrossRef
13.
go back to reference Flores PJ. Group psychotherapy and neuro-plasticity: an attachment theory perspective. Int J Psychother. 2010;60:547–70. Flores PJ. Group psychotherapy and neuro-plasticity: an attachment theory perspective. Int J Psychother. 2010;60:547–70.
14.
go back to reference Bowlby JA. secure base. Basic Books. New York: Oxford University Press; 1988. Bowlby JA. secure base. Basic Books. New York: Oxford University Press; 1988.
15.
go back to reference Pietromonaco P, Uchino B, Dunkel Schetter C, Kazak AE, Klein W, Rothman A, Cameron L. Close relationship processes and health: implications of attachment theory for health and disease. Health Psychol. 2013;32(5):499–513.CrossRef Pietromonaco P, Uchino B, Dunkel Schetter C, Kazak AE, Klein W, Rothman A, Cameron L. Close relationship processes and health: implications of attachment theory for health and disease. Health Psychol. 2013;32(5):499–513.CrossRef
16.
go back to reference Sun CF, Shek D. Life satisfaction, positive youth development, and problem behavior among Chinese adolescents in Hong Kong. Soc Indic Res. 2010;95:455–74.CrossRef Sun CF, Shek D. Life satisfaction, positive youth development, and problem behavior among Chinese adolescents in Hong Kong. Soc Indic Res. 2010;95:455–74.CrossRef
18.
go back to reference Shek D. Tackling adolescent substance abuse in Hong Kong: where we should and should not go. Sci World J. 2007;7:2021–30.CrossRef Shek D. Tackling adolescent substance abuse in Hong Kong: where we should and should not go. Sci World J. 2007;7:2021–30.CrossRef
19.
go back to reference Rosenthal D, Feldman S. The influence of perceived family and personal factors on self-reported school performance of Chinese and Western high school students. J Res Adolesc. 1991;1(2):135–54.CrossRef Rosenthal D, Feldman S. The influence of perceived family and personal factors on self-reported school performance of Chinese and Western high school students. J Res Adolesc. 1991;1(2):135–54.CrossRef
20.
go back to reference Stewart S, Bond M, Deeds O, Chung S. Intergenerational patterns of values and autonomy expectations in cultures of relatedness and separateness. J Cross-Cult Psychol. 1999;30(5):575–93.CrossRef Stewart S, Bond M, Deeds O, Chung S. Intergenerational patterns of values and autonomy expectations in cultures of relatedness and separateness. J Cross-Cult Psychol. 1999;30(5):575–93.CrossRef
21.
go back to reference Thomas RE, McLellan J, Perera R. School-based programmes for preventing smoking. Evid Based Child Health. 2013;8(5):1616–2040.CrossRef Thomas RE, McLellan J, Perera R. School-based programmes for preventing smoking. Evid Based Child Health. 2013;8(5):1616–2040.CrossRef
22.
go back to reference Caria MP, Faggiano F, Bellocco R, Galanti MR, EU-Dap Study Group. Effects of a school-based prevention program on European adolescents’ patterns of alcohol use. J Adolescent Health. 2013;48:182–8.CrossRef Caria MP, Faggiano F, Bellocco R, Galanti MR, EU-Dap Study Group. Effects of a school-based prevention program on European adolescents’ patterns of alcohol use. J Adolescent Health. 2013;48:182–8.CrossRef
23.
go back to reference Van Ryzin MJ, Fosco GM, Dishion TJ. Family and peer predictors of substance use from early adolescence to early adulthood: an 11-year prospective analysis. Addict Behav. 2012;37:1314–24.CrossRef Van Ryzin MJ, Fosco GM, Dishion TJ. Family and peer predictors of substance use from early adolescence to early adulthood: an 11-year prospective analysis. Addict Behav. 2012;37:1314–24.CrossRef
24.
go back to reference Peterson J. A qualitative comparison of parent and adolescent views regarding substance use. J Sch Nurs. 2010;26:53–64.CrossRef Peterson J. A qualitative comparison of parent and adolescent views regarding substance use. J Sch Nurs. 2010;26:53–64.CrossRef
25.
go back to reference Feil EG, Severson HH, Walker HM. Identification of critical factors in the assessment of pre-school behaviour problems. Educ Treat Child. 1995;18:261–71. Feil EG, Severson HH, Walker HM. Identification of critical factors in the assessment of pre-school behaviour problems. Educ Treat Child. 1995;18:261–71.
26.
go back to reference Hill LG, Lochman JE, Coie JD, Greenberg MT, The Conduct Problems Prevention Research Group. Effectiveness of early screening for externalizing problems: issues of screening accuracy and utility. J Consul Clin Psych. 2004;72:809–20.CrossRef Hill LG, Lochman JE, Coie JD, Greenberg MT, The Conduct Problems Prevention Research Group. Effectiveness of early screening for externalizing problems: issues of screening accuracy and utility. J Consul Clin Psych. 2004;72:809–20.CrossRef
27.
go back to reference Finkelstein DM, Kubzansky LD, Goodman E. Social status, stress and adolescent smoking. J Adolescent Health. 2006;39:678–85.CrossRef Finkelstein DM, Kubzansky LD, Goodman E. Social status, stress and adolescent smoking. J Adolescent Health. 2006;39:678–85.CrossRef
29.
go back to reference Spezaile HJ, Carpenter DR. Qualitative research in nursing: advancing the humanistic imperative. Philadelphia: Lippincott Williams and Wilkins; 2003. Spezaile HJ, Carpenter DR. Qualitative research in nursing: advancing the humanistic imperative. Philadelphia: Lippincott Williams and Wilkins; 2003.
30.
go back to reference Colaizzi PF. Psychological research as the phenomenologist view it. In: Valle R, King M, King M, editors. Existential phenomenological alternatives for psychology. New York: Oxford University Press; 1998. p. 48–71. Colaizzi PF. Psychological research as the phenomenologist view it. In: Valle R, King M, King M, editors. Existential phenomenological alternatives for psychology. New York: Oxford University Press; 1998. p. 48–71.
31.
go back to reference Sanders C. Application of Colaizzi's method: interpretation of an auditable decision trail by a novice researcher. Contemp Nurse. 2003;14:292–302.CrossRef Sanders C. Application of Colaizzi's method: interpretation of an auditable decision trail by a novice researcher. Contemp Nurse. 2003;14:292–302.CrossRef
32.
go back to reference Husserl E. Cartesian meditations: an introduction to phenomenology. The Hague: Martinus Nijhoff Publications; 1960.CrossRef Husserl E. Cartesian meditations: an introduction to phenomenology. The Hague: Martinus Nijhoff Publications; 1960.CrossRef
33.
go back to reference Bernard HR. Research methods in cultural anthropology. Newbury Park: Sage; 1988. Bernard HR. Research methods in cultural anthropology. Newbury Park: Sage; 1988.
34.
go back to reference Chen CY, Storr CL, Anthony JC. Influences of parenting practices on the risk of having a chance to try cannabis. Pediatrics. 2005;115:1631–9.CrossRef Chen CY, Storr CL, Anthony JC. Influences of parenting practices on the risk of having a chance to try cannabis. Pediatrics. 2005;115:1631–9.CrossRef
35.
go back to reference Cox RB, Roblyer MZ, Merten MJ, Shreffler KM, Schwerdtfeger KL. Do parent–child acculturation gaps affect early adolescent Latino alcohol use? A study of the probability and extent of use. Subst Abuse Treat Pr. 2013;8:4.CrossRef Cox RB, Roblyer MZ, Merten MJ, Shreffler KM, Schwerdtfeger KL. Do parent–child acculturation gaps affect early adolescent Latino alcohol use? A study of the probability and extent of use. Subst Abuse Treat Pr. 2013;8:4.CrossRef
36.
go back to reference Looze M, Van den Eijnden R, Verdurmen J, Vermeulen-Smit E, Schulten I, Vollebergh W, et al. Parenting practices and adolescent risk behavior: rules on smoking and drinking also predict cannabis use and early sexual debut. Prev Sci. 2012;13:594–604.CrossRef Looze M, Van den Eijnden R, Verdurmen J, Vermeulen-Smit E, Schulten I, Vollebergh W, et al. Parenting practices and adolescent risk behavior: rules on smoking and drinking also predict cannabis use and early sexual debut. Prev Sci. 2012;13:594–604.CrossRef
37.
go back to reference Henden E, Melberg HO, Rogeberg OJ. Addiction: choice or compulsion? Front Psychol. 2013;4:1–11. Henden E, Melberg HO, Rogeberg OJ. Addiction: choice or compulsion? Front Psychol. 2013;4:1–11.
38.
go back to reference Dmitrieva J, Chen C, Greenberger E, Gil-Rivas V. Family relationships and adolescent psychosocial outcomes: converging findings from eastern and Western cultures. J Res Adolesc. 2004;14(4):425–47.CrossRef Dmitrieva J, Chen C, Greenberger E, Gil-Rivas V. Family relationships and adolescent psychosocial outcomes: converging findings from eastern and Western cultures. J Res Adolesc. 2004;14(4):425–47.CrossRef
Metadata
Title
The vulnerability to alcohol, tobacco, and drug use of adolescents in Hong Kong: a phenomenological study
Authors
Yim Wah Mak
Doris Leung
Alice Yuen Loke
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2019
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-019-1678-1

Other articles of this Issue 1/2019

BMC Pediatrics 1/2019 Go to the issue