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May 20th, 2008 - 13:41:11
Substance abuse a major issue. It is well known that the abuse of substances, whether it is alcohol, tobacco, illicit drugs, kava/sakau, or betel nut, does exist to varying degrees in our communities. In fact, in the Marshall Islands a survey in 2006 of 1,205 households showed that almost two-thirds of residents feel that substance abuse is worsening in their communities. This substance abuse has affected our communities, changed lifestyles and health consequence issues, resulting in emerging and re-emerging infections, like HIV/AIDS, other sexually transmitted infections (STI), and alcohol/tobacco related cancers and other conditions. Tuberculosis (TB) has also increased steadily in the last few years in RMI and the Centers for Disease Control (CDC) states that substance abuse is one of the factors causing this. Substance abuse and quality of life. Quality of life is affected by conditions of social health. One indicator of increasing significance in RMI is substance abuse. The use of alcohol, tobacco, and illicit drugs (e.g. marijuana) is emerging, as a serious problem contributing to, decreased health status and low quality of life. In addition to contributing to disease and death, abuse of substances is associated with an array of social ills, such as domestic violence, low educational achievements, low income, unemployment, and crime. In the Marshall Islands substance abuse is both a precursor to, and a result of an array of other human problems. Child neglect, homelessness, gang activities, mental illness have all been linked with substance abuse. KEY FINDINGS - CONSUMPTION Consumption can be defined as the use and high-risk use of alcohol, tobacco and illicit drugs. Alcohol Ever Consumed. The WHO STEPS Survey revealed that 30.7 percent of adults had ever consumed alcohol in 2002. Current Alcohol Use. Current alcohol use was defined in the WHO STEPS Survey as having any alcohol consumption in the past 12 months. Overall, 19.3 percent were current consumers, meaning that over 80 percent of adults in the RMI (ages 15 to 64) were current abstainers from alcohol. Alcohol Consumption Per Drinking Day. Among current drinkers, 61.3 percent consumed 6 or more standard drinks per day during the past 12 months, suggesting that most current drinkers are heavy consumers of alcohol. Current Heavy Drinking. Among current drinkers, 2.2 percent drank alcohol on 4 or more days in the week prior to the survey. Binge Drinking. Binge drinking is defined as having a mean of 5 or more standard drinks per day for males and a mean of 4 or more standard drinks per day for females. Overall 65.7 percent of current alcohol consumers were binge drinkers. Influencing Factors for Starting Alcohol Consumption. The most common factor that influenced current drinkers to start consuming alcohol was a friend who drank alcohol. Among current consumers, 87.4 percent said that they started drinking because a friend drank. Place Alcohol Obtained From. The most common source of alcohol for current drinkers was stores, where 76.4 percent of alcohol beverages were consumed. Friends and family was the second most common source. Current Alcohol Use Among Female Adults Prior to Pregnancy. Of the 302 women who responded to SGS survey on pre-natal women, 232 (76.8 percent) reported never consuming alcohol in the 12 months before becoming pregnant (see table below). This result, like that from the WHO STEPS survey which showed that nearly 95 percent of females are not current alcohol users) suggests that the vast majority of women in the RMI do not consume alcohol. Youth Lifetime Alcohol Use. The 2003 YRBS reported an overall 59.6 percent of students had at least one drink of alcohol on 1 or more days during their lifetime (i.e., lifetime alcohol use). The YRBS 2007 showed an overall decrease to 55.0 lifetime alcohol use. Youth Current Alcohol Use. The 2003 YRBS reported an overall 45.7 percent of students had had at least one drink of alcohol on 1 or more of the 30 days preceding the survey (i.e. current alcohol use). The YRBS 2007 showed an overall decrease to 41.7 percent. Youth Alcohol Use Before Age 13. The 2003 YRBS reported an overall 10.5 percent of students had their first drink of alcohol (other than a few sips) for the first time before age 13. The YRBS 2007, showed a slight increase 10.9 percent of students that had their first drink of alcohol other than a few sips before age 13 years. Youth Episodic Heavy Drinking. The 2003 YRBS reported and overall 31.9 percent of students had had five or more drinks of alcohol in a row (i.e., within a couple of hours) on 1 or more of the 30 days preceding the survey (i.e., episodic heavy drinking). The YRBS 2007 showed an overall decrease to 26.6 percent. Youth Alcohol Use Before Age 13. The 2003 YRBS reported an overall 10.5 percent of students had their first drink of alcohol (other than a few sips) for the first time before age 13. The YRBS 2007, showed a slight increase 10.9 percent of students that had their first drink of alcohol other than a few sips before age 13 years. Youth Alcohol Use on School Property. The 2003 YRBS reported an overall 17.7 percent of students had had at least one drink of alcohol on school property on 1 or more of the 30 days preceding the survey. The 2007 YRBS showed a decrease to 15.3 percent. Current Smokers. The WHO STEPS Survey defined current smokers as those who have smoked any tobacco products within the past 12 months. The survey showed that overall 23.1 percent of adults smoke, with 19.8 percent currently daily smokers and 3.3 percent current but non-daily. Around 77 percent had never smoked at all (abstainers). Mean Age of Smoking Initiation. The survey revealed that the mean age of initiation among current smokers was lower among males, whose mean age for starting smoking was 17.6 compared to 19.9 for females. Mean Number of Years Smoking. The mean number of years a current smoker has smoked for is 13.3 with the mean for males at 13.2 and females at 14.2. Types of Cigarettes. The vast majority (98.4 percent) of current smokers smoked manufactured cigarettes. Mean Consumption of Manufactured Cigarettes. The mean number of manufactured cigarettes smoked daily was 11.4. More cigarettes were smoked by males (11.9 per day) compared to females (7.3 per day). Smokeless Tobacco Use. The overall percentage of smokeless (chewing) tobacco users was 8.9 percent including chewing tobacco, was reported by 64 (19 percent) of women in the SGS survey. Youth Lifetime Cigarette Use. The YRBS 2003 showed that 70.1 percent of students had ever tried cigarette smoking, even one or two puffs (i.e. lifetime cigarette use). YRBS 2007 indicated a decrease to 62.2 percent in total students. Youth Lifetime Daily Cigarette Use. YRBS 2003 showed 23.6 percent of students had ever smoked at least one cigarette every day for 30 days (i.e. lifetime daily cigarette use). A significant decrease was seen in the 2007 YRBS, showing 17.6 percent. Youth Current Cigarette Use. YRBS 2003 showed that 37.5 percent of all students had smoked cigarettes on one or more of the 30 days preceding the survey (i.e. current cigarette use). The 2007 YRBS has shown a decrease in trend at 32.4 percent. Youth Current Frequent Cigarette Use. The YRBS 2003 showed that 15.9 percent of students had smoked cigarettes on at least 20 of the 30 days preceding the survey (i.e. current frequent cigarettes use). The YRBS 2007 showed a decrease in trend to 13.1 percent. Youth More Than 10 Cigarettes Per Day. The 2003 YRBS indicated that 4.1 percent of students had smoked more than 10 cigarettes per day on the days they smoked during the 30 days preceding the survey. However the 2007 YRBS, showed an increase in trend to overall 6.9 percent. Youth Tried To Quit Smoking. Among the 37.5 percent of students who reported current cigarette use in 2003, 83.7 percent tried to quit smoking cigarettes use during the past 12 months. The 2007 YRBS showed that of the 32.4 percent of students who reported current cigarette use, 89.3 percent tried to quit smoking cigarette during the past 12 months. Youth Current Smokeless Tobacco Use. The 2003 YRBS showed that 37.5 percent of students had used smokeless tobacco (e.g. chewing tobacco, snuff, or dip) on 1 or more of the 30 days preceding the survey (i.e. current smokeless tobacco use). The 2007 YRBS showed an overall decrease in trend to 32.0 percent. Youth Current Tobacco Use. The 2003 YRBS showed that 40.3 percent of students had reported current cigarette use, current smokeless tobacco use, or current cigar use on 1 or more of the 30 days preceding the survey (i.e. current tobacco use). In 2007 the YRBS showed an overall decrease to 38.8 percent. Youth Cigarette Smoking Before Age 13. The 2003 YRBS showed that 9.6 percent of students had smoked a whole cigarette for the first time before the age 13 years. However the 2007 YRBS showed an overall decrease to 6.9 percent. Youth Purchased Cigarettes At Store or Gas Station. Data regarding access to cigarettes are reported only for 37.9 percent of students under the age of 18 years who reported current cigarette use in the YRBS 2003. Nearly one-third (32.0 percent) of these students had usually preceding the survey. Youth Cigarette Use on School Property. The 2003 YRBS showed that 17.3 percent of students had smoked cigarettes on school property on 1 or more of the 30 days preceding the survey. The 2007 YRBS showed an overall decrease to 16.3 percent. Youth Smokeless Tobacco Use on School Property. The 2003 YRBS showed that 24.9 percent of students had used smokeless tobacco on school property on 1 or more of the 30 days preceding the survey. In 2007 the YRBS trend showed an overall decrease to 21.1 percent. Regional Comparison of Youth Tobacco Use. A comparison of the RMI results to CNMI and the Republic of Palau shows that in general, the RMI youth show lower prevalence than youth in Palau and CNMI in terms of: lifetime cigarette use, current cigarette use, current smokeless tobacco use, cigarette smoking before age 13. Lifetime Other Substances Use Among Female Adults Prior to Pregnancy. The most common substance other than alcohol and tobacco to be used (lifetime) by the surveyed women included betel nut (6.4 percent), marijuana (2.6 percent), kava/sakau (1.7 percent) and other drugs (1.2 percent). KEY FINDINGS - CONSEQUENCES Substance-related consequences can be defined as adverse social, health, and safety consequences associated with alcohol, tobacco, or illicit drug use. Consequences include mortality and morbidity and other undesired events for which alcohol, tobacco, and/or illicit drugs are clearly and consistently involved. Leading Causes of Mortality. Currently, detailed mortality records from the Ministry of Health are not arranged in a fashion that would lend itself easily to identification of specific alcohol or tobacco related deaths. Nevertheless, some general estimates on the total number of deaths (and rates) attributable to alcohol and tobacco can be made from the existing records. Estimated Deaths Attributable to Alcohol and Tobacco. In FY2005, FY2006, and FY2007, there were at least 20, 13, and 18 deaths (respectively) caused by conditions linked to alcohol (this translates into estimated annual alcohol-related death rates as a percentage of all registered deaths of 7.4, 4.5, and 7.2 percent. Over the same three years, there were at least 16, 7 and 5 registered deaths caused by conditions linked to tobacco. This translates into tobacco related death rates of 5.9, 2.4, and 2.0 percent. Cancer Mortality. As reported by the Cancer Comprehensiveness Program (CCP), cancer remains a top five cause of death in the RMI. Cancer related deaths accounted for 18.2 percent of registered total deaths in 2005 and 15.6 percent in 2006. Over the two year period, there were 17 lung cancer deaths (11 in 2005 and 6 in 2006). Completed Suicides. The number of recorded completed suicides over the past eight years has steadily fallen. In 2007, only 4 completed suicides were on record, compared to a high of 28 in 2003. Attempted Suicides. Over the past eight years, the numbers of attempted suicides have followed the completed suicides trend. In 2007 only 8 attempted suicides were on record, compared to 42 in 2003. Youth Seriously Considered Attempting Suicide. Overall 26.4 percent of students had seriously considered suicide during the 12 months preceding the survey (2003). The YRBS 2007 showed a slight decrease (25.6 percent). Youth Made A Suicide Plan. During the 12 months preceding the YRBS (2003), 31.8 percent of students had made plans about how they would attempt suicide. The YRBS 2007 showed an overall decrease to 30.1 percent. Youth Attempted Suicide. The 2003 YRBS showed that 30.9 percent of students had actually attempted suicide at one or more times during the 12 months preceding the survey (2003). The 2007 YRBS showed an overall decrease to 25.0 percent. Youth Suicide Attempt Required Medical Attention. During the 12months preceding the YRBS (2003) 14.3 percent of students had made a suicide attempt that resulted in an injury, poisoning, or overdose that had to be treated by a doctor or nurse. The YRBS 2007 showed a slight decrease to14.2 percent. Traffic Accidents and DUI Violations. Total reported traffic accidents fell over the 2002 to 2004 period for the entire RMI, from 416 to 350. Drunken driving violations numbered 191, 155, and 154 over the period, again generally falling (in absolute terms). Percentagewise, drunken driving violations have accounted for 6.0, 4.0, and 4.9 percent of all violations. Alcohol Related Offenses. Drunken and disorderly conduct and disturbing the peace cases in Majuro have nearly doubled from just under 500 in 1999 to nearly 1,000 in 2006 (data for Ebeye and other areas not currently available). The percentage of drunken disorderly offenses out of total offenses has risen steadily from just over 50 percent to around 80 percent. Teenage Pregnancy. Teenage pregnancies remain high and steady in the RMI. As a percentage of total births, teen births have hovered between 17 and 18 percent since 2001, with no clear downward trend. © Copyright 2006 by DiscountCigarettesBox.Com Top of Page |
