Conclusions: Weight control practices are more frequent amongfemale daily smokers than among never smokers. This findingseems to confirm cigarette smoking as a way to control weightamong adolescent females. Health professionals should inquireadolescent female smokers about weight control practices, andthis association must be kept in mind when discussing tobaccocessation options with adolescent females.Sources of Support: The SMASH02 survey was funded by the SwissFederal Office of Public Health and the participating cantons.

71.CANNABIS USE AS A MEANS OF SOCIALIZATION? NEWCONSUMPTION PATTERNS AMONG HEAVY USERSChristina Akre, MA, Pierre-Andre Michaud, MD,Andre Berchtold, PhD, JC Suris, MD, PhD. Research Group onAdolescent Health, University of Lausanne, Switzerland

Purpose: After tobacco and alcohol, cannabis is the most usedsubstance among adolescents in Switzerland. Our aim is to assesswhether cannabis use has become an ordinary means of socializa-tion. We hypothesize that cannabis consumption has become anormative, although still illegal, behavior.Methods: As part of a larger qualitative study aimed at assessingnew ways [patterns] of cannabis consumption, 16 daily cannabisconsumers (11 males) and 2 former heavy consumers (bothfemales), aged 15 to 20 years, participated in interviews and focusgroups. Data were transcribed verbatim and analyzed usingAtlas.ti qualitative analysis software.Results: Most consumers define the beginning of their consump-tion as a moment when they made new friends. They commonlyuse cannabis in group settings, which encourages the belief that alladolescents use cannabis. Thus, cannabis is mainly identified as aneveryday social act. Joints are smoked like cigarettes: at all times ofthe day, during or after school or work with peers, often startingat lunch break, and mostly in public places. Friends offer a joint ina group setting, much like beer in a bar, as a means of makingcontact. Consumption invariably increases while socializing onvacation: “During vacation, we smoke up to 10-15 joints a day; atthe end we’re just dead.” Additionally, in order to obtain canna-bis, consumers have to be part of the right networks; theygenerally have several dealers to assure their supply, buy and sellthemselves, or practice group-buying. As a result, all friends oracquaintances of consumers are themselves cannabis users. Forinstance, 4 boys, who say they are best friends, always smoketogether and that, in order to quit, “All four of us should say toourselves, ‘Okay, now, let’s all stop smoking’. That would be theonly solution. . .but it would be impossible!” The 2 former con-sumers state that when they started using cannabis, “I foundmyself little by little in a vicious circle where I saw only peoplewho also smoked”. When they quit, they separated from theirgroup of friends: “Either you make new friends who don’t smokeor you smoke.”Conclusions: Discussions with consumers demonstrate a normativefacet of cannabis consumption as part of teenage socialization.Consequently, cannabis consumers develop a significant depen-dency since a majority of their friends use cannabis and theirconsumption involves most of their daily social life. Our studyhighlights the need for clear messages about the harmful aspects ofusing this substance while also suggesting that cessation effortsshould include helping users separate from their consumption mi-lieu.Sources of Support: Dept. of Public Health of the canton of Vaud.

72.CANNABIS AND TOBACCO CO-CONSUMPTION: CANCANNABIS CONSUMERS QUIT CIGARETTE SMOKING?Christina Akre, MA, Pierre-Andre Michaud, MD,Andre Berchtold, PhD, JC Suris, MD, PhD. Research Group onAdolescent Health, University of Lausanne, Switzerland

Purpose: To assess the relation between cannabis and tobaccoconsumption among adolescents in Switzerland and whethercannabis and tobacco co-users can quit cigarette smoking.Methods: Based on individual interviews and focus groups, 22youths aged 15-20 discussed cannabis consumption behaviours.Twenty (14 males) were cannabis consumers – of which 18 alsosmoked tobacco and 2 quit tobacco smoking – and 2 were formercannabis consumers (both females and daily smokers). Data weretranscribed verbatim and analyzed using Atlas.ti qualitative anal-ysis software.Results: Among the co-consumers, 9 started with tobacco, 7 withcannabis, and 2 with both. The main consumption mode among allcannabis consumers is joints, while other ways of consuming suchas food preparations and water pipes are rare and experimental.Joints always mix cannabis with tobacco for 3 reasons: to burncorrectly, pure cannabis is too strong, and smoking cannabis aloneis too expensive. Two cannabis consumers – one former tobaccosmoker and one occasional tobacco smoker – consider rollingtobacco less addictive than cigarette tobacco alone, and hence useit in their joints. Overall cannabis is considered ‘natural’ and lessharmful to health than tobacco. Thus, many users describe theirwish, in the longer term, to quit tobacco consumption withoutexcluding occasional cannabis consumption. Nonetheless, all co-consumers declare that they smoke cigarettes as a substitute forcannabis: For example, “If I don’t have a joint, I need fags; if I don’thave fags, I need joints; and if I don’t have anything, I go crazy!”or “About 20 minutes after smoking a joint we feel like smokingsomething again, because in the joint there is pure tobacco withouta filter as in cigarettes, and that creates a crazy dependency!”.Finally, all co-consumers state that the consumption of one of thesubstances increases when trying to diminish the other: “A fewmonths ago I stopped smoking joints for a month. Well I wassmoking more than a pack [of cigarettes] a day.” Similarly, the 2former cannabis consumers increased their cigarette use sincequitting cannabis.Conclusions: The majority of cannabis users co-consume tobaccoas a way of compensating for one substance or the other. Usingtobacco within joints implies that there is a risk that even occa-sional joints can revive nicotine addiction. Consequently, healthprofessionals wishing to help adolescents in substance use cessa-tion and prevention efforts should consider both substances in aglobal perspective.Sources of Support: Dept. of Public Health of the canton of Vaud.

73.PEER GROUP CHANGE IN SUBSTANCE-ABUSINGADOLESCENTSPaul Harrell, BS, Brian Yates, PhD, Philip Clemmey, PhD. Dept. ofPsychology, American University, Washington, DC and St. Luke’s-Roosevelt Hospital, New York

Purpose: Substance use among adolescents remains a significantproblem in the U.S., with national estimates indicating that 8% ofadolescents 12-17 reported past year substance use disorders(SAMHSA, 2006). Affiliation with substance-using peers has been

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referred to as an “established risk factor for [substance] abuseonset” (see Chassin et al., 2003; Ellickson, et al., 2004). Effectiveencouragement of adolescents to alter their peer group to includeless substance-involved peers has proved to be a difficult task fortreatment providers (Brown, 1993). However, programs that areable to manage this change have been found to reduce drug useand relapse (Mallams et al., 1982; Godley et al., 2002). The purposeof the present study was to examine the clinical characteristics andtreatment outcomes of adolescents who modified peer groupaffiliation following an index episode of treatment.Methods: Secondary analysis of data from the Adolescent Treat-ment Models (ATM, 2002) initiative, a national, multi-site evalu-ation of adolescents (14-21) in substance abuse treatment. Peergroup affiliation was assessed using the Social EnvironmentalRisk Index (SERI) (alpha � 0.79), a measure of exposure todrug-using peers. The SERI is derived from The Global Assess-ment of Individual Needs (GAIN), a multidimensional, semi-structured interview administered to participants. Participantswho reduced their involvement with drug-using peers at 3 monthsfollowing treatment admission were classified as “SERI Decreas-ers (SERI-D)” (N � 545, 62.1%). Adolescents who increasedinvolvement with drug-using peers over this time period wereclassified as “SERI Increasers” (N � 260, 29.6%). Adolescents withno change in peer group affiliation (N � 73, 8.3%) were excludedfrom analyses.Results: SERI-D had more baseline involvement with drug usingpeers, substance problems, crime involvement, conduct problems,emotional problems, and treatment motivation (all ps � 0.03).They were more likely to be female (p � 0.010) and non-Hispanic(p � 0.047). They did not differ on age or baseline levels of generalmental distress, traumatic stress, or treatment resistance (all p �0.1). SERI-D still had significantly more substance problems thanSERII 3 months after baseline (p � 0.001), but not by 12 months(p � 0.29). By 12 months post-treatment admission, 55.1% ofSERI-D had returned to or exceeded their 3-month level ofinvolvement with substance-using peers, including 24.4% whoreturned to or exceeded their baseline level.Conclusions: These data suggest that treatment does tend to leadto positive changes in peer groups, but that these changes are notpermanent and do not seem to be connected to reductions insubstance problems. Males and Hispanics were particularly resis-tant to changing to peer groups with less drug use. Research intothis area may lead to understanding the forces driving thisresistance and thus improve treatment outcomes.Sources of Support: None.

74.PREVALENCE OF SUBSTANCE USE AMONG DETAINEDYOUTH: A MIDWESTERN EXPERIENCEIris J. Meltzer, MA, MPH, Liz Piatt, PhD, Norman Jentner, PhD,James J. Fitzgibbon, MD. Akron Children’s Hospital, Akron, Ohio;Northeastern Ohio University College of Medicine and Pharmacy,Rootstown, Ohio; Akron Health Department, Akron, Ohio; AkronChildren’s Hospital, Akron, Ohio

Purpose: Public perception of youth in detention is that they aremore likely than their peers to engage in use and abuse of alcoholand other drugs (AOD). This study sought to profile the AOD useof adolescents detained in a short-term detention center andcompare it to patterns of use reported by a representative sampleof adolescents.

Methods: Between 1996 and 2005, all youth aged 9-18 years wereadministered the Substance Abuse Subtle Screening Inventory A-2(SASSI A-2) within 24-72 hours of admission to a Midwesternjuvenile detention center that serves a community that is 82%White, 14% Black, and 4% other ethnicity. Informed consent wasobtained for all participants from their legal guardians, withassent of the adolescents. Results of the CDC Youth Risk BehaviorSurvey (YRBS) for the State of Ohio from 1997-2005 were utilizedfor comparisons.Results: Our sample (n � 793) was 46.1% White, 43.9% Black, and10% other. A total of 72.4% were male. Modal age of participantswas 16 years. A total of 54.1% had completed ninth grade. Though42.3% of those surveyed reported no current AOD use, 17.4% ofAOD users reported use � 2 times/week. Modal age of first usewas 13 years. A total of 29.6% of the detained youth had their firstdrink prior to age 13, comparable to YRBS findings of first useranging from 30% (1999) to 22% (2005). A total of 57% of thosesurveyed had a high probability of substance abuse disorder. Atotal of 20.9% reported never using, comparable to the 15% (1999)to 23.5% (2005) who reported never having a drink in their lives tothe YRBS. Significant racial differences were found. Whites weremore likely to have a high probability of AOD abuse disorderscompared to Blacks (p � 0.003), but Blacks use alcohol morefrequently (p � 0.036). Significant racial differences were noted in9 of the 10 SASSI subscales, with Whites scoring higher thanBlacks on 6 of these, lower on the other 3. Significant genderdifferences were also found. Males used more frequently thanfemales; however, females were more likely to have a highprobability of AOD abuse disorders. Significant gender differ-ences were also noted on 6 of the 10 SASSI subscales. Femalesscored higher on 5 subscales.Conclusions: Youth in detention did not demonstrate AOD usesignificantly different from their peers statewide. However, thedetained population is not uniform in AOD use rates or patterns.Significant racial and gender differences have implications forpublic policy and service delivery. Further study which examinestrends in use over time by youth in short-term detention willelucidate information important to the juvenile detention system.Sources of Support: Akron Children’s Hospital Foundation Re-search Grant.

75.PREVALENCE OF AND ASSOCIATIONS WITHWATERPIPE TOBACCO SMOKING AMONG U.S.UNIVERSITY STUDENTSBrian A. Primack, MD, EdM, Jaime Sidani, MPH,Aaron A. Agarwal, BA, William G. Shadel, PhD,Eric C. Donny, PhD, Thomas E. Eissenberg, PhD. Departments ofMedicine and Pediatrics, University of Pittsburgh School of Medicine,Pittsburgh, Pennsylvania; RAND Corporation, Pittsburgh,Pennsylvania; Department of Psychology, Pittsburgh, Pennsylvania;Virginia Commonwealth University, Richmond, Virginia

Purpose: Although waterpipe tobacco smoking seems to be in-creasing on U.S. university campuses, these data have come fromconvenience samples. We aimed to determine the prevalence ofwaterpipe tobacco smoking among a random sample of students.We also aimed to determine what demographic, attitudinal, andbelief-based variables were independently associated with water-pipe tobacco smoking in this population.Methods: The data for this study were collected via the web-basedversion of the National College Health Assessment (NCHA) from

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