Several decades ago, it was the norm in the addiction community for patients to be segregated into groups according to some aspect of their humanity, be it their gender, race, sexual preference, or age. Books were written and textbooks divided along such lines. What I hadn’t noticed is that in the recent past, this divisive approach appears to have become less prevalent. I don’t know if that’s good or bad: perhaps a gay black male adolescent with addictive disease needs to be treated using an entirely different approach, so at odds with the usual treatment modalities that specialized resources are necessary. In fact, if we look at disease prevalence for nicotine dependence, we see a fairly wide range when comparing groups. In the mid-90s, black men smoked at a rate of about 32 percent, significantly higher than the rate for black women, 23 percent. White men and women had closer percentages, at 28 percent and 26 percent, respectively. One might have speculated that the difference in dependency rates could be genetic, or sociologic, or economic; a number of explanations have been offered as to why these types of demographic differences are present.

Interestingly, in the past few years, an enormous shift has taken place. Teenaged girls are now using cigarettes and prescription drugs to a greater extent than teenaged boys. While overall usage has trended downward in the federal study conducted each year, girls have exceeded boys for the last three studies in terms of marijuana use, prescription drug use (without prescriptions), and are now exceeding initiation rate for alcohol and cigarette use as well. The media pundits have openly wondered as to why this might be. Fruit-flavored alcoholic beverages, perhaps more attractive to younger women, have been blamed, as has concerns by young women about weight. Vulnerability to celebrity stereotypes in an environment where actresses, models, and singers frequently have their encounters with substances described at length in popular media has also been described.

No one to my knowledge has yet wondered whether the Internet has played a significant role in this transition. A cursory Google search leads to a wide variety of online sites that promote smoking among girls. Several provide instructions as to how to start smoking, how to smoke in a manner that will be attractive to men, how to combine nicotine use with that of other drugs to enhance pleasure, and so forth. Well outside our usual content of discussion would be why such sites exist for girls but not for boys, though I strongly suspect this has something to do with the men setting up these sites in the first place. There’s no question that there is a blatant sexuality to these sites, in many cases well over the line into pornography, but of course drug use and sexuality have always been linked. The Internet, however, seems to have heightened this link and to have made it readily available to a younger contingent than those who had access to such material in the past.

An enormous amount of time has gone into the development of what seems to be a complete database of smokers online. A quick search for “Britney Spears Smoke” brings up a pages-long entry with media citations as to does she or doesn’t she, including photographs, cigarette brand, and other miscellaneous but related material. The site has hundreds of other well-known individuals, each with their own extensive dossier of smoking history. Non-pornographic sites feature videos of young women smoking cigarettes and marijuana, sometimes while drinking alcohol. Such videos, apparently created for the entertainment of men, are without overt sexual content but are likely designed to provide sexual stimulation. Many online pornographic sites have specific sections in which images and video focus on substance use combined with sexual acts. It is unlikely that technologically savvy young women have not noticed these sites, and no one has asked them whether they’ve been starting to smoke in record numbers because they believe it attractive to their male counterparts. A review of the web brought up far more sites dedicated to the joy of girls smoking than to the health problems that such behavior will inevitably cause.

The ease with which groups of users can come together online may reduce the inhibition that girls perhaps had with greater frequency than boys in the past. “420” has been a term related to marijuana use for at least 30 years; a search of popular teen dating sites revealed a high number of entries including “420” as well as entire sites dedicated to bringing marijuana users together. Here, the division in male and female interest present with cigarette-related sites seems to dissipate, with as many younger women participating as men. These classified-like areas for any age group represent a forum in which any 14-year-old can post a message that says, essentially, “I’m looking for a guy/girl who smokes pot to hang out with.” One wonders to what extent the availability of such sites has altered the likelihood of substance use by reducing prior barriers to use.

I couldn’t find any discussion of these issues in the medical literature nor does there appear to have been any investigation by the popular media. I don’t know if the Internet has anything to do with the fairly rapid demographic changes in substance use in the past few years, but the changes appear to be at least correlated to expansion of Internet availability and access. What do you think? Is there a causal relationship here? Should we be asking our younger patients about their Internet use and increased likelihood of girls picking up drugs, how do we fix the problem?

Dr. Gitlow is on the Board of the American Society of Addiction Medicine and serves as Chair of the American Medical Association’s Task Force on Alcohol. His textbook, Substance Use Disorders: A Practical Guide, will have its second edition released any day now from Lippincott Williams & Wilkins.

This article is published in Counselor,The Magazine for Addiction Professionals, June 2006, v.7, n.3, pp.42-43.

---

Comments

Add New Search RSS

Write comment
Name:
Email:	do not notifynotify
Title:
UBBCode:	-color-aquablackbluefuchsiagraygreenlimemaroonnavyolivepurpleredsilvertealwhiteyellow -size-tinysmallmediumlargehuge
	Please input the anti-spam code that you can read in the image.

Powered by !JoomlaComment 3.25

3.25 Copyright (C) 2007 Alain Georgette / Copyright (C) 2006 Frantisek Hliva. All rights reserved."