Several authors have attempted to explain drug use debut in teenagers. Petraitis, Flay, and Miller (1995) proposed a conceptual model that includes three kinds of influences: (1) cultural and attitudinal, such as public policy and social values; (2) social and interpersonal, including social influences, family beliefs and relationships; and (3) individual baggage, including temperament and confrontation skills. They also suggested that three levels can be identified within each: proximal, distal, and distant. They recognized, however, that even though the model is conceptually clear, there has not been enough research to identify other influences underlying drug use debut.
In another related study, Castro-Sarinana (2001) identified 50 factors related to teenage drug use. He classified them into three groups using an epidemiological model: (1) predisposing environment, including type of family, demography, and social environment; (2) the drug itself (as an agent), including use and access, among other factors; and (3) individual (host), including sociodemography and personal biography.
Other reports have identified such factors as easy access to a drug, drug users among family or friends, peer approval, a perception of low risk, and unpleasant mood state as being linked to drug use (Medina-Mora, Villatoro, Lopez, Berenzon, Carreno, & Juarez, 1995). Additional associated factors include domestic violence, drug use by relatives, and sexual abuse (Sanchez-Huezca, Guisa-Cruz, Ortiz-Encinas, & de Leon Pantoja, 2002).
In a qualitative study, Nuno-Gutierrez and Flores-Palacios (2004), noted that one of the central perceptions underlying teenage drug is that they do not see it as a problem, and believe that "nothing wrong is going to happen." This perception seems to be learned from a family member. The adolescent addict also believes that s/he is stronger than others.
Some reports indicate school-related factors, such as academic failure (Bryant, Schulenberg, Bachman, O'Malley, & Johnston, 2000; Bryant & Zimmerman, 2002; Bryant, Schulenberg, Bachman, O'Malley, & Johnston, 2003; Luthar & Crushing, 1997), absenteeism, peer drug use, and psychological distress as being linked to teenage drug use (Dryfoos, 1990; Hawkins, Catalano, & Miller, 1992; Newcomb, Abbot, Catalano, Hawkins, Battin-Pearson, & Hill, 2002; Newcomb, & Bentler, 1989). Further, teenagers who engaged in misconduct and had low school performance scores had higher tobacco, alcohol and marijuana use levels (Brook, Whiteman, Gordon, & Cohen, 1986; Bryan & Zimmerman, 2002; Hawkins & Weiss, 1985; Roeser, Eccles, & Fredman-Doan, 1999; Sanchez-Huezca et al., 2002; Smith & Fogg, 1978; Voelk & Frone, 2000). This finding is supported by a number of reports showing that teenagers with more motivation and interest in school, more positive attitudes, defined academic goals, and higher self-esteem also have a lower risk for drug use (Bachman, Johnston, & O'Malley, 1981; Schulenberg, Bachman, O'Maley, & Johnston, 1994).
Adolescent drug abuse is also linked to such family factors as faulty and triangulated communication (Klein, Forehand, Armistead, & Long, 1997), multi-problem families (Sokol, Dunham, & Zimmerman, 1997), inter-parental conflict (Klein et al., 1997), parent-child conflict (Klein et al., 1997; Sokol et al., 1997), intergenerational alliances and coalitions (Graham, 1996; Sanchez-Huezca et al., Strauss et al., 1994), addiction-perpetuating family patterns (Tomori, 1994), affection-deprived family environment (Voelkl et al., 2000), ineffective problem-solving patterns (Klein et al., 1997, Sokol et al., 1997), low familial satisfaction levels (Choquet, Kovess, & Poutignat, 1993; Yeh et al., 1995), family perceptions oriented toward negative aspects (Anderson & Henry, 1994; Denton & Kampfe, 1994; Foxcroft & Lowe, 1995), family disintegration (Hagell & Newburn, 1996), type of religious practice (Foshee & Hollinger, 1996), and low levels of parental monitoring (Hawkins et al. …