Beliefs about cough medicine abuse among Chinese young people were examined using the Beliefs about Cough Medicine Abuse Scale (BACMAS; developed by Shek). A total of 225 Chinese young people, including 160 cough medicine abusers and 65 noncough-medicine abusers, participated in this study. Results showed that the scale was internally consistent, and was able to differentiate between those who did and did not abuse cough medicine. Higher BACMAS scores were related to higher levels of endorsement of cough medicine abuse and severity of consumption, thus providing support for the concurrent and construct validities of the scale. The respondents abusing cough medicine generally did not perceive the benefits of abusing cough medicine and they recognized the harmful effects of such abuse. However, 40.7% of them believed that cough medicine was not addictive and 57% believed that there was no harm in associating with friends who abused cough medicine. Results suggest that it is important to understand the beliefs of cough medicine abusers regarding cough medicine abuse.
Keywords: cough medicine, cough mixture, Chinese, young people, addiction, drug abuse, substance abuse.
The abuse of psychotropic substances is a growing problem in the global context (Shek, 2006). It is interesting that, although much attention has been given to the use of illicit psychotropic substances such as cannabis and amphetamine type stimulants (ATS) in recent years, comparatively less attention has been directed to the abuse of legal drugs, such as cough medicine, that can be bought over the counter (OTC drugs) or prescribed by medical practitioners (Lam & Shek, 2006). Cough medicine sold over the counter commonly contains psychotropic substances such as codeine or dextromethorphan.
Research results have pointed to the possible abuse of cough medicine in Western countries (e.g., Elwood, 2001; Jensen & Hansen, 1993; Jinks & Raschko, 1990). In the clinical literature, researchers have documented cases of cough medicine abuse (Miller, 2005; Price & Lebel, 2000). Regarding the abuse of cough medicine in the West, Darboe (1996) proposed a theoretical model in which four factors were identified: availability, approval, ignorance and fear. Based on a survey of school personnel, Darboe, Keenan, and Richards (1996) asserted "abuse of cough syrup (Robitussin or other brands) has increased over the years and is increasingly perceived as a problem by the community" (p. 633). Based on qualitative interviews of 48 cough medicine abusers, Peters et al. (2003) concluded that the influence of peers and hip hop music reinforced the use of cough medicine.
The literature also suggests that cough medicine abuse exists in Asian countries, such as Japan (Ishigooka, Yoshida, & Murasaki, 1991; Suzuki, Masukawa, & Misawa, 1990) and India (Borde & Nizamie, 1988; Mattoo, Basu, Sharma, Balaji, & Malhotra, 1997; Wairagkar, Das, & Kumar, 1994). With specific reference to Hong Kong, there are several sources of information suggesting that cough medicine abuse is a growing substance abuse problem. First, an examination of the data in the Central Registry of Drug Abuse shows that there has been a rising trend of cough medicine abuse (Narcotics Division, 2005). second, based on the regular school surveys conducted by the Narcotics Division (e.g., Fung & Chan, 2005; Lau, 2002), the proportion of students who indicated that they had abused cough medicine showed a rising trend in international schools. Third, based on the studies conducted or sponsored by the Narcotics Division of the Hong Kong SAR Government and research undertaken by academics, there are signs showing that cough medicine abuse is a growing problem (e.g., Shek & Lam, 2006). In a recent study, Wong, Dickinson, and Chan (2005) commented that "inappropriate and over-prescribing of cough mixtures" (p. 381) was prevalent in the health care system in Hong Kong. …