turkish high school students' attitudes toward ...

J. DRUG EDUCATION, Vol. 39(1) 59-71,2009

TURKISH HIGH SCHOOL STUDENTS' ATTITUDES TOWARD ADDICTIVE SUBSTANCES: ASSOCIATION WITH PERCEIVED PARENTAL ATTITUDES*

MEHMET USTUNER tnonu University, Turkey KASIM AKSOY Malatya Police Department, Turkey NIYAZI OZER tnonu University, Turkey

ABSTRACT The aim of this research is twofold: I) to determine attitudes of high school students toward addictive substances; and 2) to determine students' attitudes toward addictive substances in terms of some variables including gender, grade, and perceived parental attitudes. To this end, Addictive Substances Allitudes Scale and Parental Attitudes Scale were given to a sample of 745 high school students (F = 330, M = 415) chosen by purposive sampling method. Results showed that compared to the males, females had more negative attitudes toward addictive substances. And compared to students from the upper grades, students from lower grades had more negative attitudes toward addictive substances. It is also found that students' attitudes toward addictive substances correlate with perceived parental attitudes. The correlation is low and positive for perceived democratic parental attitudes (r = .29), negative and low for perceived authoritarian parental attitudes ( r = -.27).

*This study is based on the data obtained in the master thesis prepared by Kas1m Aksoy under the supervision of Mehmet Ostliner (PhD).

59

© 2009, Baywood Publishing Co., Inc. doi: 10.2190/DE.39.1.d http://baywood.com

60 I OSTONER, AKSOY AND 6ZER

INTRODUCTION Substance use and addictive disorders are topics of considerable importance both because of their significance for adolescent development and because of their public health impact (Chassin, Hussong, Barrera, Molina, Trim, & Ritter, 2004 ). According to the World Drug Report 2006 (UNDOC, 2006) total number of drug users worldwide is at some 200 million, equivalent to about 5% of the population aged 15-64. In the World Drug Report 2004 (UNDOC, 2004), it is stated that drug usc and drug-related deaths in Western Europe may have decreased by almost 20% during 2000-2002. Some European research results confirm that substance use rates are stable or declining slightly (Balding, 2000; Goddard & Higgins, 1999). Despite this encouraging news, drug usc remains as a significant problem and substance use is still pervasive among youth in many cultures and countries around the world (Windle & Windle, 2003). Several bodies of research results also confirm that adolescent use of addictive substances still appears to be increasing (e.g. Bauman & Phongsavan, 1999; Bruner & Fishman, 1988; Fombonne, 1998; Gfroerer, 1995; Kandel, 1980; Kilpatrick, Acierno, Saunders, Resnick, Best, & Schnurr, 2000; UNODC, 2004), particularly among students (e.g. Hibell, Andersson, Bjarnason, Ahlstrom, Balakireva, Kokkevi, et al., 2004; Johnston, O'Malley, & Bachman, 2000, 2002; Roy, Wibberley, & Lamb, 2005; Toumbourou, Beyers, Catalano, Hawkins, Arthur, Evans-Whippet al., 2005). For example, results of a national school-based survey show that adolescent substance use is relatively common by the end of the high school years (Johnston et al., 2002). Especially in 200 I approximately 54% of 12th graders used some illegal drug in their lifetimes, with 25.7% using in the past month, and 61% of high school seniors report some experience with cigarette smoking (Johnston et al., 2002). As Galizio and Maisto ( 1985) stated, substance use is a multi-factorial process and these factors can be classified as individual peer-related, social, and familyrelated factors involving some biological, social, and environmental factors such as certain psychological characteristics, early behavior disorders, hyperactivity, gender, cthnicity, laws, and norms favorable toward drug usc, availability of drugs, a family history of substance usc etc. (for reviews, sec Chassin ct at. 2004; Costello, Farmer, Angold, Burns, Erkanli, et at., 1997, Ennett & Bauman. 1991; Hawkins, Catalano & Miller, 1992; Johnston et al., 2002; Kafka & London, 1991; Windle, 1999). As children develop into adolescence, effects of peer-related or social factors on adolescent's substance use may increase. But effects of family-related factors remain, because family can be regarded as a major agent of socialization for adolescence. And family socialization process has great influences on adolescents' present and future social and health-related behaviors including substance usc (Foxcroft & Lowe, 1995). One of the major factors affecting substance addiction among adolescents is their attitudes toward the addictive substances. Attitude-behavior consistency

TURKISH STUDENTS AND ADDICTIVE SUBSTANCES I 61

has been an everlasting research question in the social sciences (Liska, Felson, Chamlin, & Baccaglini, 1984). But there is a general agreement in the literature that the attitudes change our social perceptions and behaviors (Kagltt;:!ba~l, 1999). To be aware of the attitudes ofhigh school students toward addictive substances and the factors affecting their attitudes is of great importance in terms of studies aiming at preventing and decreasing substance misuse among adolescents. Therefore, this study intends first of all to detem1ine the attitudes of high school students toward addictive substances. Another aim of the study is to find whether the students' attitudes toward addictive substances differ according to gender, grade, and perceived parental attitude variables. Among these variables, particularly the parental attitudes perceived by students was examined for their effect because, theoretically, family and peer relations are two of the most important socializing forces affecting adolescent behavior (Darius, Bahr, Hoffmann, & Hannon, 2004 ). Among these forces, family relations and parental attitudes have a considerable effect on the psycho-social development of the students. For the individuals to have a balanced and harmonious personality is closely related with the nature of the family settings they live in (Kuzgun & Eldeleklioglu, 2005, p. 67).

METHOD

Population and Sample The population of the study comprises a total25,470 students, including I 3,874 males and II ,596 females, who attended general and vocational-technical high schools in the province of Malatya during 2004-2005 school year. The participants of the study were chosen in two steps: first schools were chosen, next participating students were chosen. During the first process, 13 schools were chosen according to stratified random sampling method (Cohen, Manion, & Morrison, 2005, p.l 0 I) out of 31 high schools located in four school districts in Malatya. When choosing schools, it was considered to have the sample reflect some contrasting demographic statuses of the schools, such as school location (urban or suburban settings), school type (general or vocational), socio-economic status, and number of students enrolled. During the second process, a total number of745 students (female= 330 and male= 415), which exceeds the recommended sample size (Cohen et al., 2005; Krejcie & Morgan, 1970), were chosen by purposive sampling method. This sampling method was preferred to choose especially those students who live with their both natural parents, since one of the main aims in this study is to determine the association between high school students' attitudes toward addictive substances and their perceptions regarding parental attitudes. To understand better the context in which this study was

62 I OSTONER, AKSOY AND OZER

conducted, it is necessary to describe briefly the city of Malatya, together with family structure, parent-child relations, and current drug scene of the region. Malatya is one of the most developed cities in the eastern part of Turkey, specifically the western border of the East Anatolian Region. One of the leading apricot exporters in the world, Malatya has experienced a huge developmental leap since 1980s, which has led to massive migration from the eastern part of Turkey. The social life where traditional and modem aspects are interwoven is mostly formed by nuclear families (Duruhan & ~ad, 2006). Although a mutual emotional attachment and loyalty marks parent-child relationships in Turkish families in general (Ataca, 2006), sons have a special importance compared to daughters especially in rural and/or partly in eastern Turkey, since the former means economic assistance and security and a means of carrying on the family name (Ataca & Sunar, 1999). This family-based discrimination finds its reflections in the bigger society, where women's social status is inferior to that of men (Nauck & Klaus, 2005; Ytldmm, 1997). The province ofMalatya is exposed to marijuana trafficking both because of its geographical location (located on the Balkan route of drug trafficking) and its being one of the cities where hemp plantation is legally allowed. Besides, according to Department of Anti-Smuggling and Organized Crime of Turkish National Police statistics (2008), Malatya is the fifth province among the cities in Turkey where the largest amount of heroin was seized in 2007.

Research Instruments Addictive Substance Attitude Scale

''Addictive Substance Attitude Scale" (ASAS), developed by the researchers, was used in order to determine the high school students' attitudes toward addictive substances. Prior to the development of the scale: relevant literature (Galizio & Maisto, 1985; Hawkins ct al., 1992) was reviewed; similar scales (e.g. Abed & Neira-Munoz, 1990; Fok & Tsang, 2005; Francis, 1997: Francis & Mullen, 1993; Leone, 2005; Tonin, 2006) were analyzed; and finally a trial scale including 64 items was obtained. Then this trial scale was administered to 577 high school students living with both their natural parents. Rotated principle components analysis was done in order to determine the factor structure of the scale. As a result of the principle components analysis, 45 items with factor loadings ranging between .61 and .43 were qualified for the final form of the scale. In the final fom1 of the scale, there are 21 positive and 24 negative items about addictive substances. The internal consistency coefficient of the scale was found (Cronbach Alpha .92). The maximum score from the scale is 225, and minimum one is 45. Higher scores from the scale indicate more negative attitudes

TURKISH STUDENTS AND ADDICTIVE SUBSTANCES

I 63

toward addictive substances, while lower scores indicate more positive attitudes toward addictive substances.

Parental Attitudes Scale

In order to measure perceived parental attitudes, "Parental Attitudes Scale" (PAS), developed by Kuzgun and Eldeleklioglu (2005) was used. The scale includes three sub-scales which intend to measure how students perceive their parents' behaviors-i.e., whether "democratic," "authoritarian," or "protectivedemanding." The items measuring democratic attitudes are those about affection and care. The items measuring authoritarian attitudes are characterized as completely opposite the items measuring democratic attitudes. While democratic parents consider it important for their children to develop self-discipline, authoritarian parents behave cold and try to discipline them from outside them. The items measuring protective attitudes are about excessive care on the child and preventing self-realization. In the study done by Kuzgun and Eldeleklioglu (2005), internal consistency coefficient of the scale for democratic parental attitudes sub-scale was designated as 0.89, for protective parental attitudes sub-scale 0.82, and for authoritarian parental attitudes sub-scale 0.78. In this research, internal consistency coefficients of the sub-scales were found to be 0.90 for perceived democratic parental attitudes, 0.82 for perceived protective parental attitudes, and 0.77 for perceived authoritarian parental attitudes.

Data Analysis

For the analysis, first the results from Levene's Test for Equality of Variances, which tests the homogeneity of the data, were examined. Where the group variances arc homogeneous, t-test was used to test attitudinal differences by gender and one-way ANOV A analysis was used to test the attitudinal differences by grade. Where the variances are not homogeneous, Mann Whitney U test was used instead oft-test, and Kruskal Wallis-H test was used instead of one-way AN OVA analysis (Crichton, 1998; Kasuya, 2001; Sheskin, 2004).

RESULTS AND DISCUSSION

The mean score that participants obtained from ASAS was found to be 202.61. This indicates that majority of the participants think that addictive substances do not have any positive contribution to their lives and they are aware of the hannful effects of these substances.


A gender specific analysis of the mean scores, using Mann-Whitney U test revealed a significant difference (U = 44870.5, p = .000). As a result, female students have more negative attitudes (M = 208.8) toward addictive substances compared to male students (M = 197.7). This particular finding from the study is consistent with the findings from a study by Quinn-Zobeck ( 1998). Considering Turkish cultural context, girls' behaviors and roles arc, by and large, subject to stricter social control. While girls spend most of their spare time in their home environment, boys do so outside with peers (Y 1ldmm, 1997). Giving greater freedom to males in social settings may cause the male students to go to public houses such as cafes, pubs, and coffee houses more than the females do. And these arc the places where the youth mostly first encounter with addictive substances. Since the male students arc more likely to go to such places because of their social roles, they may have more positive attitudes toward addictive substances. The results of the analysis as to whether high school students' attitudes toward addictive substances differ in tcm1s of grade variable revealed that the difference between the 9th. 1Oth and II th graders' scores regarding their attitudes toward addictive substances is statistically significant (X 2 = 21, 7; p = .000). As a result of the Mann-Whitney U test employed to find the source of difference, the 9th graders were found to have more negative attitudes toward addictive substances than the I Oth and II th graders. Similarly the I Oth graders were found to have more negative attitudes compared to II th graders. Based on these findings it can be stated that as the grade level increases the students develop more positive attitudes toward addictive substances. In some empirical studies, it was also stated that as the grade increases the level of addictive substance usc increases (e.g., Johnston et al., 2000, 2002). In order to identify the relation between high school students' attitudes toward addictive substances and their perceived parental attitudes, means and standard deviations of each sub-scale in the PAS were calculated. Lower, moderate, and higher values of particular sub-scales of PAS were calculated by adding and subtracting the standard deviation value to/from the mean score. The values regarding these calculations are shown in Table I. In order to find whether there is a significant difference between the addictive substance attitude scores of the students whose perceived democratic parental attitude scores arc higher, moderate, and lower, a one-way ANOY A was carried out. Analysis results showed that there is a statistically significant difference between high school students' attitudes toward addictive substances in terms of perceived democratic parental attitude scores (F = 21.63; p = .00). Taking into consideration the means of participants' scores, it was observed that students who perceive their parents' democratic attitude level as higher (M = 209.86) have more negative attitudes toward addictive substances compared to other students. Similarly, it was observed that students who perceive their parents' democratic attitude level as moderate (M = 203.68) have more negative attitudes

Table 1. Participants' Mean Score Intervals for Parental Attitude Scale (PAS)

Sub-scales of PAS

N

Min. score

Max. score

M

so

Mean score intervals

-1

c

:D ::11\

Perceived Democratic Parental Attitude

745

15

75

59.45

12.22

Low Moderate High

Below47.2 47.2-71.6 Above 71.6

10.72

Low Moderate High

Below 32.4 32.4-53.9 Above 53.9

Low Moderate High

Below 14.5 14.5-30.7 Above 30.7

Cii I

en c 0 m -1

z

-1

Perceived Protective Parental Attitude

Perceived Authoritarian Parental Attitude

745

745

17

10

71

50

43.16

22.61

8.1

en )>

z 0

)>

0 0

0

-1

< m en c Cll en );!

z

()

m en

Ol ()1

66 I 0ST0NER, AKSOY AND OZER

toward addictive substances compared to the students who perceive as lower (M = 191. 74). These findings indicate that there is a negative association between perceived democratic parental attitudes and positive attitudes toward addictive substances. In other words, as perceived democratic parental attitude level increases, students' attitudes toward addictive substances become more negative. In order to find whether there is a significant difference between the addictive substance attitude scores of the students whose perceived protective parental attitude scores are higher, moderate, and lower, a one-way ANOV A analysis was carried out. The results of the analysis showed that there was no statistically significant difference between high school students' attitudes toward addictive substances in terms of perceived protective parental attitude scores (F = I. 78; p =.I69). In order to find whether there is a significant difference between the scores regarding students' attitudes toward addictive substances according to students' perceived authoritarian parental attitude levels, a one-way ANOV A analysis was carried out. The results revealed that there is a statistically significant difference between high school students attitudes toward addictive substances in terms of perceived authoritarian parental attitude levels (F = 25.57; p = .00). Taking into consideration the mean scores, it was observed that students perceiving their parents' authoritarian attitude level as lower (M = 210.79) have more negative attitudes toward addictive substances compared to other students. Similarly, it was observed that students perceiving their parents' level of authoritarian attitudes as moderate (M = 202.90) have more negative attitudes toward addictive substances compared to the students perceiving them as higher (M = 191.11 ). These findings indicate that there is a positive association between perceived authoritarian parental attitudes and positive attitudes toward addictive substances. In other words, as the perceived authoritarian parental attitude level increases, students' attitudes toward addictive substances become more negative. This finding of the study is consistent with the findings of a research by Foxcroft and Lowe (1995). After examining the relationship between high school students' perceived family environment and substance use, they found significant relationship between perceived family life and a range of self-reported substance use behaviors. Especially the males perceiving their parents "authoritarian" or "neglecting" were reported to usc substances including alcohol, cigarettes, and stimulants more. The correlation analyses between high school students' attitudes toward addictive substances and perceived parental attitudes revealed a positive, low, and significant correlation between students' negative attitudes toward addictive substances and perceived democratic parental attitudes (r = .29, p < 0.05). Thus, based on this finding it can be said that as the level of perceived democratic parental attitudes increase, students' negative attitudes also increase. A negative, low and significant correlation (r = -.27, p < 0.05) was also observed between high school students' attitudes toward addictive substances and perceived authoritarian parental attitudes, while a negative, low correlation

TURKISH STUDENTS AND ADDICTIVE SUBSTANCES I 67

(r = -.09) was observed between high school students' attitudes toward addictive substances and perceived protective parental attitudes. This finding shows that there is a linear negative correlation between high school students' attitudes toward addictive substances and their perceived authoritarian and protective parental attitudes. Based on this finding it can be concluded that parents' democratic attitudes toward their children can be associated with their children's negative attitudes toward addictive substances, while parents' authoritarian and protective attitudes are associated with their children· positive attitudes toward addictive substances.

CONCLUSION AND IMPLICATIONS This study intends to identify the high school students' attitudes toward addictive substances and to find whether they differ in terms of some variables. To this end, ASAS and PAS scales were conducted on a sample of745 high school students from 13 high schools in the province ofMalatya, Turkey. The analysis revealed that, compared to female students, male students have more positive attitudes toward addictive substances and they have more positive views about using such substances. Analysis regarding the grade variable revealed that as the grade increases, high school students' attitudes toward addictive substances tend to be more positive. The analysis as to whether there is a correlation between high school students' attitudes toward addictive substances and their perceived democratic, protective, and authoritarian parental attitudes revealed: a positive correlation (r = .29) between high school students' negative attitudes toward addictive substances and democratic parent attitudes; a negative correlation (r = --.27) between high school students' negative attitudes toward addictive substances and authoritarian parent attitudes; and a negative correlation (r = -.09) between high school students' negative attitudes toward addictive substances and protective parent attitudes. It was found that for the parents to have a democratic attitude toward their children has a positive correlation with high school students' negative attitudes toward addictive substances, while for the parents to have an authoritarian and protective attitude has a negative correlation with high school students' negative attitudes toward addictive substances. This finding is considered to be remarkable for the societies traditionally having an authoritarian culture and family structure. Coupled with other factors affecting substance addiction, the authoritarian nature of the family may increase the tendency of the high school students toward addictive substances. This study showed that parents' being authoritarian is related with the students' having more positive attitudes toward addictive substances. If the other factors leading substance usc were combined with the parental authoritarian attitude, it would be much more


difficult to protect the students against addictive substances. This is a topic requiring great importance and emphasis in the context of Turkey which has a traditionally authoritarian family structure. lt has been found that female students have more negative attitudes toward addictive substances compared to male students. So, gender variable should be taken into consideration in studies about addictive substances. While deciding the content of the educational programs on such an issue, it should be born in mind that the male students' attitudes toward addictive substances are more positive compared to those offcmalcs. It has been found that as the grade level increases in high schools, the students' attitudes toward addictive substances become less negative. So the educational programs on addictive substances in high schools should be provided continuously from the first grade to the last. In addition to this it will be beneficial to increase the frequency of such programs as the grade levels increases. A positive correlation has been observed between high school students' perceived democratic parental attitudes and negative attitudes toward addictive substances. Thus, studies and training programs aiming at improving the democratic parental attitudes and behaviors should be practiced and expanded more.

REFERENCES Abed, R. T., & Neira-Munoz, E. (1990). A survey of general practitioners' opinion and attitude to drug addicts and addiction. British Journal 14Addiction, 85( I), 131-136. Ataca, B. (2006). Turkey. In J. Georgas, J. W. Berry, F. van de Vijver, (,:. Kagitibasi, & Y. Poortinga (Ells.), Famizv structure and fimction across cultures: P~ychological variations. Cambridge: Cambridge University Press. Ataea, B .. & Sunar, D. (1999). Continuity and change in Turkish urban family life. P.lychology & Developing Societies. 11(1 ), 77-90. Balding, J. (2000). Young people and illegal drugs into 2000. Exeter, Schools Health Education Unit. Bauman, A., & Phongsavan, P. ( 1999). Epidemiology of substance usc in adolescence: Prevalence, trends and policy implications. Drug and Alcohol Dependence. 55. 187-207. Bruner, A. 8., & Fishman. M. ( 1998). Adolescents and illicit drug usc . .loumal ojAmcrican Medical Association (.lAMA). 280(7), 597-598. Chassin, L., Hussong, A., Barrera, M. Jr., Molina, B. S. G., Trim, R., & Ritter, J. (2004). Adolescent substance use. In R. M. Lerner & L. Steinberg (Eds.), Handbook of adolescent psychology (2nd cd., pp. 665-696). Hoboken, NJ: John Wiley & Sons, Inc. Cohen, L., Manion, L., & Morrison, K. (2005). Research methods in educational. (5th Ed.). London: Routledge Falmer. Costello, E. J ., Fam1cr, E. M. Z., Angold, A., Bums, B. J., & Erkanli, A. ( 1997). Psychiatric disorders among American Indian and white youth in Appalachia: The Great Smoky Mountains Study. American Journal ofPublic Health, 87, 827-832. Crichton N.J. ( 1998) Statistical considerations in design and analysis. In Roc B. & Webb C (Eds.), Research and development in clinical nursing practice. Whurr, London.

TURKISH STUDENTS AND ADDICTIVE SUBSTANCES

I 69

Department of Anti-Smuggling and Organized Crime of Turkish National Police. (2008). Turkish report on drugs and organized crime 2007. Retrieved September 08, 2000, !rom: http://www.kom.gov.tr. Dorius, C. J., Bahr, S.J., Hoffmann, J.P., & Harmon. E. L. (2004). Parenting practices as moderators of the relationship between peers and adolescent marijuana usc. Journal of' Marriage and the Family. 66( I), 163-178. Duruhan, K., & ~ad, S. N. (2006).