Recent and Intended Drug Trafficking Among Male and Female Urban African-American Early Adolescents

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Recent

and

Intended

Drug

Trafficking

Among

Male

and

Female

Urban

African-American

Early

Adolescents

Xiaoming Li, PhD* and Susan Feigelman, MD*

ABSTRACT. Objective. To investigate associations between recent and intended involvement in drug traf-ficking and perceptions of the social environment among high-risk urban African-American youths.

Methods. A multicomponent risk assessment survey

was conducted among a convenience sample of 351

African-American youths 9 through 15 years of age resid-ing in low-income communities. Both univariate analysis and logistic regression were performed to examine the association of youths’ perceived social environment with recent and intended involvement in drug trafficking.

Results. Drug selling or delivering in the previous 6 months was reported by 6% of the youths; 12% expected to engage in these activities in the next 6 months. There was a strong association between drug trafficking and other high-risk behaviors, including drug use. Among both genders, perceptions that neighbors, friends, or fam-ily members were involved in drug trafficking were cor-related with recent or intended drug trafficking. For boys, personal economic needs had a strong association with drug trafficking. For girls, personal feelings were more important correlates of intended involvement.

Conclusions. Efforts aimed at both drug-trafficking prevention and intervention need to be community-based and multifaceted. Programs should address the youths’ perceived social environments and consider gender dif-ferences regarding correlates of drug-trafficking involve-ment. Pediatrics 1994;93:1044-1049; gender, African-American, adolescents, drug trafficking, substance use.

ABBREVIATION. PMT, protection motivation theory.

Involvement in drug trafficking has been

increas-ingly recognized as a growing problem behavior

among early and middle adolescents, particularly

those living in low-income, urban environments

(Bush and Iannotti. 1993. Unpublished work).’ For

example, the number of African-American youths

less than 18 years of age arrested for selling drugs in

Baltimore City has increased more than 15-fold

dur-ing a 10-year period (86 for 1981 and 1305 for 1991). The attendant violence, particularly in view of alarm-ing increases in the use of firearms in the inner city in

the current decade, place youths and their

commu-nities at enormous risk. Dembo and his colleagues

reported that 67% of the young dealers they

inter-viewed had killed or hurt someone.4 Recent studies

have suggested that involvement in drug trafficking

From the *Center for Minority Health Research, University of Maryland at Baltimore, and the Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD.

may be an important pathway to substance and illicit

drug use among adolescents, thus placing these

youths at increased risk for acquisition of the human

immunodeficiency virus (Bush and lannotti. 1993.

Unpublished work).2 However, in contrast to the

ex-tensive research and prevention programs addressing

drug abuse and other problem behaviors, the

ante-cedents (both motivational and mechanistic) of drug

trafficking have received little attention to date in the scientific literature.

The few studies addressing adolescent drug

traf-ficking that have been conducted reveal potentially important risk factors: negative social influences,

per-ceived economic needs, diminished sense of

vulner-ability and/or severity of the consequences, and other risk behaviors (Bush and Iannotti. 1993. Unpublished

work).2 However, these studies did not examine

gender differences and did not address factors

asso-ciated with intended involvement. The purpose of

this study was to further explore the relationship

be-tween recent and intended future involvement in

drug trafficking and perceived social, economic,

en-vironmental, and intrapersonal factors among

inner-city African-American male and female adolescents.

Subjects

MATERIALS AND METHODS

Data were obtained from February to April 1 993 from a con-venience sample of youths, 9 through 15 years of age, attending I of 10 recreation centers serving three public housing develop-ments and other low-income neighborhoods in a large eastern metropolis. Written consents were obtained from both the youths and their guardians. Recruitment strategies have been described in detail elsewhere.5

Survey Instrument

Each youth completed a risk assessment questionnaire, the Youth Health Risk Behavioral Inventory, which was administered aurally and visually by a “talking” MacIntosh computer via mdi-vidual earphones. The Youth Health Risk Behavioral Inventory is a multicomponent risk assessment instrument developed over 3 years through a series of ethnographic and survey studies seeking to identify potentially relevant adolescent risk and protective fac-tors from the perspective of youths, parents, and other com-munity members.5 The questions were organized around the constructs of a model of behavioral change, protection moti-vation theory (PMT).7

PMT is a social cognitive theory which envisions environmental and personal factors combining to pose a potential threat. Con-sideration of a maladaptive response is mediated by a balance between rewards accompanying the behavior (both intrinsic [per-sonal pleasure] and extrinsic rewards [social approval]), and the perceived severity of and personal vulnerability to the threat. An adaptive response is mediated by balancing the response efficacy

(perceived likelihood that the action will reduce the threat) and

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completing the adaptive response. These two appraisal pathways combine to form protection motivation-the intention to respond to a potential threat in either an adaptive or maladaptive manner.7

Separate subscales of the Youth Health Risk Behavioral Inven-tory were developed to assess these seven PMT constructs for several risk behaviors including drug trafficking. As reported else-where, the median Cronbach’s a value was 0.68 for the seven subscales concerning drug trafficking (ranging from 0.40 to 0.91). In addition to these “core” questions, additional questions were asked to assess potentially relevant environmental factors, factual knowledge, and social desirability.8 The response pattern of the questions was varied, with four basic formats: five-point Likert scales assessing agreement, likelihood, and feelings; numeric as-signment (actual number); multiple choice; and, true/false.

Analysis

The Mantel-Haenszel test for linear association9 was performed for boys according to involvement in drug trafficking (sold or delivered drugs) in the previous 6 months and for boys and girls according to intention (unlikely, likely) to sell or deliver drugs in the next 6 months. For data derived from the five-point Likert scales, the categories, eg, “very good/good,” “bad/very bad,” were combined to produce three cells (ie, “good,” “uncertain,” “bad”) to enable clearer presentation of data.

Initially, univariate analyses were conducted on data from all youths, including those who were uncertain regarding intention. However, because youths who selected uncertain regarding traf-ficking intention were also highly likely to select uncertain with regard to any individual perception, this analytic strategy resulted in a large number of statistically significant but practically implau-sible associations that reflected the strength of the “uncertain-uncertain” correlation. For example, in response to the 23 ques-tions assessing intention which contain an uncertain option, 27% (29) of youths who were uncertain as to drug-trafficking intention answered at least half (12) of the questions with uncertain corn-pared wtih 2% (4) of those youths not expecting to sell or deliver drugs and 2% (1) of those youths expecting to do so (P < .00001). Therefore, the analyses assessing future intent were conducted after deleting youth who selected uncertain regarding future traf-ficking intent.

Forward stepwise logistic regression analysis9 was performed to assess the relative importance of items in predicting recent or intended drug trafficking. Logistic regression, which requires fewer assumptions than traditional regression analysis, was se-lected because it is appropriate when the dependent variables are dichotomous and the frequency of most items are not evenly distributed)’ The recent experience (yes/no) and future behavior intention (likely/unlikely) of drug trafficking were used as de-pendent variables. All items measuring PMT constructs were se-lected as predictors in the regression analysis. Based on the uni-variate significance, age was controlled for in the models of male involvement and intention; social desirability scores were con-trolled for in the male intention model. The 95% confidence inter-vals of estimated odds ratios were determined for independent variables remaining in the final regression models. Odds ratios greater than 1.0 indicate an increased likelihood of the dependent variable (recent involvement or future intention), whereas odds ratios less than 1.0 indicate a decreased likelihood.

RESULTS

Demographic Characteristics

Data were obtained and analyzed from 351

African-American youths 9 through 15 years of age, 45% of

whom were female. The median age was 12 for the

boys and 11 for the girls. The median grade was sixth for the boys and fifth for the girl. Forty-four percent of the youths (40% of the boys and 49% of the girls) reported attending religious services at least weekly. Eighty-one percent (280) lived with their mothers (217 without fathers and 63 with fathers). Eighteen percent of youths (62) lived without either biological parent. Slightly more than 1% (5) lived with their fathers only.

Extent of Drug Trafficking

Six percent of the youths (11% of the boys and one

girl) reported having sold or delivered drugs in the

previous 6 months. Fourteen percent of the boys and

8% of the girls expected to sell or deliver drugs in the

next 6 months (Table 1). Among the 6% who had been

involved in drug trafficking, 41 % expected to repeat this activity in the next 6 months. Age and grade level were positively correlated with both recent involve-ment and future intention of drug trafficking among the boys. Associations between recent involvement and other variables are not depicted for the one girl with drug-trafficking experience.

Relation Between Drug Trafficking and Other Problem Behaviors

For boy, drug trafficking (both recent involvement and future intention) was significantly associated with other problem behaviors such as school truancy, violence-related activities, and sexual intercourse. In

addition, there was a strong association between

re-cent involvement in drug trafficking and drug use,

including use of cigarettes, alcohol, and illicit drugs.

Boys with recent involvement in drug trafficking

re-ported more drug use than boys without

involve-ment. Among girls, those reporting future

drug-trafficking intention had a much higher rate of anal sex.

Social Desirability

The rate of selection of socially desirable responses did not differ according to male recent involvement

and female future intention in drug trafficking, but

was significantly higher among the boys who did

not expect to sell or deliver drugs in the next 6

months (mean 0.45) compared with those who

did (mean = 0.38, P < .05). Perceptions and Other Factors Related to Drug Trafficking

Table 2 displays abbreviated versions of relevant

questions regarding youths’ perceptions, grouped by

the PMT construct which they represent, according to

recent involvement and future intentions in drug traf-ficking by gender. Only one girl acknowledged recent drug trafficking, therefore perceptions between those

involved and not involved in this activity is only

shown for the boys.

Extrinsic Reward. More than 40% of boys and more than one third of girls reported that their friends or

family members sell or deliver drugs. More than one

half of the boys and two thirds of the girls reported that people living in the same blocks sell or deliver

drugs. Generally, these perceptions were higher

among youths who had been involved or who

ex-pected to be involved in drugs. More boys with recent involvement and future intention than those without recent involvement or future intention perceived that

people selling drugs are “cool” and that boys who

were picked up by police are respected. Among boys

intending to become involved in the drug trade, being popular was an important attribute. The perception that dealers are fun to be around was substantially

elevated among girls who intended to deal drugs.

at Viet Nam:AAP Sponsored on September 1, 2020 www.aappublications.org/news

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TABLE 1. Association of Recent and Intended Involvement in Drug Trafficking With Demographic Characteristics and Other Problem Behaviors*

Boys Girls

Overall Involvement Intentiont Overall Intentiont

100% (n = 194)

________

_No (89%) Yes (11%) Unlikely Likely (63%) (14%) (n 100% = 153) . Unlikely (74%) . Likely (8%)

12 12 13 12 135 11 11 11

6 6 7 6 7 5 5 6

40 42 24 35 46 49 49 54

36 37 33 38 26 53 53 54

23 21 38* 24 30 7

4 3 10 2 11 I

1 I 391 1 0 0

8 6 2911 7 255 12

6 4 1991 5 14 3

13 11 295 11 29 5

40 38 52 41 50 28

47 43 8111 44 641: 24

15 12 43** 12 3911 11

17 14 43** 16 21 11

7 4 29** 5 11 5

11 #{149}.. ... 8 2991 1

* All numbers are percents (%) of affirmative responses unless otherwise indicated. t Youths who answered “uncertain” to future intention were excluded from these analyses. P< .10.

§P < .05. #{182}P< .01.

IIP< .001.

** P < .0001.

6 12 0.44 3 39** 9 25 0.46 0.40 Demographic Median age, y Median grade level Attend church weekly One of the best students

School truancy (past 4 wk) Suspended from school Hooked school with friends Median days missed

Violence-related behaviors (past 6 mo) Carried a knife as weapon

Carried a gun as weapon Carried a bat as weapon Physical fight with friends Beat up someone didn’t know

Drug activities (past 6 mo) Smoked a cigarette Drunk liquor Used illegal drugs Sold or delivered drugs Sexual activities (past 6 mo)

Anal sex Sexual intercourse

Social desirability (mean)

21 21 24 20 29

54 50 861 52 64

0.42 0.41 0.45 0.45 0.381

7 15 1 8 0 0 12 15 3 8 4 8 25 39 28 15 10 8 11 0 5 8 0 89J

Intrinsic Reward. Among both boys and girls, few believed that drug trafficking “feels good,” although this was reported by significantly more girls with

in-tended involvement than without intended

involve-ment. The perception that dealing or selling drugs is

exciting was substantially elevated among boys and

girls who had sold or intended to sell drugs. More

boys with future drug-trafficking intention agreed

that “it is important to wear the best tenms shoes.”

Vulnerability. The proportion of youths with past

or future involvement who reported that they are

likely to deal or deliver drugs or get arrested by the

age of

25 was 3- to 10-fold higher than the among the

remainder of the youths. Almost twice as many boys

with trafficking experience and girls with future

in-tention believed that they would be in trouble with

police whether or not they dealt or delivered drugs.

Youths intending to become involved were more

likely to endorse the statement that “kids who deliver do not get hurt.”

Severity. Youths perceived a high level of severity

regarding many of the negative consequences of drug

trafficking, particularly those associated with

vio-lence. Most agreed that adolescent drug sellers get

hurt and bad things happen to sellers’ families. How-ever, only one fifth of the boys and one fourth

of

the girls believed that sellers usually use drugs, and less than one

fifth of the youths agreed that the sellers would have trouble getting out once they got involved.

Response Efficacy. Two thirds of the sample

ac-knowledged that youths would not sell drugs if

they were involved in other interesting activities.

Generally, groups did not show differences on most

of the questions assessing response efficacy. A

much smaller proportion of the boys with recent

in-volvement in drug trafficking than those without

re-cent involvement thought they could stay away

from selling if their friends did so.

Self-Efficacy. Most of the youths viewed themselves as self-efficacious regarding negative social influ-ences. Two thirds of youths believed that they could say “No” if someone on the street, friends, or relatives

asked them to run drugs. A similar proportion of

youths thought that if their friends started to deal

drugs, they would not hang out with them anymore.

Again, responses between groups were similar.

Response Cost. Overall, a few youths indicated a

need to have money. However, a much larger

per-centage of the boys who had been, or expected to be,

involved in drug trafficking thought that there was an

economic need (making money for self, for family, or

for girlfriend) to sell drugs, compared with those not

selling or intending to deal drugs. Boys with

drug-dealing experience or intention were twofold or three-fold more likely to agree with the statement that

“Sell-ing is the main way kids make money,” compared

with boys who did not sell or did not intend to sell. An

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TABLE 2. Association of Perceptions of African-American Youths Aged 9 through 15 Years According to the Protection Motivation Theory Constructs With Recent and Intended Involvement in Drug Trafficking*

Boys Girls

Overall Involvement Intentiont Overall Intentiont

100% - 100%

__

No Yes Unlikely Likely (n = 157) Unlikely Likely (n = 194)

(89%) (11%) (63%) (14%) (74%) (8%)

Extrinsic reward

Friends sell or deliver drugs Relatives sell or deliver drugs

People on my block sell or deliver drugs Dealers are fun to be around

Dealers are cool

Kids respect guys picked up by police Guys need money for respect

It is important for me to be popular It is important for friends to respect me

47 43 8111 40 ₇₉₁₁ 34 32 62

43 40 6291 44 43 36 34 62

53 53 57 50 71 69 70 54

17 16 24 16 21 19 14 54

12 10 24 11 18 13 12 23

28 24 5711 28 39 18 19 23

21 19 33 17 32 15 10 31

35 35 33 32 5791 31 29 31

64 62 81 68 79 66 66 69

13 12 19 12 25 11 9 2391

9 8 I9 10 7 7 5 2391

13 II 33 9 39** 9 6 1591

29 28 38 27 5411 29 31 31

17 15 33 18 29* 20 19 46

9 6 3391 3 32** 9 6 3911

8 4 38** 5 25** 6 5 2391

8 6 2491 5 2111 15 13 39

39 36 625 46 43 38 38 625

23 21 33 21 435 19 16 425

31 32 29 34 43 34 34 54

25 25 23 25 39 23 21 395

59 58 67 66 57 60 64 31

69 69 62 80 50 61 65 54

56 55 67 64 54 51 53 54

19 19 24 22 18 27 29 31

19 17 33 16 255 17 15 395

41 42 38 46 43 33

43 41 57 48 61 41

13 11 3391 10 39** 10 6 15

11 9 24 4 39** 4 3 0

10 7 3811 6 36** 3 1 0

26 20 71** 24 5011 24 25 31

21 21 19 19 25 12 10 8

* All numbers, unless otherwise stated, represent percent (%) of affirmative responses; N = 351. t Youths who answered “uncertain” were excluded from these analyses.

P < .10.

SP < .05. #{182}P< .01.

IIP < .001. **P < .0001. Intrinsic reward

Feel good about selling drugs Feel good about delivering drugs Dealing or selling drugs is exciting

It is important to wear the best tennis shoes Dealers are happy

Vulnerability

Likely to deal drugs by age of 25 Likely to deliver drugs by age of 25 Likely to get arrested by age of 25

Have trouble with police whether dealing or not Kids who deliver never get hurt

Kids who deliver do not get caught Kids who deal don’t get in trouble if caught

Severity

Going to prison would ruin my life Kids who sell drugs will get hurt

Bad things happen to families of kids who sell Sellers usually take drugs

Sellers would have trouble getting out Response efficacy

If friends stay away from selling, I will

Kids who have interesting activities to do will not sell drugs

If I refuse, dealer won’t bother me People do not have to keep delivering Self-efficacy

Could say no to someone on the street Could say no to a friend

Could say no to a relative If friends deal, I won’t hang

Response cost

Need to sell to make money for myself Need to sell to make money for my family Need to sell to make money for girlfriend Selling is main way kids make money If I refuse to sell, I will get beat up

50 52 2911 54

66 66 62 73

68 68 71 77

68 68 71 76

67 69 52 76

61 63 48 68

50 41 39 31

71 61 66 46

41 8

45 31

64 67 72 54

64 68 74 54

71 66 72 54

50 66 70 69

Logistic Regression Analyses (see Table 3) belief that selling is the main way youths can make

Recent Involvement in Drug Trafficking (Boys). After money was six times more likely in boys with past

controlling for age, six additional independent experience.

variables remained in the final regression equation. Drug-Trafficking Intention (Boys). Six items

re-The significant predictors represented all seven PMT mained in the final regression model controlling for

constructs except intrinsic rewards and severity. age and social desirability scores. Three of these items

Youths who reported an expectation of involvement were extrinsic rewards (“It is important for me to be

(by age of 25) were almost nine times more likely to popular,” “Friends sell or deliver drugs,” and “People

have had past experience in trafficking activities. The on my block sell or deliver drugs”). The other items

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Variable B SE Odds Ratio

95% Confidence Interval

Lower Upper

Recent involvement (boys)

Respondents’ age 0.51 0.23 I.67t I .05 2.64

Respect kids picked up by police 0.95 0.43 2.59t 1 .13 5.97

Kids who deal don’t get in trouble if caught 1.38 0.50 3.98 1.48 10.68

Selling is main way kids make money 1.79 0.51 5.975 2.21 16.14

If friends stay away from selling, I will stay away - 1.98 0.56 0.145 0.05 0.42

Could say no if someone on the street asks for sell 1.06 0.52 2.89t 1 .05 8.01

Likely to deliver drugs by age of 25 2.19 0.58 8.915 2.84 28.02

Intention (boys)

Respondents’ age 0.38 0.19 I.47t 1.00 2.14

Social desirability scores -2.61 1.74 0.07 0.00 2.22

Important for me to be popular 1.06 0.37 2.89 1.41 5.93

Likely to get arrested by age of 25 0.96 0.42 2.62t 1.15 5.93

Friends sell drugs 2.11 0.70 8.2I 2.08 32.40

Feels good about selling drugs 0.79 0.35 2.21t 1.12 4.38

People on block sell drugs 1.59 0.67 4.93t 1.33 18.31

Need to sell making money for family 0.97 0.37 2.64 1 .27 5.48

Intention (girls)

If I refuse, dealers won’t bother me -1.23 0.56 0.29t 0.10 0.87

Feels good about selling drugs 1.42 0.49 4.I3 1 .57 10.86

Dealers are happy 0.56 0.22 1.754 1.15 2.66

Dealing is exciting 1.08 0.48 2.96t 1.15 7.62

* Constant terms of the regression models are not shown in table. t P < .05.

:IP < .01. §P< .001.

TABLE 3. Results of Logistic Regression*

were categorized as vulnerability, intrinsic rewards, and response cost.

Drug-Trafficking Intention (Girls). Four items re-mained in the final regression equation; three items

were intrinsic rewards. Girls who acknowledged that

selling drugs would “feel good” were four times more likely to intend selling drugs than were girls who did

not feel the same. A belief that youths who refuse to

get involved would be left alone by drug dealers was highly protective against drug trafficking.

DISCUSSION

This study was undertaken to explore the

relation-ship between recent and intended drug trafficking

and perceived social, economic, and intrapersonal

factors among early adolescent African-American

boys and girls living in resource-depleted urban

ar-eas. The rates of recent involvement in drug traffick-ing (6%) and future intention (12%) in this age group

reported in the current study are consistent with other

studies (Bush and lannotti. 1993. Unpublished

work).2 Involvement in trafficking was strongly

as-sociated with use of alcohol, cigarettes, and illicit

drugs. Drug trafficking was also highly associated

with other problem behaviors among boys,

particu-larly, those related to violence in the community.

So-cia! influences were found to be strongly associated

with both recent involvement and future intention

among both genders, especially, among boys.

This study also validates previous research

sug-gesting that the economic motive is an important

fac-tor associated with involvement in drug trafficking or intention in this population.3’4’11 However, the connec-lion between involvement in drug trafficking and

per-sonal economic needs was perceived by boys only. For

the girls, personal feelings or otherintrinsic motives were

more important predictors of intention to sell drugs.

Strengths and Potential Limitations of the Study

Both the large sample size and the use of a

ques-tionnaire with established psychometric properties

designed to address the constructs of a model of

be-havioral change are strengths of this study. However, several issues may limit the generalizability and in-terpretation of study findings. First, given the cross-sectional nature of these data, the association of intent with actual outcome remains to be assessed. Second, these data are based on self-reporting by the adoles-cents. Although the interview responses were

anony-mous, youths may have misrepresented their actual

involvement in drug trafficking, given the legal

im-plications of the activity. However, the instrument has been assessed for reliability and construct valid-ity,6 and the extent of drug trafficking found in this study is consistent with other studies among high-risk urban African-American adolescents (Bush and Iannotti. 1993. Unpublished work).2 The relatively low selection of the “socially desirable” responses to the social desirability questions also lends credence to the results. Adolescent seif-reports of other illegal behaviors (eg, drug use) have been found to be reasonably accurate.12

Implications of the Findings

Numerous studies have implicated social factors as

correlates of multiple problem behaviors.5

How-ever, most studies of early adolescent drug behaviors have focused only on drug use, and so there is a

pau-city of knowledge regarding drug trafficking.

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The importance of both community and family influ-ences on drug trafficking suggests that changing the

per-ception that drug trafficking is an acceptable and wide-spread activity practiced by neighbors and friends will be important in preventing male, and perhaps female, adolescents from involvement in drug trafficking.

The finding that there was a gender difference in

terms of the correlates of drug-trafficking intention suggests that prevention efforts will need to deliver tailored messages to male and female participants.

The findings among the female sample reveal that the

personal feelings about drug trafficking may be

im-portant correlates; prevention approaches will need

to address this issue. Economic issues are particularly

relevant to male youths living in low-income

and high-risk environments. Therefore, prevention

and/or intervention programs need to address

appro-priate means of generation of income as well as explore issues concerning values and money. However, the fact that factors from most of the PMT constructs were cor-related with drug trafficking indicates the complexity of

involvement in drug trafficking and the necessity for

multifaceted approaches to intervention.

The finding that only 41 % of those with recent

in-volvement in drug trafficking expected to have

fur-ther participation has several implications. Similar to use of alcohol, cigarettes, and illicit drugs in this age group, involvement in drug trafficking may have an expenmen-tal nature for some youths who do not expect further involvement. However, for others, social pressures, as well as financial and intrinsic rewards, may promote their continuing this clearly dangerous activity.

ACKNOWLEDGMENTS

This research was supported by the Center for Substance Abuse Prevention (H13 5P06060) and The National Institute of Mental

Health (UlO MH48068).

The authors are grateful to Bonita Stanton and Joshua

Okun-daye for their comments and suggestions. We wish to thank all the youths, families, and other community members who have

worked with us in this effort. We thank other members of the research team including Maureen Black, Izabel Ricardo, Jennifer Galbraith, Linda Kaljee, and Rodney Nesbitt.

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1994;93;1044

Pediatrics

Xiaoming Li and Susan Feigelman

African-American Early Adolescents