African Journal of Drug & Alcohol Studies, 17(2), 2018 Copyright © 2018, CRISA Publications COMMUNITY PERSPECTIVES ON CULTURAL PRACTICES AND BELIEF SYSTEMS INFLUENCING ALCOHOL AND DRUG USE: A QUALITATIVE STUDY IN ANAANG COMMUNITY,

Nsidibe A. Usoro1, Dorothy N. Ononokpono2, Ursula Ette3, & Nkereuwem N. James4

1,2Department of Sociology and Anthropology, University of , Uyo, Nigeria; 3Ministry of Health, , Uyo, Nigeria; 4Department of Establishments, Akwa Ibom State, Uyo, Nigeria

ABSTRACT

Alcohol and drug use are socially sewn into cultural practices and belief systems in societies. This has been the case with Anaang community. This qualitative study examined narratives in a natural setting to gain insights on cultural practices relating to alcohol and drug use in Anaang society. The methods of study were participant observation and in-depth interview with 80 participants. The study found that some cultural activities harbour causal factors to alcohol use. Majority of participants reported using alcohol in conformity with societal norms and values. Participants differed in opinion concerning drug use. Some confessed using drugs out of personal conviction. Conversely, a good proportion of participants believed that cultural practices and belief system have either overtly or covertly lured them into drug use. Participants unanimously identified low literacy rates, ignorance and lack of effective regulatory mechanism as precursors to alcohol and drug use in local communities. This study mediated through Anaang cultural practices and belief system to derive informed insights that are needful for designing culture-sensitive-programme of preventive intervention for alcohol and drug use in local communities in Nigeria.

INTRODUCTION for medical and scientific use, while- re ducing the elicit use of narcotic drugs and The world drug problem remains a psychotropic substances(Common Afri- common and shared responsibility that can Position [CAP] for the UN General As- requires effective and increased -inter sembly Special Session on the World Drug national cooperation and demands an Problem, 2016). integrated, multidisciplinary, mutually Globally, alcohol use and misuse ac- reinforcing and balanced approach to count for 3.3 million deaths every year, or drug supply, demand reduction and harm 6percent of all deaths (Sudhinaraset, Wig- reduction strategies, as well as ensuring glesworth & Takeuchi, 2016). The debilitat- the availability of controlled substances ing effects of alcohol and drug misuse are USORO ET AL. not only complex but far reaching, ranging Binge drinking is conceptualized here from individual health risks, mortality, mor- as the number of instances in the past bidity and many other unpleasant conse- 12months that women drank 4 or more quences for family, friends, associates and drinks and men drank 5 or more drinks the society at large. Many researches and within a 2-hour period (Sudhinaraset, studies on alcohol and drug abuse seem et al. 2016). Among racial and ethnic to have a dedicated focus on risk factors, groups, researches have shown that, from the societal perspectives down to the Whites report the highest overall al- individual level (Sudhinaraset et al. 2016). cohol use among persons age 12 and According to a report from World Health over(57.4 percent). American Indian/ Organization[WHO] report, cited in Center Alaska Natives report the highest - lev for Disease Control and Prevention(2014), els of binge drinking (30.2percent), fol- Worldwide, 3.3million deaths were at- lowed by Whites (23.9percent), Hispanic/ tributed to alcohol misuse in 2012. Exces- Latinos(23.2percent), African American sive alcohol use is the third leading cause (20.6 percent), and Asians (12.7percent) of death in the United States, accounting (SAMHSA, 2013). for 88,000 deaths per year. Alcohol-attrib- Asians, on the other hand, generally utable disease and injury are responsible are thought to have higher abstention for an estimated 4percent of mortality and rates compared with other racial and 4 to 5 percent of disability-adjusted life- ethnic groups, especially when they are years[DALYs] (Rehm and Popova, 2009). integrated within their ethnic cultures In the United States alone, the costs of (Cook, Mulia & Karriker-Jaffe, 2012). One excessive alcohol use were estimated at measure of the retention of ethnic values $223.5billion in 2006 or $746 per person and cultural norms is generation status. (Bouchery, Harwood & Sacks, J. 2011). That is, the longer immigrants have lived Much of these costs accounted for dwin- in the United States, the more likely they dling productivity at work place as well are to acculturate to the cultural norms of as health care expenses, criminal justice their destination community (Berry, Phin- involvement and motor vehicle crashes ney, Sam, & Vedder, 2006). Lower levels (Rehm et al. 2009). Sudhinaraset, et al. of ethnic identity may be one explana- (2016) reported that alcohol consumption tion for these differences across Asian varies across gender, race or ethnic incli- subgroups. Japanese Americans, Filipino nation. Across the world, men consumed Americans, and Korean Americans often more alcohol than women, and women have been in the United States longer in more developed countries drink more than other Asian subgroups, such as Cam- than women in developing countries. bodians, Thais, and Vietnamese, and also American men are much more likely than report higher levels of alcohol use com- women to use alcohol (56.5percent Vs pared with other Asian Americans and 47.9 percent respectively, to binge drink Asian immigrants (Iwamoto, Takamatsu (30.4percent Vs 16percent respectively) & Castellanos, 2012). Ethnic identity may and to report heavy drinking (9.9percent promote stronger family values and tra- Vs 3.4 percent, respectively) (Substance ditional ties, leading to lower levels of Abuse and Mental Health Services Ad- alcohol use. Moreover, Asian-American ministration [SAMSHA], 2013). adolescents who have a high attachment

148 COMMUNITY PERSPECTIVES ON ALCOHOL AND DRUGS to family or who share their family’s neg- regional hot spots and having emphasized ative attitudes toward drinking are less hot-button topics such as HIV AIDS, ma- likely to consume alcohol (Hahm,, Lahiff, laria, and lagging agricultural production, & Guterman, 2003). Carson turned his attention to a topic Scholars have amply documented Afri- that he reminded his audience would not can drinking practices. The history of drug have been included on his list of “African use is much less studied, but in the recent problems” a decade or even five years past at least illicit drug use has become ago (Marry, 2016). Addressing a large au- ubiquitous in many African societies. And dience at the African Studies Association the fact is that African fiction and auto- meeting in Washington in mid-November, biography are awash in alcohol—and in- Carson, who has had a long career at State creasingly provide rich accounts of local and was formerly Ambassador to Kenya, drug cultures as well (Marry, 2016). In a Zimbabwe and Uganda, reminded fellow panel on “Drugs in Africa” at the African Africanists that a claimed 40% of illicit Studies Association annual meeting in drugs interdicted in Europe had passed Washington, DC in November, Donna Pat- through West Africa. What is a major is- terson, a historian in the Department of sue for Europe and the USA must there- Africana Studies at College, presented a fore become a major issue for Africa. paper on “Drug Trafficking in Africa: His- All of the focus on Guinea Bissau as torical Cases from West Africa,” which the first African narcostate has tended to in contrast to other papers on the panel distract us—according to Carson—from looked at the commerce in legal pharma- a much broader and growing pattern of ceuticals. The discussion that followed drug trafficking throughout Africa. Al- made clear the value of exploring the though Guinea Bissau may provide a dra- histories “legal” and “illegal” drugs in matic tale of high level politicians in the conjunction one with the other—some- thrall of global drug lords gunning each thing that has rarely been done for Africa, other down in the ramshackle capital of where the focus has been much more on a marginal state, the drug trade routes understanding the linkages between “tra- run through virtually every West African ditional” and Western medicine. At the country and certainly through Sénégal, same time, the discussion led us to con- Côte d’Ivoire, and especially Nige- sider how those very linkages might in- ria—which has been a nexus of trafficking form our understanding of the trade and and drug gangs that spread across five consumption of various kinds of drugs— continents through networks that reach however categorized—in African societ- across the Indian Ocean as well as the ies. Are Africans simply more abstemi- Atlantic. Unsurprisingly, Carson made the ous? This is hardly the case (Marry, 2016). case for US official support for efforts in In a recent talk on “African Issues” and African countries to combat the trade. US policy on those issues, Assistant Secre- Again unsurprisingly, he talked exclusively tary of State for African Affairs, Ambassa- about the need to provide moral, material dor Johnnie Carson, chose to conclude by and training support to the USA’s African stressing the growing challenge of drug 13allies in a global war on drugs. trafficking in Africa. Having discussed de- The literature on community influ- mocratization, having covered all of the ences on alcohol use focuses primarily

149 USORO ET AL. on environmental aspects, such as neigh- drug dealing, and seeing peers drink were bourhood characteristics and opportuni- all associated with increased alcohol use ties for alcohol purchasing and consump- (Chung, Pedersen & Kim, 2014). tion (Sudhinarasetet al., 2016). For exam- Relating neighborhood characteristics ple, one study found that individuals who to alcohol use risk is useful for public lived in a neighborhood with a poorly built health program planning because it al- environment, characterized by inferior lows policymakers and programmers to building conditions, housing, and water understand how changing structural-level and sanitation indicators, were 150 - per factors of the built environment may af- cent more likely to report heavy drinking fect health risk behaviors, including alco- compared with those living in better built hol use (Sudhinaraset, et al.2016). How- environments (Bernstein, Galea & Ahern, ever, methodological challenges remain 2007). Other studies have examined the when analyzing the impact of complex spatial epidemiology of neighborhoods community factors on individual behav- regarding alcohol availability, individual iors. Such factors include social stratifica- consumption, and community disorgani- tion (i.e., the probability of living in cer- zation and violence (Cohen, Ghosh-Dasti- tain neighborhoods, which is higher for dar, & Scribner, 2006; LaVeist and Wallace, certain types of persons) and social se- 2000; Scribner, Cohen & Fisher 2000; Shi- lection (i.e., the probability that drinkers motsu, Jones-Webb, & MacLehose, 2013; are more likely to move to certain types Theall, Lancaster & Lynch. 2011). of neighborhoods). It remains unclear Spatial relations between alcohol whether neighborhood disadvantage outlets and individual consumption also causes alcohol problems, and whether may be a key to explaining differential frequent drinkers are in fact usually more rates in alcohol use across racial/ethnic attracted to certain neighborhoods (i.e., groups. A number of studies suggest that self-selection). These challenges limit the minority communities have higher con- interpretation of research on community- centrations of liquor stores than White level effects (Sudhinaraset, et al.2016). communities (Alaniz and Wilkes, 1998; Some studies have attempted to address LaVeist and Wallace, 2000; Pollack, Cub- these issues using propensity match- bin, Ahn, & Winkleby. 2005; Romley, Co- ing and time-sensitive indicators (Ahern, hen, Ringel & Sturm, 2007; Treno, Alaniz, Galea & Hubbard, 2008). Future studies & Gruenewald, 2000), potentially increas- should take these challenges into consid- ing access to alcohol among minority eration and address subgroup differences populations (Freisthler, Lipperman-Kreda, in alcohol use norms across race/ethnicity Bersamin, & Gruenewald. 2015; Scribner and gender. et al. 2000). Moreover, living in a disad- Peer norms play an important role at vantaged neighborhood at an early age this life stage (Jackson, Roberts & Colby, has long-term effects. Childhood expo- 2014). By the late adolescent period, sure to violence leads to increased ex- parental influences related to alcohol posure to delinquent peers and alcohol use are small compared with peer influ- use (Trucco, Colder & Wieczorek, 2014). ences (Schwinn and Schinke, 2014; Zehe In another study, realizing how easy it is and Colder, 2014). Much of the focus on to get alcohol, witnessing neighborhood peer influences has highlighted the risk

150 COMMUNITY PERSPECTIVES ON ALCOHOL AND DRUGS networks associated with alcohol use. be effective among adolescents (Chap- Peer pressure (Studer, Baggio & Deline, man, Buckley, Sheehan & Shoche, 2013; 2014), peer alcohol norms (Varvil-Weld, Perry, Williams,& Komro. 2002; Toum- Turrisi & Hospital. 2014), and socializ- bourou, Gregg & Shortt, 2013). ing with substance-using peers (Patrick, Existing successful interventions to re- Schulenberg, & Martz, 2013) were associ- duce alcohol use include incorporating ated with alcohol misuse and binge drink- culturally sensitive delivery models, such ing. Studies note that leaving the home as employing community health workers environment, entering college, and join- among Latino populations (Ornelas, Allen ing Greek organizations increased alcohol & Vaughan 2014) and using Web-based use as a result of more socially permissive interventions to change norms (Patrick, norms around drinking (Scott-Sheldon, Lee & Neighbors. 2014). In a recent re- Carey & Carey 2008; White, McMorris, & view, Familias: Preparando la Nueva Catalano, 2006). Generación, a culturally grounded inter- More recent studies have attempted to vention for parents to support Mexican- assess the synergistic influence of peers heritage youth, showed reductions in and families. Whereas the majority of parental drinking (Williams, et. al. 2015). studies on peers have focused on the neg- Because past studies show that parents ative consequences of social networks, may potentially moderate negative peer research shows that greater parental sup- influence, fostering synergistic solutions port and monitoring can lead to proso- between multiple contexts should be a cial peer affiliations (Williams, Marsiglia, priority (Ewing, Osilla & Pedersen, 2015). Baldwin, & Ayers, 2015). One study found that protective influences in parental do- mains can moderate the negative effects METHOD of negative peer influences among Latino college students (Varvil-Weld et al. 2014). Study Site In particular, maternal communication re- The Anaang people are in Akwa Ibom sulted in less alcohol use; conversely, ma- state, South-south of Nigeria. They are ternal permissive norms and peer norms the second largest ethnic group of the were associated with more alcohol use. state, occupying its Northwestern part. Greater parental disapproval toward alco- They are bounded in the North by the hol use is associated with lower involve- Isogbo Igbo (), in the West by ment in peer networks that use alcohol, the Ngwas (abia state), and Ndoki (Rivers less peer influence to use, and greater state) and in the South, East and North- self-efficacy and stronger negotiation east by the Ibibios. skills to avoid alcohol (Nash, McQueen, The Anaang people are territorially lo- & Bray, 2005). Interventions aimed at es- cated in eight Local Government Areas tablishing and fostering conservative peer in Akwa Ibom State: , , norms were found to be more effective , Ika, Obot Akara, , than individual resistance training (Han- and . The Anaang sen and Graham, 1991), whereas multi- and do possess some cultur- level interventions incorporating peers, al similarities and could be traced to the families, and communities are known to same ancestral root, despite their distinct

151 USORO ET AL. ethnic inclinations. The community is be- Procedure sieged with many developmental chal- A thematic framework was designed lenges ranging from poor access to basic by the researchers to code all qualita- amenities such as good road network, tive datasets (raw narratives) and field water supply, electricity, modern health- notes emanating from participant obser- care facilities, schools, housing and other vation. Grounded theory was employed modern social amenities. Majority of the to identify key themes and variables in people are engaged in subsistent farming, the recorded interviews and participant trading and other informal sectors to earn observation conducted during the data a living. Although, good number are also collection period (Beth, Dorothy and Nsi- employed in white collar jobs. They are kanabasi, 2016). This involved immersing mostly Christians, but a good number are in the data by reading the transcribed traditional worshippers. The condition of texts over and over again (Ediomo-Ubong, living is observed to be very low. 2012). The data was thereafter coded and organized in such a manner to identify Participants and Data Collection participant type, research site and specify The study employed a multi-sited eth- their properties and dimensions to create nographic and qualitative approaches to analytic categories of thematic domains. examine the influence of cultural prac- The categories were literally placed side tices on alcohol and drug use in Anaang by side to establish similarities and dis- community. The study participants in- similarities. This is done to ensure that cluded young and adult population they are mutually exclusive. Thereafter, aged 15-60 years old. Males(n=50) and they were related to each other accord- females(n=30) participated in the study. ing to their corresponding properties Altogether, 80 participants were inter- and dimensions (Ediomo-Ubong, 2012). viewed for this study using a convenient In this study some participant’s opinions sampling method. Data was collected us- during interview are quoted verbatim to ing unstructured-open-ended in-depth illustrate their views on cultural practices, interview guide and participant obser- alcohol and drug use. vation. All interviews were conducted in Anaang dialect by three of the authors and were both audio-recorded after seek- RESULTS ing the consent of participants in addi- tion to diligent note taking of informal Culture, Belief System and Perception of discussions and interactions with study Participants on Alcohol and Drug Use participants. A Typical African is so deep in his cul- The interview guide was developed to ture. He goes to church and does every- capture participant’s perception on alco- thing with elements of his culture. There- hol and drug use and their opinions and fore, participants opined that cultural experiences on influence of cultural prac- norms, values, beliefs systems are asso- tices on drug use. Averagely, the -inter ciated with alcohol and drug misuse. It view lasted 35-60minutes. Audio-record- is a well sung saying across Anaang land ed interviews were later translated and that ” when occasion comes, drinks also transcribed by experts in that field. comes.” Alcohol drinking is so deified in

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Anaang land, to the extent that a certain socially and culturally a disgrace to date in the local calendar is set aside for her family. free drinks (Usen ibet ukot). On this day all palm wine tappers in Anaang land are Another participant (aged 25 years) forbidden from selling their wine. Men commented: are often found strolling in groups from Our culture does not sanction women one compound to another on drinking drinkers. But it is viewed as an act of episode amid songs and dance. irresponsibility for a woman to com- Participants (97%) pointed out that al- pete for alcoholic drinks with men in cohol consumption in Anaang land was the public. If she eventually become culturally tolerated as parts of ceremonial intoxicated and perhaps strip her lives of the people. It is essentially a social clothe who will marry such a wom- act subject to variety of rules and norms an? Definitely no serious minded per- regarding who may drink, when, where son will approach her for marriage. with whom and why. Raw alcohol from is called Majority of Participants (97%) believe ukot nsung. The fermented one is distilled that alcohol consumption is normal as locally to produce the local gin kaikai. long as people do not in excess to the Another form of alcohol mainly tapped point of losing self-control and become by youths is from felled palm tree, and is a public nuisance. Excess consumption of called ukot ayop. alcohol was not a norm neither was it en- Observations and comments from par- couraged and intoxication attracted nega- ticipants revealed that, local gins are com- tive sanctions such as not allowing them monly mixed with herbs, roots as herbal to partake in active or major decision therapy for various illness condition and making, not allowed to attend meetings performance boosters. were secret/deep things of the commu- Participants (85%) pointed out that al- nity was planned to avoid leakage of vital cohol is mainly consumed by male adults information to women or enemies. for pleasure while the females and chil- According to a participant (aged 57 dren were culturally restrained from years): drinking, though there were no formal rules prohibiting them. A person that is given to excessive A participant (aged 50 years) said: drinking or a drunk was not treated with dignity as he cannot be nomi- A woman is regarded as the beauty nated to represent the village or his of the family (mkpo uto) she is not peers. His family is not regarded in the expected to take part in public dis- community. Such people do not have cussions or engaged the opposite sex future prospects as they are exposed in arguments not to talk of drinking to many adverse situations in life. freely in the public. Nevertheless, de- pending on the nature of the gather- Notions on why People Misuse Drugs ing or events, she could be offered and Alcohol a little quantity. Any woman who The misuse of drugs and alcohol is one competes for drinks in the public is of the most controversial issues in our

153 USORO ET AL. society, and often a source of conflict be- as Ukot nsung, kaikai, ukot ayop, Beer, tween generations and sections of the Schnapps, Malt drinks etc. society. Participants (67%) pointed out that Circumcision: The practiced of circumci- people use drugs and alcohol out of per- sion for both male and female children sonal volition as nobody is compelled to was a major traditional rite, and is still be- use them under normal condition or as a ing in vogue currently, especially among matter of compunction. Users make con- the non-educated families. Family mem- scious decision by evaluating the risks and bers and friends gather to share drinks at benefits of indulging in the act. This, of the success of the surgical operation. course depends on an individual’s ability to make informed and positive decisions / Coming of Age: This is a rite of passage choices, which is a function of psychologi- in Anaang land where the females ap- cal, social and cultural variables. Insights proaching menarche are initiated into the from personal observation and partici- Nwowo (age of puberty) cult. Others are; pants’ responses identified low literacy Traditional Marriage, Death/Burials, Land rates, ignorant and lack of effective regu- Acquisition, Foundation Laying ceremo- latory mechanism as major precursors to nies, Chieftaincy Installation, Traditional drug use among other variables. festivals, etc

Some Cultural Practices that Influence The Community, Culture, Alcohol and Alcohol and Drug Use Drug Use Control Alcohol use is an intrinsic part of Although, alcohol and drug use is ac- Anaang cultural heritage. It played major ceptable practice in Anaang land, there roles in traditional activities. Ceremonial are some cultural practices that regulates rites and pouring of libation to propiti- or discourage the use of these harmful ate the angry gods or ancestors. In every substances: Religious belief, Family /Pa- gathering, cerebration of birth, death, rental Disapprovals, Sacred Days, Dedi- victory, success, achievements, and even cated Days, Gender/Age, Intertribal/Com- when somebody commits suicide which munal Conflicts, Era of Civilization, Use of is considered abominable, alcohol is de- Measure, etc. manded from the victim family among other items to cleanse the land and ap- pease the gods. Observations have shown DISCUSSION that most times, this local gin is garnished with herbs and roots which have drug ef- Cultural norms and beliefs are strong fects on drinkers. The participants iden- predictors of both current drinking and tified the following cultural practices as frequent heavy drinking (Brooks-Russell, having the potential to covertly or overtly Simons-Morton & Haynie, 2013; Caetano promote alcohol and drug use. and Clark 1999; LaBrie, Atkins & Neigh- bors 2012; O’Grady, Cullum, Tennen, & Births: The arrival of a new baby to the Armeli. 2011; family is usually celebrated with varieties Paschall, Grube, & Thomas, 2012). of drinks including alcohol beverages such Across race and ethnicity, African

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Americans and Latinos report more con- neighborhood-level norms. For example, servative attitudes toward drinking com- Ahern and colleagues (2008) found that pared with Whites (Caetano and Clark, neighborhood norms against drunken- 1999; LaBrie, et al. 2012). These more ness were a more robust and stronger conservative norms may be associated predictor of binge drinking than permis- with lower drinking rates among African sive beliefs about it held either by the Americans and Latinos compared with individual or family and friends. If an Whites (SAMHSA 2013). Few studies have individual lived in a neighborhood that examined diversity within racial and ethnic frowns on binge drinking, that individual groups such as Latinos, Blacks, and Asians, was less likely to drink, even if he or she limiting our ability to meet the needs of believed it acceptable to do so. This was specific subpopulations. Some studies particularly true for women, suggesting suggest that alcohol-related problems dif- gender norms around alcohol use may be fer substantially across Latino subgroups, a factor. including higher rates of alcohol abuse Specifically, past studies found that and dependence among Mexican-Amer- gender differences in alcohol use may re- ican and Puerto Rican men compared flect the greater social stigma directed at with Cuban Americans and Central and women who drink. This seems to be more South Americans (Caetano, Ramisetty- pronounced in certain cultures. Caetano Milke & Rodriguez, 2008). These findings and Clark (1999), for example, found may best be explained by considerable stronger gender norms related to alcohol differences in cultural norms, especially use in Latino cultures compared with the the cultural beliefs regarding appropriate United States (Kulis, Marsiglia & Nagoshi alcohol use (Greenfield and Room 1997; 2012). This results in greater gender dif- LaBrie, et al. 2012). For example, some ferences in alcohol use among Latinos scholars explain heavy-drinking patterns compared with other U.S. populations, among Latino men through the concept with recent trends suggesting similar lev- of machismo, which has been a significant els of binge drinking between men and cultural influence for generations and re- women in Western cultures (Iwamoto, et mains integral to Latino male identity al. 2012). This may reflect changing be- (Dolezal, Carballo-Diéguez, Nieves-Rosa liefs about gender and social status. Al- & Díaz, 2000). Machismo suggests that though traditionally perceived as a “mas- Latino men attempt to appear strong and culine” behavior, binge drinking is now masculine because of cultural values, and more acceptable among women in cer- drinking greater amounts of alcohol fur- tain cultures that foster more balanced ther exemplifies their masculinity. More gender roles (Lyons and Willott, 2008). recently, scholars have commented that Some of the strongest influences on ad- concepts like machismo cannot account olescent drinking behavior come from the for the complexity of Latino drinking be- people that youth spend the most time havior (Caetano, 1990) with: family and friends (Sudhinaraset, et Cultural norms also vary by context al. 2016). Studies have found that higher and place. Some alcohol researchers have levels of alcohol use among parents and used multilevel approaches to distinguish peers is associated with increased alco- among the causal effects of individual and hol use among adolescents and young

155 USORO ET AL. adults (Cruz, Emery & Turkheimer, 2012; is subjected to variety of rules and norms Dawson, 2000; Mares, Engels and Lich- of usage in terms of who offers it, when, twarck-Aschoff, 2011; Trucco, et al. 2014; why and where to drink. Excessive drink- Varvil-Weld, et al. 2014; Wallace, Forman, ing has some unpleasant consequences & Guthrie, 1999; Walsh, Djalovski, Boniel- socially, economically and health wise. Nissim, & Harel-Fisch,. 2014; Williams & Alcohol education programs need to also Smith, 1993). Developmentally, people’s address individual intent and motivations social contexts shift from the family unit while offering personalized feedback and during childhood to focus more on their protective behavioral strategies (Patrick peers and their schools during adoles- et. al. 2014). Public health and treat- cence. Reflecting this, parental alcohol ment programs needed to be culturally use seems to exert a greater influence sensitive, paying particular attention to before age 15 and diminishes over time cultural factors such as ethnic identifica- (Dawson, 2000). tion and orientation. This study attempts Conversely, family support, bonding, to explore how cultural practices, norms, and parental monitoring is associated and belief system can influence drug and with lower alcohol use (Bahr, Marcos & alcohol use as well as a community per- Maughan, 1995; White, et al. 2006) and spective on the war against substance social networks and social support also misuse. have protective effects (Ramirez, Hin- man & Sterling. 2012). For example, one study that assessed the effects of leaving REFERENCES home and attending college found that although the transition overall was asso- Ahern, J., Galea, S, Hubbard, A. (2008). ciated with higher levels of alcohol use, “Culture of drinking” and individual young people with fewer friends who problems with alcohol use. American use alcohol reported higher levels of re- Journal of Epidemiology. 167(9):1041- ligiosity. Higher parental monitoring also 1049. protected against alcohol and marijuana Alaniz, M. L, Wilkes, C. (1998) Pro-drink- use (White, et al. 2006). Moreover, higher ing messages and message environ- levels of familism (values that place fam- ments for young adults: The case of ily needs over individual needs) and being alcohol industry advertising in African in a nuclear family served as protective American, Latino, and Native Ameri- factors among adolescents (Ewing, et al. can communities. Journal of Public 2015). Health Policy. 19(4):447-472. Bahr, S. J, Marcos, A. C, Maughan, S.L. (1995). Family, educational and peer CONCLUSION influences on the alcohol use of fe- male and male adolescents. Journal Traditionally in Anaang land, alcohol of Studies on Alcohol. 1995;56(4): consumption is not just a social act but 457-469. is deeply entrenched and engraved in the Berkman, L.F, Kawachi, I. (2000). Social heart of Anaang cultural heritage. Even Epidemiology. 1st ed. New York: Ox- though consumption is seen as normal, it ford University Press.

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