Taylor & francis group - article
Substance Use & Misuse, 41:1967–1990Copyright 2006 Informa HealthcareISSN: 1082-6084 (print); 1532-2491 (online)DOI: 10.1080/10826080601026019 Is Hong Kong Experiencing Normalizationof Adolescent Drug Use? Some Reflections
on the Normalization Thesis
Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 NICOLE W. T. CHEUNG AND YUET W. CHEUNG Department of Sociology, The Chinese University of Hong Kong, Hong Kong The upsurge of consumption of party drugs among adolescents in recent years in HongKong has been part of the global trend of adolescent recreational use of drugs at raveparties, discos and similar party settings. Scholars in Western societies have recentlyproposed the thesis of "normalization of adolescent drug use" to describe such a trend.
The normalization thesis points at three major aspects of the normalization phenomenon,namely, a rapid increase of the prevalence of drug use in young people, the widespreadpopularity of recreational drug use that is closely linked with the recent arrival of danceclub culture, and a receptive attitude towards drug use as a normal part of leisure. Thisarticle aims to examine whether the normalization thesis can be applied to analyze thesituation of adolescent drug use in Hong Kong. Data are drawn from official statisticsand a recent survey conducted in 2002–2004 of drug use of Hong Kong marginal youths(N = 504). The case of Hong Kong only partially supports the thesis. Our findings showthat the normalization of drug use among young people has occurred in Hong Kong,but the extent of normalization is smaller than those in Western societies like the UnitedKingdom. They also suggest that a recognition of possible cultural differences may becomplementary to the normalization thesis. Limitations of the study are also noted. drug use; normalization; risk society; social capital; adolescence; Hong Perhaps the most salient change in the pattern of drug use among young people around theworld since the 1990s has been the rapid ascent in popularity of what are now collectivelyknown as "party drugs" (notably ecstasy and ketamine), commonly consumed in raveparties, discos, and similar club settings. Young consumers of illicit drugs have been onthe increase in the Western societies in the last decade (United Nations International DrugControl Programme [UNIDCP], 2000). This upsurge of adolescent drug use is reinforcedby the emergence of dance club culture in the West towards the end of the twentieth century(e.g., Malbon, 1999; Weber, 1999; Wijngaart et al., 1999; Measham, Aldridge, and Parker,2001; Allaste and Lagerspetz, 2002; Hunt and Evans, 2003; Fendrich and Johnson, 2005).
The Western dance drug scene has quickly become a globalized phenomenon, spreadingto Asian societies such as Hong Kong, Tokyo, and Kuala Lumpur (Time, 2000). This trend The manuscript has not been published elsewhere and has not been submitted simultaneously for publication elsewhere.
Address correspondence to Dr. Nicole W.T. Cheung, Department of Sociology, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong. E-mail: [email protected] Cheung and Cheung has prompted some scholars in Western societies to begin speaking of the "normalization"of adolescent drug use.
Indeed, the global expansion in the use of party drugs is not a distinctively new phe- nomenon throughout the world history of drugs (such as opium, coffee, tea, alcohol, andtobacco). New drugs recurrently emerge out of a variety of religious, political, social, eco-nomic, and professional forces (Porter and Teich, 1995; Courtwright, 2001; Pollan, 2001).
Based on their extensive study of drug use of youngsters in the United Kingdom, HowardParker and his colleagues have recently proposed the normalization thesis that attempts todescribe and explain the popularity and the changing nature of drug use among young peoplein the context of the post-modern and risk-laden society (Parker, Aldridge, and Measham, Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 1998; Parker, Williams, and Aldridge, 2002). This article tests whether the normalizationthesis can be applied to analyze the situation of adolescent drug use in Hong Kong. Doesthe current pattern of drug use among young people in Hong Kong as a Chinese societyresemble the phenomenon of normalization of adolescent drug use that has occurred inthe West? In the article, we aim to find out the extent to which normalization of drug useamong young people may be observable in Hong Kong, and to test whether the risk societymentality (operationalized by sense of uncertainty and control belief) is useful in predictingdrug use as suggested by the normalization thesis.
Normalization of Adolescent Drug Use
According to Rock (1973, p. 84), the meanings of deviant activities can be redefined so that"certain kinds of deviancy may, indeed, become normalized that they are no longer managedas intolerable" and may later become a "normal part" of leisure and lifestyle (Emerson,1992). One example of normalized deviance is recreational drug use, which demonstratesthat the definitions of what is acceptable leisure and what is not are shifting (Hathaway,1997a, 1997b). The application of the concept of normalization to the understanding ofthe current unprecedented increase in drug involvement of adolescents was popularizedby Howard Parker et al. (1998, 2002; see also Measham, Newcombe, and Parker, 1996;Egginton and Parker, 2002).
There are various foci within the thesis of normalization of adolescent drug use. The first focus is the increasing prevalence of illicit drug use in young people. Drawing on data froma nine-year northwest England longitudinal study of British high school students, Parkeret al. (1998, 2002) found that drug use has become more widespread among conventionalEnglish youth of a variety of socioeconomic backgrounds. The lifetime trying rates of drugsamong young Britons was 37% at 14 years. Entering the late teens, by the age of 18, oversix in ten of them had ever tried an illicit drug, and at 22, the rate was 76%. The past-yearprevalence of drug taking rose from 31% at 14 years to 53% at 18 years, and the rate wasstill similar at 22 years (52%). The past-month prevalence of drug taking was reported by20% at 14 years and then escalated to 35% at 18 years and 31% at 22 years.
Second, "sensible" recreational drug use, which involves cost–benefit drug decision- making, characterizes contemporary youth drug use (Parker et al., 1998, 2002). Dependentand frequent drug consumption is not very acceptable by many young drug users. Whilesome young people may use drugs in problematic ways, the normalization trend pinpointedby Parker et al. pertains to the increasing prevalence of recreational drug use in youngpeople, rather than referring to the normalization of addictive drug use.
The third aspect of normalization is that the receptive attitude towards drug use as a normal part of leisure is increasingly prevalent in young people. Young recreational drug Reflections on the Normalization Thesis users do not think of themselves as drug users. They "fit their leisure into busy lives andthen in turn fit their drug use into their leisure and ‘time out' to compete alongside sport,holidays, romance, shopping, nights out, drinking and, most important of all, having a laughwith friends" (Parker et al., 1998, pp. 156–157). Parker et al. found that nearly three quartersof young drug users manage their leisure time with party drugs in dance clubs. The growingadoption of party drugs consumption as "time out" actually runs throughout the historicalmemory surrounding drugs. Consumption of recreational substances such as caffeine drinksand tobacco, which are addictive substances and were once strictly controlled, are nowgenerally not seen as drugs by adults (Porter and Teich, 1995). Besides, Parker et al. observethat while the receptive attitude toward a recreational style of drug use is prevalent in young Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 drug users, such an attitude is also present in nearly two thirds of young abstainers. In aneat phrase, Parker et al. conceptualize these findings as "cultural accommodation," whichdescribes the growing tolerance of recreational drug use within both young drug users andabstaining adolescents.
In sum, the culture of adolescent drug use today is significantly different from those forms observable in earlier periods, but Parker alerts us that normalization of drug use doesnot mean all young people will accept, try, or take drugs. As illustrated by Parker et al.
(1998): Normalisation in the context of recreational drug use cannot be reduced to theintuitive phrase ‘it's is normal for young people to take drugs'; that is both tooversimplify and overstate the case. We are concerned only with the spread ofdeviant activity and associated attitudes from the margins towards the centre ofyouth culture where it joins many other accommodated ‘deviant' activities suchas excessive drinking, casual sexual encounters and daily cigarette smoking.
Although tobacco use is clearly normalised and most young people have trieda cigarette only a minority are regular smokers and even then their behavior isonly acceptable to their peers in certain settings. So normalisation need not beconcerned with absolutes. . (pp. 152–153) Parker's normalization thesis has been controversial in the drug and delinquency fields.
For instance, some scholars challenge Parker's work for exaggerating the extent of normal-ization in youth drug use (e.g., Shiner and Newburn, 1997, 1999; Shildrick, 2002). Despitethis criticism, it is important to note that Parker's work and a number of his findings havereceived support in other studies in the West (South, 1999; Taylor, 2000; Duff, 2003, 2005).
For example, drawing upon the normalization thesis, Duff (2003, 2005) reports that druguse is increasingly seen as a normal and uncontroversial aspect of Australian adolescents'culture.
Risk Society and Normalization
What motivates adolescents to pursue a recreational style of drug use? The idea that druguse has become normalized in young people has been related to the wider social change thatis associated with the rise of risk society. Beck (1992) argues that modern society is beingreplaced by a new modernity wherein the old, scientific worldview is being challenged. Beckdescribes this new type of society in post-modernity as "risk society," in which people'slives have seemingly become more fraught with risks and uncertainty.
Cheung and Cheung Increased Sense of Uncertainty in Risk Society
A key element in a risk society is that the calculation of risks is a functional necessity(Giddens, 1991). Risk assessment is incorporated into decisions concerning lifestyle choicesin this uncertain, "runaway world," a world out of our control (Giddens, 2000). Alongsidesuch changes comes the growth of individualization, which, as Beck (1992) contends,is an important force in negotiating risks and uncertainty in the risk society. Argumentsabout social change related to risk, individualization, and uncertainty have implications forthe changing experience of being young. Contemporary young people are encountering agreater diversity of risk and uncertainty than their predecessors, and they have less and Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 less control over them (Furlong and Cartmel, 1997; Miles, 2000; Cieslik and Pollock,2002). For instance, there is no shortage of literature pointing out the growing uncertaintyand risks in the school-to-work transition faced by contemporary youths (e.g., Furlongand Cartmel, 1997; MacDonald, 1998; Miles, 2000; MacDonald and Marsh, 2003). Theincreased difficulties of young people in entering the labor market are reflective of theimpact of economic restructuring in the post-industrial era and changing labor marketrequirements, which favor educated, informal, and flexible work. Like the West, HongKong has entered into the post-industrial era since the late 1980s. Under the changingsocioeconomic conditions, youngsters' school-to-work transition in Hong Kong is alsogetting more uncertain than those of the previous generations (Ho, 1999; Chiu, 2005).
Arguing along this line, Parker et al. (1998) suggest that contemporary young recre- ational consumers of drugs have been found to be increasingly committed to taking cal-culated risks for pleasure and stress relief in the uncertain world. They are described asbeing drug wise, in the sense that they carry out cost–benefit drug decision-making (Parker,2003; Gamble and George, 1997; Allaste and Lagerpsetz, 2002).1 The tendency to makesensible drug use among youths demonstrates that the elements of risk assessment andindividualization—self-responsibility for the cost of recreational drug use—have been in-tegrated into today's youth lifestyles.
Individualization and Control Belief in Risk Society
Why does individualization intensify in risk society? The failure of modern scientific knowl-edge to maintain its claims to universal authority has opened the way to a plurality of knowl-edge (Lyotard, 1984). As the range of knowledge and option widens and the necessity ofdeciding between them grows, the demand for "living a life of one's own" also increases(Beck, 1992). Rules and values that were earlier predefined within the family and the com-munity groups, or by recourse to the rules of social classes, are no longer sufficient (Beckand Beck-Gernsheim, 2002). Consequently, problems and uncertainties that were once ad-dressed with collective solutions are increasingly left to an individual's own resources toovercome them.
In examining the individualization thesis, researchers attach importance to control belief in undertaking the individualizing process. Control belief involves self-efficacy, whichrefers to the personal sense of being capable of executing the courses of action requiredto manage prospective situations (Bandura, 1997). Control belief has been argued to bea salient quality, particularly in rapidly changing societies, as it represents one's abilityto shape a promising life course development in changing environments (Elder, 1997).
Nonetheless, individualization can be liberating or burdensome, depending on the resourcesat the person's disposal (Wallace and Kovatcheva, 1996). For those young people with highself-efficacy, individualization presents new opportunities of making their own choices andactively shaping their experiences with their own efforts. Nevertheless, for those young Reflections on the Normalization Thesis people with low self-efficacy, the individualizing process may become a burden, as theymay experience more stress and helplessness in coping with risks and uncertainty on anindividual basis. They may turn to drugs to offset the pressure induced by individualization(France, 2000; Parker, 2003).
To recapitulate, the normalization thesis identifies three major aspects of the normal- ization phenomenon, namely, a fast increase of the prevalence of drug use in young people,the widespread popularity of recreational drug use that is closely linked with the recentarrival of dance club culture, and a receptive attitude toward drug use as a normal part ofleisure. Adopting the risk society perspective, the normalization thesis explains the increaseof adolescent drug use by highlighting the impact of sense of uncertainty and control belief, Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 which are two crucial elements of the mentality in today's risk society.
Adolescent Drug Use in Hong Kong: Towards Normalization?
In the light of the normalization thesis described above, we would like to find out whetherthe phenomenon of normalization of drug use among the youth has occurred in Hong Kong.
To do this, we examine (a) the prevalence of young people's drug use in Hong Kong sincethe early 1980s, (b) the type of drugs that are most popular among them, (c) the extent towhich their use could be said to be recreational, and (d) young people's permissiveness todrug use.
Prevalence of Drug Use among Young People in Hong Kong
Let us first take a look at the data of the Central Registry of Drug Abuse, which is a gov-ernment unit that regularly collects information about drug abusersa who come into contactwith treatment, health care, social service, welfare, and law enforcement organizations. De-spite limitations such as underreporting of social service agencies and exclusion of hiddendrug users (Cheung and Ch'ien, 1996), the Registry offers useful data that reflect the patternand trend of illicit drug use in the Hong Kong population. Table 1 contains information ofdrugs commonly consumed by individuals under the age of 21 who were reported to theRegistry by the broad network of government and non-government agencies.
Table 1 notes the number of individuals under age 21 with known type of drug reported.
This number was, on the whole, less than 1,000 in the mid-1980s, but suddenly increasedby two third (1,653) in 1992, and reached its peak in 1994 (3,891). Since the mid-1990s,the number has fluctuated, and by 2000 it reached 3,467, and then decreased to 3,210 in2001, 2,494 in 2002, and 1,758 in 2003. Compared with the 1980s and the early 1990s,the number of drug users under 21 who came into contact with the Registry's network hasrisen two or three times. If we are not satisfied with absolute numbers, the proportion ofthe above-mentioned young individuals to the total number of reported drug users in thesame year also documents the sharp increase of the prevalence of young people's drug use.
As shown in Table 1, this proportion was well under 10% until 1990, and then soared, at21.1%, in 2000. By 2003, this number was still almost twice as large as the percentagein the 1980s. A limitation of the data of the Central Registry is that they do not includeoccasional drug users, as these users do not generally come into contact with treatment orhealth agencies. To have a better picture of young people's drug use, we also examine theresults of four large-scale secondary school student surveys2 conducted under the auspices aThe journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.
Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 Reflections on the Normalization Thesis Lifetime and past 30 days prevalence of use of psychoactive drugs in students of secondary schools in Hong Kong (N = 84,117) (N = 81,100) (N = 84,515) (N = 67,100) (N = 66,386) Psychoactive drugs Tried past 30 days Among ever users: (N = 1,645) (N = 2,284) (N = 2,366) (N = 2,483) (N = 1,792) Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 Source: Narcotics Division (1991, 1993, 1997), Lau (2002) and Fung (2005).
Note: n.a. = not available.
of the Narcotics Division (Narcotics Division, 1991, 1993, 1997; Lau, 2002; Fung, 2005 ).
The student surveys offer more specific data on the trend and pattern of illicit drug use inthe Hong Kong student population. Table 2 reports data from the four student surveys.
From Table 2, we can see that the percentage of lifetime use of psychoactive drugs (heroin not included) in the whole student sample almost doubled in the last decade. Thepercentage climbed from 2.1% in 1990 to 2.9% in 1992, rose substantially to 3.7% in 2000,and then declined to 2.7% in 2004. Similarly, the percentage of the past 30-day use ofpsychoactive drugs in the whole student sample increased nearly fives times, from 0.4%in 1990 to 1.9% in 2000. However, it should be pointed out that, when compared to thefindings of Parker et al.'s (1998, 2002) longitudinal study of drug use in British high schoolstudents mentioned previously, the lifetime prevalence rates and the past 30-day rates ofdrug use of Hong Kong secondary students were much lower. The above data of the CentralRegistry and the student surveys show that there have been unprecedented upswings in theprevalence of Hong Kong young people's drug use in the past two decades. It can be saidthat this aspect of normalization has occurred in a limited extent in Hong Kong, since thescale of the increase in the prevalence of drug use among adolescents in Hong Kong is notas great as that of their counterparts in the United Kingdom.
Most Popular Drugs among Young People in Hong Kong
The normalization thesis suggests that much of the increase of youth drug use can beattributed to the consumption of party drugs, notably ecstasy and ketamine, in the context ofa new rave/club culture. Have these two drugs become the drug of choice among adolescentsin Hong Kong? With reference to the Central Registry data (Table 1), heroin had attracted over 80% of reported drug users aged under 21 before the late 1980s. Since then, heroin use droppedsubstantially and, by 2003, heroin was consumed by less than 10% of reported young drugusers. The popularity of heroin was superseded by psychoactive drugs during the last twodecades. The psychoactive drugs that have achieved the most acute rise in popularity areecstasy and ketamine. Ecstasy, barely consumed by reported young users before the end of Cheung and Cheung the 1990s, suddenly became a drug that attracted over half (56.2%) of reported young drugusers in 2000. This percentage declined somewhat in 2001 (53%), and further dropped to34.1% in 2003. Ketamine also appeared on the scene suddenly in 2000, consumed by 36.9%of reported young users. The popularity of ketamine rose sharply to 59.8% in 2001, and thenincreased up to 70.4% in 2002 and 62.5% in 2003. Thus, although the two drugs exchangedtheir dominant positions from 2000 to 2003, ecstasy and ketamine have dominated thechoice of drugs among young drug users in the last several years.
Let us also take a look at the student surveys (Table 2). Before 2000, cannabis and cough medicine were the most popular drug of choice among student users. Again, after ecstasyand ketamine entered the picture in the 2000 student survey, they surfaced as the most Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 attractive drugs in student users (47% and 37.8%, respectively), though cannabis (39.4%)remained as popular as ketamine. The sudden popularity of ecstasy and ketamine amongHong Kong adolescents in the past few years might be inextricably tied to the influence ofthe dance/rave culture of the West. For Hong Kong young drug users, party drugs also donot carry the stigma of illicit drug abuse, as does heroin (Joe Laidler, 2005).
Recreational Drug Use among Young People in Hong Kong
Apart from examining the prevalence of drug use and the most popular drugs among HongKong adolescents, we will also find out whether or not drug use in young people is recre-ational in nature. To examine recreational drug use, we look at four aspects: (a) frequencyof use, (b) major setting of use, (c) major type of drugs used, and (d) major reasons foruse. We do not refer to the data of the Central Registry, nor the above student surveys, asthey somehow do not have data pertaining to all of these indicators. We will examine theresults of a recently completed study of marginal youths—Northbound Pleasures: Pattern ofCross-Border Deviance of Hong Kong Marginal Youths and Its Implications for AdolescentDeviance in Hong Kong, which was funded by the Research Grants Council of Hong Kong.
The Hong Kong Marginal Youth Study, conducted by the authors in 2002–2004, ascer- tains the drug use patterns of marginal youths and their social and psychological correlatesin Hong Kong (for details of the study, see Cheung, 2004). Findings of the study also in-form the improvement of drug prevention and intervention efforts, so that they can be moreattentive to the changing patterns of drug use among young people, particularly marginalyouths, in Hong Kong. The study had a sample of 504 marginal youths, aged 14 to 19, whowere recruited from outreaching social work agencies, a drug treatment center, and penalinstitutions. The study also had a sample of 1,217 secondary students, who were recruitedfrom randomly drawn secondary schools. From these students, a sample of 504 students,aged 14 to19, was selected by matching with the marginal youth sample according to somesocio-demographic characteristics (including sex, age, and the type of housing). This sam-ple of students served as a comparison group. Basic socio-demographic profiles of the twosamples are given in Table 3. A standardized questionnaire, which was developed on thebasis of theoretical perspectives and findings of past studies, was used to collect data fromthe samples of students and marginal youths, through self-administration in classrooms andface-to-face structured interviews, respectively.3 We found in the study that, in the student sample (N = 504), only 1% of the students had exhibited current drug use (defined as drug use in the twelve months prior to the timeof interview), and 99% were non-drug-taking students. In stark contrast, the majority of therespondents (80%) in the marginal youth sample (N = 503) were current users, and onlyone fifth of the marginal youths were not involved in current use. Given that drug use was Reflections on the Normalization Thesis Socio-demographic profiles of respondents of final marginal youth sample (N = 504) and matched student sample (N = 504) Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 Temporary housing Home ownership scheme estates Employment status Illicit employment highly prevalent among marginal youths but was rare among students, we proceed to assessthe extent to which drug use in marginal youths can be said to be recreational (Table 4).
Findings in Table 4 indicate that the major type of drug use in the marginal youth sample was recreational drug use. Firstly, marginal youths show a generally low frequency of currentuse. As many as 20% of the respondents had not used any drugs in the twelve months priorto the time of interview. Nearly one third (32.8%) had used drugs two to three times a monthor less. The remaining half (46.9%) had taken drugs once or more times a week. Second,marginal youths' favorite settings of use were mainly entertainment settings. Discos/raveparties were mentioned by 87% of the respondents, followed by karaoke lounges (52.4%).
Third, as to the major type of drugs used at discos/rave parties, ketamine was consumedmost (by 92.5% of respondents), followed by ecstasy (86.4%) and cannabis (51.3%). Fourth,regarding the major reason for current drug use, the majority of marginal youths used drugsfor leisure and recreation (mentioned by 74% of respondents). The dominance of leisure asa major motivational factor for drug use far outweighs other reported reasons such as seekexcitement/euphoria (52.9%), relief of boredom (46.3%) and pressure/stress (36%), escapefrom harsh reality (33.5%), and peers' suggestion (31%).
Cheung and Cheung Current drug use (last 12 months) of marginal youths in Hong Kong Frequency of use (N = 503) Once a month or less Two to three times a month Once a week or more Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 Typical setting of use (N = 401; multiple answers) Discos/rave parties Video game centers Major type of drugs used at discos/rave parties (N = 308; multiple answers)Ketamine Methylamphetamine (ice) Major reasons for use (N = 361; each respondent could give up to 3 reasons)For leisure and recreation To seek excitement/euphoria To relieve boredom To relieve pressure/stress To escape from harsh reality To comply with peers' suggestion Getting addicted physiologically/psychologically To enhance working/learning ability Permissiveness to Drug Use among Young People in Hong Kong
The normalization phenomenon, according to the thesis, also features a receptive attitudetowards drug use as a normal part of leisure time consumption among young people. Is druguse accepted by Hong Kong young people as a normalized leisure activity? To answer this,we employ the data of the study of Hong Kong marginal youths, and compare permissivenessto drug use between marginal youths and students (Table 5).
Table 5 reveals that around 80% of marginal youths accepted occasional use of drugs, and agreed that taking drugs was fine when going out with friends to use drugs (e.g., indiscos or rave parties) for leisure and recreation. Frequent drug taking was not as popular asoccasional and recreational use in marginal youths, as 68% of them did not accept frequentuse. Regarding the views of students, however, over 86% of them did not accept occasional, Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 Cheung and Cheung recreational, or frequent use of drugs. These results indicate that the cultural accommodationof recreational use suggested by the normalization thesis occurs mainly among marginalyouths.
On the whole, our data suggest that the major aspects of the normalization phenomenon are present in Hong Kong, but the extent of normalization in Hong Kong does not seem tobe as great as that in the United Kingdom found in Parker's study. There has been a rapidrise of the prevalence of drug use among Hong Kong adolescents in the last decade. Drugtaking is highly prevalent in marginal youths, but it is rare in regular students. A majorityof drug use in marginal youths has been recreational, mostly taking place at entertainmentsettings of discos, rave parties, and karaoke lounges, where party drugs, notably ecstasy Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 and ketamine, are commonly used. While most students disapprove drug use, a majorityof marginal youths hold a receptive attitude toward recreational, occasional use of drugs.
Drug-using marginal youths also describe their motivation of use largely in terms of timeout, suggesting that drug use is treated as more and more a normalized leisure activity withinmarginal youths in Hong Kong.
Risk Society Mentality and Adolescent Drug Use in Hong Kong
In examining the normalization phenomenon in Hong Kong, we also explore the usefulnessof the risk society mentality in explaining drug use among Hong Kong young people.
According to the normalization thesis, the feeling of uncertainty in a risk-laden society, andthe extent to which one believes that one can control one's own life (control belief), are twoimportant elements of risk society mentality affecting adolescent drug use. In testing theinfluence of these two elements of mentality, we utilize the data of the Hong Kong MarginalYouth Study. In the study, the variable of sense of uncertainty was measured with the questionasking the respondent whether or not he/she agreed with the statement: "Living in a rapidlychanging society, I sometimes feel uncertain with my future".4 Control belief was measuredwith the ten-item self-efficacy scale developed by Bandura (1977), which assesses theindividual's perceived competence in tackling environmental demands and life stressors.5As noted earlier, only 1% of the students were current drug users in the study, while mostrespondents in the marginal youth sample (80%) were current users. In view of this, wecompare the marginal youths (high-risk group of drug use) to the students (low risk groupof drug use) to see whether they differed in sense of uncertainty and self-efficacy (Table 6).
As shown in Table 6, the mean sense of uncertainty score and the mean self-efficacy score of the marginal youth sample did not differ significantly from those of the studentsample. The mean sense of uncertainty score of marginal youths was 2.91, whereas that of Comparing the marginal youth sample and the student sample with respect to risk society Risk society mentalitySense of uncertainty (score range 1–4) Self-efficacy (score range 10–40) ∗∗p < .01, t-test of means.
n.s. = not significant.
Reflections on the Normalization Thesis students was 2.87. Marginal youths had a mean self-efficacy score of 27.08, and students'mean self-efficacy score was 27.4. Since both marginal youths and students were experi-encing similar low levels of uncertainty and moderate levels of self-efficacy, such mentalityin risk society cannot be said to be associated with drug use.
Summary and Discussion
Some Reflections on the Normalization Thesis
In this article, our analysis shows that the case of Hong Kong offers only partial support to Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 the normalization thesis. The extent of normalization of adolescent recreational drug use inHong Kong appears to be smaller than those in Western societies like the United Kingdom.
The increase in the prevalence of drug use of Hong Kong adolescents, albeit substantialover the years, is not as great as that of young people in the United Kingdom. Besides, thepopularity and permissiveness to drug use in the student population are still very low inHong Kong compared with that of the student population in the United Kingdom. In HongKong, consumption of drugs, notably recreational use at discos, rave parties, and karaokelounges where ketamine and ecstasy are widely used, is confined to marginal youths. Inaddition to finding out the normalization phenomenon in Hong Kong, we also test whetherthe risk society mentality proposed by the normalization thesis effectively predicts drug useamong Hong Kong adolescents. However, in our study, the risk society mentality does notseem to offer a good explanation. Why? The introduction of risk society mentality into the analysis of youth drug use may be seen as a reaction to the tendency for structural factors to receive more attention thanindividualization factors in the structure-agency debate. In their study of normalizationof adolescent drug use, Parker et al. (1998) observe that youth drug use is no longerdominant in lower class adolescents only. This result led Parker et al. to conclude thatstructural factors in respect of socioeconomic backgrounds are becoming less predictiveof the use of drugs, and that the trend of individualization tends to obscure the ways inwhich the traditional pattern of socioeconomic inequality may impact upon young people'sexperiences. To theorists adopting the individualization approach, youth transition is notfully determined by social structure (Cote, 2002; Evans, 2002). Rather than passively acceptthe social circumstances that he/she is in, an adolescent is able to actively take individualresponsibility to choose his/her own life project and strategically deal with life stressorsupon himself/herself. Cultural variations in the process and effects of individualizationacross different societies may be one plausible explanation of the lack of significant effectof risk society mentality in the case of Hong Kong.
In Western culture, the individual occupies a central place in society. Young people growing up in Western societies attach value to individualism and are eager to launchindividual pursuits. In Hong Kong, albeit a modernized society, Chinese culture is stilldominant among the population. In Chinese culture, individual interests are often suppressedfor the purpose of facilitating collective interests, especially the family (Chan and Lee,1995; King, 1985; Yang, 1995). Since childhood, the individual is taught to be submissive,obedient, and disciplined. As young people grow up in Chinese culture, they may notaccord individualism a position as prominent as what their counterparts in the West maydo. For instance, in Hong Kong as a Chinese society, the family still serves as an importantsocial support collectivity (Leung and Fan, 1996; Lau, 1984) and may play a buffer role inhelping youngsters to cope with uncertainty. Hence, with respect to the individualizationin risk society under study, the process of individualization in Chinese societies may not Cheung and Cheung Comparing the marginal youth sample and the student sample with respect to social struc- Family social capital (Direct parental informal control,parental support, and parental Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 positive labeling) (score range3–12) School social capital (Direct school informal control, school support,and teachers' positive labeling)(score range 3–12) Socially disadvantageous Educational disadvantage (score Association with drug-using peers (score range 2–8) ∗∗p < .01, t-test of means.
n.s. = not significant.
be as elaborate as that in Western societies. Consequently, the effects of a risk societymentality on adolescent drug use in Hong Kong may not be as strong as those in the West.
If individualization does not significantly affect the behavior of adolescents in Hong Kong,are social structural factors casting a lot of influence? Our data in Table 7 show that they do.
Utilizing the data of the Hong Kong Marginal Youth Study, we also assess the differ- ences between the marginal youth sample and the student sample with respect to severalsocial structural factors. Using the social capital framework (Coleman, 1988, 1990), whichis in recent years a popular concept in the social science literature,6 we construct the variableof "family social capital" on the basis of direct parental informal control, parental support,and parental positive labeling (Hagan, MacMillan, and Wheaton, 1996; Wright and Cullen,2001; Seaman and Sweeting, 2004; Heimer and Matsueda, 1994) and the variable of "schoolsocial capital" on the basis of direct school informal control, school support, and teachers'positive labeling (Gottfredson, 2001; Munn, 2000).7 We also measure the socially disad-vantageous experiences of the respondents, which include "educational disadvantage," "as-sociation with drug-using peers," and "trouble with law."8 Family social capital and schoolsocial capital, which are embodied in conventional relationships, are conducive to the gen-eration of informal social control, legitimate life chances, learning of conventional values,and the raising of self-image. These resources can augment adolescents' capacities for con-forming action and protect them from delinquent involvement, including drug use. Sociallydisadvantageous experiences, which might reduce opportunities for an adolescent to involvein conventional relationships, impede the social capital acquisition of adolescents, therebyincreasing their likelihood of such delinquent behaviors as drug use (Sampson and Laub, Reflections on the Normalization Thesis 1997; Hagan and Parker, 1999). Results in Table 7 indicate that marginal youths and studentsdiffered significantly in all of these social structural factors. Marginal youths possessed lessfamily social capital and school social capital, suffered more educational disadvantage, hadinvolvement with drug-taking peers, and encountered more trouble with the law.
As a modernized society, Hong Kong is subject to the fast influence of Western culture.
It is no surprise that rave parties and the club culture of the West would quickly land onHong Kong in the late 1990s. While the youth dance drug scene has emerged at center stageas a global phenomenon, existing studies on youth dance drug scene have largely ignoredthe impact of cultural contexts in which dance drug use has occurred (Hunt and Evans,2003). In the present example, we suggest that limited normalization has occurred in Hong Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 Kong, but it might have been due to the weakening of social structural forces in the family,school, and community, rather than the emergence of an individualization process like whathas happened in the West. While we appreciate the strength of the normalization thesis inaccounting for increasing drug use among young people today, we raise the issue that recog-nition of possible cultural differences may be complementary to the normalization thesis.
Limitations of the Study
As a pioneer study of normalization of adolescent drug use in Hong Kong, this study hasa number of weaknesses. First, as there is no way to ascertain the size of the population ofmarginal youths in Hong Kong, it was not possible for us to draw a representative sampleof marginal youths by random sampling in the Hong Kong Marginal Youth Study. We triedto improve the representativeness of our sample of marginal youths by, firstly, maintaininga reasonably large sample size and, secondly, recruiting respondents from a variety of non-government youth service agencies, correctional institutions/homes for youths run by thegovernmental departments, and a drug treatment organization. In future research, we shouldconduct a household survey and draw a representative non-student sample of young people,in order to further estimate the extent of normalization of drug use among out-of-schooladolescents in Hong Kong.
Second, since data of the official statistics and the Hong Kong Marginal Youth Study are cross-sectional in nature, they are unable to disclose whether the "extended normalizationof adult recreational drug use" has happened in Hong Kong young people. A growing bodyof research has revealed that adolescents increasingly carry their recreational drug use intotheir adulthood without turning to addiction (Williams and Parker, 2001; Measham, Parker,and Aldridge, 1998). A possible explanation for this phenomenon is the delayed settlingprocess of drug use. Owning to the uncertain journey to adulthood in risk society today,the coming of transition markers such as permanent job, marriage, and parenting, whichwere traditionally associated with the maturing out of drug use (Henley and Adams, 1973),are being deferred. Will recreational drug-using marginal youths in our study quit usingdrugs in their transition to adulthood or develop a recreational drug use career? Will theyprogress into an addict career? There is a need for longitudinal study on the normalizationof adolescent drug use to be conducted in Hong Kong.
The third constraint of our study is that the measurement of risk society mentality suffers certain weaknesses. While control belief was measured by a well-established self-efficacy scale, sense of uncertainty was assessed by only a rough question on the extent ofagreement on the statement "Living in a rapidly changing society, I sometimes feel uncertainwith my future." This question does not capture what kinds of uncertainty today's youngpeople are encountering. Future research should make use of more questions to constructa more comprehensive measurement of sense of uncertainty of adolescents. Fourth, due to Cheung and Cheung the absence of data, the extent of individualization/collectivistic orientation in Hong Kongas a Chinese society was not assessed in this study. How does the Chinese collectivistic ori-entation affect risk society mentality? Does individualization develop in Chinese societies?The possible cultural variations in the impact of individualization process and risk societymentality on adolescent drug use in different societies, as discussed above, merit closerexamination.
Fifth, we have not delved into the prevalence and properties of networks in the normal- ization of adolescent drug use. Even Parker's work has not dealt with the network issue.
Indeed, much of human behavior, including drug use, is network based and subject to theinfluence of a complex series of social and virtual networks (Barabasi, 2002; Cheung and Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007 Cheung, 2003). The implications of networks for the normalization process warrant futureresearch attention.
Lastly, due to the above-mentioned limitations, findings reported in this article will be suggestive rather than affirmative. Using the Hong Kong case as an example, our studyprovides the groundwork for examining the normalization phenomenon in non-Westernsocieties. Knowledge on the normalization phenomenon thus far is restricted to the West.
Naturally, far more detailed empirical work will be required to assess the significance ofthe normalization thesis in understanding the changing patterns of adolescent drug use innon-Western cultures.
This study was supported by the research project "Northbound Pleasures: Pattern of Cross-Border Deviance of Hong Kong Marginal Youths and Its Implications for Adolescent De-viance in Hong Kong," which was funded by the Research Grants Council of the HongKong Special Administrative Region (Project number CUHK4331/01H).
L'utilisation de la drogue par les adolescents a HongKong est –elle en train de se
normaliser ? Quelques r´eflexions sur la th ese de normalisation
L'augmentation de la consommation des drogues qui sont consomm´ees par les adolescentslors des soir´ees ou des fˆetes ("party drugs") ces derni eres ann´ees a HongKong fait partied'une tendance mondiale a l'utilisation des drogues par les adolescents pour s'amuser lors desoir´ees ou de fˆetes de d´elire ou d'extase ("rave party"), dans les discoth eques, et d'autres telslieux ou circonstances. Des savants dans les soci´et´es occidentales ont r´ecemment propos´ela th ese de "la normalisation de l'usage des drogues par les adolescents" pour d´ecrire cettetendance. La th ese de normalisation met en valeur trois aspects importants du ph´enom ene denormalisation, a savoir, une augmentation rapide du niveau de consommation de la droguespar les jeunes, la popularit´e r´epandue de la consommation r´ecr´eationnelle de drogue quiest ´etroitement li´ee a l'arriv´ee r´ecente de la culture de clubs de danse, et une attituder´eceptive envers l'utilisation de drogues en tant que faisant partie normale des loisirs.
Cet article vise a examiner si la th ese de normalisation peut s'appliquer a l'analyse dela situation a HongKong quant a la consommation des drogues par les adolescents. Nosdonn´ees viennent des statistiques officielles et d'une enquˆete r´ecente des les ann´ees 2002–04 a HongKong sur la consommation des drogues chez les jeunes en marge de la soci´et´e (N= 504). Le cas de HongKong soutient seulement partiellement la th ese de normalisation.
Reflections on the Normalization Thesis
Nos r´esultats montrent que la normalisation de la consommation de drogues chez les jeunesa eu lieu a HongKong, mais l'´etendue de cette normalisation est moindre a ce qui a ´et´eobserve dans d'autres soci´et´es occidentales tel le Royaume-Uni. Nos r´esultats indiquent
´egalement que le fait de reconnaˆıtre la possibilit´e de diff´erences culturelles, pourrait ˆetre
compl´ementaire a la th ese de normalisation. Des limitations de l'´etude sont ´egalementnot´ees.
¿Est´a Hong-Kong experimentando la normalizaci´on del uso de las drogas en los
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adolescentes? Algunas reflexiones en la tesis de la normalizaci´on
El aumento del consumo de las drogas festivas entre adolescentes en a˜nos recientes en Hong-Kong ha sido parte de la tendencia global del uso recreacional de drogas entre adolescentesen las fiestas "rave," las discotecas y los sitios similares de fiestas. Los academicos ensociedades occidentales han propuesto recientemente la tesis de la "normalizaci´on del usode drogas en los adolescentes" para describir tal tendencia. La tesis de la normalizaci´onse˜nala tres aspectos importantes del fen´omeno de la normalizaci´on, a saber, un aumentor´apido de la prevalencia del uso de las drogas en la gente joven, la popularidad extensadel uso recreacional de las drogas que se liga de cerca a la llegada reciente de la culturadel club de la danza, y una actitud receptiva hacia el uso de las drogas como parte normalde ocio. Este articulo apunta examinar si la tesis de la normalizaci´on se puede aplicarpara analizar la situaci´on del uso de las drogas entre los adolescentes en Hong-Kong. Losdatos se obtienen de estad´ıstica oficial y de una encuesta reciente conducida en 2002–04 del uso de la droga entre jovenes marginados de Hong-Kong (N = 504). El caso deHong-Kong apoya solamente parcialmente la tesis. Nuestros resultados demuestran que lanormalizaci´on del uso de la droga entre la gente joven ha ocurrido en Hong-Kong, peroel grado de la normalizaci´on es m´as peque˜no que ´esos en sociedades occidentales comoInglaterra. Tambi´en sugieren que un reconocimiento de posibles diferencias culturales puedaser complementario a la tesis de la normalizaci´on. Se notan las limitaciones del estudiotambi´en.
THE AUTHORS
Nicole W. T. Cheung, Ph.D., is an assistant professor in
the Department of Sociology, the Chinese University of
Hong Kong. Her areas of specialization are sociology of
deviance, drug addiction, and youth problems. She has
participated in several large-scale research projects on
drug abuse and adolescent deviance in Hong Kong. Her
most recent publication has appeared in Addiction Re-
search and Theory.
Cheung and Cheung
Yuet W. Cheung, Ph.D., is a professor in the Depart-
ment of Sociology, the Chinese University of Hong Kong.
His major areas of specialization are alcohol and drug
addiction, adolescent delinquency, sociology of deviance,
medical sociology, and family violence. He has conducted
extensive research on drug treatment and adolescent de-
viance in Hong Kong. A member of the editorial board of
Substance Use & Misuse, he has published in, among oth-
ers, International Journal of Drug Policy,Substance Use
& Misuse,Addiction Research and Theory,Social Science
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and Medicine, and Journal of Youth and Adolescence.
1. The argument concerning the cost–benefit drug decision-making in the normalization
thesis has introduced the thesis of rational addiction (Vuchinich and Heather, 2003). Itshould be noted, however, that human judgments might have irrational underpinnings(Kahneman, Slovic, and Tverskey, 1982).
2. All the four student surveys enumerated large samples of Form 1 to Form 7 students
from mainstream Chinese-speaking secondary schools in Hong Kong. The sample size ofeach student survey was 84,117 for the 1990 survey, 81,100 for the 1992 survey, 84,515for the 1996 survey, 67,100 for the 2000 survey, and 66,386 for the 2004 survey. Thesampling frame was a list of secondary schools provided by the Education Department.
For each survey, a two-stage stratified cluster sampling method was employed. At stageone, schools were stratified according to the criteria of location (Hong Kong Island,Kowloon, and the New Territories) and by type of school (government, aided, andprivate). A sample of schools were then randomly selected for each of the strata. At stagetwo, classes of students from selected schools were randomly selected for participationin the survey.
3. It should be noted that the use of different data collection methods might have affected
the comparability of the data of the student sample and the marginal youth sample.
Self-administered questionnaires have the advantage of encouraging more candid re-sponses on sensitive questions, but they have the weaknesses of more incomplete ques-tionnaires and some of the questions being misunderstood. Although the weaknesses ofself-administered questionnaires could be minimized by the use of structured interviews,structured interviews also have drawbacks, including reluctance of giving true responseson sensitive questions, interviewer bias, and social desirability effect. Despite havingthe possibility of affecting the comparability of the data, these two methods of datacollection were adopted for some reasons. Self-report questionnaires were used for thestudent sample because it was difficult to conduct structured interviews when the size ofthe student sample was very large. In data collection of marginal youths, social workersof participating outreaching social work agencies were recruited to conduct structuredinterviews. Conducting interviews by social workers had an advantage, since the trustbetween social workers and their clients could enhance the reliability of responsesgiven by marginal youths. Several briefing sessions were arranged for social workers,in order to help them to avoid interviewer bias and social desirability effect duringinterviews.
Reflections on the Normalization Thesis
4. The response format for the statement measuring sense of uncertainty ranges from
"Strongly agree" (scored 4), "Agree" (scored 3), "Disagree" (scored 2), to "Stronglydisagree" (scored 1).
5. The ten-item general self-efficacy scale has been adapted and widely used in Chinese
context (Zhang and Schwarzer, 1995). The response format for each item ranges from"Strongly agree" (scored 4), "Agree" (scored 3), "Disagree" (scored 2), to "Stronglydisagree" (scored 1). The ten items are as follows: (a) I can always manage to solvedifficult problems if I try hard enough; (b) if someone opposes me, I can find means andways to get what I want; (c) it is easy for me to stick to my aims and accomplish mygoals; (d) I am confident that I could deal efficiently with unexpected events; (e) thanks
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to my resourcefulness, I know how to handle unforeseen situations; (f) I can solve mostproblems if I invest the necessary effort; (g) I can remain calm when facing difficultiesbecause I can rely on my coping abilities; (h) when I confront with a problem, I canusually find several solutions; (i) if I am in a bind, I can usually think of something todo; and (j) no matter what comes my way, I am usually able to handle it. The ratingsare summed to form a general self-efficacy scale, with scores ranging from 10 to 40.
The lower the score, the lower the level of self-efficacy. Cronbach alpha for the generalself-efficacy scale was 0.8 for the marginal youth sample and 0.88 for the student sample.
6. The concept of social capital has been used for analyzing a wide range of social behaviors,
such as educational and occupational attainment (Hagan et al., 1996; Teachman, Paasch,and Carver, 1997; Lin, 2001), health (Lomas, 1998; Ziersch, 2005), post-treatment druguse (Cheung and Cheung, 2003), and crime and delinquency (Hagan and McCarthy,1997; McNulty and Bellair, 2003; Messner, Baumer, and Rosenfeld, 2004). Social cap-ital refers to those resources embodied in the structure of social relations, includinginterpersonal ties and institutional linkages (e.g., family, schools, work, and communitysetting) that can facilitate social actions or achievement of goals (Coleman, 1988, 1990).
In order to derive social capital, embeddedness in social relations is necessary.
7. Family social capital and school social capital capture the extent to which parents and
school generate social capital for adolescents. The measurement of family social capitalfocuses on three dimensions—parental informal control, parental support, and parentalpositive labeling. The first dimension of direct parental informal control was measured bythe question: "How often did you need to seek approval from parents when going out?"The response categories for this question were "Never" (scored 1), "Seldom" (scored2), "Sometimes" (scored 3), and "Often" (scored 4). The second dimension of parentalsupport was assessed with the item: "How often were your parents willing to try to helpyou solve problems when you need their help?" The response categories for this itemwere "Often" (scored 4), "Sometimes" (scored 3), "Seldom" (scored 2), and "Never"(scored 1). The third dimension of parental positive labeling was measured by the ques-tion: "How did your parents think of you as a son/daughter?" The response categoriesfor this question were "Very good" (scored 4), "Good" (scored 3), "Poor" (scored 2),and "Very poor" (scored 1). We combined the scores of the three items measuring directparental informal control, parental support, and parental positive labeling to construct ascale of family social capital, with scores ranging from 3 to 12. The higher the score, themore family social capital an adolescent can obtain. Cronbach alpha for the family socialcapital scale was 0.55 for the marginal youth sample and 0.53 for the student sample.
For the measurement of school social capital, we propose three dimensions includingdirect school informal control, school support, and teachers' positive labeling. The firstdimension of direct school informal control was assessed with this question: "How strictwas your school's supervision on students?" The response items for this question were
Cheung and Cheung
"Strict/very strict" (scored 4), "Fair" (scored 3), "Not strict" (scored 2), and "Not strict atall" (scored 1). The second dimension of school support was measured by this question:"Do you think that your teachers showed concern in students' non-academic matters,such as those concerning personal hobbies, emotions, friendship and family?" The re-sponse items were "Cared very much" (scored 4), "Somewhat cared" (scored 3), "Didn'tcare" (scored 2) and "Didn't care at all" (scored 1). The third dimension of teachers'positive labeling was assessed with this question: "How did your teachers think of youas a student?" The response items included "Very good" (scored 4), "Good" (scored 3),"Poor" (scored 2), and "Very poor" (scored 1). The scores of the three items measur-ing the three dimensions of school social capital were summed to form a school social
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capital scale, with scores ranging from 3 to 12. The higher the score, the more schoolsocial capital an adolescent can obtain. The school social capital scale had Cronbachalpha values of 0.53 for the marginal youth sample and of 0.58 for the student sample. Itshould be mentioned that, unfortunately, the measurements of the family social capitalscale and the school social capital scale were less than satisfactory, as their alpha valueswere barely acceptable. However, they were quite close to the minimally accepted valueof 0.6 and, as such, they were used in the present analysis. More research efforts areneeded to improve the family social capital scale and the school social capital scaleconstructed in this study.
8. Socially disadvantageous experiences are operationalized with three variables, edu-
cational disadvantage, association with drug-using peers, and trouble with law. Twodimensions are used to represent educational disadvantage: educational underachieve-ment and diminished educational effort (Hagan and McCarthy, 1997; Hagan and Parker,1999). Educational underachievement was measured by asking the question: "How didyou rate your academic performance in school?" The response categories for this ques-tion were "Very good" (scored 4), "Quite good" (scored 3); "Quite poor" (scored 2),and "Very poor" (scored 1). Diminished educational effort was measured with this item:"Did you think you are a hard-working student?" The response items for this questionwere "Very lazy" (scored 4), "Quite lazy" (scored 3), "Quite hard-working" (scored 2),and "Very hard-working" (scored 1). We constructed an educational disadvantage scaleby combining the scores of the measures of the two dimensions. Scores of this scale werefrom 2 to 8. Cronbach alpha of this scale was 0.62 for the sample of marginal youths and0.6 for the sample of students. The measurement of association with drug-using peersconsisted of two items asking the respondent to report how many of his/her good friendshad engaged in drug use in Hong Kong, Shenzhen, or other locations of mainland China.
Two questions were asked: (a) "How many of your good friends have taken drugs inHong Kong?"; and (b) "How many of your good friends have taken drugs in Shenzhenor other places of mainland China?" The response categories for each question were"Many" (scored 4), "Some" (scored 3), "Very few" (scored 2), and "No/don't know"(scored 1). A scale of association with drug-using peers were formed by summing thescores of the two questionnaire items, with scores ranging from 2 to 8. Cronbach alphafor this scale was 0.59 for the marginal youth sample and 0.67 for the student sample. Toassess trouble with law, we asked the respondent to report how many times he had beenput under police superintendent's discretionary scheme, probation orders or communityservice orders, or had been sent to penal institutions prior to the interview (or prior to theadmission to the residential drug treatment center or penal institution, if the respondentwas at the time of interview under the residential drug treatment, or if the respondent wasstill in penal institution). The higher the scores, the more the socially disadvantageousexperiences an adolescent has encountered.
Reflections on the Normalization Thesis
Normalization. A process in which deviant behaviors traditionally considered to be intol-
erable are increasingly accepted by the mainstream society.
Post-modernity. A new form of social order which differs from the previous modern form,
because of its intensification of globalizing tendency, decontextualization, risk culture,reflexivity of social life, and the degree to which it undercuts the potential of scientificknowledge as a single, grand, and overarching perspective.
Risks. Possibility of meeting danger and suffering loss, such as physical injury, psychological
problem, loss in life chances, and impairment of social life.
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Risk assessment. Cost–benefit decision-making with reference to risks.
Risk society mentality. Feeling of uncertainty and sense of personal control in changing
environments of a risk society.
Individualization. A process in which individualized decisions increasingly supersede the
rules and values of social collectivities (e.g., extended family, local community, andstatus groups), which are becoming inadequate for directing actions.
Social capital. Resources embedded in the structure of social relations that can be acquired
and used to achieve goals or facilitate social actions.
Allaste, A., Lagerspetz, M. (2002). Recreational drug use in Estonia: The context of club culture.
Contemporary Drug Problems 29:183–200.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological
Bandura, A. (1997). Self-efficacy in changing societies. Cambridge: Cambridge University Press.
Barabasi, A. L. (2002). Linked: The new science of networks. Cambridge, MA: Perscus.
Beck, U. (1992). Risk society: Towards a new modernity. London: Sage.
Beck, U., Beck-Gernsheim, E. (2002). Individualization: Institutionalized individualism and its social
and political consequences. London: Sage Publications.
Chan, H. M., Lee, R. P. L. (1995). Hong Kong families: At the crossroads of modernism and tradi-
tionalism. Journal of Comparative Family Studies 26(1):83–99.
Cheung, N. W. T. (2004). Social capital and individualization in the normalization of drug use among
adolescents in Hong Kong. Unpublished Ph.D. thesis, Department of Sociology, The ChineseUniversity of Hong Kong, Hong Kong.
Cheung, Y. W., Cheung, N. W. T. (2003). Social capital and risk level of posttreatment drug use:
Implications for harm reduction among male treated addicts in Hong Kong. Addiction Researchand Theory 11:145–162.
Cheung, Y. W., Ch'ien, J. M. N. (1996). Drug use and drug policy in Hong Kong: Changing patterns
and new challenges. Substance Use & Misuse, 31(11, 12):1573–1597.
Chiu, S. W. S. (2005). Rethinking youth problems in a risk society: Some reflections on working with
"youth-at-risk" in Hong Kong. In F. W. L. Lee (Ed.), Working with youth-at-risk in Hong Kong(pp. 97–112). Hong Kong: Hong Kong University Press.
Cieslik, M., Pollock, G. (Eds.). (2002). Young people in risk society: The restructuring of youth
identities and transitions in late modernity. England: Aldershot Ashgate.
Coleman, J. (1988). Social capital in the creation of human capital. American Journal of Sociology
Coleman, J. (1990). Foundations of social theory. Cambridge: Harvard University Press.
Cote, J. E. (2002). The role of identity capital in the transition to adulthood: The individualization
thesis examined. Journal of Youth Studies 5(2):117–134.
Courtwright, D. T. (2001). Forces of habit: Drugs and the making of the modern world. Cambridge:
Harvard University Press.
Cheung and Cheung
Duff, C. (2003). Drugs and youth cultures: Is Australia experiencing the "normalization" of adolescent
drug use? Journal of Youth Studies 6(4):433–446.
Duff, C. (2005). Party drugs and party people: Examining the "normalization" of recreational drug
use in Melbourne, Australia. International Journal of Drug Policy 16:161–170.
Egginton, R., Parker, H. (2002). From one-off triers to regular users: Measuring the regularity of
drug taking in a cohort of English adolescents (1996–1999). Addiction Research and Theory10(1):97–114.
Elder, G. H., Jr. (1997). Life trajectories in changing societies. In A. Bandura (Ed.), Self-efficacy in
changing societies (pp. 46–68). Cambridge: Cambridge University Press.
Emerson, E. (1992). What is normalization? In H. Brown H. Smith (Eds.), Normalisation: A reader
for the nineties (pp. 1–18). London: Routledge.
Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007
Evans, K. (2002). Taking control of their lives? Agency in young adult transitions in England and the
New Germany. Journal of Youth Studies 5(3):245–269.
Fung, A. C. W. (2005). Report on the 2004 survey of drug use among students. Submitted to theAction Committee Against Narcotics. Hong Kong: The Hong Kong Baplist University.
Fendrich, M., Johnson, T. (Eds.) (2005). Special issue on club drug epidemiology. Substance Use &
France, A. (2000). Towards a sociological understanding of youth and their risk-taking. Journal of
Youth Studies 3(3):317–331.
Fung, A.C.W. (2005). Report on the 2004 survey of drug use among students. Submitted to the Action
Committee Against Narcotics. Hong Kong: The Hong Kong Baptist University.
Furlong, A., Cartmel, F. (1997). Young people and social change: Individualization and risk in late
modernity. Buckingham: Open University Press.
Gamble, L., George, M. (1997). "Really useful knowledge": The boundaries, customs and folklore
governing recreational drug use in a sample of young people. In P. G. Erickson, D. M. Riley,Y. W. Cheung, & P. A. O'Hare (Eds.), Harm reduction: A new direction for drug policies andprograms (pp. 340–362). Toronto: University of Toronto Press.
Giddens, A. (1991). Modernity and self-identity: Self and society in the late modern age. Stanford,
CA: Stanford University Press.
Giddens, A. (2000). Runaway world: How globalisation is reshaping our lives. New York: Routledge.
Gottfredson, D. C. (2001). Schools and delinquency. Cambridge: Cambridge University Press.
Hagan, J., MacMillan, R., Wheaton, B. (1996). New kid in town: Social capital and the life
course effects of family migration on children. American Sociological Review 61:368–385.
Hagan, J., McCarthy, B. (1997). Mean streets: Youth crime and homelessness. Cambridge: Cambridge
University Press.
Hagan, J., Parker, P. (1999). A life-course capitalization theory of the intergenerational causes of
delinquency. Theoretical Criminology 3(3):259–286.
Hathaway, A. D. (1997a). Marijuana and lifestyle: Exploring tolerable deviance. Deviant Behavior
Hathaway, A. D. (1997b). Marijuana and tolerance: Revisiting Becker's sources of control. Deviant
Heimer, K., Matsueda, R. L. (1994). Role-taking, role commitment, and delinquency: A theory of
differential social control. American Sociological Review 59:365–390.
Henley, J. R., Adams, L. D. (1973). Marijuana use in post-collegiate cohorts: Correlates of use,
prevalence patterns, and factors associated with cessation. Social Problems 20(4):514–520.
Ho, D. K. L. (1999). The employment situation in post-industrial society: The way to survive for
youth. Journal of Youth Studies 2(2):14–27 (in Chinese).
Hunt, G., Evans, K. (2003). Dancing and drugs: A cross-national perspective. Contemporary Drug
Joe Laidler, K. (2005). The rise of club drugs in a heroin society: The case of Hong Kong. Substance
Use & Misuse 40:1257–1278.
Reflections on the Normalization Thesis
Kahneman, D., Slovic, P., Tverskey, A. (1982). Judgement under uncertainty: Heuristics and biases.
Cambridge: Cambridge University Press.
King, A. Y. C. (1985). The individual and group in Confucianism: A relational perspective. In D.
J. Munro (Ed.), Individualism and holism: Studies in Confucian and Taoist values (pp. 57–70).
Ann Arbor: Center for Chinese Studies, University of Michigan.
Lau, J. (2002). Report on the 2000 survey of drug use among students. Submitted to the Action Com-
mittee Against Narcotics. Hong Kong: Centre for Clinical Trial & Epidemiological Research,The Chinese University of Hong Kong.
Lau, S. K. (1984). Perception of authority by Chinese adolescents: The case of Hong Kong. Youth
and Society 15:259–284.
Leung, K., Fan, R. M. T. (1996). Adolescent delinquent behavior in Chinese societies. In S. Lau (Ed.),
Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007
Growing up the Chinese way: Chinese child and adolescent development (pp. 237–264). HongKong: The Chinese University Press.
Lin, N. (2001). Social capital: A theory of social structure and action. Cambridge: Cambridge Uni-
versity Press.
Lomas, J. (1998). Social capital and health: Implications for public health and epidemiology. Social
Science and Medicine 47:1181–1188.
Lyotard, J. F. (1984). The postmodern condition: A report on knowledge. Manchester: Manchester
University Press.
MacDonald, R. (1998). Youth, transitions and social exclusion: Some issues for youth research in the
UK. Journal of Youth Studies 1(2):163–176.
MacDonald, R., Marsh, J. (2003). Crossing the Rubicon: Youth transitions, poverty, drugs and social
exclusion. International Journal of Drug Policy 13:27–38.
Malbon, B. (1999). Clubbing: Dancing, ecstasy and vitality. London: Routledge.
McNulty, T. L., Bellair, P. E. (2003). Explaining racial and ethnic differences in adolescent vio-
lence: Structural disadvantage, family well-being, and social capital. Justice Quarterly 20(1):1–31.
Measham, F., Aldridge, J., Parker, H. (2001). Dancing on drugs: Risk, health and hedonism in the
British club scene. London: Free Association Books.
Measham, F., Newcombe, R., Parker, H. (1996). The normalization of recreational drug use amongst
young people in North-West England. Sociology 45(2):287–312.
Measham, F., Parker, H., Aldridge, J. (1998). The teenage transition: From adolescent recreational
drug use to the young adult dance culture in Britain in the mid-1990s. Journal of Drug Issues28(1):9–32.
Messner, S. F., Baumer, E. P., Rosenfeld, R. (2004). Dimensions of social capital and rates of criminal
homicide. American Sociological Review 69(6):882–903.
Miles, S. (2000). Youth lifestyles in a changing world. Buckingham: Open University Press.
Munn, P. (2000). Social capital, schools, and exclusion. In S. Baron, J. Field, T. Schuller (Eds.), Social
capital: critical perspectives (pp. 168–181). Oxford: Oxford University Press.
Narcotics Division. (1990). Central registry of drug abuse: Twenty-seventh report (1981–1990). Hong
Kong: Narcotics Division, Government Secretariat, Government of Hong Kong SAR.
Narcotics Division. (1991). 1990 survey on non-medical use of psychotropic substances among stu-
dents of secondary schools and technical institutes. Hong Kong: Narcotics Division, GovernmentSecretariat, Government of Hong Kong SAR.
Narcotics Division. (1993). 1992 survey on drug use among students of secondary schools and
technical institutes. Hong Kong: Narcotics Division, Government Secretariat, Government ofHong Kong SAR.
Narcotics Division. (1997). 1996 survey on drug use among students of secondary schools and
technical institutes. Hong Kong: Narcotics Division, Government Secretariat, Government ofHong Kong SAR.
Narcotics Division. (2000). Central registry of drug abuse: Forty-seventh report (1991–2000). Hong
Kong: Narcotics Division, Government Secretariat, Government of Hong Kong SAR.
Cheung and Cheung
Narcotics Division. (2004). Central registry of drug abuse: Fifty-third report (1994–2003). Hong
Kong: Narcotics Division, Government Secretariat, Government of Hong Kong SAR.
Parker, H. (2003). Pathology or modernity: Rethinking risk factor analyses of young drug users.
Addiction Research and Theory 11(3):141–144.
Parker, H., Aldridge, J., Measham, F. (1998). Illegal leisure: The normalization of adolescent recre-
ational drug use. London: Routledge.
Parker, H., Williams, L., Aldridge, J. (2002). The normalization of "sensible" recreational drug use:
Further evidence from the North West England longitudinal study. Sociology 36(4):941–964.
Pollan, M. (2001). The botany of desire: A plant's eye view of the world. New York: Random House.
Porter, R., Teich, M. (1995). Drugs and narcotics in history. Cambridge: Cambridge University Press.
Rock, P. (1973). Deviant behavior. London: Hutchinson.
Downloaded By: [Chinese University of Hong Kong] At: 06:03 2 February 2007
Sampson, R. J., Laub, J. H. (1997). A life-course theory of cumulative disadvantage and the stability
of delinquency. In T. P. Thornberry (Ed.),Advances in criminological theory, Volume 7: Devel-opmental theories of crime and delinquency (pp. 133–164). New Brunswick, NJ: TransactionPublishers.
Seaman, P., Sweeting, H. (2004). Assisting young people's access to social capital in contemporary
families: A qualitative study. Journal of Youth Studies 7(2):173–190.
Shildrick, T. (2002). Young people, illicit drug use and the question of normalization. Journal of Youth
Shiner, M., Newburn, T. (1997). Definitely, maybe not? The normalisation of recreational drug use
amongst young people. Sociology 31(3):511–529.
Shiner, M., Newburn, T. (1999). Taking tea with noel: The place and meaning of drug use in everyday
life. In N. South (Ed.), Drugs: Cultures, controls and everyday life (pp. 140–159). London: SagePublications.
South, N. (1999). Drugs: Cultures, controls and everyday life. London: Sage Publications.
Taylor, D. (2000). The word on the street: Advertising, youth culture and legitimate speech in drug
education. Journal of Youth Studies 3(3):333–352.
Teachman, J. D., Paasch, K., Carver, K. (1997). Social capital and the generation of human capital.
Social Forces 75:1343–1359.
(2000, November 13). Ecstasy: Happiness is. . a pill? Time 156(20).
United Nations International Drug Control Programme (UNIDCP). (2000). World drug report. Oxford:
Oxford University Press.
Wallace, C., Kovatcheva, S. (1996). Youth cultures and consumption in Eastern and Western Europe.
Youth and Society 28:189–214.
Weber, T. (1999). Raving in Toronto: Peace, love, unity and respect in transition. Journal of Youth
Wijngaart, V. D., Braam, R., Bruin, D. D., Fris, M., Maalste, N. J. M., Verbraeck, H. T. (1999). Ecstasy
use at large-scale dance events in the Netherlands. Journal of Drug Issues 29(3):679–702.
Williams, L., Parker, H. (2001). Alcohol, cannabis, ecstasy and cocaine: Drugs of reasoned choice
amongst young adult recreational drug users in England. International Journal of Drug Policy12:397–413.
Wright, J. P., Cullen, F. T. (2001). Parental efficacy and delinquent behavior: Do control and support
matter? Criminology 39(3):677–705.
Yang, K. S. (1995). Chinese social orientation: An integrative analysis. In T. Y. Liu, W. S. Tseng, E.
K. Yeh (Eds.), Chinese societies and mental health (pp. 19–39). Hong Kong: Oxford UniversityPress.
Zhang, J. X., Schwarzer, R. (1995). Measuring optimistic self-beliefs: A Chinese adaptation of the
general self-efficacy scale. Psychologia 38:174–181.
Ziersch, A. M. (2005). Health implications of access to social capital: Findings from an Australian
study. Social Science & Medicine 61(10):2119–2131.
Source: http://www.cheungkwokche.hk/sites/default/files/files/general/0904203.pdf
Finaledp
EVALUACIÓN CONJUNTA DE LA DECLARACIÓN DE PARÍS, FASE 2 COLOMBIA 31 de diciembre de 2010 Centro de Pensamiento Estratégico Internacional – Cepei- Grupo Coordinador Philipp Schönrock Coordinador General e-mail: [email protected] Juan Fernando Buchelli Coordinador Académico e-mail: [email protected] Asistente de Investigación
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