Fred Mettler commented that 20 years later: "The population remains largely unsure of what the effects of radiation actually are and retain a sense of foreboding. A number of adolescents and young adults who have been exposed to modest or small amounts of radiation feel that they are somehow fatally flawed and there is no downside to using illicit drugs or having unprotected sex. To reverse such attitudes and behaviours will likely take years, although some youth groups have begun programs that have promise." In addition, disadvantaged children around Chernobyl suffer from health problems that are attributable not only to the Chernobyl accident, but also to the poor state of post-Soviet health systems.