While general substance abuse among American adolescents is dropping, there is an upward spiral in cannabis and vaping use, a Columbia University Mailman School of Public Health study has found, with the findings showing that low social engagement and participation in structured activities could be the overall best predictors of substance abuse avoidance.
The results were published online in the journal Substance Use and Misuse.
After examining data from 536 291 adolescents between 1991–2019, researchers said that while the reasons for this phenomenon are not entirely clear, they appear to correlate to various other social factors, including increased parental monitoring and decreased partying and dating notable among them.
Lead author Noah Kreski, MPH, in the Department of Epidemiology at Columbia Mailman School, said several demographic factors seem to link to increased substance abuse, even today.
“Substance use prevalence decreases across decades were largest for the groups defined by significant paid employment or high levels of social time, either with low engagement in other activities or lower levels of supervision, though these groups had the highest initial prevalence of each variety of substance use,” he said.
Using data from the National Institute on Drug Abuse (NIDA)’s Monitoring the Future survey the researchers tracked trends in use of cigarettes, alcohol, cannabis, vaping of both nicotine and cannabis, and other substances for school-age student in grades 8 (13-14 years-old), 10 (15- 16 years-old) and 12 (17–18 years old), and cross-referenced these habits against demographic factors like level of social engagement, participation in structured activities, level of adult supervision, and employment. They further analysed these patterns across race, sex and parental education, along with other demographics.
Conversely, substance abuse was higher overall in the highly social and highly engaged groups with less supervision. Time at a paid job was also a significant factor in increasing the chances of trying illicit substances.
Cannabis use increased among all groups, but especially among adolescent workers.
Nicotine vaping increased the most among the highly social and engaged group that was less supervised, and cannabis vaping increased most among social but disengaged teens.
“Social settings where adolescents interact with peers, at parties, for example, provide opportunities for substance use, especially in the absence of adult supervision,” Kreski says. “These social settings may produce peer pressure for adolescents to engage in substance use in order to fit in.”
This may be particularly true of employed adolescents, who regularly interact with older teens and adults. Employed adolescents often come from lower income brackets and are thus propelled into an early “pseudo-adulthood”, leading them to adopt the habits more typical of people older than they are. Further, cannabis users particularly appear to seek out other cannabis users, leading to social circles in which the drug plays a significant role. Vaping was similarly correlated to social influence.
Analysing the data further, results show:
• 15% of respondents reported any past two-week binge drinking
• 27% drank alcohol in the past month
• 15% of adolescents smoked cigarettes in the past month
• 13% reported any past-month cannabis use
• 9% percent reported past-month use of other substances
• 12% reported nicotine vaping
• 6% reported cannabis vaping from 2017 onward.
In summary, Kreski noted: “Uncovering these links between complex patterns of time use and substance use outcomes could reveal new opportunities for intervention and education of adolescents surrounding substances, helping to promote declines in use.
“Taken together, while the prevalence of substance use varied drastically between the groups, the trends in substance use were relatively consistent across groups. Further research is needed to investigate the factors driving these universal trends.”
The authors suggest that various peer-led and community-based programmes may help reduce use across a broad spectrum of adolescent demographics. They urge further examination of mental health conditions that may lead to substance abuse.
Study details
Adolescents’ Use of Free Time and Associations with Substance Use from 1991 to 2019
Noah Kreski, Magdalena Cerdá, Qixuan Chen, Deborah Hasin, Silvia Martins, Pia Mauro et al.
Published in Substance Use and Misuse on 20 September 2022
Abstract
Background
Understanding time trends in risk factors for substance use may contextualise and explain differing time trends in substance use.
Methods
We examined data (N = 536,291; grades 8/10/12) from Monitoring the Future, years 1991-2019. Using Latent Profile Analyses, we identified six time use patterns: one for those working at a paid job and the other five defined by levels of socialisation (low/high) and engagement in structured activities like sports (engaged/disengaged), with the high social/engaged group split further by levels of unsupervised social activities. We tested associations between time use profiles and past two-week binge drinking as well as past-month alcohol use, cigarette use, cannabis use, other substance use, and vaping. We examined trends and group differences overall and by decade (or for vaping outcomes, year).
Results
Prevalence of most substance use outcomes decreased over time among all groups. Cannabis use increased, with the largest increase in the group engaged in paid employment. Vaping substantially increased, with the highest nicotine vaping increase in the high social/engaged group with less supervision and the highest cannabis vaping increase in the highly social but otherwise disengaged group. Substance use was lowest in the low social groups, highest in the high social and employed groups.
Conclusions
While alcohol, cigarette, and other substance use have declined for all groups, use remained elevated given high levels of social time, especially with low engagement in structured activities or low supervision, or paid employment, cannabis use and vaping are increasing across groups, suggesting the need for enhanced public health measures.
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