Adolescent-specific risk and protective factors of substance use among high school students in the United States: A cross-sectional study

Abstract

Objective: Substance use among U.S. adolescents is a critical public health concern. This study evaluates risk and protective factors for substance use among high school students. Methods: Using data from the 2022 National Survey on Drug Use and Health, a cross-sectional analysis of 6,072 high school students was conducted. Multivariable logistic regression analyzed associations between substance use (alcohol, tobacco, illicit drugs) and adolescent-specific factors, adjusting for sex, grade, health insurance, and poverty status. Results: Overall, 35.6% of students reported using alcohol, tobacco, or illicit drugs in the past year. Antisocial behavior significantly increased the odds of alcohol (AOR = 2.54, 95% CI = 2.02–3.19), tobacco (AOR = 2.36, 95% CI = 1.92–2.89), and illicit drug use (AOR = 2.66, 95% CI = 2.22–3.19; p < .001). Religious involvement reduced the odds of alcohol (AOR = 0.79, 95% CI = 0.64–0.97, p = .026), tobacco (AOR = 0.71, 95% CI = 0.56–0.90, p = .006), and illicit drug use (AOR = 0.59, 95% CI = 0.45–0.77, p < .001). Conclusions: One in three high school students reported substance use. Antisocial behaviors increase risk, while religious involvement offers protection. Interventions targeting these factors may reduce adolescent substance use.

Plain Language Summary

High school students in the U.S. face the effects of using substances like alcohol, tobacco, and illegal drugs. Our study looked at national survey data to understand how many high school students use these substances and what factors might influence their use. We found that about one in three high school students had used these substances in the past year, and the rate of use increased as students moved from freshman to senior year. Students who argued or fought with their parents, or who were involved in school or group fights, were more likely to use these substances. On the other hand, students who participated in religious activities or held religious beliefs tended to use fewer of these substances. Based on these findings, we believe it is important to create programs that help reduce negative behaviors, like fighting, and provide positive support for students, like participation in religious groups or other community-based programs. By focusing on reducing conflict and promoting healthy, supportive environments, schools and communities can work together to guide students toward better choices and improve their overall well-being.

Keywords

Adolescents substance use factors behavior

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