Substance Use Among Rural Adolescents

Background/Significance: Adolescent substance use is a pressing public health problem. Rates of alcohol, cigarette, and marijuana use increase throughout middle- and high-school resulting in multiple risk factors such as health problems, abuse of other drugs, impaired neurological development, risky sexual behaviors, and poor academic functioning. Research suggests that rural youth are a particularly vulnerable group and often use substances at an equivalent or higher rate relative to urban and suburban youth. However, there is a dearth of research on rural adolescent substance use. The current presentation aims to fill this research gap by uncovering forms of social capital (e.g., ethnic identity), social capital deprivation (e.g., parent-adolescent conflict), and anti-social capital (e.g., delinquent friends) that impact the use of alcohol, cigarette, and marijuana use in a sample of rural middle- and high-school students. It was hypothesized that social capital factors would be associated with decreased substance use while social capital deprivation and anti-social capital factors would be associated with increased substance use. 

Methods: The final analytic sample consisted of 7,081 racially/ethnically diverse adolescents. Data were collected using the School Success Profile Plus. Following multiple imputation, binary logistic regression examined the association between the probability of substance use and social capital, social capital deprivation, and anti-social capital factors. Generalized estimating equations adjusted for correlations within schools and false discovery rate adjustments were implemented.

Results: For middle school youth every one-unit increase in aggression or delinquent friends was associated with more than twice the odds of using alcohol, cigarettes, and marijuana (delinquent friends only). A one-unit increase in aggression was associated with a threefold increase in the odds of marijuana use. For high school youth every one-unit increase in aggression, delinquent friends, and neighborhood crime was associated with more than double the odds of using alcohol. A similar trend was found for cigarette and marijuana use.

Conclusion/Implications: In line with our hypothesis, neighborhood crime was significantly associated with an increased likelihood of using cigarettes and marijuana across age groups. Adolescents are impressionable; being surrounded by violence, crime, and substance use normalizes these behaviors, sending the message that anti-social behaviors are acceptable. Delinquent friends were significantly associated with an increased likelihood of substance use across ages. Delinquency and substance use often co-occur and adolescents mimic the behavior of their friends. Thus, youth who spend time with friends who engage in delinquency and substance use also engage in these behaviors.  Aggression was also associated with an increased likelihood of substance use across age groups. It is possible that using substances increases aggression. However, it is also possible that youth begin spending time with anti-social peers who gradually introduce them to deviant behavior starting with aggressive acts and moving onto more severe forms such as substance use. Findings suggest that substance use programs should emphasize the skills necessary to avoid or disengage from antisocial relationships. Although the findings across substances are consonant, further research should examine the concomitant use of multiple substances in this population to understand the role of different patterns of substance use.