Adolescent Adversity and Concurrent Tobacco, Alcohol, and Marijuana Use

Objectives: Adolescent health behaviors may be linked to elevated morbidity and mortality in adulthood. This study examines relationships between broad concepts for adverse childhood experiences (ACEs) and adolescent substance use outcomes among youth participating in a statewide, school-based survey. Methods: Data are from 8th, 9th, and 11th graders participating in the 2016 Minnesota Student Survey (N = 126,868). Logistic regression was used to determine whether 10 types of adversity related to abuse, household dysfunction, and food and housing hardship, and 7 types of bully victimization were associated with youth tobacco, alcohol, and marijuana use after adjustment for demographics, risk perceptions, academic engagement, parent communication, self-esteem, and health perceptions. Results: Individual and cumulative measures for adversity were significantly associated with youth increased odds of early substance initiation, binge drinking, and daily tobacco, alcohol, and marijuana use, even with adjustment for demographics and other contextual factors. Conclusions: Findings suggest a significant link between broad concepts for ACEs and adolescent tobacco, alcohol, and marijuana use. Consideration of information related to ACEs may inform timing and content of substance use prevention and intervention activities directed at youth.