“…While adolescent substance use has been well-studied [32][33][34], the impact of adolescent substance use on the children of adolescent parents is less well established in the literature and future research is needed to determine the effects of adolescent parent tobacco, alcohol and marijuana use on the adolescent's child. Our cross-sectional findings may reflect increasing and decreasing trajectories in substance use across development based on the age, gender, and race [35], sexual orientation [36], sexual involvement [37], and due to the life stresses, potentially such as of having young children [38,39], found among adolescents. Future longitudinal studies of these young parents in the ED would better characterize these relationships.…”