“…Early initiation of substance use often leads to addiction in adulthood (Phillips et al, 2021; US Department of Health and Human Services, 2016) and is associated with other negative physical and mental health outcomes such as cancer, cardiac disorder, visual impairment, depression, and anxiety (Carrano, 2012; Hussain et al, 2023; US Department of Health and Human Services, 2022). Adolescent substance use has also been found to be associated with risky behaviours including violent or delinquent acts (Hoeben et al, 2021; Walters, 2022), riding with a driver under the influence of alcohol (Sharp et al, 2019), drunk driving (Ewing et al, 2015), weapon carrying (Baiden et al, 2021; Laufer et al, 2006), and unsafe sex (Quinn et al, 2023; Voisin et al, 2013). Therefore, it is particularly important to understand adolescent substance use, as the median age of onset for drug use has been found to be around age 15 years (Holmstedt et al, 2020; Swendsen et al, 2012).…”