Risk factors for substance use in Swedish adolescents: A study across substances and time points

Abstract

Aim: The public health model for prevention of disease and disorder has been influential in informing interventions regarding substance use. While a number of risk factors within this model have been found to predict substance use, few studies have explored the associations across substances, at different time points and in the same individuals. The aim of this study was to test this model across legal and illegal substance use among adolescents, and to identify potential changes in associations over time. Methods: Data from two waves of a nationally representative cohort study among Swedish adolescents were used. Baseline data were collected in 2017 (9th grade) with a follow-up in 2019 (11th grade). Using modified Poisson regression analyses, we explored cross-sectional associations between factors from different domains and prevalence of cigarette use, binge-drinking and illegal drug use at both baseline and follow-up. Results: The results in part supported the public health model. Substance use was predicted by factors within the family, school and the individual/peer domain, but several associations were not statistically significant. The only consistent risk factors across substances and time points were lack of parental monitoring, truancy and minor criminal activities. Conclusion: Despite widely different prevalence rates across substances, some risk factors were consistently associated with adolescent substance use. Nonetheless, the findings challenge the assumption that risk factors are stable over adolescence. They suggest a need for flexible prevention interventions spanning across substances and legal boundaries of substances, but also over domains to reflect the heterogenous needs of adolescents.

Digital screens and children

“…The study shows that for many tobacco users buying tobacco became more expensive and that the taxes on tobacco to a greater extent remained in force. Dennermalm et al (2022) found that some risk factors are consistently associated with adolescent substance use, but their findings challenge the assumption that risk factors are stable over adolescence. The last research report in this issue is a psychometric evaluation of a Swedish version of the Impaired Control Scale for Individuals with Alcohol Use Disorder by Ingesson et al (2022).…”

Parenting Practices and Psychosomatic Complaints Among Swedish Adolescents

“…Parental support was measured with the statements: “I can easily get warmth and caring from my mother and/or father” and “I can easily get emotional support from my mother and/or father”. The statements for parental knowledge were: “My parent(s) know who I am with in the evenings” and “My parent(s) know where I am in the evenings.” Parental rule-setting was assessed with the statements “My parent(s) set definite rules about what I can do at home,” and “My parent(s) set definite rules about what I can do outside the home.” For each statement, there were five response alternatives: 5 = “Almost always,” 4 = “Often,” 3 = “Sometimes,” 2 = “Seldom,” and 1 = “Almost never.” Composite measures were created for the three scales by calculating mean scores based on answers to each pair of statements [ 51 , 52 ]. Each scale consequently represented an overall score for mother and/or father parenting practices, which is a common approach in parenting research [ 53 , 54 ].…”

“…For each statement, there were five response alternatives: 5 = "Almost always," 4 = "Often," 3 = "Sometimes," 2 = "Seldom," and 1 = "Almost never." Composite measures were created for the three scales by calculating mean scores based on answers to each pair of statements [51,52]. Each scale consequently represented an overall score for mother and/or father parenting practices, which is a common approach in parenting research [53,54].…”

School attendance problems and absenteeism as early warning signals: review and implications for health-based protocols and school-based practices

“…Substance use and its disorders are also deeply entwined with school absenteeism, with the literature base primarily focused on marijuana/cannabis, tobacco, alcohol, and use of multiple substances (Gakh et al, 2020). Possible mechanisms specific to this relationship include missing school to engage in substance use and other risky behaviors, less supervision/monitoring, less self-control, stress, criminality, and self-medication for emotional and sleep disorders (Kiani et al, 2018;Dennermalm et al, 2022). The relationship between substance use and school absenteeism is likely quite complex, however, intersecting with family substance use, maltreatment, race/ethnicity, poverty, interaction with the juvenile justice system, and other broader variables (Maynard et al, 2017;Iverson et al, 2018).…”