Substance Use and School Characteristics in Lesbian, Gay, Bisexual, and Heterosexual High School Students

Abstract

BACKGROUND Tobacco, alcohol, and illicit drug use among lesbian, gay, and bisexual (LGB) high school students as well as related environment and school‐level risk and protective factors were examined. METHODS Data was acquired from the 2015 CDC's Youth Behavior Risk Survey for Kentucky (N = 2577). Prevalence of substance use was calculated for all high school respondents by reported sexual orientation. Multivariate analyses estimated the relationship between school and environmental‐level factors (eg, having an adult to talk to) and tobacco, alcohol, and illicit drug use via logistic regressions. Sexual orientation, gender, age, and race/ethnicity were covariates. RESULTS LGB students used tobacco, alcohol, and illicit drugs more frequently than their heterosexual counterparts. More LGB teens report facing school risk factors (eg, 37% LGB vs 20% heterosexual bullied at school, p ≤ .001; 17% LGB vs 5% heterosexual ever threatened or injured at school, p < .001; 13% LGB vs 7% heterosexual involved in a school fight, p = .001). Adjusting for school related risk factors, having an adult to talk to was associated with a reduced likelihood of daily smoking (adjusted odds ratio [aOR]: 0.43; 95% confidence interval [CI]: 0.26–0.73), past 30‐day alcohol use (aOR: 0.71; 95% CI: 0.50–0.95), and ever marijuana use (aOR: 0.71; 95% CI: 0.50–1.00). CONCLUSION Innovative strategies are needed to create safe, supportive school environments. These strategies are particularly needed in predominately rural states like Kentucky.

Tobacco use and mental health disparities in LGB youth

“…There is a well‐documented history of tobacco use disparities between lesbian, gay, and bisexual (LGB) youth and their heterosexual counterparts (Fallin‐Bennett & Goodin, 2019; Fish et al., 2019; Watson et al., 2018). These disparities have been attributed to various factors at the individual, family, and community level.…”

Mental health disparities and high‐risk alcohol use among non‐heterosexual high school students

“…Research shows that positive adult‐child relationships serve as a protective factor against a variety of negative mental health outcomes including youth suicide, risky sexual behavior, perpetuating and being victimized by bullying, and anxiety and depression . Similarly, the presence of a supportive adult relationship is a protective factor against cigarette smoking, alcohol use, and substance use . Lack of positive adult relationships may particularly be a risk factor for LGB youth because they tend to have poorer relationship quality with parents .…”

Intersectional Differences in Protective School Assets by Sexuality, Gender, Race/Ethnicity, and Socioeconomic Status

“…Moreover, research can elucidate how the differences in protective school assets from our study contribute to known disparities in educational and health outcomes for minority groups. Sexual and gender minority populations face great disparities in a variety of preventable health risk behaviors, from substance use 39‐41 and mental health problems 42,43 to educational outcomes 44,45 . Racial and ethnic minorities as well as sexual and gender minorities are disproportionately impacted in schools 46,47 .…”