Substance use disparities in adolescents of lower socioeconomic status: emerging trends in electronic cigarettes, alternative tobacco products, marijuana, and prescription drug use

2018-05-25Objective markers of socioeconomic status (SES), such as parental education, have demonstrated inverse associations with adolescent cigarette, alcohol, and marijuana use. However, the extent to which these associations generalize to new substances that are gaining popularity in youth (e.g., electronic cigarettes) are unknown. How someone subjectively perceives their social status relative to a larger group may also provide incremental information about SES not captured by objective measures. The current study examined associations of objective SES and subjective social status (SSS) with use of a wide range of substances (i.e., alcohol, combustible cigarettes, hookah, cigars, electronic cigarettes, marijuana, and prescription drugs) in a socioeconomically diverse sample of 11th grade students in Los Angeles, California. Participants (N = 2,166) completed semi-annual surveys assessing parental education, free or subsidized lunch, SSS (societal- and school-level), and substance use over one’s lifetime, in the past 6 months, and in the past 30 days. Utilizing polytomous logistic regression models that adjusted for covariates and SES variables, we found that lower objective SES was incrementally associated with increased odds of being a lifetime or recent user. Lower school-level SSS was incrementally associated with greater odds of being a current user of majority of the substances. Our findings provide evidence for varying patterns of association across objective SES and SSS dimensions with adolescent drug use. Policy-making, interventions, and educational efforts to increase prevention campaigns that reduce exposure to new, emerging drugs and increase access to substance-free activities may effectively reduce substance-related health disparities among socioeconomically disadvantaged adolescent populations