Exploring Risk and Protective Factors for Alcohol and Tobacco Use Among Youth: An Innovative Approach

Most recent data from the Youth Risk Behavior Survey (YRBS; 2013) suggest that 41% of youth have ever tried cigarettes, and 66.2% have ever tried alcohol. Targeted public health interventions are desperately needed for this at risk population. The purpose of the secondary analysis study using YRBS data from 2011 was to use an innovative segmentation approach, chi-squared automatic interaction detection (CHAID) to identify unique segments at risk for and protected from tobacco and alcohol use to inform future public health efforts. The sample comprised 2,613 youth in middle school from racially diverse backgrounds. The segment most at risk for current cigarette smoking were those youth who used cigarettes to cope with stress. The segment protected from cigarette use comprised youth who disagreed that smoking reduced stress and felt good about saying no to tobacco use. The segment most at risk for having consumed alcohol in the past thirty days was comprised of those who thought those who used did more poorly in school, agreed that alcohol use reduced stress, and made Ds in school. The segment most protected from alcohol use comprised those who believed alcohol made youth do poorly in school, alcohol did not reduced stress, and made higher grades in school. Classification accuracy for both test models exceeded 70%. All results were significant at or below the p=.05 level. Results suggest a variety of complex interactions determine past thirty day tobacco and alcohol use. Prevention programming recommendations will be made