Investigating illicit drug use in adolescent students in England

Abstract The Smoking Drinking Drug Use Survey of adolescents aged 11 to 15 years living in England shows that lifetime drug use by adolescents aged 11 to 15 years has increased (15% to 24%) from 2014 to 2018 (NHS Digital, 2017, 2021b). This upward trend is despite the implementation of drug policies focused on reducing supply, possession, and manufacture of illicit drugs. Based on the premise that drug use is a socially learnt behaviour, the main objective of this research is to investigate whether social learning factors (imitation, parental reinforcement, peer association and attitudes to drug use) mediate drug use in adolescents aged 11 to 15 years living in England. The second objective is to identify which social learning factors mediate drug use by ages, region, and gender. Using the Social Structure Social Learning (SSSL) theory as a framework for the research, this study contributes to the literature by identifying a) the strongest social learning behaviour for each age, gender and region in England and b) the mechanism (mediation) by which social learning affects drug use. This research employs rich data on drug use drawn from the Smoking Drinking Drug Use Survey 2016, a cross-sectional survey of adolescents aged 11-15 years across England (as of October 2021 the data for the most recent survey 2018 was not available for analysis). Mediation analysis was used to evaluate which social learning factors mediate the association between age, gender, region and drug use. The results showed that there were differences in learning behaviours that were specific to age, gender and region. For example, the most significant social learning behaviour for drug use among boys was “imitation of friends”, whilst for females, it was “peer association” among females (i.e. having a perception that peers are using drugs). In addition, having “positive attitudes to glue” (i.e. “it is ok to try glue”) was the strongest learning behaviour for drug use among younger individuals (i.e. at ages 11 to 13). Furthermore, whilst in Northern England, the strongest learning behaviour was having “positive attitudes to cannabis”, in London peer association was found to be the strongest learning pathway to drug use. Family disapproval of drug use (“persuade me not to take drugs”) was found to be a protective factor against drug use for all ages except for age 11 and 12 years and those living in the East Midlands and London. In these cases, more authoritarian parenting –– strong parental disapproval (“stop me from taking drugs”) was found to be a protective factor. This research offers two main contributions to the literature. First, it shows empirical linkages between constructs built using SSSL theory that have not been previously explored within a population of young adolescents in England. Second, it identifies the effects and degree to which social learning affects the relationship between drug use and social structure. Overall, this research also contributes to an improved theoretical rationale for existing SSSL associations; that is, social learning can behave as a mediator or a moderator depending on the context. The evidence produced by this thesis could also have potentially relevant policy implications. More specifically, the differences in the social learning behaviours may suggest the need to implement more targeted prevention policies aimed by age, gender and regional groups of young adolescents