Sexual Minority Disparities in Substance Use Willingness Among Youth

BACKGROUND

Disparities in substance use have been observed in sexual minority youth, but less is known about willingness to use substances, an important precursor to actual use.

OBJECTIVE

The goal of this study was to examine willingness to use cigarettes, alcohol, and marijuana among sexual minority youth compared to their non-sexual minority counterparts using both cross-sectional and longitudinal data.

METHODS

The present study drew on two waves (Times 1 and 2; 6 months apart) of data collected during high school as part of a prospective study of substance use initiation and progression in Rhode Island. At Time 1, participants (N = 443) ranged in age from 15 to 20 years (M age = 16.7 years, 26.6% sexual minority, 59.5% female, 72.0% White). Participants self-reported their sexual identity and attraction, lifetime use of alcohol, cigarettes and marijuana, and cigarette, alcohol, and marijuana use willingness (i.e., if offered by a best friend or group of friends).

RESULTS

In cross-sectional multivariate regression models, sexual minority youth were more likely to report willingness to use cigarettes (p <.05) and marijuana (p <.01) compared to their non-sexual minority counterparts. Longitudinal multivariate regression models revealed that sexual minorities were only significantly more likely to report cigarette willingness at Time 2 compared to their non-sexual minority counterparts (p <.01). There were no significant differences in alcohol use willingness in multivariable cross-sectional or longitudinal models by sexual minority status.

CONCLUSIONS

Sexual minority youth reported more willingness than non-sexual minority youth to use substances offered by peers; however, longitudinal analyses revealed that peers appear to play a role only in willingness to smoke cigarettes for these youth, and thus peer influence may be a contributing factor in explaining tobacco-related disparities among sexual minority youth. Given that stigma and peer groups may a particular risk factor for tobacco among sexual minority youth, our findings highlight the importance of prevention programs such as social marketing approaches that correct social norms, reduce stigma, and provide refusal-skills training to reduce tobacco-related disparities among sexual minorities.

Associations Between Physical and Relational Forms of Peer Aggression and Victimization and Risk for Substance Use Among Elementary School-Age Youth

This study examined associations between physical and relational forms of aggression and victimization and risk for willingness to engage in substance use and actual use in a sample of 231 (50% Male) 2nd thru 4th grade students (Mean age = 8.3 years). Physical aggression was more strongly associated with risk for substance use outcomes than physical victimization. Neither relational aggression nor victimization were linked to risk for substance use. Specifically targeting physical aggression for the prevention of early substance use among elementary school-age youth appears to be warranted.