THURS-008 - Perceived Racial Discrimination and Age of Onset for Cigarette, Alcohol, and Marijuana Use in Adolescents

Brief Abstract Summary: Discover the link between perceived racial discrimination and the age of onset for cigarette, alcohol, and marijuana use in a nationally representative sample of U.S. adolescents. In this project, a sample of 7,705 U.S. high school students who completed the 2021 Adolescent Behaviors and Experiences Survey were studied. Analyses revealed that adolescents who experienced any form of lifetime perceived racial discrimination had higher odds of initiating cigarette, alcohol, and marijuana use before age 13. Additionally, adolescents who identified as gay or lesbian also had increased odds of early initiation for all three substances. Adolescents facing racial discrimination or identifying as sexual minorities are at greater risk of early substance use, raising health concerns in adolescence and adulthood. These psychosocial factors should be further explored. Public health practitioners should address perceived racial discrimination in early adolescence or child-focused interventions.

Detailed abstract description:

Objectives: Early initiation of substance use among adolescents has been linked to significant social and health concerns including lower educational attainment, elevated sexual health risks, increased risk for addictions, and mental health concerns. High levels of psychosocial stress have been associated with increased risk for substance use among adolescents, including experiences of perceived racial discrimination which is operationally defined as one’s subjective experiences of unfair treatment due to their race or ethnicity. This study explored the relationship of perceived racial discrimination and age of initiation for alcohol, cigarette, and marijuana use among a nationally representative sample of U.S. adolescents.

Methods: Data was analyzed from the 2021 Adolescent Behaviors and Experiences Survey which was administered to students (N = 7705) in 128 U.S. high schools. A series of bivariate logistic regressions were performed to explore the relationship between demographic variables (age, sex, race/ethnicity, sexual identity), perceived racial discrimination, and initiation age of cigarette smoking, alcohol, and marijuana. Key measures of interest in this study included perceived racial discrimination and age of initiation for cigarette, alcohol, and marijuana use, with specific interest on age of onset below 13 years old.

Results: Among participants, 6.1% reported their first cigarette smoking experience before age 13, 11.9% reported their first drink of alcohol before age 13, and 3.7% reported their first marijuana use before age 13. Most participants reported never experiencing perceived racial discrimination (62.5%) while 20.1% reported rarely experiencing it and 17.0% reported experiencing it sometimes, most of the time, or always. Odds of initiating all three substance use behaviors (cigarette, alcohol, marijuana) before age 13 were increased among participants who reported experiencing any level of perceived racial discrimination compared to those who reported never experiencing perceived racial discrimination. When examining demographic variables, participants who identified as gay or lesbian experienced increased odds of early onset use of all three substances.

Conclusions: Adolescents experiencing perceived racial discrimination, as well as sexual minority youth, report a higher likelihood of early onset cigarette, alcohol, and marijuana use compared to their peers. Early onset substance use increases health risks for youth during both adolescence and adulthood. The psychosocial relationship between perceived racial discrimination and behavioral intentions, particularly among adolescents, should be further explored in public health research and practice.