Family, Peer and School Influence on Substance Use and Initiation Patterns in Portuguese Adolescents

Background: Adolescence is a critical period of social and cognitive development, as well as a period of vulnerability to substance use and other health risk behaviors. The interaction between family, peer and school factors influence adolescence substance use and initiation patterns.

Objectives: The present study aims to define patterns of substance use and initiation and identify its predictors in adolescents.

Methods: Data from the Portuguese ‘Health Behavior in School-aged Children (HBSC)’ 2010 study were analyzed, including 1551 students (mean age=15.46; 14.58-16.42; 56.3% female). A latent class regression analysis was used to identify patterns of substance use and assess the influence of ecological factors.

Results: Five latent classes were identified, namely non-users (32.9%), alcohol experimenters (33.2%), alcohol and tobacco experimenters (19.2%), alcohol and tobacco frequent users (11.2%), and very early substance/poly-substance users (3.5%). Very early substance use class membership was associated with poor communication with mother, early sex, and spending evenings with friends, while alcohol and tobacco frequent use class membership was associated with higher socioeconomic status, not living with both parents, bullying others, fighting, early sex and spending evenings with friends compared to the non-users class.

Conclusion: Compared to the non-users latent class, very early substance users and frequent substance users latent classes were associated with different family and peer factors. These results may inform prevention strategies in adolescent substance use.