Youth's personal relationships, psychological symptoms, and the use of different substances: A population-based study

Combining family history and alcohol screening measures to identify emerging adults at risk of not being in education, employment, or training (NEET)

PURPOSE

Being outside of the labor and education system during young adulthood, a status termed not in education, employment, or training (NEET), is a risk factor for later social and health outcomes. This study examined whether parental substance use (PSU) moderates the relationship between personal alcohol consumption and NEET. Such information may inform screening practices.

METHODS

Participants included 2,940 respondents (15-25-year-olds) to a 2014 Danish national survey. In this historical cohort study, survey data were linked with register data on respondents' parents and follow-up register data on respondents' educational/employment status (2015-2018). The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) identified respondents with hazardous drinking. PSU was measured using survey and register data. Our outcome identified those who were NEET during 1 + years follow-up. Analyses included gender stratified multivariable logistic regressions.

RESULTS

Survey-based PSU was associated with higher odds of NEET (OR = 1.67, p <.001). An AUDIT-C + by survey PSU interaction was statistically significant for females (OR = 2.70, p =.007): AUDIT-C + females with survey PSU had higher odds of NEET than AUDIT-C + females without survey PSU. Results were similar using register PSU. For both genders, other parental factors (unemployment and psychiatric problems) were also associated with higher odds of NEET.

CONCLUSION

Using family history (including unemployment, psychiatric problems, and substance use) may enhance screening to identify emerging adults at risk of adverse social outcomes. Survey- and register-based PSU were similarly associated with NEET, suggesting that asking emerging adults about their parents' substance use may be as informative as more objective measures of family risk.

Risk factors for substance use in Swedish adolescents: A study across substances and time points

Aim: The public health model for prevention of disease and disorder has been influential in informing interventions regarding substance use. While a number of risk factors within this model have been found to predict substance use, few studies have explored the associations across substances, at different time points and in the same individuals. The aim of this study was to test this model across legal and illegal substance use among adolescents, and to identify potential changes in associations over time. Methods: Data from two waves of a nationally representative cohort study among Swedish adolescents were used. Baseline data were collected in 2017 (9th grade) with a follow-up in 2019 (11th grade). Using modified Poisson regression analyses, we explored cross-sectional associations between factors from different domains and prevalence of cigarette use, binge-drinking and illegal drug use at both baseline and follow-up. Results: The results in part supported the public health model. Substance use was predicted by factors within the family, school and the individual/peer domain, but several associations were not statistically significant. The only consistent risk factors across substances and time points were lack of parental monitoring, truancy and minor criminal activities. Conclusion: Despite widely different prevalence rates across substances, some risk factors were consistently associated with adolescent substance use. Nonetheless, the findings challenge the assumption that risk factors are stable over adolescence. They suggest a need for flexible prevention interventions spanning across substances and legal boundaries of substances, but also over domains to reflect the heterogenous needs of adolescents.