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Adolescent Adversity and Concurrent Tobacco, Alcohol, and Marijuana Use

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Adolescent health behaviors may be linked to elevated morbidity and mortality in adulthood. This study examines relationships between broad concepts for adverse childhood experiences (ACEs) and adolescent substance use outcomes among youth participating in a statewide, school-based survey.


Data are from 8th, 9th, and 11th graders participating in the 2016 Minnesota Student Survey (N = 126,868). Logistic regression was used to determine whether 10 types of adversity related to abuse, household dysfunction, and food and housing hardship, and 7 types of bully victimization were associated with youth tobacco, alcohol, and marijuana use after adjustment for demographics, risk perceptions, academic engagement, parent communication, self-esteem, and health perceptions.


Individual and cumulative measures for adversity were significantly associated with youth increased odds of early substance initiation, binge drinking, and daily tobacco, alcohol, and marijuana use, even with adjustment for demographics and other contextual factors.


Findings suggest a significant link between broad concepts for ACEs and adolescent tobacco, alcohol, and marijuana use. Consideration of information related to ACEs may inform timing and content of substance use prevention and intervention activities directed at youth.
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Keywords: adolescent health; adverse childhood experiences (ACEs); binge drinking; bully victimization; marijuana use; tobacco use

Document Type: Research Article

Affiliations: Division of General Pediatrics and Adolescent Health, University of Minnesota Department of Pediatrics, Minneapolis, MN.

Publication date: 01 September 2018

More about this publication?
  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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