Adolescent Substance Use Among High School Students Before and After the Covid-19 Pandemic
A Repeated Cross-Sectional Study of Peer Exposure and Risk
Bibliographic Data
Background The COVID-19 pandemic disrupted schooling for many during the middle-to-high school transition, a critical period for initiation of substance use. This study examines how reduced in-school peer exposure was associated with substance use patterns among ninth and tenth graders before and after the pandemic.Objectives To examine the relationship between differential in-school peer exposure to substance use patterns among ninth and tenth graders before and after the pandemic.Methods We conducted a repeated cross-sectional study of ninth and tenth graders (total N = 2,024) from a large US high school, using annual in-school survey data from 2017–2019 (N = 1,550) and 2023 (N = 474). We compared substance use prevalence and risk factors pre- and post-pandemic.Results The pre-pandemic sample was 48% boys and the post-pandemic sample was 57% boys. Ninth graders (one year less exposure to in-school peers) had significant declines pre- to post-pandemic in 30-day alcohol use (13% to 7%), 30-day e-cigarette use (12% to 7%), lifetime alcohol use (31% to 20%), lifetime marijuana use (18% to 10%), and lifetime e-cigarette use(23% to 13%). Tenth graders (one additional year of in-school peer exposure) did not experience similar declines. Perceived substance use accessibility increased among ninth graders pre- to post-pandemic (mean risk perception score: 3.18 to 3.33, p < 0.05).Conclusions Less in-school peer exposure during a critical developmental period was associated with reduced substance use initiation and progression. These findings highlight the importance of in-school exposure to peers in adolescent substance use trajectories. Future research should investigate specific mechanisms of peer influence—such as substance availability on campus—to inform targeted prevention and early intervention strategies
Peer group · Peer influence · Peer relations · Peer review · Substance abuse · Substance use · Young adult · Bullying, Victimization, and Aggression · Child and Adolescent Psychosocial and Emotional Development · Substance Abuse Treatment and Outcomes
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