Abstract
BackgroundAdolescence is a critical period of vulnerability to substance use. Recent research has shown that gender differences in adolescence substance use are complex and in constant flux. The present study aims to investigate gender differences in substance use and initiation patterns in male and female adolescents, and to assess individual, family, peer, and school associated factors of these patterns.MethodsWe applied latent class regression analysis to a Portuguese representative population sample of 1551 15-year-old adolescents, drawn from the 2010 ‘Health Behavior in School-Aged Children’ survey, to characterise different profiles of substance use and initiation for boys and girls, and to identify factors associated with latent class membership, stratifying the associations analysis by gender.ResultsThree common classes were found for both genders, specifically, Non-Users (boys [B] 34.42%, girls [G] 26.79%), Alcohol Experimenters (B 38.79%, G 43.98%) and Alcohol and Tobacco Frequent Users (B 21.31%, G 10.36%), with two additional unique classes: Alcohol Experimenters and Tobacco Users in girls (18.87%), and Early Initiation and Poly-Substance Users in boys (5.48%). Poor school satisfaction, bullying, fighting and higher family affluence scale score formed a common core of associated factors of substance use, although we found gender differences in these associations. In girls, but not in boys, family factors were associated with more problematic substance use. Not living with both parents was associated with girl’s Alcohol and Tobacco Frequent Users (gATFU) class (OR 3.78 CI 1.18–12.11) and Alcohol Experimenters and Tobacco Users (AETU) class (OR 3.22 CI 1.4–7.44). Poor communication with mother was also associated with gATFU class membership (OR 3.82 CI 1.26–11.53) and AETU class (OR 3.66 CI 1.99–6.75). Additionally, a higher psychological symptoms score was associated with gATFU class membership (OR 1.16 CI 1.02–1.31).ConclusionAlthough we found common patterns and associated factors between boys and girls, we report two unique patterns of substance use in boys and girls and specific associations between family, school and peers, and individual factors with these patterns. These findings underscore the need for substance use prevention and health promotion programmes that address potential differences in substance use patterns and associated factors.
Highlights
Adolescent substance use is an important modifiable risk behaviour, with significant immediate and lasting adverse health and social consequences
We focused on 15-year-olds, n = 1553, because the substance use prevalence tends to increase with age and gender differences are more pronounced during late adolescence and adulthood compared with early adolescence [10]
full-information maximum likelihood (FIML) approaches cannot handle missingness on the Characteristics of the sample Tables 1 and 2 report descriptive statistics of adolescents included in this study, including substance use measures and covariates, stratified by gender
Summary
Adolescent substance use is an important modifiable risk behaviour, with significant immediate and lasting adverse health and social consequences. Adolescence is a critical period of psychological, social and cognitive development, as well as a period of increased vulnerability to substance use, delinquency and sexual risk behaviours. There are gender differences in adolescent substance use. A review focusing on risk factors influencing drinking progression among adolescents suggests that boys are more vulnerable to substance use because of social factors like higher tolerance, social expectation in use, and higher influence of parental drinking, while girls display higher permeability to parental control [10]. Recent research has shown that gender differences in adolescence substance use are complex and in constant flux. The present study aims to investigate gender differences in substance use and initiation patterns in male and female adolescents, and to assess individual, family, peer, and school associated factors of these patterns
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