Perceptions of peer and parental attitudes toward substance use and actual adolescent substance use: The impact of adolescent-confidant relationships

Abstract

Objective: While peer influence is a well-documented risk factor for adolescent substance use, it remains unclear whether peer or parental attitudes have greater impact, and if this relationship is moderated by having a confidant and the relationship between adolescents and their confidant. Method: Pooled (2015–2018) National Survey on Drug Use and Health (NSDUH) data on adolescents (12–17 years) were used. Perceived peer and parental disapproval of tobacco, alcohol, and marijuana use were dichotomized. We assessed associations between disapproval and past-month tobacco (N = 51,352), alcohol (N = 51,407), and marijuana use (N = 51,355) using separate multivariable logistic regression models. We explored effect modification by the presence of a confidant, parental vs. non-parental disapproval, and peer vs. non-peer confidant relationship. Results: Peer and parental disapproval, presence of any confidant, and identifying a parental confidant were consistently protective against substance use; identifying a peer confidant increased odds of use across substances. For marijuana use, peer disapproval (adjusted odds ratio [aOR]: 0.07, 95% confidence interval [CI]: 0.06, 0.08) was more protective than parental disapproval (aOR: 0.13, 95% CI: 0.12, 0.15). The joint presence of peer/parental disapproval and any confidant decreased the odds of substance use beyond the individual effects of peer/parental disapproval and having a confidant. However, having a peer confidant attenuated the protective association between peer/parental disapproval and tobacco, alcohol, and marijuana use. Conclusions: Both peer and parental relationships are salient when considering the social context of adolescent substance use and should be considered when studying the effects of perceived disapproval.

Keywords:

• Social support
• marijuana use
• tobacco use
• adolescent health
• alcohol use

Acknowledgements

This work would not be possible without all NSDUH participants, to whom we are grateful for providing their time and effort

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

MEM: study conception, data analysis, writing, reviewing

NSL: data analysis, writing, reviewing

SSM: study conception, reviewing

Additional information

Funding

This work was supported by National Institutes of Health, National Institute on Drug Abuse grant R01DA037866 (PI: Martins) and T32DA031099 (PI: Hasin).