Changes in young adult substance use during COVID-19 as a function of ACEs, depression, prior substance use and resilience

Abstract

Background: Given the potential for increased substance use during COVID-19, we examined (1) young adults’ changes in cigarette, e-cigarette, marijuana, and alcohol use from pre- to during COVID-19; and (2) related risk/protective factors. These findings could inform intervention efforts aimed at curbing increases in substance use during periods of societal stress. Methods: We analyzed Wave 3 (W3; September–December 2019) and Wave 4 (W4; March–May 2020) from the Vape shop Advertising, Place characteristics and Effects Surveillance (VAPES), a 2-year, five-wave longitudinal study of young adults across six metropolitan areas. We examined risk/protective factors (i.e. adverse childhood experiences [ACEs], depressive symptoms, resilience) in relation to changes in past 30-day substance use frequency. Results: In this sample (N = 1084, M_age=24.76, SD = 4.70; 51.8% female; 73.6% White; 12.5% Hispanic), W3/W4 past 30-day use prevalence was: 29.1% cigarettes (19.4% increased/26.4% decreased), 36.5% e-cigarettes (23.2% increased/28.6% decreased), 49.4% marijuana (27.2% increased/21.2% decreased), and 84.8% alcohol (32.9% increased/20.7% decreased). Multivariate regressions indicated that, greater increases were predicted by: for e-cigarettes, greater ACEs; and for alcohol, greater depression. Among those with low resilience, predictors included: for e-cigarettes, greater depression; and for marijuana, greater ACEs. Conclusions: Interventions to reduce substance use during societal stressors should target both risk and protective factors, particularly resilience.

Keywords:

• COVID-19
• e-cigarettes
• substance use
• depression
• ACEs
• resilience

Disclosure statement

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

Author contributions

Berg and Crawford designed the study and wrote the protocol. Berg and Romm led the conceptualization of these analysis. Romm led the analysis and the writing of the first draft of the manuscript. Patterson, Posner, West, and Wedding assisted with data analysis. Berg and Crawford contributed additional components to the manuscript. All authors contributed to and have approved the final manuscript.

Additional information

Funding

This publication was supported by the US National Cancer Institute [R01CA215155-01A1; PI: Berg]. Dr Berg is also supported by other US National Cancer Institute funding [R01CA179422-01; PI: Berg; R01CA239178-01A1; MPIs: Berg, Levine], the US National Institutes of Health/Fogarty International Center [1R01TW010664-01; MPIs: Berg, Kegler], and the US National Institute of Environmental Health Sciences/Fogarty International Center [D43ES030927-01; MPIs: Berg, Marsit, Sturua].