Cigarette Smoking, Mental Health, and Other Substance Use among Court-Involved Youth

Abstract

Background: Justice-involved youth are at risk to become cigarette smokers as they age, leading to a variety of poor health outcomes. However, little is known about cigarette use among justice-involved youth, especially youth supervised in the community where there is ample opportunity to smoke. Objective: This study investigates the prevalence of cigarette smoking and the associations between cigarette smoking, emotional and behavioral functioning, and other substance use among a sample of first-time offending court-involved, non-incarcerated (FTO-CINI) youth. Methods: Youth were recruited from a family court in the Northeast (N = 423). Substance use was self-reported using the Adolescent Risk Behavior Assessment (ARBA). Emotional and behavioral functioning was measured using the Behavior Assessment Schedule for Children-Second Edition (BASC-2), the Affect Dysregulation Scale (ADS), National Stressful Events Survey PTSD Short Scale (NSESSS), and the National Survey of Self-Reported Delinquency (NYS-SRD). Results: About 9.9% of FTO-CINI youth had smoked cigarettes in the past 30 days. Compared with FTO-CINI youth who had not smoked recently, recent smokers endorsed more emotional and behavioral symptoms, such as school problems (p < .001), internalizing problems (p = .012), inattention/hyperactivity (p = .020), affect dysregulation (p = .044), PTSD symptoms (p = .006), and delinquent behavior (p < .001). Recent smokers were also more likely to use alcohol (OR = 5.61, p < .001), marijuana (OR = 11.27, p < .001), and other drugs (OR = 5.00, p < .001). Conclusions: Recent smoking was higher among FTO-CINI youth than youth in the general population. Findings underscore the need to incorporate nicotine into existing substance use prevention interventions for this population, who are at high risk to initiate cigarette use as they age.

Keywords:

• Juvenile justice
• cigarette smoking
• mental health
• adolescent substance use

Acknowledgments

The authors extend their gratitude to the adolescents and families who participated in this study, to the collaborating juvenile court system and staff, as well as to Yu (Seashore) Li (Brown University School of Public Health) for her assistance with data management and Brandon Marshall (Brown University School of Public Health) for his assistance in variable creation. We also acknowledge Martha Shumway (University of California, San Francisco) for her consultation during data analysis.

Declaration of interest

Drs. Ramo and Hall have consulted to Carrot, Inc., which makes a tobacco cessation device; Dr. Hall is on their advisory board. Dr. Hall has also consulted for BioRealm, Inc.

Notes

1 Status petitions are those filed for an offense that is illegal because the youth is a minor (e.g. truancy, alcohol use).

2 Delinquency petitions are those filed for offenses that are illegal regardless of minor status (e.g. assault, possession of an illicit substance).

3 With some limited exceptions, a Certificate of Confidentiality (CoC) prohibits disclosure of participants’ identifiable information to parties not connected to the research study. The CoC is issued by the National Institutes of Health and prohibits disclosure of such information in response to legal demands (e.g., subpoena).

4 Lifetime cigarette smoking in the jurisdiction from where these youth were sampled is estimated to be approximately 18%, lower than the national average of 25.1% (Centers for Disease Control and Prevention, 2018).

Additional information

Funding

This work was supported by the National Institute on Drug Abuse (grant numbers T32DA007250; R01DA034538 and R01DA035231). The funding source had no involvement in study design, data collection, data analysis, interpretation of data, the writing of the report, or the decision to submit the article for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.