Predictors of Substance Use Among Young Adults Transitioning Away from High School: A Narrative Review

Abstract

Background: Young adulthood has been shown to be a time of increased substance use. Yet, not enough is known about which factors contribute to initiation and progression of substance use among young adults specifically during the transition year away from high school. Objectives: A narrative review was undertaken to increase understanding of the predictors of changes in use of tobacco, alcohol, cannabis, other illicit drugs, and mental health problems among young adults during the transition period after high school. Methods: A review of academic literature examining predictors of the use of tobacco, alcohol and cannabis, and co-morbidities (e.g., co-occurring substance use and/or mental health issues) among young adults transitioning from high school to post-secondary education or the workforce. Results: Twenty six studies were included in the review. The majority of the studies (19) examined substance use during the transition from high school to post-secondary settings. Seven studies examined substance use in post-secondary settings. The studies consistently found that substance use increases among young adults as they transition away from high school. During the transition away from high school, common predictors of substance use include substance use in high school, and peer influence. Common predictors of substance use in post-secondary education include previous substance use, peer influence, psychological factors and mental health issues. Conclusions/Importance: Further research on social contextual influences on substance use, mental health issues, gender differences and availability of substances during the transition period is needed to inform the development of new preventive interventions for this age group.

Keywords :

• young adults
• smoking
• tobacco use
• alcohol use
• cannabis use
• illicit drug use
• transition
• review

THE AUTHORS

Maritt Kirst, PhD, is a Research Scientist with the Centre for Research on Inner City Health, St. Michael's Hospital and an Assistant Professor in the Dalla Lana School of Public Health, University of Toronto. She received her PhD in Sociology and Addiction Studies from the University of Toronto. She has extensive experience conducting socio-behavioral addiction research, program evaluations of mental health and addiction services, and community-based health research with socio-economically marginalized populations.

Graham Mecredy, MSc, is an Epidemiologist at the Institute for Clinical Evaluative Sciences (ICES). He received his MSc in Community Health and Epidemiology from Queen's University. His current research focuses on respiratory health, chiefly in the areas of chronic obstructive pulmonary disease and asthma, using health administrative data. As a former Research Officer at the Ontario Tobacco Research Unit (OTRU). He remains active in the tobacco control community, with research interests focusing on tobacco use from a population health perspective.

Tracey Borland, MSc, is a Research Officer with the OTRU at the University of Toronto. Her current research interests include: health equity; gender and tobacco use; global health governance and global tobacco control policy.

Michael Chaiton, PhD, is a Scientist at the OTRU and Assistant Professor at the Dalla Lana School of Public Health, University of Toronto. He has a PhD in Epidemiology from the University of Toronto. His current research interests include smoking cessation, smoking related co morbidities, and understanding the impact of widespread retail availability of tobacco. He holds a career development award from the Canadian Cancer Society.