School-Level Correlates of Adolescent Tobacco, Alcohol, and Marijuana Use

Abstract

Background: School-level characteristics are related to students’ substance use, but little research systematically examined multiple school characteristics in relation to different types of substance use across grade levels. Objectives: This study examines multiple school-level characteristics as correlates of students’ tobacco, alcohol, marijuana, and combined substance use across three grade levels. Methods: Students (N = 23,615) from 42 urban and suburban middle schools and 24 high schools in the U.S. reported on their tobacco, alcohol, and marijuana use. Students’ mean age was 14 years; 47% were male, 53% African American, and 41% Caucasian. School-level data included poverty, racial composition, academic achievement, student-teacher ratio, absenteeism, and school size. Multilevel logistic and Poisson regressions tested associations between school-level predictors and adolescent substance use in middle school, early high school, and late high school. Results: School-level poverty, more ethnic minority students, low achievement, and higher absenteeism were related to alcohol, marijuana, and combined substance use, particularly at lower grade levels. By contrast, cigarette smoking was more prevalent in more affluent high schools with more White students. After adjusting for other school characteristics, absenteeism emerged as the most consistent predictor of student substance use. Conclusions/Importance: Interventions addressing absenteeism and truancy in middle and high schools may help prevent student substance use. Schools serving poor, urban, and mostly minority students may benefit from interventions targeting alcohol and marijuana use, whereas interventions focusing on tobacco use prevention may be more relevant for schools serving more affluent and predominantly White students.

Keywords :

• adolescence
• school
• alcohol
• tobacco
• marijuana

THE AUTHORS

Danielle Hill, B.S., received the B.A. degree in psychology from Spelman College, Atlanta, Georgia, USA, and completed a Post-Baccalaureate program at the University of Alabama at Birmingham, Birmingham, Alabama, USA. She is a doctoral student in clinical psychology at the University of Rhode Island, Kingston, Rhode Island, USA. Her research addresses the impact of personal, family, school, and community factors on mental and physical health of minority youth. Additionally, her interests include developing and implementing community and school based intervention programs that promote individual growth and prevent social and mental health problems among minority adolescents at risk.

Sylvie Mrug, Ph.D., received a doctorate in clinical psychology from Purdue University, West Lafayette, Indiana, USA. She is an Associate Professor of psychology at the University of Alabama at Birmingham, Birmingham, Alabama, USA. She studies the interplay of risk and protective factors in the development of behavioral and emotional problems in adolescence, including antisocial behavior, substance use, depression, and anxiety. 

GLOSSARY

• Multilevel logistic regression: Analysis predicting a dichotomous outcome (e.g., any versus no alcohol use) of individuals nested within larger groups (e.g., schools).

• Multilevel Poisson regression: Analysis predicting an outcome that follows a Poisson distribution (e.g., count variables) among individuals nested within larger groups.

• School-level factors: Composite indicators of the characteristics of all students attending a given school (e.g., race, achievement), or a characteristic of the school itself (e.g., size).

• Student substance use: Defined as any use of cigarettes, alcohol, or marijuana within the past year.