Family incarceration and adolescent nicotine, alcohol, and cannabis use: A coarsened exact matching approach

Evidence overwhelmingly indicates that adverse childhood experiences (ACE), a set of highly correlated traumatic events experienced before age 18, increase risk for adolescent substance use. However, few studies have examined the association of family/household member incarceration (FI) and early substance use initiation (≤14 years old) and past 30-day substance use accounting for other ACE, demographic characteristics, and socio-economic status. To fill this gap, we used a matching method to explore the unique effect of FI on early substance use initiation and past 30-day use among diverse adolescents.

Data are baseline survey responses of high school students enrolled in the first year of a longitudinal school-based study. After matching youth on key characteristics to create balanced groups of exposed and non-exposed respondents, logistic regression models assessed the association between FI and early initiation of alcohol and cannabis use and past 30-day nicotine, alcohol and cannabis use.

Exposure to FI was significantly associated with higher odds of early initiation of alcohol (OR = 2.54, 95 % CI: 1.64-3.90) and cannabis (OR = 1.63, 95 % CI: 1.03-2.59) use and past 30-day alcohol (OR = 2.11, 95 % CI: 1.50-2.94), nicotine, (OR = 1.72, 95 % CI: 1.21-2.45) and cannabis (OR = 1.71, 95 % CI: 1.17-2.48) use.

Despite advocacy and criminal justice reform initiatives, generations of families in vulnerable communities navigate the complexities of arrest, incarceration, and reintegration with few supports or initiatives for impacted youth. Our findings point towards the need and potential benefit of prevention programs and services, especially upstream prevention efforts, for this youth population.