Differences in substance use initiation patterns among biracial and monoracial adolescents: an integrative data...

Adolescence is a critical period for substance use initiation, with consequences for addiction and psychosocial problems in adulthood. However, differences in initiation by key variables such as age and racialized/ethnic group remain understudied.

This study examined age and peer influence in relation to alcohol, cannabis, and cigarette initiation across eight racialized/ethnic groups (Asian or Pacific Islanders, Black, Indigenous, Hispanic White, White, Biracial White-Asian, Biracial White-Black, and Biracial White-Indigenous) to compare biracial groups with their monoracial counterparts.

Using integrated data analysis with Add Health (n = 15,844; mean age = 15.6) and Monitoring the Future (MTF; n = 9,600; mean age 18.4), we applied discrete-time survival analysis to estimate initiation hazards during adolescence (ages 12-18), accounting for racialized/ethnic group, sex, and peer substance use.

The hazards for new initiations of alcohol and cannabis followed a quadratic function of age, peaking around ages 16 and 18. Cigarette use initiation, in contrast, had a relatively flat hazard function. Biracial youth typically showed intermediate or higher risk of substance use initiation relative to their monoracial peers depending on the specific subgroups and substances considered. Peer substance use was associated with increased initiation across all groups, with stronger effects during peak initiation ages and variations in magnitude across racialized groups.

Our findings show substance use initiation risks and susceptibility to peer influence differ between biracial and monoracial adolescents and between specific biracial subgroups, highlighting the need to consider subgroup differences when addressing adolescent substance use.