Perceived Social Connectedness and Substance Use among Adolescents and Young Adults in North Carolina

Substance use during adolescence and young adulthood is a persistent public health problem. Social connectedness is associated with health, but research is needed to clarify the potential protective role of different aspects of social connectedness in primary prevention of substance use behaviors. This study explores associations between perceived social connectedness to two developmentally important social groups (friends and family) and various substances (alcohol, e-cigarettes, cigarettes, cannabis, and prescription medication) among adolescents and young adults. In addition, it examines how descriptive and injunctive norms within social groups affect associations between perceived social connectedness and substance use behaviors among adolescents and young adults. A statewide survey was conducted among 15,000 adolescents and young adults (12-25 years old, 52.6% female, 69.6% White) in North Carolina. Perceived social connectedness and substance use were assessed cross-sectionally, along with potential moderators (perceived friend and parent substance use and disapproval). Logistic regression was used to model associations with substance use. Moderation was examined with a regions-of-significance approach. Overall, perceived social connectedness was associated with lower odds of using most substances among adolescents and young adults. However, associations were moderated by perceptions of parental and friend substance disapproval and to a lesser extent by perceptions of parental and friend substance use behaviors. Findings suggest perceived connectedness to friends could potentially protect against substance use in the context of high perceived friend disapproval, whereas perceived connectedness to family is complex and may protect against substance use in the context of moderate/lower perceived parental disapproval of substance use. Longitudinal research is needed to understand the direction of associations with additional measures of social connectedness to help elucidate which aspects are protective and which are risky for adolescent and young adult substance use.