Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
Subst Abus. 2022;43(1):1085-1093. doi: 10.1080/08897077.2022.2060439.
While peer influence is a well-documented risk factor for adolescent substance use, it remains unclear whether peer or parental attitudes have greater impact, and if this relationship is moderated by having a confidant and the relationship between adolescents and their confidant. : Pooled (2015-2018) National Survey on Drug Use and Health (NSDUH) data on adolescents (12-17 years) were used. Perceived peer and parental disapproval of tobacco, alcohol, and marijuana use were dichotomized. We assessed associations between disapproval and past-month tobacco ( = 51,352), alcohol ( = 51,407), and marijuana use ( = 51,355) using separate multivariable logistic regression models. We explored effect modification by the presence of a confidant, parental vs. non-parental disapproval, and peer vs. non-peer confidant relationship. : Peer and parental disapproval, presence of any confidant, and identifying a parental confidant were consistently protective against substance use; identifying a peer confidant increased odds of use across substances. For marijuana use, peer disapproval (adjusted odds ratio [aOR]: 0.07, 95% confidence interval [CI]: 0.06, 0.08) was more protective than parental disapproval (aOR: 0.13, 95% CI: 0.12, 0.15). The joint presence of peer/parental disapproval and any confidant decreased the odds of substance use beyond the individual effects of peer/parental disapproval and having a confidant. However, having a peer confidant attenuated the protective association between peer/parental disapproval and tobacco, alcohol, and marijuana use. : Both peer and parental relationships are salient when considering the social context of adolescent substance use and should be considered when studying the effects of perceived disapproval.
虽然同伴影响是青少年物质使用的一个有据可查的风险因素，但仍不清楚是同伴还是父母的态度影响更大，以及这种关系是否受到有知己的调节以及青少年与其知己的关系。使用了 2015-2018 年全国药物使用与健康调查（NSDUH）中青少年（12-17 岁）的数据。感知到的同伴和父母对烟草、酒精和大麻使用的不赞成被分为两类。我们使用单独的多变量逻辑回归模型评估了不赞成与过去一个月内吸烟（ = 51,352）、饮酒（ = 51,407）和使用大麻（ = 51,355）之间的关联。我们探讨了知己的存在、父母与非父母的不赞成以及同伴与非同伴的知己关系的修饰作用。同伴和父母的不赞成、知己的存在以及识别父母的知己始终对物质使用具有保护作用；识别同伴的知己会增加使用各种物质的几率。对于大麻使用，同伴的不赞成（调整后的优势比[aOR]：0.07，95%置信区间[CI]：0.06，0.08）比父母的不赞成（aOR：0.13，95% CI：0.12，0.15）更具保护性。同伴/父母不赞成和任何知己的共同存在降低了物质使用的几率，超过了同伴/父母不赞成和有知己的个体效应。然而，有一个同伴知己会减弱同伴/父母不赞成与吸烟、饮酒和使用大麻之间的保护关联。当考虑青少年物质使用的社会背景时，同伴和父母关系都很重要，在研究感知到的不赞成的影响时应予以考虑。
