Comparison of Risk Factors for Habitual Substance Use Among Adolescents in Korea by Maternal Nationality: Analysis of 18th and 19th Korea Youth Risk Behavior Surveys (2022 and 2023).

: This study identified the risk of habitual substance use among multicultural adolescents, focusing on health behavior characteristics and cultural differences based on their mother's country of origin. : This secondary data analysis used data from the 18th (2022) and 19th (2023) Korea Youth Risk Behavior Web-based Surveys, which are repeated cross-sectional surveys conducted annually. The analyses of 82,520 adolescents included descriptive statistics, the Rao-Scott χ test, and logistic regression. : The prevalence of habitual substance use among multicultural adolescents whose mothers were from the examined countries was 2.01%, which is 0.74 percentage points higher than the 1.27% prevalence observed among adolescents with Korean mothers. Among multicultural adolescents, the risk of habitual substance use was higher under specific conditions: those with Chinese mothers faced increased risks when not living with family (OR = 6.22) or smoking (OR = 12.65); Korean-Chinese adolescents had higher risks when experiencing suicidal ideation (OR = 3.41) or anxiety (OR = 8.17); and those with Vietnamese mothers were at greater risk when exposed to violence (OR = 12.42) or depression (OR = 14.06). These results underscore the role of cultural and psychological factors in adolescent substance use. : Our findings revealed differences in risk factors based on the mother's country of origin. These results underscore the importance of understanding adolescents' unique characteristics and developing tailored intervention strategies that account for these cultural and familial differences.