The consequences of community exposure to firearm homicide for adolescent substance use.

In areas with high levels of violence, not just the individuals involved but entire communities experience harm. Acts of violence in the community that a young person did not witness or experience directly can still have consequences for their health behaviors. Using survey data from the Future of Families and Child Wellbeing Study merged with the Gun Violence Archive ( = 3042), we investigate associations between community exposure to firearm homicide and adolescent substance use. Results indicate that exposure to a local firearm homicide in the past 180 days is associated with 1.56 higher odds of adolescent marijuana use, and exposure to multiple incidents nearly doubles the odds of use. There is no significant association between exposure and either alcohol or cigarette use. Moderation analyses show a positive association between firearm homicide exposure and marijuana use among Black and low-income adolescents and adolescents living in disadvantaged neighborhoods. These results suggest that health and healing-centered prevention and intervention strategies aimed at reducing exposure to firearm violence and mitigating subsequent harm, including substance use, are particularly important for those most impacted by co-occurring stressors linked to structural disadvantage.