Predictors of substance use among vulnerable adolescents in five cities: Findings from the well-being of adolescents in vulnerable environments study

Adesola O. Olumide, Allysha C. Robinson, Paul A. Levy, Lawrence Mashimbye, Heena Brahmbhatt, Qiguo Lian, Oladosu Ojengbede, Freya L. Sonenstein, Robert W. Blum

Research output: Contribution to journalArticle


Purpose Adolescent substance use has numerous consequences. Our goals in this article are to compare the prevalence and correlates of substance use among ethnically diverse adolescents.

Methods Data were from 2,332 adolescents aged 15-19 years recruited via respondent-driven sampling from disadvantaged settings in five cities. Multivariate logistic regression was used to identify correlates of current substance use.

Results About half of the respondents were male. Most adolescents (73.4%) were currently enrolled in school and identified a father (86.2%) and mother (98.6%) figure and strong peer support. Sixty-two percent reported lifetime use of at least one substance. Overall, the most common substances ever used were alcohol (44.6%), cigarettes (26.2%), and marijuana (17.9%). Mean age at first use of alcohol was 14.2 ± 3.1 years. Current alcohol use was highest in Johannesburg (47.4%) and lowest in Delhi (2.1%). The mean age at first use of cigarettes was 14.4 ± 2.8 years. Current cigarette smoking was highest in Johannesburg (32.5%) and lowest in Delhi (3.7%). Male gender predicted current alcohol use in all sites, older age (17-19 years) was also a predictor in Baltimore. Male gender (Johannesburg and Shanghai), older age (Baltimore and Shanghai), and being out of school (Baltimore, Johannesburg, and Shanghai) predicted current cigarette smoking. Absence of a caring father figure was predictive for current alcohol use in Baltimore and Shanghai. Stronger peer support predicted alcohol (Johannesburg and Shanghai) and cigarette use (Johannesburg).

Conclusions Substance use is still a major issue among adolescents around the world, underscoring the need for continued research and interventions.

Original languageEnglish (US)
Pages (from-to)S39-S47
JournalJournal of Adolescent Health
Issue number6
StatePublished - Dec 1 2014



  • Adolescents
  • Global health
  • Health behaviors social determinants of health
  • Health disparities
  • Substance use

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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