New from ADAI: Food Hardship as a Strong Predictor of Tobacco and Cannabis Use by WA Youth

Citation: Harwick RM, Carlini BH, Williams JR. Food hardship as a strong predictor of tobacco and cannabis use among youth in WA state. Children and Youth Services Review 2024;157:107427. (free link, available through March 4)

This brief report from ADAI researchers Robin Harwick, PhD, MS, Beatriz Carlini, PhD, MPH, and Jason Williams, PhD, examines data from the Washington Healthy Youth Survey to understand the likelihood of tobacco and cannabis use by students in the state who experienced poverty (as measured by participation in the free and reduced lunch (FRL) program or self-reported food hardship).

Previous research has documented that poverty, as well as being from marginalized ethnic/racial minorities, is a risk factor for substance use among youth. Poverty also increases the likelihood a child will not graduate from high school – as does tobacco and/or  cannabis use.

Less is known, though, about the impact of racial/ethnic differences in cannabis and tobacco use patterns for students who experience poverty. To help fill that gap, the authors decided to look at food hardship, a particularly stressful element of poverty, and how it is connected to cannabis or tobacco use, as well as differences in substance use between ethnic/racial groups by poverty status.

Using data from the 2014 2016, and 2018 Healthy Youth Survey, the team focused on grades 8, 10, and 12 (omitting 6^th graders because they weren’t asked all relevant questions). Analysis revealed:

• White students reported higher use of both tobacco (43% higher) and cannabis (65% higher)
• Black and mixed-race students were more likely to report cannabis use if they were in the FRL program
• Students reporting food hardship were an average of 1.5-2 times more likely to use cannabis and tobacco, regardless of race/ethnicity
• Students reporting food hardship who were white, Asian, mixed-race, or “other” race/ethnicity were over twice as likely to use tobacco or cannabis than other groups
• Hispanic students were the only racial/ethnic group experiencing povery who did not have a higher likelihood of tobacco use

The authors suggest that lived experience of poverty (i.e., students’ perception of not having enough food) provides important context about their risk factors for substance use. In fact, students’ awareness of poverty may be a stronger predictor of cannabis and/or tobacco use than simply receiving FRL. Therefore, schools should screen for students who have perceived food hardship, then deliver targeted interventions to prevent cannabis and tobacco initiation regardless of the students’ racial/ethnic background.

Read the complete paper here
(free version available until March 4, 2024)