Addictions, Drug & Alcohol Institute

New ADAI Report: Language Matters: Cannabis & Tobacco Use Among Youth of Diverse Racial/Ethnic Backgrounds


Citation: Language Matters: Cannabis and Tobacco Use Among Youth of Diverse Racial/Ethnic Backgrounds. Carlini BH, Harwick RH, Williams JR. Seattle, WA: Addictions, Drug & Alcohol Institute, Department of Psychiatry & Behavioral Sciences, School of Medicine, University of Washington, July 2024.

Stack of 3 binders with New ADAI Report on the spines

Previous studies have highlighted the importance of acculturation — when someone adopts the values and behaviors of a new culture while still keeping some elements of their own culture — on health behaviors. Studies have found that low acculturation is associated with lower risk of substance use in youth when compared with their higher-acculturated peers.

Meanwhile, other studies report that youth from historically marginalized cultural backgrounds often experience a disproportionate prevalence or health burden from substance use.

These two findings seem to be in conflict, so ADAI researchers Drs. Beatriz Carlini, Robin Harwick, and Jason Williams wanted to dig in deeper.

Language spoken at home is a measure of acculturation – speaking English at home is a measure of high level of acculturation in the U.S., while speaking the language of origin is considered a measure of low level of acculturation. Using Washington State Healthy Youth Survey data from 2014, 2016, and 2018, Dr. Carlini and colleagues looked at cannabis and tobacco use for youth of different racial/ethnic backgrounds, comparing those who primarily spoke English at home to those who primarily spoken another language.

For youth who spoke a language other than English at home (compared to those who spoke English at home):

  • Hispanic and Asian youth were significantly less likely to use cannabis or tobacco,
  • American Indian/Alaska Native, Black, and Multi-ethnic (non-Hispanic) youth were more likely to use tobacco but less likely to use cannabis, and
  • White youth (mostly Russian or Ukranian) were more likely to use both cannabis and tobacco.

These findings question the widespread belief that low acculturation alone is associated with lower prevalence of substance use, as they demonstrate that white youth are at higher risk for substance use if they speak a language other than English at home (low acculturation).

This information can help identify priorities for prevention and intervention efforts targeting youth cannabis and/or tobacco use. Creating culturally relevant substance use interventions to reduce the health risks for these overlooked students should be a priority, and schools should ensure that health education/prevention materials are translated to the family’s primary language before dissemination.

Read the full report here.