Associations between digital technology and substance use among U.S. adolescents: Results from the 2018 Monitoring the Future survey

doi:10.1016/j.drugalcdep.2020.108124

Drug and Alcohol Dependence

Volume 213, 1 August 2020, 108124

https://doi.org/10.1016/j.drugalcdep.2020.108124 Get rights and content

Highlights

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Social media and digital technology exposes youth to substance-related content.
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Adolescents who use social media are more likely to use substances.
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This relationship is also observed across other forms of digital communication.
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More socially connected adolescents are more likely to use substances.

Abstract

Objective

Social media and other digital technology use facilitate connection among adolescents, but also may reinforce norms and substance-related content from peers and advertisers. We use nationally representative data to examine the association between digital technology and past 30-day use of alcohol, cannabis, and vaping.

Methods

Data were drawn from the 2018 Monitoring the Future survey of US adolescents (N = 44,482). Poisson regressions estimated the association between hours/day of technology use and past 30-day use of alcohol, cannabis, and vaping adjusting for grade, sociodemographics, and other past-year drug use.

Results

Across grades, mean hours of social media/day was 3.06 (standard deviation = 2.90), past 30-day alcohol, cannabis, flavor vaping, cannabis vaping, and nicotine vaping were 15.7 %, 12.6 %, 10.6 %, 4.9 %, and 11.2 %, respectively. Digital technology use that required interaction with others was associated with increased risk of past 30-day drinking, cannabis use, and vaping. For example, social media 3+ hours/day was associated with past 30-day drinking (adjusted relative risk [aRR]: 1.99, 95 % CI: 1.65, 2.41). The magnitude of association was consistent across texting, phone calls, and video chatting, which were all more strongly associated with substance use than with activities that do not require interaction such as gaming and watching videos.

Conclusion

Digital technology that facilitates interaction among adolescents, such as texting and social media, is associated with past substance use. Magnitudes of association are consistent across substances, supporting the hypothesis that networks of adolescents are social drivers of substance use, rather than the technology itself.

Introduction

Smart phones and digital technology are ubiquitous among adolescents and facilitate new ways for adolescents to connect. For example, >90 % of teens reported multi-daily engagement with social media (e.g. Instagram, Facebook, Snapchat) (Pew Research Center, 2018). While digital technology has potential benefits for social connection (Gross, 2009; Lee, 2009; Pew Research Center, 2018), they also provide a new vector to introduce and reinforce social norms around substance use (Cabrera-Nguyen et al., 2016; Frost and Rickwood, 2017; Miller et al., 2014), as well as expose adolescents to substance-related advertising (Camenga et al., 2018; Jernigan et al., 2017; Krauss et al., 2017; Pokhrel et al., 2018). Historically, manufacturers of addictive products such as alcohol and nicotine have targeted advertising to adolescents in an effort to gain a new market share (Chester et al., 2010; King III and Siegel, 1999; Pucci and Siegel, 1999). While regulation has reduced advertisers’ ability to market to adolescents using traditional media (magazines, TV, etc.), particularly alcohol (Anderson et al., 2009; Jernigan, 2011), new media types may offer other ways to display products to a young market.

Available evidence indicates that exposure to substance-related content, both from peers and advertisers, is common when engaging with digital media, and that involvement with wider social networks and friends engaged with substance-related content is associated with higher substance use (Cabrera-Nguyen et al., 2016; Frost and Rickwood, 2017; Hoffman et al., 2014; Huang et al., 2014). While existing research has predominately focused on alcohol, cannabis content is rapidly expanding given shifting legal markets, and social media depictions of use and users, as well as advertising, are becoming more frequent. Indeed, cannabis advertising is more common on social media that traditional media (Krauss et al., 2017), and cannabis posts by young people on social media are not only more frequent than older adults, but also largely positive in nature (Park and Holody, 2018) and associated with higher levels of cannabis use (Cabrera-Nguyen et al., 2016).

In addition to alcohol and cannabis, vaping and e-cigarette use have increased dramatically among youth in since 2016 (Miech et al., 2019), and social media advertising and peer content has followed. In addition to high levels of e-cigarette advertising in traditional sources such as stores (Margolis et al., 2018), exposure to e-cigarette content on social media is associated with future e-cigarette use (Camenga et al., 2018; Pokhrel et al., 2018), with variation based on social media site.

Many of the aforementioned studies focus on specific subsets of the population and, therefore, the total population association between exposure to digital media and risk of alcohol, cannabis and e-cigarette use remains inadequately identified. Furthermore, the landscape of both digital technology use (Pew Research Center, 2018) as well as substance use (Miech et al., 2019) is rapidly changing among youth. Therefore, evaluation of the relationship between digital technology and substance use requires up-to-date data. We use 2018 Monitoring the Future (MTF) data to examine the association between adolescent exposure to traditional and newer forms of media and substance use, namely alcohol (past 2-week binge drinking and past 30-day use), cannabis (past 30-day use), and vaping (past 30-day use). Monitoring the Future is the only national study containing stream-lined, well-replicated measures of digital media engagement and substance use among US school-attending adolescents in 8th, 10th, and 12th grade, thus providing a large sample size and allowing for nationally representative inferences.

Section snippets

Sample

MTF includes annually administered cross-sectional surveys of 8th, 10th, and 12th grade students in the contiguous US. The survey is conducted at approximately 400 U.S. public and private high schools selected using a multi-stage random sampling design. Selected schools are invited to participate in MTF for 2 years, and schools that decline to participate are replaced with schools that have similar size, geographic location, and urbanicity. While the questionnaire is administered annually, the

Results

Table 1 provides participant sociodemographic data. A majority of a sample comprised 8th (42.6 %) and 10th graders (43.5 %). The sample was balanced in terms of sex: 50.8 % female and 49.2 % male. A majority of participants self-identified as white (46.0 %) and came from families where the maximum parental education was college or higher (55.4 %). Spearman’s correlations between digital technology use variables were very weak to moderate, ranging from 0.08 (coefficient between hours spent video

Discussion

This study is the first to estimate associations between digital technology and substance use using nationally representative data among the current cohort of US adolescents. We find that digital technology, including social media, is associated with past substance use in adolescents. However, this association is present across many forms of digital communication, including texting, talking on the phone, and video chatting. In contrast, we generally did not observe consistent associations

Contributors

Navdep Kaur provided feedback on the statistical analysis approach, drafted the paper, and approved the final version.

Caroline G. Rutherford conducted the statistical analysis, provided feedback on the paper draft, and approved the final version.

Katherine M. Keyes and Silvia S. Martins conceived the study aims, secured funding, provided feedback on the statistical analysis approach, provided feedback on the paper draft, and approved the final version.

All authors approved the final manuscript as

Funding source

This work is supported by the Centers for Disease Control and Prevention (R49CE003094 (PI: Branas)), and National Institute on Drug Abuse (R01-DA048853 (PI: Keyes)).

Declaration of Competing Interest

None.

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Full length articleAssociations between digital technology and substance use among U.S. adolescents: Results from the 2018 Monitoring the Future survey

Highlights

Abstract

Objective

Methods

Results

Conclusion

Introduction

Section snippets

Sample

Results

Discussion

Contributors

Funding source

Declaration of Competing Interest

J. Adolesc.

Addict. Behav.

Drug Alcohol Depend.

Drug Alcohol Depend.

Comput. Human Behav.

Drug Alcohol Depend.

J. Adolesc. Heal.

Drug Alcohol Depend.

Prev. Med. (Baltim).

Addict. Behav.

Prev. Med. (Baltim).

Special issue: The message and the media: Impact of alcohol advertising and media exposure on adolescent alcohol use: a systematic review of longitudinal studies

Alcohol Alcohol.

The Monitoring the Future Project After Four Decades: Design and Procedures

Parental and peer influences on the risk of adolescent drug use

J. Prim. Prev.

Social media use and episodic heavy drinking among adolescents

Psychol. Rep.

Young adults’ exposure to alcohol- and marijuana-related content on twitter

J. Stud. Alcohol Drugs

Marijuana-related posts on instagram

Prev. Sci.

E-cigarette marketing exposure and subsequent experimentation among youth and young adults

Pediatrics

Alcohol Marketing in the Digital Age | Digital Ads

Frequent electronic media communication with friends is associated with higher adolescent substance use

Int. J. Public Health

Logging on, bouncing back: an experimental investigation of online communication following social exclusion

Dev. Psychol.

Full length article
Associations between digital technology and substance use among U.S. adolescents: Results from the 2018 Monitoring the Future survey