Effect of immigration background and country-of-origin contextual factors on adolescent substance use in Spain

Abstract

Purpose: The effects of adolescent- and parental-birthplace and country-of-origin contextual factors on substance use among adolescents with recent immigrant background (ARIBs) are poorly understood. We aimed to assess these effects and identify the main mediating factors in Spain.

Methods: Participants were 12,432 ARIBs (≥1 foreign-born parent) and 75,511 autochthonous adolescents from pooled 2006-2010 school surveys. Outcomes were prevalence of use of alcohol, tobacco, cannabis, stimulants and sedative-hypnotics. ARIBs were classified by adolescent birthplace (Spain/abroad), whether they had mixed-parents (one Spanish-born and one foreign-born), and country-of-origin characteristics. Adjusted prevalence ratios (aPRs) and percent change expressing disparities in risk were estimated using Poisson regression with robust variance.

Results: Compared to autochthonous adolescents, foreign-born ARIBs without mixed-parents showed significant aPRs <1 for all substances, which generally approached 1 in Spanish-born ARIBs with mixed-parents. The main factors mediating ARIBs' lower risk were less frequent socialization in leisure environments and less association with peers who use such substances. ARIBs' lower risk depended more on country-of-origin characteristics and not having mixed-parents than being foreign-born. Tobacco, cannabis and stimulant use in ARIBs increased with increasing population use of these substances in the country-of-origin. ARIBs from the non-Muslim-regions had a lower risk of using alcohol and higher risk of using sedative-hypnotics than those from the Muslim-region.

Conclusions: Among ARIBs in Spain, parental transmission of norms and values could influence substance use as much as or more than exposure to the Spanish context. Future research should better assess effects of adolescent- and parental-birthplace and country-of-origin contextual factors on substance use.

Keywords: Adolescent; Country of origin; Generation; Immigration; Mixed couples; Substance use.