Trends in substance use and prevention education involvement among U.S. adolescents receiving public assistance: new evidence

Purpose: The present study aimed to examine the substance use prevention education involvement in different social settings among adolescents receiving public assistance—cash or food voucher—for low household income (heretofore, “PA program enrollees”) and preventive effects of each prevention educational setting on current substance use. Methods: Using data from a nationally-representative sample of PA program enrollees from the 2002−2017 National Survey on Drug Use and Health, we estimated the prevalence of substance use prevention education involvement in home, school, and neighborhood settings and the associations between involvement in each educational setting and current alcohol/illicit drug use. Results: Compared to nonenrollees, PA program enrollees reported significantly lower rates of involvement in all prevention education settings, including parent-child conversations (54.6% vs. 60.1%) and neighborhood prevention resources (71.3% vs. 79.3%). All educational setting were associated with lower odds of current substance use, with the largest effects found for parent-child conversations (AOR = 0.821 [P < .001] for alcohol use; AOR = 0.817 [P < .001] for illicit drug use). Conclusions: To reduce the elevated risk of illicit drug use among PA program enrollees, special attention needs to be paid to promote parent-child conversation about substance use and increase access to prevention education in regular classes and preventive messages outside schools.