Adolescent substance use and correlates among multi-ethnic youth in Hawaii: The importance of family and peer substance use

This study investigated family and peer substance use as predictors of substance use among 133 adolescents sampled from a high-risk multi-ethnic community in Hawaii. As extended families play a significant role in child-rearing among ethnic groups in Hawaii, our study focused on the potential influences of extended family's substance use in explaining adolescent substance use. Over one-quarter of the adolescents surveyed in our study reported living in family households that included one or more adult extended family members (e.g., biological and/or non-biological “hanai” grandparents, aunts, uncles). Multiple regression analyses of our survey data showed that parent, peer, sibling, and extended family substance use significantly predicted past 30-day adolescent substance use of cigarettes, alcohol, and marijuana. Significant risk factors varied across substances, with peer use consistently predicting adolescents' use of all three substances, parental use predicting cigarette and marijuana use, sibling use predicting alcohol and marijuana use, and extended family use predicting cigarette and alcohol use. Our results highlight the importance of addressing an adolescent's proximal social environment including extended family members in substance use studies among youth in Hawaii. Prior published studies have not addressed potential risk factors that derive from the youth's extended family. This inattention reflects a primarily Western cultural perspective that traditionally defines “family” in terms of nuclear family members. Our findings suggest that, at least for some ethnic populations, it is necessary to consider a broader, more culturally appropriate definition of “family” than has been traditionally investigated in the existing substance use literature.