Abstract
BACKGROUND: The COVID-19 pandemic required the public to alter their daily lives drastically. For adolescents, school closures and social isolation added further challenges to a stressful stage of life, potentially increasing the likelihood of substance use initiation. This study explored the relationship between adolescent substance use initiation and negative life changes due to COVID-19. METHODS: Students from 9 high schools (N = 2478) in Los Angeles County were surveyed as 9th graders in the 2019-2020 school year and re-surveyed in 10th and 11th grades as part of an ongoing longitudinal study. Two logistic regression models were conducted to test hypotheses that negative life changes due to the COVID-19 pandemic increases the odds of initiation of both tobacco/nicotine products and cannabis products, controlling for sex, age, and race/ethnicity. RESULTS: The final analytic sample included adolescents in 10th grade who were never-users of tobacco/nicotine (N = 809) and cannabis (N = 837). The odds of initiating cannabis use increased by 6.42% for every 1 standard deviation increase in the COVID-19 negative daily life changes index [AOR: 1.063; 95% CI: 1.010, 1.121]. The association between the COVID-19 negative daily life changes index and tobacco/nicotine use initiation was not significant. DISCUSSION: Adolescents who experienced life changes due to COVID-19 were more likely to initiate cannabis use, but not tobacco/nicotine use. Results identify a need for early intervention efforts to promote effective coping skills and prevent cannabis initiation among adolescents during a wide-scale stressor, such as COVID-19.