Spirituality, Ethnic Identity, and Substance Use among American Indian/Alaska Native Adolescents in California
Open accessAbstract
Background. American Indian/Alaska Native (AIAN) adolescents have a higher prevalence of commercial tobacco, alcohol, and marijuana use than other racial/ethnic groups in the United States. It is unclear whether cultural factors such as ethnic identity, spirituality, and ceremonial use of traditional tobacco are associated with substance use, especially use of emerging tobacco products such as electronic cigarettes, among AIAN adolescents. Methods. This study investigated the association between hypothesized cultural protective factors (ethnic identity, spirituality, and ceremonial use of traditional tobacco) and past-month use of commercial cigarettes, e-cigarettes, marijuana, blunts, and alcohol among 156 AIAN adolescents in California (mean age = 15.3 years, 55% female). Adolescents from six AIAN schools and afterschool programs completed paper-and-pencil surveys. We used Logistic regression analyses to identify the significant cultural correlates of past-month substance use, controlling for demographic covariates. Results. As hypothesized, strong ethnic identity was protective against cigarette, marijuana, and alcohol use. However, it was not protective against e-cigarette or blunt use. Spirituality was associated with an increased risk of cigarette and marijuana use. Previous ceremonial use of traditional tobacco was not associated with past-month recreational substance use. Conclusions. Results indicate that the associations between cultural factors and substance use vary across substances. Future research should identify cultural factors that protect AIAN adolescents against use of newer products such as e-cigarettes and blunts.
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For some AIAN youth it is difficult to refuse drug or other substance offers when they come from parents and other family members or when tobacco products are offered during a ceremony.
“Specifically, for some AIAN youth it is difficult to refuse drug or other substance offers when they come from parents and other family members or when tobacco products are offered during a ceremony [32,66].”
From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [66]
The Introduction (page unavailable) discusses ceremonial tobacco use and the possibility that substituting commercial tobacco makes it more available to adolescents. Neither it nor the Discussion (page unavailable) addresses whether AIAN youth have difficulty refusing substance offers from family members or tobacco offered during a ceremony; searches for refusal and offers found no such passage. (LLM, conf=0.73)
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Cited by
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Substance and Behavioral Addictions among American Indian and Alaska Native Populations
Soto, C., West, A. E., Ramos, G. G., & Unger, J. B. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19052974 · Cited by 49 · see citing works
Self-citation
- Authors
- Unger, J. B., Sussman, S., Begay, C., Moerner, L., & Soto, C.
- Affiliations
- University of Southern California (US)
- Corresponding author
- Unger, Jennifer B.
- Venue
- Substance Use & Misuse
- Publisher
- Informa UK Limited
- Published
- 2020-01-30
- Volume
- 55
- Issue
- 7
- Pages
- 1194-1198
- ISSN
- 1082-6084 (ISSN-L)
- 1532-2491
- PMC
- PMC7453493
- OpenAlex
- W3003660241
- Cited by
- 20
- References
- 2
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 6 · 2021: 4 · 2020: 1
- FWCI
- 1.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Substance Use & Misuse (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (P30CA014089)
- Topics
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- substance use, ethnic identity, spirituality, electronic cigarettes, blunts, cannabis use, cigarette smoking, alcohol consumption, California
- MeSH terms
- Alaska Natives, Alaskan Natives, Adolescent, California, Ethnicity, Female, Humans, Male, Substance-Related Disorders, Spirituality, American Indian or Alaska Native, Electronic Nicotine Delivery Systems
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