Smoking on School Property as a Risk Factor for Substance Use Among Adolescent Smokers

The purpose of the current study was to determine if smoking on high-school property was associated with increased risk for other substance use among U.S. adolescents. Secondary analyses were carried out with data from the 2011 Youth Risk Behavior Survey (YRBS, N = 15,503). Only adolescents who reported smoking at least one cigarette in the last 30 days were selected for analyses (n = 2531, 44% female). Alcohol, marijuana, and cocaine use was assessed among participants. Binary logistic regression analysis was carried out to examine the relationship between smoking on school property (yes versus no) with each of the substance use variables. Adolescent smokers who reported smoking on school property were significantly more likely to report substance use across all substances examined compared to smokers who did not smoke on campus. For example, campus smokers were 3.91 times more likely to use marijuana in their lifetime and 3.85 times more likely to have used crack or cocaine in their lifetime compared to smokers who did not smoke on campus. Health care providers who provide services to adolescents should screen for smoking on school property to help identify adolescents at increased risk for substance use.