The relationship between physical maltreatment and substance use among adolescents: a survey of 95,788 adolescents in Hong Kong.
OBJECTIVE
To determine the prevalence of corporal punishment and the infliction of injuries from a beating occurring without provocation in the previous 6 months among secondary school children in Hong Kong, and to examine the associations between these two forms of physical maltreatment with substance-use-related behaviors and attitudes.


METHODS
Using secondary data, a cross-sectional, self-administered, anonymous survey of 95,788 secondary school students was conducted in Hong Kong.


RESULTS
The prevalence of physical maltreatment showed statistically significant associations with younger age, attendance in Chinese-speaking day schools, temporary housing, residence with only one parent, poorer parental relationship, greater peer influence, perceptions of excessive academic pressure, and feelings of being blamed for poor academic performance. Adolescents who had experienced corporal punishment were more likely to be current users of alcohol (OR = 1.11), tobacco (OR = 1.31), psychoactive substances (OR = 1.60), or heroin (OR = 1.90). Those who had been beaten to injury by a family member without provocation within the past 6 months also were more likely to be current users of alcohol (OR = 1.35), tobacco (OR = 1.65), psychoactive substances (OR = 2.39), and heroin (OR = 3.07). Additionally, students who experienced physical maltreatment were more likely to be acquainted with habitual substance users, have better access to psychoactive substances, to have engaged in sex after abusing drugs, have obtained money from illegal sources to purchase drugs, and believe that psychoactive substances are not harmful or addictive.


CONCLUSIONS
Physical maltreatment showed strong associations with drug-related behaviors and attitudes, after adjusting for potential confounders. Further longitudinal studies are required to understand the causal direction of the relationship.
Lau
Joseph T F
JT
Centre for Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. jlau@cuhk.edu.hk
Kim
Jean H
JH
Tsui
Hi-Yi
HY
Cheung
Albert
A
Lau
Mason
M
Yu
Aaron
A
D000293:Adolescent; D003430:Cross-Sectional Studies; D017579:Domestic Violence; D005260:Female; D006306:Health Surveys; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000209:etiology*; D014947:Wounds and Injuries