title: Predictors of substance use among vulnerable adolescents in five cities: findings from the well-being of adolescents in vulnerable environments study.
abstract: OBJECTIVE
  Adolescent substance use has numerous consequences. Our goals in this article are to compare the prevalence and correlates of substance use among ethnically diverse adolescents.
  
  
  METHODS
  Data were from 2,332 adolescents aged 15-19 years recruited via respondent-driven sampling from disadvantaged settings in five cities. Multivariate logistic regression was used to identify correlates of current substance use.
  
  
  RESULTS
  About half of the respondents were male. Most adolescents (73.4%) were currently enrolled in school and identified a father (86.2%) and mother (98.6%) figure and strong peer support. Sixty-two percent reported lifetime use of at least one substance. Overall, the most common substances ever used were alcohol (44.6%), cigarettes (26.2%), and marijuana (17.9%). Mean age at first use of alcohol was 14.2 ± 3.1 years. Current alcohol use was highest in Johannesburg (47.4%) and lowest in Delhi (2.1%). The mean age at first use of cigarettes was 14.4 ± 2.8 years. Current cigarette smoking was highest in Johannesburg (32.5%) and lowest in Delhi (3.7%). Male gender predicted current alcohol use in all sites, older age (17-19 years) was also a predictor in Baltimore. Male gender (Johannesburg and Shanghai), older age (Baltimore and Shanghai), and being out of school (Baltimore, Johannesburg, and Shanghai) predicted current cigarette smoking. Absence of a caring father figure was predictive for current alcohol use in Baltimore and Shanghai. Stronger peer support predicted alcohol (Johannesburg and Shanghai) and cigarette use (Johannesburg).
  
  
  CONCLUSIONS
  Substance use is still a major issue among adolescents around the world, underscoring the need for continued research and interventions.
authors.affiliation: Institute of Child Health, College of Medicine, University of Ibadan/University College Hospital Ibadan, Oyo State, Nigeria. Electronic address: daisyolu@yahoo.co.uk.
authors.forename: Adesola O
authors.initials: AO
authors.lastname: Olumide
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Allysha C
authors.initials: AC
authors.lastname: Robinson
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Levy
authors.affiliation: Wits Reproductive Health & HIV Institute, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Mashimbye
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Heena
authors.initials: H
authors.lastname: Brahmbhatt
authors.affiliation: Department of Epidemiology and Social Science Research on Reproductive Health, Shanghai Institute of Planned Parenthood Research, Shanghai, China.
authors.forename: Qiguo
authors.initials: Q
authors.lastname: Lian
authors.affiliation: Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan/ University College Hospital, Ibadan, Oyo State, Nigeria.
authors.forename: Oladosu
authors.initials: O
authors.lastname: Ojengbede
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Freya L
authors.initials: FL
authors.lastname: Sonenstein
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Blum
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology; D002681:China / Q000453:epidemiology; D005260:Female; D014943:Global Health; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology / Q000523:psychology; D009549:Nigeria / Q000453:epidemiology; D011204:Poverty Areas; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012494:Sampling Studies; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D013019:South Africa / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D014504:Urban Health / Q000191:economics; D055815:Young Adult
keywords: Adolescents; Global health; Health behaviors; Health disparities; Substance use; social determinants of health