Effect of immigration background and country-of-origin contextual factors on adolescent substance use in Spain

Abstract Purpose The effects of adolescent- and parental-birthplace and country-of-origin contextual factors on substance use among adolescents with recent immigrant background (ARIBs) are poorly understood. We aimed to assess these effects and identify the main mediating factors in Spain. Methods Participants were 12,432 ARIBs (≥1 foreign-born parent) and 75,511 autochthonous adolescents from pooled 2006–2010 school surveys. Outcomes were prevalence of use of alcohol, tobacco, cannabis, stimulants and sedative-hypnotics. ARIBs were classified by adolescent birthplace (Spain/abroad), whether they had mixed-parents (one Spanish-born and one foreign-born), and country-of-origin characteristics. Adjusted prevalence ratios (aPRs) and percent change expressing disparities in risk were estimated using Poisson regression with robust variance. Results Compared to autochthonous adolescents, foreign-born ARIBs without mixed-parents showed significant aPRs Conclusions Among ARIBs in Spain, parental transmission of norms and values could influence substance use as much as or more than exposure to the Spanish context. Future research should better assess effects of adolescent- and parental-birthplace and country-of-origin contextual factors on substance use.