COVID-19 Pandemic, Parental Protective Factors, and Substance Use Onset Among Early Adolescents in Appalachia

AJPM Focus. 2025 Jun 28;4(5):100390. doi: 10.1016/j.focus.2025.100390. eCollection 2025 Oct.

Abstract

Introduction: During the pandemic, adolescents spent significantly more time at home with their families than during nonpandemic eras. This change could be beneficial because time spent with family has been linked to positive health outcomes; however, given the stress and strains accompanied by COVID-19, research has yet to assess the potential effect that increased family time may have had on youth substance use onset and development during this strenuous period.

Methods: School-based survey data from 2,322 students in the Young Mountaineer Health Study were collected during the fall of 2020 (Wave 1), spring of 2021 (Wave 2), and fall of 2021 (Wave3) and were used to create logistic regression models to identify variables at Wave 1 that related to 3 types of substance use onset in the sample at Wave 2 and Wave 3. The study's primary independent variable was COVID-19-related emotional impact (scale range: 5-25).

Results: Average age of participants at Wave 1 was 11.50 years (males=42.9%). COVID-19-related emotional impact was positively associated with an increase in cigarette (AOR=1.06, p=0.008) and E-cigarette use onset (AOR=1.06, p<0.001). Parental monitoring (AOR=0.89, p=0.013) and parental social support (AOR=0.93, p=0.026) were associated with a decreased initiation of cigarette use, respectively.

Conclusions: The authors found that higher levels of COVID-19-related emotional impact were predictive of increased cigarette and E-cigarette onset but were only marginally related to alcohol use onset. The authors also identified that increased parental monitoring and parental social support might decrease the onset risks for cigarette and alcohol use among early adolescents.

Keywords: COVID-19; adolescents; parental monitoring; social support; substance use; youth.