The Turning Point of Substance Use Among Disadvantaged Young People in England: A Mediation Analysis

OBJECTIVES: Although the overall tendency of substance use among disadvantaged young people dropped during previous decades in England, there was a rebound in 2016, separating the anti-illicit drug campaign into two phases. This study examines mechanisms of substance use related to disadvantaged backgrounds among young English people in the two phases.

METHODS: The panel includes 55284 observations from the Survey of Smoking, Drinking and Drug Use among Young People in England from 2011 to 2021. Mediation analysis is adopted to inspect differences in the mechanisms of disadvantaged backgrounds on substance use among young people. Substance use includes the use of class A, B or C drugs, temporary class drugs or psychoactive substances. Disadvantaged backgrounds are measured by family affluence scale scores. Mediators contains family support, social support, health services, media and school education. Three mediation analyses are conducted for the first phase (2011-2015), the second phase (2016-2021) and the whole period (2011-2021). This study also inspects subgroups by gender, age and region.

RESULTS: Before 2016, family support takes the largest part (30%) in the reduced substance use among disadvantaged young people, and school education takes the second largest proportion (21%). After 2016, media contributes the largest (36%) to the substance use reduction among disadvantaged young people; family support weights the second (15%) to the reduction; and health services become the third force (8%) to decrease the substance use. Subgroup analysis shows consistent results.

CONCLUSIONS: Family and school play important roles to lower substance use among disadvantaged young people before 2016. After 2016, the internet and social media strongly influence the attitude of disadvantaged young people towards substance use. Also after 2016, health services such as consultation and treatment start to take significant effects on reducing substance use, indicating an achievement of the English healthcare system on anti-illicit drugs.