Tobacco, alcohol and marijuana use among Indigenous youth attending off-reserve schools in Canada: cross-sectional results from the Canadian Student Tobacco, Alcohol and Drugs Survey.

introductionOngoing surveillance of youth substance use is essential to quantify harms and to identify populations at higher risk. In the Canadian context, historical and structural injustices make monitoring excess risk among Indigenous youth particularly important. This study updated national prevalence rates of tobacco, alcohol, and marijuana use among Indigenous and non-Indigenous students.

methodsDifferences in tobacco, alcohol, and marijuana use were examined, using logistic regression, among 1700 Indigenous and 22 800 non-Indigenous youth in Grades 9-12 who participated in the 2014/15 Canadian Student Tobacco, Alcohol and Drugs Survey. Differences by sex were also examined. Mean age of first alcohol and marijuana use was compared in the two populations using OLS regression. Results were compared to 2008/09 data.

resultsWhile smoking, alcohol, and marijuana rates have decreased compared to 2008/09 in both populations, the gap between the populations has mostly not. In 2014/15, Indigenous youth had higher odds of smoking (odds ratio [OR]: 5.26; 95% confidence interval [CI]: 3.54-7.81) and past-year drinking (OR: 1.43; 95% CI: 1.16- 1.76) than non-Indigenous youth. More Indigenous than non-Indigenous youth attempted quitting smoking. Non-Indigenous males were less likely to have had at least one drink in the past-year compared to non-Indigenous females. Indigenous males and females had higher odds of past-year marijuana use than non-Indigenous males (OR: 1.84; 95% CI: 1.32-2.56) and females (OR: 2.87; 95% CI: 2.15-3.84). Indigenous youth, especially males, drank alcohol and used marijuana at younger ages.

conclusionAdditional policies and programs are required to help Indigenous youth be successful in their attempts to quit smoking, and to address high rates of alcohol and marijuana use.