Our study sample size is 604, with most high school adolescents falling within the 15-17 age range, comprising 26.9%, 22.5%, and 21.1%, respectively—more than half of the participants identified as female (51.4%). Regarding race/ethnicity, 42.0% were White, 34.7% were Black or African American, and 15.6% identified as Hispanic or Latino. Additionally, 29.2% of participants were in grade 9, with another 25.3% in grade 10. Table 1 contains a data summary of the demographic.
Among our study participants, the most prevalent substances for current use were alcohol (23.4%), electronic vapor products (16.3%), binge drinking (13.1%), and cigars (4.4%). In terms of lifetime use prevalence, marijuana was the most common (28.4%), followed by prescription pain medicine use (16.1%), ecstasy (4.2%), cocaine (4.1%), and methamphetamines (3.6%). Table 2 provides a comprehensive summary of the prevalence of substance use among our study population.
Table 1: Demographic Characteristics of High School Adolescent Sample
Variables
|
N (Weighted %)
|
Age
|
|
At most 13 years
|
2 (0.1%)
|
14 years
|
139 (19.8%)
|
15 years
|
189 (26.9%)
|
16 years
|
142 (22.5%)
|
17 years
|
92 (21.1%)
|
At least 18 years
|
40 (9.6%)
|
Sex
|
|
Female
|
322 (51.4%)
|
Male
|
282 (48.6%)
|
Grade
|
|
9th Grade
|
216 (29.2%)
|
10th Grade
|
171 (25.3%)
|
11th Grade
|
134 (24.0%)
|
12th Grade
|
83 (21.5%)
|
Race
|
|
Black or African American
|
216 (34.7%)
|
White
|
261 (42.0%)
|
Hispanic/Latino
|
75 (15.6%)
|
Other Races
|
52 (7.7%)
|
We also compared demographic characteristics and substance use behaviors between students who usually did not sleep in their parent's/guardian's home (homeless, n=39, weighted% = 4.9%) and those who did (non-homeless, n=565, weighted% = 95.1%). While there were no significant differences in sex, age, race, or grade level between the two groups, homeless adolescents tended to be older. Additionally, a higher percentage of homeless adolescents identified as Black or African American (40.2% vs. 34.4%), Hispanic/Latino (24.4% vs. 15.2%), and male (67.3% vs. 47.6%) compared to non-homeless peers.
Table 2: Substance Use Prevalence of the High School Adolescents
Variables
|
N (Weighted %)
|
Currently Used an Electronic Vapor Product
|
|
Yes
|
92 (16.3%)
|
No
|
512 (83.7%)
|
Currently Smoked Cigars
|
|
Yes
|
26 (4.4%)
|
No
|
578 (95.6%)
|
Currently Smoked Cigarette
|
|
Yes
|
13 (2.4%)
|
No
|
591 (97.6%)
|
Currently Use Smokeless Tobacco
|
|
Yes
|
14 (1.7%)
|
No
|
590 (98.3%)
|
Currently Drank Alcohol
|
|
Yes
|
125 (23.4%)
|
No
|
479 (76.6%)
|
Currently Binge Drinking
|
|
Yes
|
65 (13.1%)
|
No
|
539 (86.9%)
|
Lifetime Use of Prescription Pain Medicine
|
|
Yes
|
102 (16.1%)
|
No
|
502 (83.9%)
|
Lifetime Use of Marijuana
|
|
Yes
|
160 (28.4%)
|
No
|
444 (71.6%)
|
Lifetime Use of Cocaine
|
|
Yes
|
29 (4.1%)
|
No
|
575 (95.9%)
|
Lifetime Use of Methamphetamines
|
|
Yes
|
25 (3.6%)
|
No
|
579 (96.4%)
|
Lifetime Use of Ecstasy
|
|
Yes
|
29 (4.2%)
|
No
|
575 (95.8%)
|
Several substance use behaviors were significantly associated with homelessness among high school adolescents. Those who usually did not sleep at their parent's or guardian's home showed significantly higher rates of current electronic vapor product use than those who did (36.9% vs. 15.2%, p<0.0001). Similarly, a higher percentage reported current cigarette smoking (10.4% vs. 2.0%, p=0.0411). Moreover, this group exhibited significantly higher prevalence rates of lifetime methamphetamine usage (13.1% vs. 3.1%, p<0.001) and ecstasy usage (11.0% vs. 3.8%, p=0.0305). Although not statistically significant, trends indicated higher rates of substance use among those not sleeping at their parent's or guardian's home, including cigar smoking, smokeless tobacco use, lifetime prescription pain medication use, and lifetime cocaine use. Conversely, adolescents who typically sleep at home showed slightly higher rates of current alcohol use (23.5% vs 22.3%) and current binge drinking (13.3% vs 9.6%) compared to those who do not.
Table 3: Demographic Characteristics and Substance Use of High School Students by Homelessness
Variables
|
Homelessness
|
|
Usually did not sleep in Parent's/Guardian's home (N = 39, 4.9%)
|
Usually did sleep in Parent's/Guardian's home (N = 565, 95.1%)
|
P-Value
|
Phi Coefficient or Cramer's V
|
Age
|
|
|
0.3139
|
0.116+
|
At most 13 years
|
-
|
2 (0.1%)
|
|
|
14 years
|
10 (22.1%)
|
129 (19.6%)
|
|
|
15 years
|
6 (7.6%)
|
183 (28.0%)
|
|
|
16 years
|
10 (24.5%)
|
132 (22.4%)
|
|
|
17 years
|
8 (26.3%)
|
84 (20.8%)
|
|
|
At least 18 years
|
5 (19.5%)
|
35 (9.1%)
|
|
|
Sex
|
|
|
0.1757
|
0.0853
|
Female
|
15 (32.7%)
|
307 (52.4%)
|
|
|
Male
|
24 (67.3%)
|
258 (47.6%)
|
|
|
Grade
|
|
|
0.5824
|
0.08+
|
9th Grade
|
14 (27.6%)
|
202 (29.3%)
|
|
|
10th Grade
|
9 (12.9%)
|
162 (25.9%)
|
|
|
11th Grade
|
9 (36.0%)
|
125 (23.4%)
|
|
|
12th Grade
|
7 (23.5%)
|
76 (21.4 %)
|
|
|
Race
|
|
|
0.1552
|
0.0887+
|
Black or African American
|
19 (40.2%)
|
197 (34.4%)
|
|
|
White
|
11 (24.0%)
|
250 (42.9%)
|
|
|
Hispanic/Latino
|
5 (24.4%)
|
70 (15.2%)
|
|
|
Other Races
|
4 (11.4%)
|
48 (7.5%)
|
|
|
Currently Used an Electronic Vapor Product
|
|
|
< 0.0001*
|
0.1274
|
Yes
|
15 (36.9%)
|
77 (15.2%)
|
|
|
No
|
24 (63.1%)
|
488 (84.8%)
|
|
|
Currently Smoked Cigars
|
|
|
0.758
|
0.0166
|
Yes
|
4 (5.8%)
|
22 (4.3%)
|
|
|
No
|
35 (94.2%)
|
543 (95.7%)
|
|
|
Currently Smoked Cigarette
|
|
|
0.0411*
|
0.1204
|
Yes
|
1 (10.4%)
|
12 (2.0%)
|
|
|
No
|
38 (89.6%)
|
553 (98.0%)
|
|
|
Currently Use Smokeless Tobacco
|
|
|
0.5882
|
0.0256
|
Yes
|
2 (3.2%)
|
12 (1.7%)
|
|
|
No
|
37 (96.8%)
|
553 (98.3%)
|
|
|
Currently Drank Alcohol
|
|
|
0.8881
|
0.0057
|
Yes
|
13 (22.3%)
|
112 (23.5%)
|
|
|
No
|
26 (77.7%)
|
453 (76.5%)
|
|
|
Currently Binge Drinking
|
|
|
0.5519
|
0.0236
|
Yes
|
7 (9.6%)
|
58 (13.3%)
|
|
|
No
|
32 (90.4%)
|
507 (86.7%)
|
|
|
Lifetime Use of Prescription Pain Medicine
|
|
|
0.2474
|
0.0305
|
Yes
|
11 (21.0%)
|
91 (15.8%)
|
|
|
No
|
28 (79.0%
|
474 (84.2%)
|
|
|
Lifetime Use of Marijuana
|
|
|
0.7236
|
0.01
|
Yes
|
17 (30.4%)
|
143 (28.3%)
|
|
|
No
|
22 (69.6%)
|
422 (71.7%)
|
|
|
Lifetime Use of Cocaine
|
|
|
0.1769
|
0.0668
|
Yes
|
7 (9.9%)
|
22 (3.8%)
|
|
|
No
|
32 (90.1%)
|
543 (96.2%)
|
|
|
Lifetime Use of Methamphetamines
|
|
|
< 0.001*
|
0.1155
|
Yes
|
6 (13.1%)
|
19 (3.1%)
|
|
|
No
|
33 (86.9%)
|
546 (96.9%)
|
|
|
Lifetime Use of Ecstasy
|
|
|
0.03054*
|
0.0776
|
Yes
|
7 (11.0%)
|
22 (3.8%)
|
|
|
No
|
32 (89.0%)
|
543 (96.2%)
|
|
|
* are p-values less than 0.05, + are the Cramer-V coefficients
Regarding demographic variables, weak associations were found between homelessness and age, sex, grade, and race among high school students, suggesting a minimal relationship. Regarding substance use behaviors, we found weak associations between homelessness and current electronic vapor product use (Phi=0.1274), lifetime methamphetamine use (Phi=0.1155), and cigarettes (Phi=0.1204). Conversely, we observed negligible associations for smoking cigars and cigarettes, using smokeless tobacco, drinking alcohol, binge drinking, and lifetime use of prescription pain medication, suggesting less pronounced connections with homelessness. Overall, homeless high school adolescents exhibit significantly higher rates of substance use behaviors compared to their housed peers, emphasizing the need for targeted interventions to address these disparities.