Substance Use Among Middle School Adolescents: Association with Family Members’ and Peers’ Substance Use and the Mediating Role of School and Mental Difficulties

We assessed the associations of substance (alcohol, tobacco, cannabis, and other illicit drugs) use of adolescents with that of their family members (father, mother, step-parent, brothers/sisters, and grandparents) and peers, and the mediating role of school and mental difficulties (SMDs) which remained insufficiently addressed.