Characterizing Profiles of Substance Use and Addictive Behaviors Among High School Students: A Latent Class Analysis

Adolescence is a critical period for experimenting with substances and addictive behaviors. Early initiation and co-occurrence of these behaviors are associated with adverse mental health, academic, and social outcomes/measures, underscoring the importance of identifying distinct patterns. We investigated correlates of substance use, gambling, and high-frequency screen time from a representative school-based survey. Using 2019 Youth Risk Behavior Survey Connecticut data (N = 2,015), we conducted a latent class analysis using 17 behavioral and substance use indicators. Chi-square test and logistic regressions explored associations between class membership and demographics, health, academic grades, perceived support, physical fights, and other high-risk behaviors. Four classes emerged: minimal substance use and addictive behaviors (Low Class: 63.9%), frequent screen time, gambling, e-vaping, alcohol and marijuana use (MEG (Marijuana/E-vapor/Gambling) Class: 22.0%), frequent screen time, gambling, e-vaping, alcohol use, binge drinking, marijuana and non-prescribed pain medication use (BigMEG (Binge-drinking/Marijuana/E-vapor/Gambling) Class: 11.8%), and high probability across all features (High Class: 2.3%). Compared to Low Class, males had lower odds of BigMEG Class membership; higher grades with lower odds of MEG, BigMEG, and High Classes membership; higher perceived family/teacher support with lower odds of High Class membership; good mental health with lower odds of MEG and BigMEG membership; and, involvement in physical fights and high-risk behaviors with higher odds of MEG, BigMEG, and High Classes membership. Findings highlight the need for targeted prevention strategies addressing specific behavioral patterns. Future studies with more specific assessments are needed to better understand the patterns of gambling and high-frequency screen time.