What question did this study set out to answer?

This study aims to identify distinct patterns of problematic social media use (PSMU) and examine their associations with adolescent substance use across multiple countries.

June 10, 2026

Problematic Social Media Use Profiles and Adolescent Substance Use Across Countries: A Latent Class Analysis With Multilevel Models

Key Points

This study aims to identify distinct patterns of problematic social media use (PSMU) and examine their associations with adolescent substance use across multiple countries.
Analyzed a representative sample of 157,717 adolescents from 39 countries using data from the 2017-2018 HBSC survey.
Conducted latent class analysis to identify patterns of PSMU.
Utilized multilevel logistic regression models to assess associations with smoking, drunkenness, and cannabis use.
Identified five PSMU patterns: Non-problematic (52.60%), Preoccupation-driven (8.42%), Conflictual-compulsive (11.37%), Regulation-failure (25.16%), and Highly-problematic (2.45%).
Highly-problematic users demonstrated the strongest links to substance use, followed by conflictual-compulsive and preoccupation-driven users.
Regulation-failure users showed the weakest associations with adolescent substance use, suggesting diverse implications.

Abstract

BACKGROUND: While substantial evidence suggests a significant association between problematic social media use (PSMU) and adolescent substance use, the complex nature of PSMU and its cross-national variations remain unclear. OBJECTIVES: This study aimed to identify distinct patterns of PSMU, compare their prevalence across countries, and examine the associations between these patterns and adolescent substance use. METHODS: This study analyzed a representative adolescent sample (N = 157,717) from 39 countries, utilizing data from the 2017-2018 Health Behaviour in School-aged Children (HBSC) survey. Latent class analysis (LCA) was conducted to identify different patterns of PSMU. Multilevel logistic regression models were then used to investigate the associations between these identified PSMU patterns and adolescent substance use, specifically focusing on smoking, drunkenness, and cannabis use. RESULTS: Five distinct patterns of PSMU were identified: Non-problematic users (52.60%), Preoccupation-driven users (8.42%), conflictual-compulsive users (11.37%), regulation-failure users (25.16%), and highly-problematic users (2.45%). The distribution of PSMU patterns varied across countries and regions, suggesting cross-national heterogeneity rather than a clear geographical or economic gradient. Consistent patterns of association were found between adolescent PSMU and substance use. Highly-Problematic Users showed the strongest associations with smoking, drunkenness, and cannabis use, followed by conflictual-compulsive users and preoccupation-driven users, while regulation-failure users exhibited the weakest association. CONCLUSIONS: These findings underscore the importance of developing tailored interventions for adolescent PSMU that are based on distinct patterns. Furthermore, special attention should be given to the diverse associations of these PSMU patterns with adolescent substance use.

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