Adolescent Romantic Breakup and Substance Use Among Emerging Adults in Delhi-NCR, India

BACKGROUND: While life-course research has emphasized the role of early-life adversity in shaping substance use trajectories, less attention has been paid to developmentally normative yet emotionally salient experiences, such as adolescent romantic breakups (ARBs). This study examined associations between ARBs and substance use patterns (alcohol, tobacco, and cannabis) and addiction-related risk among emerging adults in the Delhi National Capital Region, independent of adverse childhood experiences (ACEs). METHODS: This cross-sectional study included 1468 college-going young adults aged 18-25 years. ARB was defined as experiencing a romantic breakup before age 18. Substance use and addiction-related risk were assessed using the WHO ASSIST. RESULTS: ARB was associated with higher odds of lifetime alcohol use (adjusted OR [aOR] = 2.55), frequent alcohol use (aOR = 4.77), and alcohol-related addiction risk (aOR = 3.59). Similar associations were observed for tobacco (lifetime use aOR = 2.97; addiction risk aOR = 3.13) and cannabis, particularly for frequent use (aOR = 6.27). These associations remained significant after adjustment for ACEs. However, correlations between substance use and addiction risk were comparable among participants with and without ARB. CONCLUSIONS: ARB may be an overlooked but important factor associated with substance use initiation and escalation in emerging adulthood, alongside other factors, including mental health.