A Literature Review of Caregiver Risk Factors for Adolescent Substance Use

Background: Adolescent substance use is a significant public health concern in Canada, with rates of alcohol use reaching 75%, and both cannabis and tobacco use reaching 26%, in Ontario schools. This behaviour poses serious health risks, including dependence, neurocognitive deficits, and mental health challenges. Caregiver influence plays a critical role in shaping adolescent substance use. Currently, there remains a gap in the literature regarding prevention and intervention strategies tailored to at-risk youth that specifically consider caregiver-related risk factors. Objective: To identify evidence-based parental risk factors for adolescent substance use, to inform future prevention and intervention strategies. Methods: 420 studies were identified from an initial search for studies related to adolescent (defined as aged 10-19) substance use and parents. Results: 11 unique parental risk factors for adolescent substance use were identified. Low parental monitoring (24) and prenatal substance exposure (20) had the greatest number of studies and the largest compiled study populations. Seven risk factors were related to the parent-child relationship, such as low parental support and high parental permissiveness. Interparental conflict and parental substance use were also identified as significant risk factors. Three parent-child relationship factors, low parental punishment, low parental communication, and harsh parenting, had few but recent studies, indicating they may be emerging research topics in parent-child dynamics. Conclusion: This review identified several caregiver-related factors commonly associated with adolescent substance use, including prenatal substance exposure, low parental monitoring, and poor parent-child communication. While findings suggest these factors may interact in complex ways, further research is needed to clarify how they contribute to risk and how they might inform the development of supportive, family-centered prevention efforts.