A prospective study of the risk and protective factors of substance use among vocational high school students in Taipei

Objectives: This three-year longitudinal study examined changes in the patterns of risk and protective factors of substance initiation (smoking, alcohol use, betel quid chewing, and illicit drug use) among a vocational high school student cohort in Taipei. Methods: A total of 1763 10th graders were followed to the 12th grade (2000-2002). Logistic regression was used to examine the baseline and longitudinal changes in risk and protective factors for substance initiation. Results: Among students who did not use any substances in grade 10. 166 (11.0%), 184 (13.1%), 40 (2.3%), and 28 (1.6%) students initiated smoking, alcohol use, betel quid chewing, and illicit drug use by grade 12, respectively. In the 10th grade, higher risk factors, such as peer use, being offered the substance by another person, concomitant substance use (i.e. smoking and alcohol use), and lower protective factors, such as refusal selp-efficacy and presence of an anti-substance use attitude, predicted youth substance initiation by grade 12. Increases in risk factors and decreases in protective factors from the 10th to 12th grades were significantly associated with substance use initiation in youths. Conclusions: The risk and protective factors in grade 10 and longitudinal changes from grade 10 to 12 predicted youth substance use initiation.