Prevention Science

, Volume 17, Issue 4, pp 483–492 | Cite as

Associations Among Excess Weight Status and Tobacco, Alcohol, and Illicit Drug Use in a Large National Sample of Early Adolescent Youth

  • Meg H. Zeller
  • Jennifer Becnel
  • Jennifer Reiter-Purtill
  • James Peugh
  • Yelena P. Wu


Adolescent substance use and overweight/obesity each are public health priorities, with unique prevalences based on race/ethnicity. Whether these biobehavioral risks are linked in today’s youth is unknown, leaving critical gaps in prevention science. Utilizing a national epidemiological sample of 10th grade students (N = 19,678; M age = 16.09 years; 69.5 % White, 14.5 % Black, 16.0 % Hispanic; 2008–2009 Monitoring the Future), we examined adolescent substance use behaviors (current use, grade of first use, polysubstance use) for adolescents of overweight (OV), obese (OB), or severely obese (SO) status compared to adolescents of healthy weight (HW) for each race/ethnicity group. We also examined how engagement in smoking behaviors (current, early grade at first use) was linked to other substance use behaviors for youth of varying degrees of excess weight. Relative to HW youth, White youth of excess weight, particularly SO, had higher odds of early (<grade 9) substance use and use of some illicit substances (inhalants, cocaine, amphetamines) within the past year. Among White early smokers, OB and SO had higher odds of other substance use, whereas White OB and SO recent smokers had lower odds of other substance use. Few significant findings based on weight status were identified for Black or Hispanic youth. These findings suggest adolescent health risk behaviors co-occur uniquely for White youth, in particular those who are SO and by early adolescence. Understanding the downstream public health consequences and how risk pathways of excess weight, tobacco, and other substance use may uniquely unfold for each race/ethnicity group is imperative.


Adolescence Obesity Substance use 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


This paper uses data from the Monitoring the Future Study, which is supported by grants from the National Institute on Drug Abuse (R01DA001411, R01DA016575). Dr. Zeller’s effort was supported by grants from the National Institutes of Health (R01DA033415, 2R01DK080020). Dr. Becnel’s effort was supported by an NIH training grant (T32DK063929). Dr. Wu’s effort, in part, was also NIH supported (K07CA196985).

Research Involving Human Participants

The present manuscript involved secondary data analyses of de-identified data from a Monitoring the Future. Secondary analyses were approved by the Institutional Review Board with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent is not applicable.


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Copyright information

© Society for Prevention Research 2016

Authors and Affiliations

  • Meg H. Zeller
    • 1
    • 4
  • Jennifer Becnel
    • 2
  • Jennifer Reiter-Purtill
    • 1
  • James Peugh
    • 1
    • 4
  • Yelena P. Wu
    • 3
  1. 1.Division of Behavioral Medicine and Clinical PsychologyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Human Development and Family Studies, School of Human Environmental SciencesUniversity of ArkansasFayettevilleUSA
  3. 3.Department of Family & Preventive Medicine, Division of Public Health, Cancer Control and Population Sciences, Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUSA
  4. 4.Department of PediatricsUniversity of College of MedicineCincinnatiUSA

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