Older age and free school meals are associated with increased likelihood of substance use

Alcohol, tobacco and illegal drug use among young people is a public health concern in the UK. The short and long term risks to health are well known and range from accidental injuries, violence, sexual ill-health and increased rates of chronic conditions and premature death. A range of policies have been directed at reducing substance use among English children. Despite this, the number of children taking substances remains substantial. In 2009, it was reported that 180,000 children aged 11 to 15 years old in England smoked tobacco regularly, 540,000 had consumed alcohol in the previous week, and 250,000 had taken drugs in the previous month.

A new study, published today in the Journal of Public Health, explores the relationship between substance use, subjective wellbeing and in 10-15 year olds attending schools in two local authorities in the North West of England. The authors, Siobhan Farmer and Dr. Barbara Hanratty from the University of Liverpool, have found that receiving free and a feeling of wellbeing are associated with substance use in children and . Young people who report being happy or are able to communicate with their family rather than friends are less likely to use substances. But older age and receiving free school meals are associated with an increased likelihood of substance use.

The study, entitled 'The relationship between subjective wellbeing, low income and substance use among schoolchildren in the north west of England: a cross-sectional study', analysed the Tellus4 dataset, a national, anonymous, school-based cross sectional survey for children aged 10 and 11 (year 6), 12 and 13 (year 8), and 14 and 15 (year 10). The data included the responses of 3903 children from two and represents 1.2% of the national sample, with approximately equal distribution across all year groups.

Substance use

The main finding of the study was that age was the most significant predictor of substance use. Compared to children in year 6, year 8 children were between two and six times more likely to misuse substances and year 10 children between eleven and twenty-nine times more likely. Smoking was found to be associated with the use of other substances. The number of children smoking more than one cigarette a week was much higher amongst those who were regular users of drugs and alcohol, compared to children with no experience of drugs and alcohol. Smoking more than one cigarette was also negatively associated with a sense of happiness and being able to talk to their parents.

A sense of well being

Children who reported feeling happy were 18.4% less likely to have tried smoking, 44.8% less likely to have used alcohol, and 6.4% less likely to have tried drugs. Three-quarters of the participants who felt happy said that they could talk to their parents, while only half of those who said they did not feel happy could do so. Interestingly, children who reported having a better relationship with their friends were 40% more likely to use substances than those who had poor relationships.

Free school meals

In the study, approximately one in five children (18.2%) were eligible for free school meals. Children eligible for free school meals were more likely to report being unhappy than children who were not eligible, felt less able to talk to their friends or parents, and were less likely to say they had one or more good friends. One third (31.6%) of children eligible for free school meals smoked at least once, compared to one fifth of children not eligible. Just over one in four (25.9%) who reported drinking alcohol were drunk once or more often in the last 4 weeks, in comparison to one in five (19.5%) of their peers who did not receive free school meals. The study showed that children in years 8 and 10 eligible for free school meals were twice as likely to have tried drugs, compared to children who did not receive free school meals.

Gender differences

The results showed a gender variation in substance use, with 23.5% of girls reporting trying a cigarette in comparison to 20.5% of boys, although there was no significant difference in those that smoke more than one cigarette a week. Boys were significantly more likely to have tried both alcohol and drugs, with 4% reporting having an alcoholic drink and twice as many reporting experimentation with drugs. Importantly, this general trend was consistent across all age groups with the exception of alcohol use in year 10. In year 10, Girls were 3% more likely than boys to have tried alcohol. They were also more likely to have been drunk in the preceding four weeks, with almost twice as many girls in year 10 – 19.5% compared to 11.5% - reporting being drunk at least three times. Differences in subjective wellbeing were also found, with 3% of girls feeling less able to talk to their parents and 7% reporting feeling unhappy.

Siobhan Farmer comments that, 'our findings show that a sense of wellbeing and the use of drugs, alcohol and cigarettes are associated with each other. The connection between substance use and free school meals also suggests that policies need to address income inequality and environmental factors that affect children's use of drugs. Our research suggests that addressing income inequality and environmental factors may be an essential adjunct to intervention in to reduce inequalities associated with and enhance the health and wellbeing of young people in the UK."

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