Under the Influence of Norms: Social Support and the Use of Alcohol and Cannabis Among Reservation-Based Adolescents.

Adolescent substance use is influenced by social support and social norms, which can be protective or risk-enhancing. This study analyzed survey data at baseline and 6-month follow-up from 919 adolescents attending schools on or near the Cherokee Nation Reservation. Generalized linear mixed-effects models assessed the influence of social support from parents/caregivers, teachers, community adults, and peers on alcohol and cannabis use with tests of moderation by injunctive and descriptive norms. Results revealed significant moderation in four of ten models. Parental support had stronger protective effects on alcohol use when parental disapproval was high, and teacher support had stronger protective effects on cannabis use when adult disapproval was high. Community adult support consistently protected against cannabis use. In low-normative contexts, friend support was a risk factor for alcohol use. Findings show the complex interaction of social support and norms with source- and substance-specific effects alongside implications for theory and prevention.