Exploring the protective role of school peers in substance use prevention among American Indian adolescents.

Social network scholars have long recognized the role that social connections play in the substance use behavior of adolescents as they rely less on their parents/caregivers and more on their school peers. In this article, we explore the role of social networks as they relate to the substance use patterns of American Indian youth, 9th and 10th grade students attending one of three schools on one large Great Plains reservation. Using social network information from eligible youth (egos), we explore how their connections to others (alters) are associated with substance use patterns of alcohol, marijuana, and tobacco use. We found that a higher proportion of family members in social networks was protective against alcohol use, while a high proportion of alters who used substances increased the likelihood of use across all substances. We also find that egos who have alters that actively discourage the use of specific substances are protective for some substances. These results underscore the complexity and interplay of alters' behaviors and influence on egos and the need for further exploration of positive peer influence, especially to address the vexing issue of persistent substance use for AI youth.