Factors associated with alcohol abstinence in North American Indigenous youth: Age, gender, and cultural identity.

BACKGROUND

North American Indigenous youth are at increased risk for alcohol use, yet little literature explores why some choose to abstain from alcohol use. This study aimed to: characterize the reasons why Indigenous youth abstain from alcohol; explore how these reasons vary by age, sex, and whether or not the youth reside on or off a reservation; and examine how reasons for abstaining may mediate the relationship between cultural identity and intentions to drink 5 years in the future.

METHODS

Data were sourced from the Substance Use Among American Indian Youth: Epidemiology and Etiology, [United States], 2015-2020 study. Data from 2665 Indigenous youth (48.1% female, Mage = 14.2 (SD = 1.7)) who reported no lifetime alcohol use were extracted.

RESULTS

Factor analysis of the reasons for abstaining from alcohol resulted in two factors: to avoid negative consequences and due to social reasons. Females (vs. males), younger (vs. older) youth, and youth who lived on a reservation (vs. those who did not) endorsed avoiding consequences and social reasons as more important (p's < 0.01). A serial mediation analysis found that, while controlling for age, sex, and reservation-dwelling, social, but not negative consequences, reasons significantly mediated the relationship between cultural identity and intention to drink 5 years in the future (indirect effect = -0.020, p = 0.02, 95% CI [-0.039, -0.005]).

CONCLUSIONS

These results extend previous research on the protective role of cultural identity on alcohol use and suggest that developing social reasons to abstain from alcohol may be a modifiable risk factor to encourage alcohol abstinence in Indigenous youth.