Quantity and quality of outside of schooltime activities and substance use among Minnesota's LGBTQ+ students.

OBJECTIVE

To examine whether quantity and quality of outside of schooltime (OST) activities are associated with substance use among lesbian, gay, bisexual, transgender, queer, and beyond (LGBTQ+) youth.

METHODS

Data came from the Minnesota Student Survey, administered January-June 2022 in public, tribal, and charter schools in Minnesota, United States. The sample included 24,400 LGBTQ+ students in grades 8, 9, and 11. Logistic regression assessed associations between OST activity quantity and quality and past-30-day e-cigarette, alcohol, and cannabis use.

RESULTS

Overall, 21% of the LGBTQ+ subsample reported past-30-day substance use. Examined independently, high OST quantity was associated with lower odds of e-cigarette (aOR = 0.73, 95% CI = 0.66, 0.81) and cannabis use (aOR = 0.77, 95% CI = 0.68, 0.87). Analyzed together, higher quality was associated with lower odds of all three substances, and inverse associations for quantity became nonsignificant. Adjusting for quality, high quantity was associated with higher odds of alcohol use (aOR = 1.16, 95% CI = 1.05, 1.28).

CONCLUSIONS

Activity quality was more consistently associated with lower odds of substance use than quantity of participation. Constructing high-quality, supportive OST environments could reduce substance use risk and address behavioral health disparities.