Cultural Stressors Related to Positive Tobacco, Alcohol and Drug Use Attitudes in Immigrant Hispanic Adolescents and the Role of Self-Identity

Introduction: Positive attitudes toward alcohol, tobacco and drug (ATOD) use can be influenced by multiple internal and external factors including, but not limited to: parent/peer norms, personality traits, self-identity and stress exposure. Bicultural stress (a cognitive appraisal of stress related to conflict from balancing two cultural domains simultaneously), perceived discrimination (being treated differently based on membership in a cultural group) and perceived negative context of reception (feeling unwelcome or not afforded the same opportunities compared to others due to social group membership) have been implicated in substance use behavior among United States (U.S.) born and immigrant Hispanic/Latino adolescents, but have not been studied concurrently in relation to positive ATOD attitudes. The goal of this investigation was to determine whether different sources of cultural stress (bicultural stress, perceived discrimination and perceived negative context of reception) were associated with positive ATOD attitudes in a sample of immigrant Hispanic adolescents with identity cohesion and confusion as mediating pathways.

Methods: Data came from the COPAL (Constuyendo Oportunidades Para Adolecentes Latinos) study, a multisite longitudinal investigation of culture, migration and health behaviors among immigrant adolescents and their families in Miami, Florida and Los Angeles, California. The analytic sample for the present investigation consists of 271 Hispanic adolescents with 128 from Los Angeles (70% Mexican) and 143 from Miami (61% Cuban).

Results: On average, participants were 14.51 years old at Time 1 (SD = 0.88) and 142 (47%) are female. Controlling for age, gender, site, and years in the U.S., multivariate linear regression analyses revealed that positive alcohol and drug use attitudes at time 3 were directly and prospectively related to time 1 bicultural stress (p<0.05) and perceived negative context of reception (p<0.01). Results from structural equation modeling indicated that bicultural stress and perceived negative context of reception were indirectly associated with positive attitudes for tobacco use, alcohol and other drug use at Time 3 through higher levels of identity confusion. Perceived discrimination was not associated with any outcomes when accounting for other cultural stressors, and identity cohesion was not related to positive ATOD attitudes.

Conclusions: Bicultural stress can contribute to identity confusion and enhance risk for increased positive attitudes towards tobacco, alcohol and other drugs.  Moving into a community with negative perceptions toward Hispanic/Latino immigrant groups also appears to promote identity confusion leading to heightened positive substance use attitudes among immigrant adolescents.