Date of Conferral





Public Health


Nancy Rea


The purpose of this study was to examine the strength of the association between race, trauma, and the age of initiation for substance use, specifically tobacco, marijuana, alcohol among high school students aged 13-18 in the United States. This research is critical because prior research has shown that trauma and race led to higher rates of substance use in adulthood. Still, limited research has shown how these factors affect the age of substance use initiation. The theoretical foundation for this study was the general strain theory since the theory posits that exposure to stresses or strain leads to delinquency, which in this case is substance use. Further, past research on adverse childhood experiences of abuse, neglect, and exposure to substances defined trauma for this study. The 6 research questions looked at the difference in the age of initiation for 3 substances (tobacco, alcohol, and marijuana) by race/ethnicity and trauma history, while controlling for age, grade level, gender, and sexual identity. The strength of the association between variables were assessed using risk analysis and ordinal logistic regression. The results showed that trauma consistently contributed to an earlier age of initiation of substance use across all 3 substances. Race contributed at very early ages of initiation (age of 10 or younger) for all substances, but only with marijuana across all adolescent ages of initiation. However, trauma and race both contributed to very early substance use initiation (age 10 or younger) across all 3 substances. These findings demonstrate that positive social change can be achieved by preventing trauma in youth; therefore, funding more interventions to children 8 years old and younger to help build protective factors against trauma will help prevent substance use.