Weighted Family History Density of Substance Use: Influence on Participant Substance Use Onset, Duration, and Escalation

Higher WFHD is strongly associated with earlier initiation, faster escalation to peak use, prolonged duration of substance use, and patterns of substance preference concordance, highlighting the importance of including family history assessments in substance use prevention and intervention strategies. Future research should use longitudinal studies to establish causal relationships and explore interactions between WFHD and other risk factors, such as environmental stressors, epigenetic changes, or genetic markers.