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: = 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.