A Theory-Guided Examination of Intrapersonal, Interpersonal and Environmental Correlates of Problematic Substance Use Among a National Sample of College Students Who Engage in Substance Use

Alcohol, tobacco and cannabis use remain prevalent among college students. To gain a comprehensive understanding of factors related to problematic use of these substances, we applied the Theory of Triadic Influence (TTI) and nested logistic regression. We used ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) scores from Spring 2023 American College Health Association-National College Health Assessment III participants without a previously diagnosed substance use disorder who had a lifetime history of alcohol, tobacco and cannabis use (N = 18,948 students). The prevalence of moderate-to-high alcohol-, tobacco- and cannabis-risk scores were 27.62%, 47.39%, and 50.23%, respectively. TTI-aligned correlates associated with increased likelihood of moderate-to-high risk use for all three substances included: psychological distress (intrapersonal), financial stress (environmental), and engaging in related behaviors including self-harm, partying, and additional substance use (immediate precursors). Several unique substance-specific correlates were identified as well. Strengths, limitations, and implications are discussed.