Childhood Exposure to Household Substance Use Problems and Substance-Related Outcomes: Smoking, Drug Use, Self-Directed Medication Use, Hazardous Alcohol Use, and Self-Perceived Addiction

Childhood exposure to household substance use problems is a recognized adverse childhood experience associated with increased risk for substance-related problems later in life. However, less is known about whether this exposure is associated with multiple substance-related outcomes after accounting for other adverse and positive childhood experiences. Data were drawn from a nonprobability quota-based survey of Slovenian adults (N = 4,940), weighted to population benchmarks. Childhood exposure to household substance use problems was defined as living before age 18 with someone who was addicted to alcohol, used illicit drugs, or misused medications. Logistic regression models examined current smoking, lifetime illicit drug use, self-directed medication use, hazardous alcohol use, and self-perceived addiction to tobacco, alcohol, or illicit drugs. Models were adjusted for sex, age, education, other adverse childhood experiences (ACEs) and positive childhood experiences (PCEs). Childhood exposure to household substance use problems was reported by 21.1% of participants. After adjustment for sociodemographic characteristics, other ACEs, and PCEs, exposure to household substance use problems was associated with higher odds of current smoking, lifetime illicit drug use, self-directed medication use, and self-perceived addiction. The association with hazardous alcohol use was less robust and varied across alternative operationalizations. Associations were modest in magnitude. Childhood exposure to household substance use problems was associated with several substance-related outcomes although associations were generally modest and the finding for hazardous alcohol use was less robust. The findings support considering household substance use problems within the broader context of childhood adversity while avoiding causal interpretations.