Original article
Substance Use Among Asian Americans and Pacific Islanders Sexual
Minority Adolescents: Findings from the National Longitudinal
Study of Adolescent Health
Hyeouk Chris Hahm, Ph.D., L.C.S.W.
a,
*, Frank Y. Wong, Ph.D.
b
,
Zhihuan Jennifer Huang, M.B., Ph.D., M.P.H.
b
, Al Ozonoff, Ph.D.
c
, and
Jieha Lee, M.S.W., M.A.
a
a
Boston University School of Social Work, Boston, Massachusetts
b
Department of International Health, NHS, Georgetown University, Washington, DC
c
Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
Manuscript received October 9, 2006; manuscript accepted August 10, 2007
Abstract Purpose: We assessed the prevalence, incidence, and correlates of substance use among Asian
American individuals transitioning from adolescence to young adulthood.
Methods: Data were obtained from the National Longitudinal Study of Adolescent Health, Wave
II (1996) and Wave III (2001). Information on substance use was abstracted from a nationally
representative sample of 1108 Asian Americans and Pacific Islanders (AAPIs) from both Waves.
Weighted prevalence, incidence, and patterns of smoking, binge drinking, marijuana use, and other
drug use were analyzed by sexual orientation and gender. Multiple logistic regression analyses were
conducted to investigate the unique contribution of being a sexual minority in relation to four types
of substance use by gender.
Results: A link between sexual orientation and substance use behaviors among AAPIs did not
emerge until young adulthood. Significant increases in the incidence and prevalence of all four types
of substance use (tobacco, binge drinking, marijuana, and other drugs) were found among sexual
minority AAPIs. Specifically being an AAPI sexual minority young woman, compared with being
a heterosexual young woman, a heterosexual young man, or a sexual minority young man, was
significantly associated with substance use after controlling for demographic characteristics, prob-
lem behaviors, and substance use during adolescence. Also the highest prevalence of substance use
was found among AAPI sexual minority women.
Conclusions: These findings add greater urgency to addressing the role of sexual orientation in
designing substance abuse programs. © 2008 Society for Adolescent Medicine. All rights reserved.
Keywords: Substance use; Asian Americans; AAPI; Adolescent; Adolescents; Sexual minority adolescents; Gays and
lesbians; Sexual orientation; Add Health; Health risk behavior; Alcohol and drug use
Adolescent substance use is associated with a broad
range of social, psychological, behavioral, and health risks
[1], including increased risk of car accidents, violence [2],
and suicide [3]. The initiation of drug use usually occurs
during this “emerging adulthood” and may lead to chronic
substance abuse as well [4]. Epidemiologic studies have
documented that sexual minority groups have higher rates
of substance use and abuse than heterosexual groups [5].
Despite the marked population growth among Asian Amer-
icans and Pacific Islanders (AAPIs), we know little about
substance use in this population, particularly about the sub-
stance use of AAPI sexual minority groups. Understanding
substance use among AAPI sexual minority groups will
*Address correspondence to: Hyeouk Chris Hahm, Ph.D., L.C.S.W.,
Boston University School of Social Work, 264 Bay State Road, Boston,
MA 02215.
E-mail address: hahm@bu.edu
Journal of Adolescent Health 42 (2008) 275–283
1054-139X/08/$ – see front matter © 2008 Society for Adolescent Medicine. All rights reserved.
doi:10.1016/j.jadohealth.2007.08.021