Abstract
Background: Substance use, including tobacco, alcohol, and cannabis, is widespread among college students and has been linked to mental health issues. This study investigates the relationship between substance use risk and serious mental illness (SMI) in a large college student sample, examining how different levels of use correlate with mental health outcomes.
Methods: Utilizing variables from the American College Health Association National College Health Assessment III (Fall 2019-present) Spring 2022 reference group dataset (n = 69,131 students), we assessed the association between levels of substance use (tobacco, alcohol, cannabis) and SMI, controlling for demographic and behavioral covariates. The sample included college students at low, moderate, and high risk for each substance.
Results: Findings indicated significant associations between increased substance use risk and increased odds of SMI, as evidenced in tobacco moderate-risk users (OR = 1.30, 95% CI: 1.21–1.40) and high-risk users (OR = 2.67, 95% CI: 2.27–3.14) when compared to low-risk users. Alcohol moderate-risk users (OR = 1.66, 95% CI: 1.55–1.77) and high-risk users (OR = 3.38, 95% CI: 2.83–4.04) had higher odds of SMI. Also, cannabis moderate-risk users (OR = 1.66, 95% CI: 1.55–1.77) and high-risk users (OR = 3.33, 95% CI: 2.82–3.92).
Conclusion: The study highlights a strong link between substance use and SMI among college students, emphasizing the need for targeted mental health interventions that address substance use. Results underscore the importance of incorporating substance use prevention and mental health support programs tailored to at-risk groups.
Implications: These associations indicate the need for early intervention programs that identify students at risk of developing more severe substance use behaviors and mental health issues. Further, these findings suggest colleges should prioritize integrated health services that address physical, mental, and behavioral health. There is a need for longitudinal research to understand better how substance use impacts mental health outcomes over time by tracking the mental health trajectories of students to identify potential long-term risks and protective factors.
Notes
References:
1. Becker, H. C. (2017). Influence of stress associated with chronic alcohol exposure on drinking. Neuropharmacology, 122, 115-126. https://doi.org/10.1016/j.neuropharm.2017.04.028
2. De Faria, L., Mezey, L., & Winkler, A. (2021). Cannabis Legalization and College Mental Health. Current Psychiatry Reports, 23(4), 17. https://doi.org/10.1007/s11920-021-01231-1
3. Fluharty, M., Taylor, A. E., Grabski, M., & Munafò, M. R. (2017). The Association of Cigarette Smoking With Depression and Anxiety: A Systematic Review. Nicotine Tob Res, 19(1), 3-13. https://doi.org/10.1093/ntr/ntw140
4. Garey, L., Olofsson, H., Garza, T., Shepherd, J. M., Smit, T., & Zvolensky, M. J. (2020). The Role of Anxiety in Smoking Onset, Severity, and Cessation-Related Outcomes: a Review of Recent Literature. Current Psychiatry Reports, 22(8), 38. https://doi.org/10.1007/s11920-020-01160-5
5. Grant, J. E., Lust, K., Fridberg, D. J., King, A. C., & Chamberlain, S. R. (2019). E-cigarette use (vaping) is associated with illicit drug use, mental health problems, and impulsivity in university students. Ann Clin Psychiatry, 31(1), 27-35.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Interprofessional, Interdisciplinary, Public and Community Health, Health Equity or Social Determinants of Health, College Students, Substance Use, Mental Health
Recommended Citation
Elijah, Odunayo A.; Mugoya, George T.; and Mumba, Mercy Ngosa, "The Association Between Substance Use and Mental Health in College: A Multi-Substance Analysis" (2025). International Nursing Research Congress (INRC). 259.
https://www.sigmarepository.org/inrc/2025/presentations_2025/259
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
The Association Between Substance Use and Mental Health in College: A Multi-Substance Analysis
Seattle, Washington, USA
Background: Substance use, including tobacco, alcohol, and cannabis, is widespread among college students and has been linked to mental health issues. This study investigates the relationship between substance use risk and serious mental illness (SMI) in a large college student sample, examining how different levels of use correlate with mental health outcomes.
Methods: Utilizing variables from the American College Health Association National College Health Assessment III (Fall 2019-present) Spring 2022 reference group dataset (n = 69,131 students), we assessed the association between levels of substance use (tobacco, alcohol, cannabis) and SMI, controlling for demographic and behavioral covariates. The sample included college students at low, moderate, and high risk for each substance.
Results: Findings indicated significant associations between increased substance use risk and increased odds of SMI, as evidenced in tobacco moderate-risk users (OR = 1.30, 95% CI: 1.21–1.40) and high-risk users (OR = 2.67, 95% CI: 2.27–3.14) when compared to low-risk users. Alcohol moderate-risk users (OR = 1.66, 95% CI: 1.55–1.77) and high-risk users (OR = 3.38, 95% CI: 2.83–4.04) had higher odds of SMI. Also, cannabis moderate-risk users (OR = 1.66, 95% CI: 1.55–1.77) and high-risk users (OR = 3.33, 95% CI: 2.82–3.92).
Conclusion: The study highlights a strong link between substance use and SMI among college students, emphasizing the need for targeted mental health interventions that address substance use. Results underscore the importance of incorporating substance use prevention and mental health support programs tailored to at-risk groups.
Implications: These associations indicate the need for early intervention programs that identify students at risk of developing more severe substance use behaviors and mental health issues. Further, these findings suggest colleges should prioritize integrated health services that address physical, mental, and behavioral health. There is a need for longitudinal research to understand better how substance use impacts mental health outcomes over time by tracking the mental health trajectories of students to identify potential long-term risks and protective factors.
Description
This study identifies significant associations between substance use (tobacco, alcohol, cannabis) and serious mental illness (SMI) in college students, with higher substance use risk correlating with increased odds of SMI. Findings emphasize the need for targeted, integrated health interventions and mental health support tailored to at-risk students. Attendees will learn about the critical role of substance use prevention in mental health and effective strategies for college health services.