Adolescent Polysubstance Use: The Intersection of Social Media Use Frequency and Cyberbullying

Polysubstance use among adolescents is a growing public health concern related to serious health risks. While prior research has explored the impact of social media and cyberbullying on adolescent substance use, most studies focus on individual substances. This study examined the association between social media use frequency and adolescent polysubstance use, accounting for the role of cyberbullying. This study utilized data from the 2023 Youth Risk Behavior Survey, a nationally representative sample of high school students (N = 18,149, 47.7% female). Descriptive analyses identified patterns of e-cigarette, alcohol, and marijuana use among adolescents. Multinomial logistic regression assessed the relationship between social media use and polysubstance use, with cyberbullying included as a covariate. Approximately 29.6% of participants (n = 5425) reported engaging in substance use behaviors. Among these adolescents, nearly one in four (24.8%) reported concurrent use of all three substances. The multinomial logistic regression revealed that adolescents using social media more than once per hour had nearly 10 times higher odds of using all three substances (OR = 9.79; 95% CI: 4.68–20.51) compared to nonsocial media users. Adolescents who experienced cyberbullying in the past year had four times higher odds (OR = 4.06; 95% CI: 3.01–5.49) of engaging in concurrent use of all three substances, compared with their peers. Social media use frequency and cyberbullying are significantly associated with adolescents’ polysubstance use behavior. To address this public health issue, intervention efforts may benefit from targeting high-frequency social media users and adolescents who have experienced cyberbullying.