Illicit Substance Use Among Youth in Taiwanese Temple Parade Troupes: The Roles of Social Relationships and Substance Acquisition Settings

This study examined illicit substance use among youth in Taiwanese temple parade troupes, a culturally distinct but high-risk population. In 2019, we surveyed 696 participants recruited on-site through convenience sampling across Taiwan using a structured questionnaire that assessed demographics, alcohol and tobacco use, substance-involved social ties, and acquisition settings. Three domains of substance-involved ties (family, peers, intimate partners; range 0–3) and three types of acquisition settings (private, social, public; range 0–3) were analyzed using descriptive statistics, one-way ANOVAs, and logistic regression models. The lifetime prevalence of illicit substance use was 9.8%. Because only three female participants reported illicit substance use, multivariable logistic regression analyses were restricted to male participants (n = 593) and adjusted for age and education. Odds of illicit substance use increased with the accumulation of substance-involved social relationships, with adjusted odds ratios (aORs, 95% CI) of 2.96 (1.48–5.91) for one type and 11.32 (3.72–34.44) for two types, compared with none; estimates for three types could not be obtained due to complete separation. In contrast, awareness of any acquisition setting was associated with markedly higher odds of illicit substance use (aORs, 95% CI: 1 = 22.48, 5.25–96.34; 2 = 59, 3.78–81.79; 3 = 37.27, 4.75–292.23). Findings highlight that accumulated substance-involved relationships and access through any acquisition setting are key structural conditions shaping substance use in this cultural context. While limited by its cross-sectional design and convenience sampling, the study provides novel evidence on culture-embedded risk structures and underscores the need for longitudinal and context-sensitive prevention strategies.