Purpose: To evaluate whether children's Exposure to Violence (EV) is associated with their own or their friends' use of alcohol, tobacco, and other drugs (ATOD).
Methods: The Violence Exposure Scale for Children-Revised (VEX-R) and the Substance Exposure Assessment (SXA) were given to 104 children participating in a longitudinal study of in-utero cocaine exposure (IUCE) at age 8.5, 9.5, and 11 years. Survival analyses evaluated the association of the quartile of VEX total score (higher scores indicating more violence exposure) at age 8.5 years, with time to first report of their own and their friends' use of ATOD from age 8.5-11 years.
Results: The sample consisted of 90% African-American/Caribbean children (mean age 8.5 years, SD 3 years), 53% males, and 49% with IUCE. The percentage of children who reported having substance-using friends was 12% at 8.5 years, 25% by 9.5 years, and 45% by 11 years. In multivariate survival analyses controlling for caregiver type, IUCE category, and child gender, children in the upper quartile of VEX-R total score at age 8.5 years were at significantly greater risk of having reported friends' use of ATOD by age 11 compared to those in the first through third quartiles (hazard ratio = 2.2; 95% CI = 1.14, 4.23; p = .02). Quartiles of the VEX score, however, were not significantly associated with children's acknowledgment of their own use (p = .85).
Conclusions: Our findings suggest an association between EV in childhood and report of peer ATOD use at school age. Campaigns to prevent ATOD use should address the impact of childhood exposure to violence.