Mapping the Landscape of Adolescent Substance Use: A Review

Abstract

Introduction: Adolescence (10–19 years) is a critical developmental period marked by biological, psychological, and social transitions that increase vulnerability to substance use. Globally, alcohol, tobacco, cannabis, and emerging products such as e-cigarettes contribute substantially to adolescent morbidity and long-term health risks. The evolving landscape of novel psychoactive substances, shifting cannabis policies, and post-pandemic behavioral changes necessitates updated synthesis of evidence. Methods: A systematic search of PubMed, MEDLINE, PsycINFO, Scopus, Web of Science, and the Cochrane Library identified peer-reviewed studies published between January 2010 and December 2024. Eligible studies included adolescents (mean age 10–19 years) and examined prevalence, determinants, consequences, or interventions. Two reviewers independently screened records (κ = 0.84). Of 1,261 identified records, 24 studies met inclusion criteria. Due to heterogeneity, findings were synthesized narratively using a socio-ecological framework. Study quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Results: Alcohol and tobacco remain the most prevalent substances globally, with increasing uptake of e-cigarettes and region-specific rises in cannabis and opioid use. Indian studies report prevalence ranging from 7% to 56%, with tobacco as the most common substance and early initiation often before age 15. Risk factors span genetic vulnerability, mental health disorders, peer influence, family substance use, and socioeconomic disadvantage. Consequences include impaired neurocognitive development, psychiatric comorbidity, academic decline, and social dysfunction. School-based life-skills programs, family-focused interventions, taxation policies, and brief motivational interventions demonstrate modest but meaningful preventive effects. Conclusion: Adolescent substance use is a multifactorial public-health challenge requiring integrated, multi-level prevention and culturally responsive interventions, particularly in low- and middle-income settings.