{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:06:03Z","timestamp":1780031163171,"version":"3.53.1"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adolescent substance use is high in the Caribbean. To inform policy and programming, it is necessary to understand these behaviors at the country level. However, little is known about adolescent substance use in small island states. For the first time, we determined the prevalence and correlates of adolescent substance use in the Turks and Caicos Islands (TCI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We used secondary data from the first Global School-based Health Survey, conducted from May to June 2022. All students in all schools were invited to complete the cross-sectional survey in their classrooms. The student response rate was 66.5%;\n                      <jats:italic>N<\/jats:italic>\n                      = 1,684, M\n                      <jats:sub>age<\/jats:sub>\n                      = 14.3 years, 49.82% male. We determined the frequency of recent alcohol, tobacco, and marijuana use, defined as any use in the previous 30 days (yes\/no). Informed by the socioecological model, we considered individual factors (sex, age, food scarcity, bullying victimization, and psychological distress) and interpersonal factors (peer support and parent-adolescent relationship quality) as predictors of substance use in logistic regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Recent alcohol, tobacco, and marijuana use was reported by 29.11, 12.05, and 9.01% of adolescents, respectively. Older age, psychological distress, and lower parental involvement were associated with alcohol use. Psychological distress and lower parental involvement were associated with tobacco use. Finally, male sex, older age, psychological distress, bullying victimization, and lower parental involvement were associated with marijuana use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study demonstrates substance use above global averages and suggests interventions primarily focused on promoting parental involvement and preventing psychological distress. Further qualitative and quantitative interviews will provide more informed intervention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1747234","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:50:53Z","timestamp":1780030253000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and socio-ecological correlates of adolescent alcohol, tobacco, and marijuana use in the Turks and Caicos Islands"],"prefix":"10.3389","volume":"14","author":[{"given":"Shandey D.","family":"Malcolm","sequence":"first","affiliation":[{"name":"Department of Public Health, Purdue University, West Lafayette","place":["IN, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Psychological Sciences, Purdue University, West Lafayette","place":["IN, 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