A Mediation Model for Biculturalism and Cigarette and Betel Nut Use: The Case of Adolescents in Guam.

The present study examined the associations between biculturalism and cigarette and betel nut use and the potential mediating roles of cigarette and betel nut use risk perception and resistance to peer and adult influence among adolescents in Guam. Participants were 673 ethnically diverse students (49% female; M age = 12.7, SD = .89) from eight public middle schools. The results showed that biculturalism was not associated with cigarette use directly; however, this association was mediated by cigarette use risk perception and resistance to peer and adult influence. In other words, higher biculturalism was associated with more risk perception and then more resistance to peer and adult influence, which sequentially predicted less cigarette use. Similarly, the association between biculturalism and betel nut use was mediated by betel nut use risk perception and resistance to peer and adult influence. Higher biculturalism was associated with greater risk perception and then more resistance to peer and adult influence, which in turn resulted in less betel nut use. These findings can be used to inform the design and implementation of intervention and prevention programs targeting youth who are vulnerable to substance use.