LAUSR

Objective As impacts of the COVID-19 pandemic continue to unfold, research is needed to understand how school-aged youth are coping with COVID-19-related changes and disruptions to daily life. Among a sample of Canadian youth, our objective was to examine the mental health factors associated with using substances to cope with COVID-19-related changes, taking account of expected sex differences. Methods We used online data collected from 7,150 students in the COMPASS study, during the early months of the COVID-19 pandemic (May-July 2020) in British Columbia, Ontario, and Quebec, Canada. We specified a sex-stratified, generalized linear mixed model to estimate the likelihood of engagement in substance-related coping behaviours, while testing for the effects of students’ mental health, individual characteristics, and school neighborhood characteristics. Results Twelve percent of students (13.4% of females, 9.9% of males) in our sample reported using cannabis, alcohol, cigarettes, and/or vaping to help cope with COVID-19-related changes. Regardless of sex, students with greater depressive symptoms were more likely to engage in substance-related coping (aORFemale=1.04, 95%CI[1.01-1.07]; aORMale=1.06, 95%CI[1.013-1.11]). Among females, better psychosocial wellbeing was protective against engagement in substance related-coping (aOR=0.96, 95%CI[0.94-0.98]), controlling for current substance use. Conclusions Canadian school-aged youth with generally poor mental health may be more likely to have engaged in substance use to help cope with COVID-19-related changes during the first wave of the pandemic, and female youth may be at disproportionate risk of engaging in the behaviour. Ongoing evaluation of the impacts of COVID-19 on youth health is required.