Date of Award


Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Monica Swahn

Second Advisor

Dr. Matthew Magee


INTRODUCTION: The World Health Organization (WHO) defines adolescence as “the period in human growth and development that occurs after childhood and before adulthood, from ages 10 to 19” (Adolescent Development). The National Institute on Drug Abuse (NIDA) reports that people are most likely to begin abusing drugs during adolescence and young adulthood and adolescents who use drugs often have mental health issues (Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide, n.d.). Cyber bullying is defined as “using technology, like cell phones and the Internet, to bully or harass another person”, and can include anything from sending mean messages or threats through email, spreading rumors through texts, posting harmful messages on social media, sexting, and many other acts (Cyber Bullying Statistics, 2015). Although multiple studies have shown an association between substance use and suicide, the affect electronic bullying has on this relationship has not been examined. This study will attempt to find an answer to the research questions “What is the relationship between illicit substance use (specifically alcohol, heroin, methamphetamines, and prescription drugs) and suicide among adolescents?” and “How does electronic bullying affect the relationship between illicit substance use and suicide among adolescents?”.

METHODS: This study used data from the Centers for Disease Control and Prevention’s (CDC) 2015 National Youth Risk Behavior Surveillance Survey (YRBS). The 2015 YRBS survey included questionnaires from 125 schools and 15, 624 student surveys. SAS 9.4 software was used for analysis of demographic variables, bivariate logistic regression, and multivariable logistic regression. Odds ratios, p-values (α=0.05), and 95% Confidence Intervals were reported.

RESULTS: Analysis showed that White male students who were 17 years old had the highest proportions of engaging in using and abusing heroin, alcohol, methamphetamines, and/or prescription drugs. Among those students who were victims of electronic bullying and those who attempted suicide in the past 12 months, 15-year-old White female students had the highest proportions. Substance use showed an association with students attempting suicide, and heroin and meth use were associated with the highest increased odds. There was also a change in the associations of substance use and attempting suicide in those students who were electronically bullied. Combining the effect of substance use and electronic bullying does show a change in the association between using drugs and attempting suicide.

CONCLUSION: The findings of this study show that in adolescents there are separate associations between: 1) engaging in substance and attempting suicide and 2) being a victim of electronic bullying and attempting suicide. This study also found that there is an association with suicide attempts in those students who are both engaging in substance use and who are victims of electronic bullying, suggesting that electronic bullying is acting as an effect modifier on this association.