Social Media, Substance Use Exposure, and Family Communication: A Qualitative Study of Parent and Teen Perspectives

Background: Social media has fundamentally altered the landscape of youth substance use (SU) exposure, shifting from sporadic in-person encounters to a persistent presence in youth’s everyday social life. Despite growing concern about the role of social media in normalizing SU among youth, little is known about how parents and teens perceive, navigate, and communicate about this exposure within the family context. Existing prevention frameworks have predominantly focused on individual-level risk factors or school-based interventions (Liu et al., 2023), with limited attention to family communication dynamics in digital environments (Romer & Moreno, 2017). This study examines how parents and youth describe SU exposure on social media and the communication strategies they identify as effective or ineffective for addressing it within the family.

Methods: This qualitative study analyzed focus group data from parents (n = 19) and teens (n = 21, age 15-20; mean age = 17.19, 24% male) participating in a broader intervention study aimed at preventing teen SU through improved parent-teen communication about social media. Focus groups were held separately for parents and teens using a semi-structured protocol, allowing open, participant-driven discussion while ensuring coverage of key topics. Discussions explored experiences of social media use, SU exposure on social media, and parent-teen communication practices and strategies related to these issues. Data were analyzed using inductive thematic analysis, with two authors independently coding transcripts and the whole team comparing interpretations and iteratively refining themes through regular analytic meetings.

Results: Five themes were identified. First, parents and teens described social media as an amplifier of SU exposure, with content being ambient, repeated, and socially embedded within peer culture. Second, parents described a pervasive fear of losing control, encompassing diminished visibility, an inability to filter exposure, weakened authority, and limited platform familiarity. Third, teens positioned themselves as active, critical interpreters of content, differentiating sources, managing digital identities, and demonstrating awareness of reputational consequences, all while reporting that parents underestimated their capacities. Fourth, a generational gap in platform literacy compounded parental feelings of helplessness, constraining meaningful family engagement around online SU content. Fifth, all identified strict rules and surveillance as ineffective, with teens describing workarounds and resentment; teens most commonly cited non-punitive, open-door approaches as effective and desired.

Conclusions and Implications: These findings suggest SU prevention in the context of social media requires a shift from control-oriented strategies toward relational, developmentally aligned communication approaches that recognize youth agency. Surveillance-based parenting may undermine trust necessary for open family dialogue. Interventions supporting stigma-reducing, non-reactive, and ongoing parent-teen communication hold particular promise. Social workers are well positioned to support parents in building the relational credibility needed to engage effectively with teens around SU in digital environments.

Data collection and manuscript preparation were supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (R34AA026332) awarded to Dr. Dana M. Litt. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Alcohol Abuse and Alcoholism or the National Institutes of Health.