The association between substance use and subsequent employment among students: prospective findings from the CONSTANCES cohort

PURPOSE: To examine prospectively associations between substance use and subsequent employment among young students. METHODS: From the French population-based CONSTANCES cohort, 1427 students who never worked were included between 2012 and 2018 and followed up for 2.1 years on average. Generalized estimating equations computed the odds of being unemployed versus employed according to substance use at baseline controlling for sociodemographic factors and depressive state. Tobacco use (smoking status and number of cigarettes), cannabis use frequency, and at-risk alcohol use according to the Alcohol Use Disorder Identification Test (total score > 7) were introduced separately in the models. RESULTS: Tobacco use was not significantly associated with employment. Cannabis use at least weekly was associated with increased odds of being unemployed OR 1.73 (1.16–2.57). At-risk alcohol use was no longer significantly associated with employment after adjustment for depressive state, while analyses on sub-scores of alcohol use suggested that alcohol dependence was associated with increased odds of being unemployed OR 1.65 (1.16–2.34). CONCLUSION: Public health campaigns targeting youth should include lower chances of getting employed among the detrimental roles of regular cannabis use and at-risk alcohol use. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00127-022-02357-0.