High-quality family dinners reduce teen substance use risk yet severe adversity blunts the benefit

By Priyanjana Pramanik, MSc.Reviewed by Susha Cheriyedath, M.Sc.Feb 8 2026

Strong family mealtime interactions may help protect teens from substance use, but new research shows childhood adversity can limit how much this everyday routine helps.

Study: Family Dinner Quality and Adolescent Substance Use: Moderation by Adverse Childhood Experiences. Image Credit: Roman Samborskyi / Shutterstock

In a recent study published in the Journal of Aggression, Maltreatment & Trauma, researchers investigated how adverse childhood experiences (ACEs) affect the relationship between the quality of family interactions during meals and adolescent substance use.

High-quality family dinners were associated with lower adolescent substance use among those with fewer ACEs. In contrast, adolescents with high ACE exposure did not show a statistically significant association between dinner quality and substance use, although ACEs themselves were independently associated with higher substance use risk.

Background

Regular family meals have been linked to lower adolescent substance use, and evidence suggests that the quality of interactions during meals, rather than their frequency alone, may be particularly important.

Meaningful interactions during shared meals have been associated with stronger parent–child relationships, improved psychosocial outcomes, and reduced risk of behaviors such as substance use.

At the same time, ACEs, including exposure to violence, family substance use, mental health problems, or parental separation, are common and strongly associated with increased substance use during adolescence. Although both family dinner quality and ACEs are independently related to substance use, less is known about how these factors interact.

Because ACEs often co-occur and can undermine family relationships and communication, adversity may weaken the protective associations of positive family routines. However, causal mechanisms cannot be established from cross-sectional data, and the absence of moderation does not imply that family-based interventions are ineffective.

About the Study

The researchers examined whether different levels of ACEs moderate the association between interactions during family meals and adolescent substance use. Understanding this interaction may help refine prevention strategies and identify which adolescents are most likely to benefit from family-focused approaches.

Data were drawn from a national online survey of 2,090 U.S. parent–adolescent dyads. Adolescents were aged 12 to 17 years and lived with a parent or guardian for at least half of the time. Parents and adolescents completed surveys independently, with safeguards to ensure data quality.

Quality of family meal interactions was assessed using the child-reported Family Dinner Index, Child Version, which measures communication, enjoyment, digital distractions, and meal logistics. Substance use outcomes included adolescent self-reported alcohol use, vaping, and cannabis use in the previous six months, dichotomized as any use versus none.

A cumulative, substance-use–specific ACE score was constructed using seven parent- and adolescent-reported indicators of adversity. Scores were weighted according to their correlations with substance use and categorized as none, low to moderate, or high, reflecting a targeted composite of adversity indicators rather than a general ACE inventory.

Poisson regression models with robust standard errors were used to estimate prevalence ratios. Interaction terms tested whether ACEs moderated the association between family dinner quality and substance use, adjusting for key sociodemographic variables.

Key Findings

The mean age of adolescents was 14.9 years, and approximately half identified as female. Substance use in the past six months was reported by 17.6 percent for alcohol, 17.1 percent for vaping, and 15.5 percent for cannabis. More than 70 percent of adolescents reported at least one ACE, and about one in five reported four or more.

Across the full sample, higher-quality family interactions during meals were associated with lower alcohol use, vaping, and cannabis use after adjustment for demographic factors. Each one-point increase in the Family Dinner Index score corresponded to an estimated 9-17 percent lower prevalence of substance use, depending on substance type and ACE category.

ACEs significantly moderated these associations. Among adolescents with no ACEs, higher dinner quality was associated with 30 to 34 percent lower prevalence of substance use across outcomes. Similar but weaker associations were observed among adolescents with one to three ACEs. No statistically significant association was observed among adolescents with four or more ACEs.

These results indicate that while high-quality family dinners are broadly associated with lower substance use, the strength of this association varies according to adversity exposure rather than operating uniformly across all adolescents.

Conclusions

This study suggests that ACEs shape how family dinner quality relates to adolescent substance use. Higher-quality family meals were associated with lower substance use, primarily among adolescents with no or few ACEs.

For adolescents with high adversity exposure, family dinner quality alone did not appear sufficient to offset substance use risk. Trauma-related stress, social withdrawal, and disrupted family dynamics may contribute to this pattern, although these mechanisms were not directly examined.

Strengths of the study include a large, nationally diverse sample and the use of validated measures. Limitations include the cross-sectional design and reliance on online recruitment, which restricts causal inference and may affect generalizability.

The findings support promoting meaningful family interactions during mealtimes as a practical prevention strategy for lower-risk adolescents, while underscoring the need for more targeted, trauma-informed approaches for youth with high ACE exposure.