Substance use (SU) peaks during emerging adulthood (18–25 years) and has vast implications on lifelong health and opportunities for individuals, communities, and society (O'Connor et al., 2018, Wisk and Weitzman, 2016). Tobacco, alcohol, and cannabis are the most commonly used substances as they have the greatest perceived availability and the lowest perceived risk (SAMSHA, 2020). While perceived risk is low, tobacco is the top preventable cause of death worldwide (Samet, 2013), excessive alcohol consumption is a leading cause of premature mortality in the United States (O'Connor et al., 2018), and cannabis is linked with work challenges, poor school achievement, financial challenges, and increased risk of psychiatric disorders (Brook et al., 2016). The high prevalence of SU among young adults (Baumer et al., 2018) makes it imperative to better understand risk factors in emerging adulthood.

Some early life experiences can elevate risk of SU and misuse, including exposure to adverse childhood experiences (ACEs). Defined as potentially traumatic or stressful events that occur before age 18 (CDC, 2019; Felitti et al., 1998), ACEs typically refer to exposures of abuse (sexual, physical, emotional), neglect (physical, emotional), or household dysfunction (parental divorce, parental death, incarceration, mental health challenge, substance use disorder). Within the last decade researchers have expanded classifications of ACEs to include exposures outside of the household in a child’s social environment that can impact health and development, such as bullying, witnessing violence, war, or terrorism (Pace et al., 2022). Nearly two-thirds of adults have one or more ACE (CDC, 2019). Findings from systematic reviews demonstrate that the number of ACEs has a moderate to strong association with SU in emerging adulthood (Park et al., 2021) and as ACEs exposure increases so does the likelihood of SU (Rogers et al., 2022). Further studies indicate that ACEs may exert differing risks by specific substance types (Forster et al., 2019, Forster et al., 2019), as every additional ACE was associated with a corresponding 1.13, 1.38, and 1.28 increase for binge drinking, marijuana use, and smoking, respectively.

There remain several gaps in what is known about the relationship between ACEs and SU. The majority of studies have utilized cross-sectional study design amongst university student populations, hindering understanding of how ACEs impact SU patterns after emerging adulthood and amongst persons with different educational backgrounds (Grigsby et al., 2020, Kim, 2017, Wiehn et al., 2018, Windle et al., 2018). Epidemiological studies have often utilized general classifications of substance use including lifetime use or within the last year, months, or weeks which may capture persons who experimentally or occasionally use substances instead of frequent SU (Schwartz et al., 2022). As regular SU increases risk of developing substance use disorders (Moss et al., 2012), it is imperative to investigate the association between ACEs and frequent SU.

Understanding protective factors on the pathway between ACEs and SU is critical as protective factors, such as physical activity (PA), may buffer the impact of ACEs and support resilience. Resilience aims to understand healthy development of individuals regardless of risk exposure and can be nurtured through promotive factors (e.g., assets or resources) (Fergus and Zimmerman, 2005). PA could represent both an asset (e.g., increase self-efficacy) or a resource (e.g., social support from coaches, teammates), thus would contribute to a protective resilience model as a promotive factor, mitigating current or future SU in the presence of ACEs. Further, PA is associated with enhanced resilience to stress and decreased SU across both human and animal species (Brellenthin and Lee, 2018, Perez et al., 2019, Sanchez et al., 2015).

PA has demonstrated a dose-response relationship with primary and secondary prevention of 25 chronic medical conditions (Warburton and Bredin, 2017) and is inversely associated with SU (Linke and Ussher, 2015). PA may act as a replacement for substance use as it increases neurotransmitters (e.g., epinephrine, serotonin, beta-endorphins, norepinephrine, and dopamine), which contributes to a reward circuitry similar to that of substance use (Boecker et al., 2008; Greenwood and Fleshner, 2011; Linke and Ussher, 2015). In addition, PA is associated with self-efficacy, positive mood, less mental health challenges, and other positive health behaviors, including a healthy diet and good sleep, all of which are typically negatively associated with SU (Berrigan et al., 2003, Daley, 2008, Lavie et al., 2011, Terry-McElrath and O'Malley, 2011). The impact of PA on SU has differed by substance type and physical activity modality, highlighting the importance to analyze PA modality and SU separately (Brellenthin and Lee, 2018, Lynch et al., 2017). What is not known, however, is if PA has a protective effect in the presence of ACEs.

Using the National Longitudinal Study of Adolescent to Adult Health (Add Health) (http://www.cpc.unc.edu/projects/addhealth), we hypothesized that a higher number of ACEs would be associated with greater odds of frequent SU in emerging and early adulthood and that PA during emerging adulthood will lower current and prospective frequent SU. Guided by the protective resilience model, this study analyzed the potential moderating role of PA modalities on the association of ACEs with daily cannabis and cigarette use and frequent weekly binge drinking. We progress the understanding of ACEs by utilizing a large, nationally representative sample to inform the impact on nine ACEs on frequent SU patterns in emerging and early adulthood and investigate the protective capacity of PA on current and prospective SU by analyzing several PA modalities (walking, strength training, team sports, and individual sports). Our study builds upon the existing literature by investigating several types of SU, having a longitudinal study design, examining frequent SU, and investigating the potential of PA to buffer the impact of ACEs on SU.