Family meals are often promoted as a simple way to support adolescent health. New research suggests they can help reduce substance use for many teens but also shows clear limits to what shared meals alone can accomplish.
In a national study of U.S. adolescents, researchers found that higher-quality family dinners were associated with lower rates of alcohol, cannabis and e-cigarette use for teens who had no or low to moderate exposure to childhood adversity. For adolescents facing high levels of stress or trauma, however, family meals offered little protection on their own.
The study, led by researchers at Tufts University School of Medicine, was published in Journal of Aggression, Maltreatment & Trauma. It analyzed online survey data from 2,090 adolescents ages 12 to 17 and their parents from across the United States.
Rather than focusing only on how often families ate together, the researchers assessed meal quality, including communication, enjoyment, digital distractions and how meals were managed. Adolescents also reported their use of alcohol, cannabis and e-cigarettes during the previous six months.
The researchers then examined how these patterns differed based on adolescents’ exposure to adverse childhood experiences, such as household substance use, mental health challenges in the family, exposure to violence, weight-based teasing or dating violence. Instead of counting each experience equally, the team created a weighted score reflecting how strongly different stressors are linked to substance use.
Among adolescents with no or low to moderate levels of adversity, higher-quality family dinners were associated with a 22% to 34% lower prevalence of substance use. For teens whose adversity scores reached the equivalent of four or more experiences, family meals showed little protective effect.
Lead author Margie Skeer said the findings reinforce what earlier research has suggested about the role of shared meals, while also clarifying where their impact falls short. She emphasized that the benefit is not about what families eat or whether meals are formal.
“Routinely connecting over meals, which can be as simple as a caregiver and child standing at a counter having a snack together, can help establish open communication and parental monitoring,” Skeer said. “It’s not about the food, timing or setting. It’s the parent-child relationship and interactions that matter.”
The study also highlights why family meals should not be treated as a universal solution. Nearly one in five U.S. high school students has experienced levels of adversity comparable to those in the highest-risk group identified in the research. For these adolescents, the authors say, trauma-informed support and targeted mental health services are likely needed alongside, or instead of, routine family practices.
The researchers caution that the study shows association, not causation. Substance use and family dynamics were self-reported, and the data capture a snapshot in time rather than changes over years. Even so, the findings offer practical insight for clinicians and public health professionals working with families.
Taken together, the results suggest that shared meals can be a meaningful, accessible protective factor for many adolescents, but they are not sufficient for all. For teens dealing with significant stress or trauma, broader support systems play a critical role in reducing risk and promoting long-term health.
This research was partially supported by the National Institutes of Health’s National Institute on Drug Abuse.