Greater loss of face and family honor values are associated with greater positive expectancies and substance abuse among Middle Eastern/Northern African U.S. college students

Background: Traditional cultural orientation is protective against substance use for Asian Americans and Latinos. However, little empirical research has examined traditional cultural values and substance use among Middle Eastern and North African (MENA) individuals. MENA cultures tend to emphasize maintaining family honor and personal social integrity, which may influence substance use cognitions and behavior. Objective: Test whether loss of face and family honor influenced risky alcohol/cannabis use via positive expectancies. We expected that greater loss of face and family honor values would predict lower positive expectancies and risky substance use. Methods: MENA college students (N = 246; 58.6% women) were recruited via Qualtrics Panels and completed an online survey. We tested path models, estimating direct and indirect effects of cultural predictors, adjusting for age, gender, generation status, marital status, and living situation. Substance use was modeled as risk categories (low- versus high-risk) and as count-type outcomes using zero-inflated models. Results: Greater family honor values predicted higher positive alcohol and cannabis expectancies (b = .24-.32, p < .001). Greater loss of face values also predicted more positive expectancies (b = .22-.24, p < .001). Mediation analysis generally indicated that cultural factors were indirectly associated with risky use via positive expectancies. Conclusion: MENA college students’ greater family honor and loss of face values are associated with greater alcohol and cannabis use, in part through positive expectancies. Cultural pressures may enhance the perceived benefits of alcohol and cannabis use. Substance use intervention programs should integrate MENA college students, and address family honor and loss of face as culturally-salient risk indices.