Further investigation of psychological and environmental correlates of substance use in adolescence in six European countries

doi:10.1016/j.drugalcdep.2006.10.004

Drug and Alcohol Dependence

Volume 88, Issues 2–3, 11 May 2007, Pages 308-312

https://doi.org/10.1016/j.drugalcdep.2006.10.004 Get rights and content

Abstract

Aim

To study the multifactorial correlates of adolescents’ use of legal and illegal substances in six European countries and to assess whether a common pattern of factors exists irrespective of the countries’ different sociocultural backgrounds.

Design

Cross-sectional European school population survey (ESPAD) following standardized methodology.

Participants

National probability samples of 16-year-old high school students from Bulgaria, Croatia, Greece, Romania, Slovenia and the UK. Total sample 16,445.

Measurements

Anonymous questionnaire self-administered in the classroom. Self-reported use of tobacco, alcohol, marijuana and other illegal drugs. Correlates examined: environmental, such as peer culture and family-related; behavior-related such as antisocial behavior, truancy and anomie; and psychological factors such as self-esteem and depressive mood.

Findings

Separate logistic regressions for the two genders produced a set of psychosocial correlates common to the use of all legal and illegal substances. The strongest were peer and older sibling models of use, and peer-oriented lifestyle, followed by patterns of antisocial behavior and truancy. Family-related variables such as not living with both parents, parental monitoring and relationships with parents were less significant. Self-esteem and depressive mood were not significant. Girls’ use of substances, especially illegal ones, showed stronger associations than boys’ with a deviant behavior pattern. Few interactions between country and other correlates were significant.

Conclusions

Common correlates can be identified across countries. Older siblings’ and peers’ substance have a strong impact on adolescents’ use. Preventive interventions should include all substances with addictive potential.

Introduction

Patterns of substance use, initiation and progression in adolescence are generally considered to be predictive of later involvement with substance use and its harmful consequences (Tucker et al., 2005). Understanding the factors associated with substance use in adolescence is therefore crucial in the field of prevention. However, a study restricted to one specific sociocultural context has uncertain generalizability; consequently, cross-national studies of the topic are particularly valuable. The European School Survey on Alcohol and Other Drugs (ESPAD; Hibell et al., 2004) provides an excellent context for cross-national investigations, employing standardized methodology and large probability samples. In the present paper, we use data collected among 16-year-olds in 1999 in those ESPAD countries that used a questionnaire module on potential psychosocial correlates of substance use. These were Bulgaria, Croatia, Greece, Romania, Slovenia and the UK, a set of countries differing in sociocultural background, stage of development of the drug use epidemic and current prevalence of substance use.

In the first part of this study (Kokkevi et al., in press), almost all the variables considered as potential correlates of legal and illegal substance use in these countries were significantly associated with substance use when taken one by one. In this second part, we extend the analysis by including all covariates simultaneously in regression models.

Section snippets

Methods

ESPAD draws probability samples of 16-year-old high school students, followed by self-completion of an anonymous questionnaire in the classroom after authorization of the survey by the education authorities. Detailed procedures in each country can be found in the 1999 ESPAD Report (Hibell et al., 2000; www.espad.org/reports.html). In every country, a clustered probability sample was drawn, with school classes forming the sampling units. Sample sizes were: Bulgaria 3229, Croatia 3602, Greece

Results

Table 1 shows the marginal distributions of all of the variables included in the analysis, by gender. The web appendix contains further details, with breakdown by country.

Table 2 shows estimated odds ratios (with 95% confidence intervals) obtained from the models that included all the potential covariates plus country. Odds ratios were particularly high for going out most evenings, especially in relation to smoking, and for substance use by peers and older siblings. In particular, the use of

Discussion

Although our earlier results (Kokkevi et al., in press) showed that almost all the covariates under consideration were associated with each of the four response variables when taken one by one, the present results indicate that going out most evenings, substance use by peers and siblings, and antisocial behavior are generally the strongest correlates of substance use by adolescent students. Family related factors seem to be less important than the peer culture and, apart from antisocial

Acknowledgments

Funding agencies of the ESPAD survey in the participating countries were as follows: National Centre for Public Health, Bulgarian Lions Quest Foundation, Ministry of Education (Bulgaria); Croatian National Institute of Public Health, The Government of the City of Zagreb, The Governmental Commission for Drug Prevention (Croatia); University Mental Health Research Institute (Greece); Institute of Health Services Management, Compartments of Health Education from Public Health Authority from each

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^☆: Items used in the questionnaire employed in this study can be viewed by accessing the online version of this paper at http://dx.doi.org by entering doi:10.1016/j.drugalcdep.2006.10.004.

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Short communicationFurther investigation of psychological and environmental correlates of substance use in adolescence in six European countries☆

Abstract

Aim

Design

Participants

Measurements

Findings

Conclusions

Introduction

Section snippets

Methods

Results

Discussion

Acknowledgments

Monitoring the Future: Questionnaire Responses from the Nation's High School Seniors, 1982

Parents, religion and perceived social coherence: a Durkheimian framework of adolescent anomie

J. Sci. Study Religion

A longitudinal study of children of alcoholics: predicting young adult substance use disorders, anxiety and depression

J. Abnorm. Psychol.

Exploring the association between cannabis use and depression

Addiction

Characteristics associated with the persistence of antisocial behavior: results from recent longitudinal research

Aggress. Violent Behav.

Short communication
Further investigation of psychological and environmental correlates of substance use in adolescence in six European countries☆