Original article
A cross-national comparison of risk and protective factors for adolescent substance use: the United States and Australia

https://doi.org/10.1016/j.jadohealth.2003.08.015Get rights and content

Abstract

Purpose

To compare risk and protective factors that influence youth substance use in Australia and the United States. The two countries have different policy orientations toward substance use: Australia has adopted harm-reduction policies, and the United States has adopted abstinence-focused polices.

Methods

Cross-sectional survey data were collected from independent samples of adolescents in the states of Maine (N = 16,861; 53% female, 7% Non-white) and Oregon (N = 15,542; 51% female, 24% Non-white) in the United States and Victoria in Australia (N = 8442; 54% Female, 11% Non-white) in 1998 (Maine and Oregon) and 1999 (Victoria). Chi-square tests, t-tests, effect size comparisons, and logistic regression analyses that accounted for age and gender were used to investigate cross-national similarities and differences in: (a) rates of cigarette, alcohol, and marijuana use; (b) levels of risk and protective factors; and (c) magnitudes of associations between risk and protective factors and substance use.

Results

More adolescents in Victoria reported using cigarettes and alcohol, whereas more of the U.S. adolescents reported using marijuana. Exposure to risk and protective factors was generally similar in the cross-national samples. However, adolescents in Maine and Oregon perceived handguns to be more readily available, reported more participation in religious activities, and were higher in sensation-seeking and social skills; and adolescents in Victoria had more favorable attitudes toward drug use and reported community norms and parental attitudes more favorable to drug use. Most of the risk and protective factors were strongly associated with substance use to a similar degree in Victoria, Maine, and Oregon. However, among adolescents in Maine and Oregon peer/individual risk and protective factors associated with social detachment were more strongly related to substance use, and among adolescents in Victoria, family protective factors were less strongly related to alcohol use.

Conclusions

Inter-country influences on youth substance use are generally similar despite different policy directions. Existing differences suggest that the abstinence policy context is associated with higher levels of illicit drug use and stronger relations between individual indicators of social detachment and substance use, whereas the harm reduction policy context is related to more cigarette and alcohol use, possibly from exposure to normative influences that are more tolerant of youth drug use.

Section snippets

Risk and protective factors for adolescent substance use

Although the United States and Australia are similar in many ways, the policy and cultural differences outlined above suggest this question: Are the same risk and protective factors predictive of substance use in both countries? If not, there may be differential implications for activities in each country that aim at preventing youth substance use. A brief review of risk and protective factors relevant to this study is provided below (see Hawkins et al 21, 22 for reviews).

Risk factors

The current study

Many prior research studies have investigated risk and protective factors for adolescent substance use. However, few studies have investigated cross-national similarities and differences in such relations, and existing cross-national investigations have examined only a limited number of risk and protective factors [15]. The present study used comparable survey data from three independent samples. Three primary research questions were addressed: Are there different rates of substance use in

Participants

Data were obtained from independent samples of students in three states: Maine and Oregon in the United States and Victoria, a southern state in Australia. The U.S. samples were recruited and surveyed in 1998 and the Victorian sample in 1999. In Maine, all public schools serving students in grades 6 through 12 were solicited for participation. Two-hundred-twelve (46.1%) schools agreed to participate. Classes were randomly selected for surveying from participating schools serving more than 250

Analysis

As stated above, there were very few differences between the Maine and Oregon samples in both substance use rates and risk and protective factor levels. Therefore, the samples were combined to provide the most parsimonious investigation of the primary research questions. The few cross-national comparisons that differed when Maine and Oregon adolescents were compared separately to Victoria adolescents are described with the results for the combined sample.

Three sets of analyses were conducted to

Rates of substance use

As shown in Figure 1, more Victorian youths reported using cigarettes and alcohol regularly than adolescents in Maine and Oregon, whereas more Maine and Oregon youths reported current use of marijuana (see Figure 1). Across gender, the rate of regular cigarette use among early adolescents in Victoria was 6.2% (95% CI = 5.5%, 6.8%) versus 4.8% (95% CI = 4.5%, 5.1%) in Maine and Oregon. The rate was also higher among later (older) adolescents in Victoria: 20.3% (95% CI = 18.9%, 21.7%) versus

Discussion

This study used independent samples from Maine and Oregon in the United States and the state of Victoria in Australia to investigate cross-national similarities and differences in (a) rates of adolescent substance use, (b) levels of risk and protective factors for substance use, and (c) relations between risk and protective factors and substance use. We found higher rates of regular alcohol and cigarette use among youths in Victoria compared to Maine and Oregon youths, and higher rates of

Acknowledgements

Analyses for this project were supported by grant No. DA12140 from the National Institute on Drug abuse (NIDA). Data collection in Maine and Oregon was made possible through NIDA grant No. DA10768 and additional support from the Maine Office of Substance Abuse and the Oregon Office of Alcohol and Drug Abuse Programs. The Victorian data collection was funded by the Department of Human Services, Victoria. We wish to acknowledge Lyndal Thomas who managed the Victorian data collection and John

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    The writing of the manuscript was supported in part by grants from the National Institute of Drug Abuse (#DA 12140 and #DA 10768). Earlier versions of this manuscript were presented in poster sessions at the annual meeting of the Society of Prevention Research, May 30–June 1, 2002, Seattle, Washington and the annual meeting of the American Public Health Association, November 9–13, Philadelphia, Pennsylvania.

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