Short communicationIs alcohol, tobacco, and cannabis use as well as polydrug use increasing in France?
Introduction
Alcohol, tobacco, and cannabis are the most common drugs among adolescents in all Western countries Bauman & Phongsavan, 1999, Hibell et al., 2000, Johnston et al., 2002, Smart & Ogborne, 2000. Since many studies have shown that marijuana users are more likely than nonusers to be alcohol drinkers and cigarette smokers Kandel & Yamaguchi, 1993, Merrill et al., 1999, growing attention has been paid to polydrug use Hoffman et al., 2001, Johnson et al., 2000, especially since multiple substance use is a high-risk factor of substance-related problems, such as abuse and dependence (Wills, Namara, Vaccaro, & Hurky, 1996). However, data are lacking on the increase in this polydrug use among adolescents (Poulin and Elliott, 1997).
The present paper describes recent trends in drug consumption (alcohol, tobacco, and cannabis) and polydrug use among youngsters in a wet and male traditional European country. The authors hypothesize that in France, (1) substance use has increased as in most European countries (Hibell et al., 2000); (2) alcohol consumption (lifetime, regular) remains very high over time compared to tobacco and cannabis consumption, especially among boys; (3) polydrug use (lifetime, regular) increased, especially when alcohol is concerned (“alcohol+tobacco” or “alcohol+cannabis”); (4) substance use as well as polydrug use increased whatever the age group.
Section snippets
Subjects
Two national cross-sectional school surveys were conducted by INSERM (National Institute of Health and Medical Research) among representative samples of 7–12th grade students. The first was carried out in 1993 (ENADO survey, 420 school classes, N=8435,48.8% males) and the second in 1999 (ESPAD 99, 563 school classes, N=11,331, 47.9% males).
Procedure
The two surveys used a multistage probability sample design, with a response rate of 87.3% (1993) and 83.6% (1999). An anonymous, self-administered
Results
A comparison of ORs between substance use and polydrug use (for the total sample, by gender, by age) is being used to determine which group showed a greater increase from 1993 to 1999. Between 1993 and 1999,
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There was an overall increase in lifetime prevalence for the total sample, for boys and for girls (Table 1). This increase was inversely related to the frequency observed in 1993 and was greater for girls than for boys. Thus, the increase was more important for cannabis, “tobacco+cannabis,”
Discussion
Our data seem to confirm our hypothesis that substance use (lifetime, regular) increased significantly among French youngsters during the period 1993–1999 (Observatoire Francais des Drogues et des Toxicomanies [OFDT], 2001). However, these increases are not homogeneous across substances because alcohol, a traditional and legal substance in France, increased little (OR=1.5 for lifetime use, 1.0 for regular use), whereas cannabis, an illegal substance of more recent appearance, increased
Acknowledgments
The study 1993 was funded by the French Department of Health—Ministry of Social Affairs and Solidarity. The study 1999 was funded by Observatoire Frangais des Drogues et des Toxicomanies (OFDT). The two surveys were carried out in collaboration with the Ministry of Education (MENRT). The authors thank Pascal Tubert for her statistical help and her attentive re-read.
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