Aims
To estimate temporal trends in adolescents’ current cigarette, alcohol and cannabis use in Europe by gender and region, test for regional differences and evaluate regional convergence.
Design ...and Setting
Five waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 28 countries between 1999 and 2015. Countries were grouped into five regions northern (NE), southern (SE), western (WE), eastern Europe (EE) and the Balkans (BK).
Participants
A total of 223 814 male and 211 712 female 15–16‐year‐old students.
Measurements
Daily cigarette use, weekly alcohol use, monthly heavy episodic drinking (HED) and monthly cannabis use. Linear and quadratic trends were tested using multi‐level mixed‐effects logistic regression; regional differences were tested using pairwise Wald tests; mean absolute differences (MD) of predicted prevalence were used for evaluating conversion.
Findings
Daily cigarette use among boys in EE showed a declining curvilinear trend, whereas in all other regions a declining linear trend was found. With the exception of BK, trends of weekly drinking decreased curvilinear in both genders in all regions. Among girls, trends in WE, EE and BK differed from trends in NE and SE. Monthly HED showed increasing curvilinear trends in all regions except in NE (both genders), WE and EE (boys each). In both genders, the trend in EE differed from the trend in SE. Trends of cannabis use increased in both genders in SE and BK; differences were found between the curvilinear trends in EE and BK. MD by substance and gender were generally somewhat stable over time.
Conclusions
Despite regional differences in prevalence of substance use among European adolescents from 1999 to 2015, trends showed remarkable similarities, with strong decreasing trends in cigarette use and moderate decreasing trends in alcohol use. Trends of cannabis use only increased in southern Europe and the Balkans. Trends across all substance use indicators suggest no regional convergence.
Aims
To study the prevalence of cannabis use and drug-related problems among European adolescents and the utility of the prevention paradox.
Methods
Survey data from the European School Survey ...Project on Alcohol and Other Drugs (ESPAD) in 2007 in the 27 countries with information about drug use and drug-related problems was used. We analysed the proportion of all drug-related problems that occurred in a high risk group and among others who had used cannabis in the previous 12 months. The cut-off for the high risk group was chosen to include 10-15 % of the most frequent cannabis users.
Results
The high risk groups accounted for a substantial, but a minority, of drug-related problems among boys as well as girls. A minority of those who had used cannabis reported any drug-related problem. The proportion of adolescents with drug-related problems and the average number of problems increased with frequency of cannabis use.
Conclusions
We find support for policy measures of more general character, supported by the prevention paradox. However, this does not exclude a policy supporting frequent drug users if they can be identified
ABSTRACT
Aims According to the prevention paradox, a majority of alcohol‐related problems in a population can be attributed to low to moderate drinkers simply because they are more numerous than ...heavy drinkers, who have a higher individual risk of adverse outcomes. We examined the prevention paradox in annual alcohol consumption, heavy episodic drinking (HED) and alcohol‐related problems among adolescents in 23 European countries.
Design and setting Survey data from the 2007 European School Survey Project on Alcohol and Drugs (ESPAD) among 16‐year‐old students were analysed.
Participants A total of 38 370 alcohol‐consuming adolescents (19 936 boys and 18 434 girls) from 23 European countries were included.
Measurements The upper 10% and the bottom 90% of drinkers by annual alcohol intake, with or without HED, and frequency of HED, were compared for the distribution of 10 different alcohol‐related problems.
Findings Although the mean levels of consumption and alcohol‐related problems varied largely between genders and countries, in almost all countries the heavy episodic drinkers in the bottom 90% of consumers by volume accounted for most alcohol‐related problems, irrespective of severity of problem. However, adolescents with three or more occasions of HED a month accounted for a majority of problems.
Conclusions The prevention paradox, based on measures of annual consumption and heavy episodic drinking, seems valid for adolescent European boys and girls. However, a minority with frequent heavy episodic drinking accounted for a large proportion of all problems, illustrating limitations of the concept. As heavy episodic drinking is common among adolescents, our results support general prevention initiatives combined with targeted interventions.
Aims. The purpose of this study was to compare the phenomenon of episodic heavy drinking (binge drinking) and its different indicators in the Nordic countries.
Design. A comparative survey of four ...Nordic countries.
Setting. Telephone interviews in Denmark, 1997; Finland, 1996; Norway, 1996; and Sweden 1996‐97.
Participants. Random samples of men and women aged 19‐71 years.
Measurements. Episodic heavy drinking was measured by the frequency of subjective intoxication, of drinking six or more drinks at a time (6+), and of negative consequences (mainly hangover symptoms). Additionally, annual consumption and measures of intake per occasion were used.
Findings. Annual consumption, overall frequency of drinking and frequency of drinking 6+ were highest in Denmark and lowest in Norway. Frequency of subjectively defined intoxication was highest in Finland. There it was clearly higher than the frequency of drinking 6+, whereas in Denmark the contrary was observed. Finnish and Norwegian men and Danish women reported the largest quantities drunk per occasion. Results on 6+ frequency and the prevalence of negative consequences, with annual consumption held constant, suggest that Danes have the least concentrated drinking pattern. With annual consumption held constant, Norwegians report as high a frequency of intoxication, as do Finns.
Conclusions. The relations between subjective and more objective measures of episodic heavy drinking vary considerably between the Nordic countries. The results suggest that the definition, acceptability and experience of intoxication vary even when a set of relatively homogeneous countries are compared.
The European School Survey Project on Alcohol and Other Drugs (ESPAD) collects comparable data on substance use among 15-16-year-old students since 1995. The purpose of the study is to monitor ...substance use behavior in adolescents in as many European countries as possible. With next year's data collection the observation period in those countries that have participated in ESPAD since the projects start will encompass 20 years, and analyses of temporal changes can then be based on six measurement points.
This articles explores the merits and problems of survey research in analysing national alcohol consumption. Whereas sales and taxation records usually provide the macro-level data for estimating ...alcohol consumption in a country as a whole, this data say very little about both the distribution of alcohol consumption with smaller social groups or the consumption of alcohol that is not registered by sales or taxes (such as the consumption of alcohol abroad or contraband liquor). However, survey research into alcohol consumption faces significant challenges: typically, alcohol consumption reported in surveys accounts for about 40-60% of overall consumption. The article evaluates, assesses and compares different survey and questionaire methods aimed at minimizing the problem of underreporting of alcohol consumption. These methods combine both conventional positivist as well as more interpretative approaches.
Compares the phenomenon of episodic heavy drinking (binge drinking) & its different indicators, using survey data from telephone interviews conducted in Denmark, 1997; Finland, 1996; Norway, 1996; & ...Sweden 1996-97 among random samples of men & women aged 19-71 years. Episodic heavy drinking was measured by the frequency of subjective intoxication, of drinking six or more drinks at a time (6+), & of negative consequences (mainly hangover symptoms). Additionally, annual consumption & measures of intake per occasion were used. Annual consumption, overall frequency of drinking, & frequency of drinking 6+ were highest in Denmark & lowest in Norway. Frequency of subjectively defined intoxication was highest in Finland. There it was clearly higher than the frequency of drinking 6+, whereas in Denmark the contrary was observed. Finnish & Norwegian men & Danish women reported the largest quantities drunk per occasion. Results on 6+ frequency & the prevalence of negative consequences, with annual consumption held constant, suggest that Danes have the least concentrated drinking pattern. With annual consumption held constant, Norwegians report as high a frequency of intoxication, as do Finns. The relations between subjective & more objective measures of episodic heavy drinking vary considerably between the Nordic countries. The results suggest that the definition, acceptability, & experience of intoxication vary even when a set of relatively homogeneous countries are compared. 3 Tables, 3 Figures, 12 References. Adapted from the source document.
The purpose of the study is to describe the long-term trends in drinking habits among Swedish students aged 15-16 years. Data were collected from 1971 to 1999, using self-administered questionnaires ...from nationally representative random cluster samples of school classes, totalling on average 6000 students per year.The highest proportion of alcohol consumers among both boys and girls, about 90%, was seen in the 1970s; this percentage decreased to about 80% in the 1980s and remained at that level through the 1990s. The estimated average annual consumption of pure alcohol was 4 litres for boys in 1977. It fell to 2.1 litres in 1988 and rose to 3.9 litres in 1999. The tendency was similar for girls, with 3.5 litres consumed in 1977, about 1.5 litres in the 1980s and 2.3 litres in 1999. Also frequent binge drinking and intoxication were reported by the largest proportions in the 1970s; the figures decreased in the 1980s and rose again among both boys and girls in the first part of the 1990s. Hence, although fewer of the students in this age group are alcohol consumers at the end of the 1990s compared with the 1970s, those who drink are approaching the high consumption levels of the 1970s. The beverages of choice are beer and spirits.
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