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Adolescent substance use: beware of international comparisons

      Abstract

      Purpose

      To compare prevalence estimates of adolescents' cigarette, alcohol and marijuana use from one Australian and two U.S. surveys, and to consider the effect of methodological differences on reported use.

      Methods

      Secondary analysis of data from the Australian Child and Adolescent Component of the National Survey of Mental Health and Well-being (NSMHWB, 1998), the U.S. Youth Risk Behavior Survey (YRBS, 1999), and National Household Survey on Drug Abuse (NHSDA, 1998). Prevalence estimates and 95% confidence intervals were derived for three substance use behaviors. Differences between estimates were considered statistically significant if the 95% confidence intervals did not overlap.

      Results

      When Australian and U.S. adolescents were compared using NSMHWB and YRBS data, the former were generally found to be less likely to report using cigarettes, alcohol and marijuana than the latter. However, when NHSDA was used as the comparator, the prevalence of substance use among Australian adolescents was either no different from, or greater than, that of U.S. adolescents. Likely explanations for the discrepant findings include the population focus (i.e., whether the survey targeted only young people or adults as well), sampling issues (i.e., whether school-based and household-based sampling frames introduced different biases in terms of who was likely to be absent when the survey was administered), response rates, the survey context (i.e., whether school-based and household-based survey administration methods promoted different kinds of response behavior), the wording of questions and the precision of estimates of the different surveys.

      Conclusions

      Cross-national data on adolescent substance use should be interpreted cautiously. Cross-national comparisons that are done well (i.e., using standard, uniform approaches) can be invaluable in highlighting worthwhile policy directions; cross-national comparisons that are done poorly may lead to erroneous assumptions.

      Keywords

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      References

        • Ministerial Council on Drug Strategy
        National Drug Strategic Framework 1998–99 to 2002–03: A Strategy to Reduce the Harm Caused by Drugs in Our Community.
        Commonwealth of Australia, Canberra1998
        • Office of National Drug Control Policy
        The National Drug Control Strategy.
        Office of National Drug Control Policy, Washington, DC2001
        • Everett S.A.
        • Kann L.
        • McReynolds L.
        The Youth Risk Behavior Surveillance System.
        J Sch Health. 1997; 67: 333-335
        • Bauman A.
        • Phongsavan P.
        Epidemiology of substance use in adolescence.
        Drug Alc Depend. 1999; 55: 187-207
        • Gfroerer J.
        • Wright D.
        • Kopstein A.
        Prevalence of youth substance use.
        Drug Alc Depend. 1997; 47: 19-30
        • Santelli J.S.
        • Lindberg L.D.
        • Abma J.
        • et al.
        Adolescent sexual behavior.
        Fam Plann Perspect. 2000; 32: 156-165
        • Sawyer M.G.
        • Arney F.M.
        • Baghurst P.A.
        • et al.
        The mental health of young people in Australia.
        Aust NZ J Psychiatry. 2001; 35: 806-814
        • Kann L.
        • Kinchen S.A.
        • Williams B.I.
        • et al.
        Youth Risk Behavior Surveillance—United States, 1999. State and local YRBSS Coordinators.
        J Sch Health. 2000; 70: 271-285
        • Substance Abuse and Mental Health Services Administration
        1998 National Survey on Drug Abuse.
        Substance Abuse and Mental Health Services Administration, Rockville, MD1999
        • Bachman J.G.
        • Johnston L.D.
        • O'Malley P.M.
        The Monitoring the Future Project After Twenty-Two Years.
        Institute for Social Research, Ann Arbor, MI1996
      1. SUDAAN [computer program]. Version 7.5.4. Research Triangle Park, NC; 2000

        • Sackett D.L.
        • Haynes R.B.
        • Guyatt G.H.
        • Tugwell P.
        Clinical Epidemiology.
        Little, Brown and Company, Boston1991
        • Gans J.E.
        • Brindis C.D.
        Choice of research setting in understanding adolescent health problems.
        J Adolesc Health. 1995; 17: 306-313
        • Tourangeau R.
        • Smith T.
        Asking sensitive questions.
        Public Opin Q. 1996; 60: 275-304
        • Everett S.A.
        • Warren C.W.
        • Sharp D.
        • et al.
        Initiation of cigarette smoking and subsequent smoking behavior among U.S.
        high school students. Prev Med. 1999; 29: 327-333
        • Bonomo Y.
        • Bowes G.
        Putting harm reduction into an adolescent context.
        J Paediatr Child Health. 2001; 37: 5-8
        • Warren C.W.
        • Riley L.
        • Asma S.
        • et al.
        Tobacco use by youth.
        Bull World Health Organ. 2000; 78: 868-876
        • King A.
        • Wold B.
        • Tudor-Smith C.
        • Harel Y.
        The Health of Youth. A Cross-National Survey.
        World Health Organization, Geneva1996