High prevalence rates of tobacco, alcohol and drug use in adolescents and young adults in France: Results from the GAZEL Youth study
Introduction
Adolescence is a period of high risk for the initiation of tobacco, alcohol and illicit drug use. In recent years, rates of adolescent substance use appear to have increased across industrialized countries (Bachman et al., 1998, Beck et al., 2004, Choquet et al., 2004, Choquet et al., 2004). Moreover, there is evidence that youths start using psychoactive substances at earlier ages than in the past (Monshouwer et al., 2005, Perkonigg et al., 2006). This is of concern because adolescents who regularly use psychoactive substances are at high risk of substance-related abuse or dependence, as well as employment problems and delinquency later in life (Ellickson et al., 2003, Perkonigg et al., 1999, Riala et al., 2004). The earlier substance use is initiated the worse the adult outcomes (Arseneault et al., 2002, Ellickson et al., 2003).
In order to understand youths' patterns of substance use, it is essential to describe them in detail. As levels of substance use in the population change over time, only studies that compare youths of different ages at a single point in time can assess age-and cohort-related trends. To date, research has mostly focused on substance use among adolescents, and there is still need for additional data pertaining to young adults (Perkonigg et al., 2006).
Our study is set in France, where adolescents' rates of substance use are among the highest in Europe — particularly tobacco and cannabis use. According to national surveys, approximately 35% of French 16–18 year olds daily smoke cigarettes and about 20% regularly use cannabis (Beck and Legleye, 2003, Choquet et al., 2000). French youths are also more likely than youths from Northern European countries to concurrently use several psychoactive substances (Choquet et al., 2004, Choquet et al., 2004, Hibell et al., 2000). However, past research either focused on school-aged adolescents (ages 14–18) (Beck et al., 2004, Choquet et al., 2004, Choquet et al., 2004, Choquet et al., 2000, Ledoux et al., 2002) or combined adolescents and young adults into one broad category (ages 15–25) (INPES, 2001) and patterns of substance use among young adults in France have not been documented.
The aim of our study is to describe patterns of tobacco, alcohol, and illicit drug use in relation to age and sex in a large sample of French youths aged 12–26 years.
Section snippets
Study population
Participants were drawn from the GAZEL Youth study, which aims to examine mental health and substance use in a large, nationwide, sample of youths in France. As previously described, participating youths were recruited in 1991, via their parents who take part in an ongoing epidemiological study: the GAZEL cohort (Fombonne and Vermeersch, 1997, Goldberg et al., 2007). The GAZEL Youth study sample was selected to represent the socio-demographic characteristics of French youths. The original
Results
Our study population consisted of 600 males and 733 females aged 12–26 years. 16.4% lived in a rural environment, 42.5% in a town of 2000 to 30 000 inhabitants, and 41.1% in a town of over 30 000 inhabitants. A majority (99.0% of those aged under 18 and 61.4% of those aged 19 or older) lived with their parents. Among 12–18 year-olds, 93.6% attended secondary school, 2.7% were enrolled at university and 4.1% were in vocational training. Among 19–26 year-olds, 9.7% were enrolled in secondary
Main findings
Our study shows high rates of substance use in a large, nationwide, cohort of French youths. By age 26, approximately 49% of youths had used tobacco, 91% had used alcohol, and 42% had used cannabis. Our estimates are comparable to recent data from national surveys of French junior high school and high school students, which reported lifetime rates of substance use of 55% for tobacco, 81% for alcohol and 49% for cannabis (Choquet et al., 2004, Choquet et al., 2004). Tobacco, cannabis and
Conclusion
French adolescents and young adults have high rates of tobacco, alcohol and illicit drugs use: approximately 40% regularly use at least one psychoactive substance. Moreover, substance use is initiated at younger ages than in previous birth cohorts. Research on factors associated with long-term trajectories of substance use is greatly needed.
Acknowledgements
The authors received funding from the French Institute of Medical Research (INSERM-CNRS: Sociobiomedical Research Program) and the National Institute of Mental Health. The authors thank all youths of the GAZEL Youth study and their parents who facilitated data collection. Additionally, we are grateful to Louise Arseneault and Bertrand Redonnet for the many insightful comments on previous versions of the manuscript.
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