title: Violence exposure and substance use in adolescents: findings from three countries.
abstract: OBJECTIVE
  To investigate relationships between exposure to community violence (witnessing and victimization) and reported substance use (cigarettes, alcohol, marijuana, and hard drugs) in a cross-national sample of adolescents, after controlling for the level of the adolescents' own violent behavior.
  
  
  METHODS
  A self-report survey was conducted in 3380 14- to 17-year-old adolescents in urban communities of 3 different countries: Antwerp, Belgium (N = 958); Arkangelsk, Russia (N = 1036); and New Haven, Connecticut (N = 1386).
  
  
  RESULTS
  In all 3 countries, levels of reported smoking, alcohol use, marijuana use, and hard drug use showed increases with adolescent exposure to violence. Although positively related, substance use was increased less markedly in US adolescents who witnessed violence.
  
  
  CONCLUSIONS
  Current findings further emphasize the association between violence exposure and potential severe physical and psychosocial health problems in adolescents. In addition, the findings suggest that violence exposure and its consequences are a worldwide urban phenomenon. Cross-national differences were found, however, that warrant additional research, and prospective studies are needed to investigate the pathways from violence exposure to substance abuse.
authors.affiliation: University Department of Child and Adolescent Psychiatry, Middelheimhospital, University of Antwerp, Antwerp, Belgium. rvermeiren@europemail.com
authors.forename: Robert
authors.initials: R
authors.lastname: Vermeiren
authors.forename: Mary
authors.initials: M
authors.lastname: Schwab-Stone
authors.forename: Dirk
authors.initials: D
authors.lastname: Deboutte
authors.forename: Peter E
authors.initials: PE
authors.lastname: Leckman
authors.forename: Vladislav
authors.initials: V
authors.lastname: Ruchkin
mesh_terms: D000293:Adolescent; D001530:Belgium / Q000453:epidemiology; D003237:Connecticut / Q000453:epidemiology; D003431:Cross-Cultural Comparison; D006801:Humans; D012426:Russia / Q000453:epidemiology; D012931:Social Environment; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*