title: Epidemiology of substance use in a representative sample of 18-year-old males.
abstract: OBJECTIVE
  To assess recent drug use through urine testing as well as the prevalence of tobacco and alcohol dependence among young males and to analyse the associations between tobacco dependence and cannabis use (delta-9-tetrahydrocannabinol, THC), tobacco dependence, and alcohol dependence as well as between THC use and other illicit drug use.
  
  
  METHODS
  Urine samples were collected, and nicotine and alcohol questionnaires were administered. Carbon monoxide was assessed in exhaled air. Data from young males from representative, selected districts of Lower Austria were recorded during the annual physical examination for mandatory military service. Out of all 18-year-old males in Austria 3.8% (n = 1902) were included in the study. Prevalence of recent illicit drug use, tobacco dependence (heavy smoking index, HSI), alcohol dependence (The 4-item cutting down, annoyance by criticism, guilty feeling, and eye-openers (CAGE) questionnaire), and associations between substance categories by means of logistic regression analyses were calculated.
  
  
  RESULTS
  Alcohol abuse was found in 15.1% and alcohol dependence was found in 3.2%. According to the HSI 51.5% of males reported daily smoking, of whom 43.7% showed a mild level, and 7.8% a high level, of nicotine dependence. About 5.1% of the sample evidenced THC in urine. Opiates were identified in 2.7% of urine samples. Smokers showed a higher risk of THC use. THC users had a tendency to use cocaine and amphetamines more frequently than THC abstainers.
  
  
  CONCLUSIONS
  Nicotine and alcohol dependence is common among young males. Biological assessment of illicit drug use seems to confirm previous questionnaire-based findings of associations between THC use and other illicit drugs. Urine testing seems to be an adequate method to analyse associations of THC use and other illicit drugs. In combination with questionnaires urine testing may be used for the assessment of associations of tobacco dependence and recent illicit drug use based on epidemiological surveys.
authors.affiliation: Department of Psychiatry, Waehringer Guertel 18-20, A-1090 Vienna, Austria. nestor.kapusta@meduniwien.ac.at
authors.forename: Nestor D
authors.initials: ND
authors.lastname: Kapusta
authors.forename: Katrin
authors.initials: K
authors.lastname: Ramskogler
authors.forename: Ines
authors.initials: I
authors.lastname: Hertling
authors.forename: Rainer
authors.initials: R
authors.lastname: Schmid
authors.forename: Alexander
authors.initials: A
authors.lastname: Dvorak
authors.forename: Henriette
authors.initials: H
authors.lastname: Walter
authors.forename: Otto M
authors.initials: OM
authors.lastname: Lesch
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology; D001317:Austria / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology
chemical_list: D013287:Illicit Drugs