title: Psychosocial correlates of substance use in adolescence: a cross-national study in six European countries.
abstract: OBJECTIVE
  To examine the psychosocial correlates of substance use among adolescents in six European countries.
  
  
  METHODS
  Cross-sectional school population survey (ESPAD) based on standardized methodological procedures.
  
  
  METHODS
  High schools in six European countries: Bulgaria, Croatia, Greece, Romania, Slovenia and UK.
  
  
  METHODS
  Representative samples of a total sample of 16,445 high school students whose 16th birthday fell in the year of data collection.
  
  
  METHODS
  Anonymous self-administered questionnaire. Self-reported substance use was measured by core items on tobacco, alcohol, marijuana and any illegal drug use. Psychosocial correlates included scales of self-esteem, depression, anomie and antisocial behavior, and items pertaining to family, school and peers.
  
  
  RESULTS
  Logistic regression analyses for each potential correlate adjusted for country, taking into account the clustered sample, showed statistically significant associations with each substance use variable separately, in almost every case. Particularly strong associations were found between smoking and going out most evenings and having many friends who smoke, while cannabis and illegal drugs were strongly correlated with having friends or older siblings who used these substances. The self-esteem scale score was not correlated with substance use. Anomie and antisocial behavior were more strongly associated than depression with substance use. In the case of depression, anomie and most of the other items examined, associations were stronger for girls than for boys.
  
  
  CONCLUSIONS
  The present cross-national study identified correlates of legal and illegal substance use which extend outside specific countries, providing grounds to believe that they can be generalized. They provide evidence for the need to address both the use of the gateway drugs and deviant behavior in conjunction with environmental risk factors when designing and implementing preventive interventions in schools.
authors.affiliation: Department of Psychiatry, Medical School, University of Athens, Greece. kokkevi@hol.gr
authors.forename: Anna
authors.initials: A
authors.lastname: Kokkevi
authors.forename: Clive
authors.initials: C
authors.lastname: Richardson
authors.forename: Silvia
authors.initials: S
authors.lastname: Florescu
authors.forename: Marina
authors.initials: M
authors.lastname: Kuzman
authors.forename: Eva
authors.initials: E
authors.lastname: Stergar
mesh_terms: D000293:Adolescent; D000850:Anomie; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002391:Catchment Area, Health; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005060:Europe / Q000453:epidemiology; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D011584:Psychology; D012649:Self Concept; D012931:Social Environment; D013334:Students / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D013287:Illicit Drugs