title: Trends in the prevalence of multiple substance use in adolescents in England, 1998-2009.
abstract: BACKGROUND
  This study examines demographic risk factors and trends from 1998 to 2009 for concurrent multiple substance use in adolescence in England.
  
  
  METHODS
  We used data from the 'Smoking, Drinking and Drug Use among Young People in England' survey, a nationally representative annual survey of 11-15 year olds. Measures of smoking, drinking and illicit drug use frequency and weekly alcohol consumption were combined to create variables representing concurrent substance use.
  
  
  RESULTS
  All forms of substance use were strongly related. The prevalence of multiple substance use decreased significantly across time in line with decreases in individual substance use. The prevalence of individual and multiple substance use across years is higher amongst white young people. Males are more likely to engage in risky drinking behaviour with females more likely to smoke regularly but females were at increased risk for multiple substance use. Deprivation was unrelated to drinking behaviour but was associated with increases in smoking and illicit drug use and all forms of multiple substance use.
  
  
  CONCLUSIONS
  These findings affirm the importance of continued prevention efforts targeting individual substance uses while highlighting the policy relevance of multiple substance use and interventions which target it. These interventions should be tailored for at-risk groups including deprived adolescents and young women.
authors.affiliation: Policy Research Unit in the Health of Children, Young People and Families, General and Adolescent Pediatrics, Institute of Child Health, London, UK. daniel.hale@ucl.ac.uk
authors.forename: Daniel
authors.initials: D
authors.lastname: Hale
authors.forename: Russell
authors.initials: R
authors.lastname: Viner
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology; D002648:Child; D004739:England / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*
keywords: alcohol; smoking; young people