title: Substance Use among European Students: East - West Comparison between 1995 and 2011.
abstract: OBJECTIVE
  The aim of the study was to investigate long-term trends differences in student substance misuse between countries of former Eastern Bloc (FEB) and Western Europe (WEST). Overall data on student substance misuse gathered in five waves of the European School Survey Project on Alcohol and other Drugs (ESPAD) conducted between 1995 and 2011 were pooled and analysed. Findings were compared between FEB and WEST countries at the five time-points of data collection.
  
  
  METHODS
  Over 396,000 of 16 years old students from thirteen FEB and thirteen WEST countries completed anonymous ESPAD questionnaires. The following data were compared by Wilcoxon test: proportion of students with experience of taking a legal drug at less than 13 years of age (early onset), regular tobacco use, emerging signs of alcohol abuse, and differences in prevalence of illegal drug use.
  
  
  RESULTS
  Significant differences in selected variables were found in the early onset of legal and illegal drug use between FEB and WEST countries. On the contrary, no significant differences were present when several random samples from the pool of 26 participating countries were drawn and compared. This strengthens our confidence that the differences between FEB and WEST countries did not occur due to chance.
  
  
  CONCLUSIONS
  Student drug use in FEB countries tended to follow the trends and patterns of legal and illegal drug use in WEST countries with some time lag. At the times of decline in use of both, legal and illegal substances in the WEST countries, the FEB countries were experiencing increase and later on stabilisation in drug use. The possible explanatory factors including the impact of profound political, cultural and socio-economic changes following the fall of the Iron Curtain in 1989 were discussed. The implications of these trends and suggestions for drug prevention strategies were outlined.
authors.affiliation: Department of Psychology, St. Elisabeth University of Health and Social Work, Bratislava, Slovak Republic.
authors.forename: Alojz
authors.initials: A
authors.lastname: Nociar
authors.affiliation: Institute of Psychiatry and Neurology in Warsaw, Warsaw, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Sierosławski
authors.affiliation: Prague Psychiatric Centre, Prague, Czech Republic.
authors.forename: Ladislav
authors.initials: L
authors.lastname: Csémy
mesh_terms: D000293:Adolescent; D005060:Europe / Q000453:epidemiology; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D013334:Students / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
keywords: ESPAD survey; East–West comparison; alcohol and drug use; early onset