Differences between men and women in substance use: the role of educational level and employment status.
OBJECTIVE
To determine differences between men and women in hazardous drinking, heavy cannabis use and hypnosedative use according to educational level and employment status in the economically active population in Spain.


METHODS
Cross-sectional study with data from 2013 Spanish Household Survey on Alcohol and Drugs on individuals aged 25-64 [n=14,113 (women=6,171; men=7,942)]. Dependent variables were hazardous drinking, heavy cannabis use and hypnosedative consumption; the main independent variables were educational level and employment situation. Associations between dependent and independent variables were calculated with Poisson regression models with robust variance. All analyses were stratified by sex.


RESULTS
Hazardous drinking and heavy cannabis use were higher in men, while women consumed more hypnosedatives. The lower the educational level, the greater the gender differences in the prevalence of this substances owing to different consumption patterns in men and women. While men with a lower educational level were higher hazardous drinkers [RII=2.57 (95%CI: 1.75-3.78)] and heavy cannabis users [RII=3.03 (95%CI: 1.88-4.89)] compared to higher educational level, in women the prevalence was the same. Women with a lower education level and men with a higher education level had higher hypnosedative consumption. Unemployment was associated with increased heavy cannabis use and hypnosedative use in both women and men and with lower hazardous drinking only in women.


CONCLUSIONS
There are differences between men and women in the use of psychoactive substances that can be explained by the unequal distribution of substance use in them according to educational level. Unemployment was associated with substance use in both men and women.
Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain; Departament de Ciències Experimentals i de la salut, Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra (UPF), Barcelona, Spain.
Ester
E
Teixidó-Compañó
Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Departament de Psicobiologia i Metodologia en Ciències de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès, Barcelona), Spain. Electronic address: aespelt@aspb.cat.
Albert
A
Espelt
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain; Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
Luis
L
Sordo
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
María J
MJ
Bravo
CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
Ana
A
Sarasa-Renedo
Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
B Iciar
BI
Indave
Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain; Departament de Ciències Experimentals i de la salut, Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra (UPF), Barcelona, Spain.
Marina
M
Bosque-Prous
Agència de Salut Pública de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain; Departament de Ciències Experimentals i de la salut, Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra (UPF), Barcelona, Spain.
M Teresa
MT
Brugal
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004522:Educational Status; D004651:Employment; D005260:Female; D006306:Health Surveys; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D008571:Men / Q000523:psychology*; D008875:Middle Aged; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014478:Unemployment; D014930:Women / Q000523:psychology*
D006993:Hypnotics and Sedatives
Alcohol consumption; Consumo de bebidas alcohólicas; Educational status; Empleo; Employment; Escolaridad; Fumar marihuana; Hipnóticos y sedantes; Hypnotics and sedatives; Marijuana smoking; Sex; Sexo