Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys

By L. Degenhardt, W. Chiu, N. Sampson, Ronald C. Kessler, J. Anthony, M. Angermeyer, R. Bruffaerts, G. de Girolamo, O. Gureje, Yueqin Huang and 11 more. PLoS Medicine, 2008

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Background Alcohol, tobacco, and illegal drug use cause considerable morbidity and mortality, but good cross-national epidemiological data are limited. This paper describes such data from the first 17 countries participating in the World Health Organization's (WHO's) World Mental Health (WMH) Survey Initiative. Methods and Findings Household surveys with a combined sample size of 85,052 were carried out in the Americas (Colombia, Mexico, United States), Europe (Belgium, France, Germany, Italy, Netherlands, Spain, Ukraine), Middle East and Africa (Israel, Lebanon, Nigeria, South Africa), Asia (Japan, People's Republic of China), and Oceania (New Zealand). The WHO Composite International Diagnostic Interview (CIDI) was used to assess the prevalence and correlates of a wide variety of mental and substance disorders. This paper focuses on lifetime use and age of initiation of tobacco, alcohol, cannabis, and cocaine. Alcohol had been used by most in the Americas, Europe, Japan, and New Zealand, with smaller proportions in the Middle East, Africa, and China. Cannabis use in the US and New Zealand (both 42%) was far higher than in any other country. The US was also an outlier in cocaine use (16%). Males were more likely than females to have used drugs; and a sex–cohort interaction was observed, whereby not only were younger cohorts more likely to use all drugs, but the male–female gap was closing in more recent cohorts. The period of risk for drug initiation also appears to be lengthening longer into adulthood among more recent cohorts. Associations with sociodemographic variables were consistent across countries, as were the curves of incidence of lifetime use. Conclusions Globally, drug use is not distributed evenly and is not simply related to drug policy, since countries with stringent user-level illegal drug policies did not have lower levels of use than countries with liberal ones. Sex differences were consistently documented, but are decreasing in more recent cohorts, who also have higher levels of illegal drug use and extensions in the period of risk for initiation.

Subfields: Epidemiology, Pharmacology, Toxicology

View Paper: https://www.semanticscholar.org/paper/90e7ee9dda3312a2c5053ef1a0d37a9952e6c701

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Citations in the corpus

General Growth Mixture Analysis of Adolescents' Developmental Trajectories of Anxiety: The Impact of Untested Invariance Assumptions on Substantive Interpretations (2011, background): “…girls tend to present higher levels of academic achievement (e.g., Freudenthaler et al., 2008) and lower levels of drug-related problems (e.g., Degenhardt et al., 2008; Robbins, 1989) than boys, the low levels of GPA and elevated levels of drug-related problems observed in the school-related…”
What Can We Learn From The Portuguese Decriminalization of Illicit Drugs (2010, background): “Despite international evidence that rates of drug use are not directly affected by harsher punishment of drug users (Reuter and Stevens 2007; Degenhardt et al. 2008) (and pressure from multiple advocates), the British Government has firmly opposed any move towards decriminalization.”
How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment (2009, methodology): “We present NZMHS and NCS-R data to show that the USA and New Zealand do not differ on disorder prevalence (both used the same measure and methods as part of the World Mental Health Surveys ; Degenhardt et al. 2008).”