ANN ARBOR, Mich. The U.S. had the second lowest proportion of students who used tobacco and alcohol compared to their counterparts in 36 European countries, a new report indicates.
The results originate from coordinated school surveys about substance use from more than 100,000 students in some of the largest countries in Europe like Germany, France and Italy, as well as many smaller ones from both Eastern and Western Europe.
Because the methods and measures are largely modeled after the University of Michigan’s Monitoring the Future surveys in this country, comparisons are possible between the U.S. and European results. The 15 and 16 year old students, who were drawn in nationally representative samples in almost all of the 36 countries, were surveyed last spring. American 10th graders in the 2011 Monitoring the Future studies are of the same age, so comparisons are possible.
The differences found between adolescent behaviors in the U.S. and Europe are dramatic, according to Lloyd Johnston, the principal investigator of the American surveys.
About 27 percent of American students drank alcohol during the 30 days prior to the survey. Only Iceland was lower at 17 percent, and the average rate in the 36 European countries was 57 percent, more than twice the rate in the U.S.
The proportion of American students smoking cigarettes in the month prior to the survey was 12 percent again the second lowest in the rankings and again only Iceland had a lower rate at 10 percent. For all European countries the average proportion smoking was 28 percent, more than twice the rate in the U.S.
“One of the reasons that smoking and drinking rates among adolescents are so much lower here than in Europe is that both behaviors have been declining and have reached historically low levels in the U.S. over the 37 year life of the Monitoring the Future study,” Johnston said. “But even in the earlier years of the European surveys, drinking and smoking by American adolescents was quite low by comparison.
“Use of illicit drugs is quite a different matter.”
The U.S. students tend to have among the highest rates of use of all of the countries. At 18 percent, the U.S. ranks third of 37 countries on the proportion of students using marijuana or hashish in the prior 30 days. Only France and Monaco had higher rates at 24 percent and 21 percent, respectively. The average across all the European countries was 7 percent, or less than half the rate in the U.S.
American students reported the highest level of marijuana availability of all the countries and the lowest proportion of students associating great risk with its use factors that may help to explain their relatively high rates of use here, according to Johnston.
Clearly the U.S. has attained relatively low rates of use for cigarettes and alcohol, though not as low as we would like,” Johnston said. “But the level of illicit drug use by adolescents is still exceptional here.”
The U.S. ranks first in the proportion of students using any illicit drug other than marijuana in their lifetime (16 percent compared to an average of 6 percent in Europe) and using hallucinogens like LSD in their lifetime (6 percent vs. 2 percent in Europe). It also ranks first in the proportion reporting ecstasy use in their lifetime (7 percent vs. 3 percent in Europe), despite a sharp drop in their ecstasy use over the previous decade. American students have the highest the proportion reporting lifetime use of amphetamines (9 percent), a rate that is three times the average in Europe (3 percent). Ecstasy was seen as more available in the U.S. than in any other country.
For some drugs, however, the lifetime prevalence rate in the U.S. was just about the average for the European countries, including inhalants (10 percent), cocaine (3 percent), crack (2 percent), heroin (1 percent) and anabolic steroids (1 percent).
“Clearly the U.S. has attained relatively low rates of use for cigarettes and alcohol, though not as low as we would like,” Johnston said. “But the level of illicit drug use by adolescents is still exceptional here.”
This was the fifth coordinated data collection in Europe as part of the European School Survey Project on Alcohol and Other Drugs, the first being held in 1995 with 26 countries participating. The research plan this time was for each country to generate a representative national sample of 15 and 16 year olds with at least 2,400 students being surveyed. All samples were nationally representative, except those in Germany, Russia, Flanders (the Dutch part of Belgium) and Bosnia Herzegovina. In each of these cases a sub national representative sample was surveyed, such as Moscow in the case of Russia.
The European survey group was led by Swedish sociologist Bjorn Hibbell, who has worked in the substance abuse field for many years. The American survey is led by social psychologist Lloyd Johnston, who has served as principal investigator of Monitoring the Future since its inception 37 years ago. MTF, which is conducted by the University of Michigan’s Institute for Social Research and is funded by the National Institute on Drug Abuse, had a sample of 15,400 10th grade students in 126 high schools in the 2011 survey. Students completed confidential, self administered questionnaires right in their classrooms in both the American and European surveys.
- Full European report
- Monitoring the Future report (PDF)
- Marijuana use continues to rise among U.S. teens, while alcohol use hits historic lows
- Decline in teen smoking resumes in 2011
By Jared Wadley
University of Michigan News Service
Illicit cigarettes and hand-rolled tobacco in 18 european countries: a cross-sectional survey — joossens et al. — tobacco
- Luk Joossens1,
- Alessandra Lugo2,
- Carlo La Vecchia2,3,
- Anna B Gilmore4,
- Luke Clancy5,
- Silvano Gallus2
- 1Association of European Cancer Leagues, Foundation against Cancer, Brussels, Belgium
- 2Department of Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
- 3Department of Clinical Sciences and Community Health, Universit degli Studi di Milano, Milan, Italy
- 4Department for Health, University of Bath, Bath, UK
- 5TobaccoFree Research Institute Ireland, Dublin, Ireland
- Correspondence to Luk Joossens, Foundation against Cancer, Chauss e de Louvain 479, Brussels B 1030, Belgium LJoossens at
- Received 18 June 2012
- Accepted 10 October 2012
- Published Online First 10 December 2012
Objective Little evidence, other than that commissioned by the tobacco industry, exists on the size of the illicit tobacco trade. This study addresses this gap by examining the level and nature of illicit cigarettes and hand rolled tobacco in 18 European countries.
Design Face to face cross sectional survey on smoking.
Setting 18 European countries.
Participants For each country, around 1000 subjects representative of the population aged 15 and over were enrolled. Current cigarette smokers were asked to show their latest purchased pack of cigarettes or hand rolled tobacco.
Main outcome measure A comprehensive measure called an Identification of an Illicit Pack (IIP) was used to study the extent of illicit trade, defining a pack as illicit if it had at least one of the following tax evasion indicators (1) it was bought from illicit sources, as reported by smokers, (2) it had an inappropriate tax stamp, (3) it had an inappropriate health warning or (4) its price was substantially below the known price in their market.
Results Overall, the proportion of illicit packs was 6.5%. The highest prevalence of IIP was observed in Latvia (37.8%). Illicit packs were more frequent among less educated smokers and among those living in a country which shared a land or sea border with Ukraine, Russia, Moldova or Belarus. No significant association was found with price of cigarettes.
Conclusions This study indicates that IIP is less than 7% in Europe and suggests that the supply of illicit tobacco, rather than its price, is a key factor contributing to tax evasion.
- Illegal tobacco products