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Drug Alcohol Depend. 2007 May 11;88(2-3):308-12. Epub 2006 Nov 17.

Further investigation of psychological and environmental correlates of substance use in adolescence in six European countries.

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Department of Psychiatry, Medical School, University of Athens, Athens, Greece.



To study the multifactorial correlates of adolescents' use of legal and illegal substances in six European countries and to assess whether a common pattern of factors exists irrespective of the countries' different sociocultural backgrounds.


Cross-sectional European school population survey (ESPAD) following standardized methodology.


National probability samples of 16-year-old high school students from Bulgaria, Croatia, Greece, Romania, Slovenia and the UK. Total sample 16,445.


Anonymous questionnaire self-administered in the classroom. Self-reported use of tobacco, alcohol, marijuana and other illegal drugs. Correlates examined: environmental, such as peer culture and family-related; behavior-related such as antisocial behavior, truancy and anomie; and psychological factors such as self-esteem and depressive mood.


Separate logistic regressions for the two genders produced a set of psychosocial correlates common to the use of all legal and illegal substances. The strongest were peer and older sibling models of use, and peer-oriented lifestyle, followed by patterns of antisocial behavior and truancy. Family-related variables such as not living with both parents, parental monitoring and relationships with parents were less significant. Self-esteem and depressive mood were not significant. Girls' use of substances, especially illegal ones, showed stronger associations than boys' with a deviant behavior pattern. Few interactions between country and other correlates were significant.


Common correlates can be identified across countries. Older siblings' and peers' substance have a strong impact on adolescents' use. Preventive interventions should include all substances with addictive potential.

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