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J Public Health (Oxf). 2012 Dec;34(4):512-22. doi: 10.1093/pubmed/fds022. Epub 2012 Apr 26.

The relationship between subjective wellbeing, low income and substance use among schoolchildren in the north west of England: a cross-sectional study.

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Cheshire and Merseyside Health Protection Unit, 5th Floor, Rail House, Lord Nelson Street, Liverpool L1 1JF, UK.



The consumption of tobacco, alcohol and illegal drugs by young people is a public health concern. This study aimed to explore the associations between subjective wellbeing, living in a low-income household and substance use by schoolchildren.


Data were analysed from a nationally representative cross-sectional survey of schoolchildren in England (Tellus4, 2009). Participants were 3903 children aged 10 and 15 years from two local authorities in the North West. Eligibility for free school meals provided a proxy for living in a low-income household. Multiple logistic regression was conducted with the main outcome measure, a composite indicator of self-reported regular substance use.


More boys than girls had experimented with drugs or alcohol, but in the fourth year of secondary education, girls were significantly more likely than boys to have been drunk (P ≤ 0.001). In the multivariate analysis, older age was the most important factor associated with the consumption of substances. Living in a low-income household was associated with substance use, adjusting for age and subjective wellbeing (adj. OR = 1.78, 95% CI = 1.36-2.34). Respondents who reported being happy (adj. OR = 0.67, 95% CI = 0.52-0.86) or able to communicate with their family (adj. OR = 0.51, 95% CI = 0.39-0.65), were less likely to be regular users.


Interventions to prevent regular substance use should be carefully targeted by age. Policies aimed at social determinants may be an important adjunct to individual-level interventions to reduce some inequalities in health associated with substance misuse.

[Indexed for MEDLINE]

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