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.
References
[1]
Ezzati M, Lopez A, Rodgers A, Vander Hoorn S, Murray C, et al. (2002) Selected major risk factors and global and regional burden of disease. Lancet 360: 1347–1360.
[2]
Rehm J, Room R, Monteiro M, Gmel G, Graham K, et al. (2004) Chapter 12. Alcohol use. In: Ezzati M, Lopez AD, Rodgers A, Murray R, editors. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. 2nd edition. Geneva: World Health Organization. pp. 959–1108.
[3]
Degenhardt L, Hall W, Lynskey M, Warner-Smith M (2004) Chapter 13. Illicit drug use. In: Ezzati M, Lopez AD, Rodgers A, Murray R, editors. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk factors. 2nd edition. Geneva: World Health Organization. pp. 1109–1176.
[4]
Ezzati M, Lopez AD (2004) Chapter 11. Smoking and oral tobacco use. In: Ezzati M, Lopez AD, Rodgers A, Murray R, editors. Comparative quantification of health risks: global and regional burden of disease attributable to selected major risk Factors. 2nd edition. Geneva: World Health Organization. pp. 883–957.
[5]
Kessler RC, Abelson J, Demler O, Escobar JI, Gibbon M, et al. (2004) Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMHCIDI). Int J Methods Psychiatr Res 13: 122–139.
[6]
Kessler RC, Ustun TB (2004) The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 13: 93–121.
[7]
Farr W (1885) Vital statistics: memorial volume of selections from the reports and writings, 1885. Bulletin of the World Health Organization 78: 88–95.
[8]
Dudfield R (1905) A critical exmianation of the methods of recording and publishing statistical data bearing on public health; with suggestions for the improvement of such methods. Journal of the Royal Statistical Society 68: 1–49.
[9]
World Health Organization (1920) International Classification of Diseases. 3rd revision. Geneva: World Health Organization.
[10]
World Health Organization (1973) Report of the International Pilot Study of Schizophrenia. Geneva: World Health Organization.
[11]
Manski C, Pepper JV, Petrie CV (2001) Informing America's policy on illegal drugs: what we don't know keeps hurting us. Council NR, editor. Washington (D.C.): National Academy Press.
[12]
Clark WB (1966) Operational definition of drinking problems and associated prevalence rates. Q J Stud Alcohol 27: 648–668.
[13]
Cahalan D, Room R (1974) Problem drinking among American men. Monograph number 7. New Brunswick (New Jersey): Rutgers Center of Alcohol Studies.
[14]
Room R (1988) Cross-cultural research in alcohol studies: research traditions and analytical issues. In: Harford T, Towle L, editors. Cultural influences and drinking patterns: a focus on Hispanic and Japanese populations NIAAA Research Monograph number 19. Rickville (Maryland): National Institute of Alcohol Abuse and Alcoholism. pp. 9–40.
[15]
Robins LN (1966) Deviant children grown up: a sociological and psychiatric study of sociopathic personality. Baltimore (Maryland): Williams & Wilkins.
[16]
Nicolaides-Bouman A, Wald N, Forey B, Lee P (1993) International smoking statistics. Oxford: Oxford University Press.
[17]
Room R, Janca A, Bennett L, Schmidt L, Sartorius N (1996) WHO cross-cultural applicability research on diagnosis and assessment of substance use disorders: an overview of methods and selected results. Addiction 91: 199–220.
[18]
Fitch C, Stimson GV, Rhodes T, Poznyak V (2004) Rapid assessment: an international review of diffusion, practice and outcomes in the substance use field. Soc Sci Med 59: 1819–1830.
[19]
Ahlstr？m S, Bloomfield K, Knibbe R (2001) Gender differences in drinking patterns in nine European countries: descriptive findings. Subst Abus 22: 69–85.
[20]
Obot IS, Room R, editors. (2003) Alcohol, gender and drinking problems: perspectives from low and middle income countries. Geneva: World Health Organization.
[21]
Leifman H (2002) A comparative analysis of drinking patterns in six EU countries in the year 2000. Contemp Drug Probl 29: 501–548.
[22]
Bloomfield K, Gmel G, Neve R, Mustonen H (2001) Investigating gender convergence in alcohol consumption in Finland, Germany, the Netherlands and Switzerland: a repeated survey analysis. Subst Abus 22: 39–53.
[23]
Dormitzer CM, Gonzalez GB, Penna M, Bejarano J, Obando P, et al. (2004) The PACARDO research project: youthful drug involvement in Central America and the Dominican Republic. Rev Panam Salud Publica 15: 400–416.
[24]
World Health Organization (2004) Global status report on alcohol. Geneva: World Health Organization.
[25]
World Health Organization (1997) Tobacco or health: a global status report. Geneva: World Health Organization.
[26]
Warren C, Jones R, Eriksen M, Asma S, for the Global Tobacco Surveillance System (GTSS) collaborative group (2006) Patterns of global tobacco use in young people and implications for future chronic disease burden in adults. Lancet 367: 749–753.
[27]
Heeringa SG, Wells JE, Hubbard F, Mneimneh Z, Chiu WT, et al. (2008) Sample designs and sampling procedures. In: Kessler RC, üstün TB, editors. The World Mental Health Survey Initiative volume one: patterns of mental illness in the WMH Surveys. New York: Cambridge University Press. In press.
[28]
Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, et al. (2004) Sampling and methods of the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica 420: 8–20.
[29]
Alonso J, Ferrer M, Romera B, Vilagut G, Angermeyer M, et al. (2002) The European Study of the Epidemiology of Mental Disorders (ESEMeD/MHEDEA 2000) project: rationale and methods. Int J Methods Psychiatr Res 11: 55–67.
[30]
Harkness J, Pennell B-E, Villar A, Gebler N, Aguilar-Gaxiola S, et al. (2008) Translation Procedures and Translation Assessment in the World Mental Health Survey Initiative. Kessler RCü, T.B., editor. The World Mental Health Survey Initiative volume one: patterns of mental illness in the WMH Surveys. New York: Cambridge University Press. In press.
[31]
Solow R (1967) Inequality and poverty. New York: WW Norton and Co.
[32]
Simon GE, VonKorff M (1995) Recall of psychiatric history in cross-sectional surveys: implications for epidemiologic research. Epidemiol Rev 17: 221–227.
[33]
Knauper B, Cannell CF, Schwarz N, Bruce ML, Kessler RC (1999) Improving the accuracy of major depression age of onset reports in the US National Comorbidity Survey. Int J Methods Psychiatr Res 8: 39–48.
[34]
SAS Institute (2001) SAS/STAT software: changes and enhancements, Release 8.2. Cary (North Carolina): SAS Publishing.
[35]
Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53: 457–481.
[36]
Halli SS, Rao KV, Halli SS (1992) Advanced techniques of population snalysis. New York: Plenum.
[37]
Efron B (1988) Logistic regression, survival analysis, and the Kaplan-Meier curve. J Am Stat Assoc 83: 414–425.
[38]
Hosmer D W, Lemeshow S (2000) Applied logistic regression. 2nd edition. New York: Wiley & Sons.
[39]
Wolter KM (1985) Introduction to variance estimation. New York: Springer-Verlag.
[40]
Research Triangle Institute (2002) SUDAAN Version 8.0.1. 7.5.3 edition. Research Triangle Park (North Carolina): Research Triangle Institute.
[41]
Research Triangle Institute (2002) SUDAAN: Professional Software for Survey Data Analysis. 8.01 edition. Research Triangle Park (North Carolina): Research Triangle Institute.
[42]
Kessler RC, Little RJ, Groves RM (1995) Advances in strategies for minimizing and adjusting for survey nonresponse. Epidemiol Rev 17: 192–204.
[43]
United Nations Office on Drugs and Crime (2005) World drug report 2005. Geneva: United Nations.
[44]
Fergusson DM, Horwood LJ (1997) Early onset cannabis use and psychosocial adjustment in young adults. Addiction 92: 279–296.
[45]
Substance Abuse and Mental Health Services Administration Office of Applied Studies (2003) Result from the 2002 National Survey on Drug Use and Health: national findings. Rockville (Maryland): Office of Applied Studies, National Household Survey on Drug Abuse Series H-22, Department of Health and Human Services Publication number SMA 03–3836.
[46]
Wu LT, Korper S, Marsden M, Lewis C, Bray R (2003) Use of incidence and prevalence in the substance use literature: A review. Rockville (Maryland): Substance Abuse and Mental Health Services Administration, Office of Applied Studies.
[47]
Hall W, Degenhardt L, Lynskey M (2001) The health and psychological consequences of cannabis use. National Campaign Against Drug Abuse Monograph number 44. Canberra: Australian Publishing Service.
[48]
Engels R, Knibbe R, Drop M (1997) Inconsistencies in adolescents' self-reports of initiation of alcohol and tobacco use. Addict Behav 22: 613–623.
[49]
Labouvie E, Bates M, Pandina R (1997) Age of first use: its reliability and predictive utility. J Stud Alcohol 58: 638–643.
[50]
Henry B, Moffitt T, Caspi A, Langley J, Silva P (1994) On the “remembrance of things past”: a longitudinal evaluation of the retrospective method. Psychol Assess 6: 92–101.
[51]
Kerr W, Greenfield T, Bond J, Ye Y, Rehm J (2008) Age-period-cohort influences on trends in past year marjiuana use in the US from 1984, 1990, 1995 and 2000 National Alcohol Surveys. Drug Alcohol Depend 86: 132–138.
[52]
Johnson RA, Gerstein D (1998) Initiation of use of alcohol, cigarettes, marijuana, cocaine and other substances in US birth cohorts since 1919. Am J Public Health 88: 27–33.
[53]
Degenhardt L, Lynskey M, Hall W (2000) Cohort trends in the age of initiation of drug use in Australia. Aust N Z J Public Health 24: 421–426.
