Socioeconomic Inequalities in Adolescent Substance Use: Evidence From Twenty-Four European Countries

Abstract

Background: While there is evidence for socioeconomic inequalities in some adolescent substance use behaviors, there is limited information on how socioeconomic inequalities compare across European countries and over time. Objectives: To compare socioeconomic inequalities in problematic adolescent substance use (regular smoking, heavy episodic drinking, and cannabis use) across 24 European countries at two time points. Methods: We use the European School Survey Project on Alcohol and Other Drugs (ESPAD) to examine socioeconomic inequalities in problematic adolescent substance use across 24 European countries in 2007 (n = 73,877) and 2011 (n = 71,060) using within country logistic regressions. Socioeconomic inequalities are measured using a relative index of inequality based on highest level of parental education relative to country of residence within survey year. Countries are ranked according to socioeconomic differentials. Results: In 2007, lower socioeconomic status (SES) adolescents had significantly higher odds of heavy episodic drinking in 10 countries, regular smoking in 12 countries, and recent cannabis use in 1 country. In 2011, the number of countries were 11, 15, and 0, respectively. In 2007, lower SES adolescents had a significantly lower odds of heavy episodic drinking in one country, regular smoking in one country, and cannabis use in four countries. In 2011, the number of countries were two, one, and six, respectively. There was little evidence for changes in socioeconomic inequalities over time. Conclusions: There are large country level differences in socioeconomic inequalities in adolescent substance use.

Keywords:

• Adolescence
• socioeconomic
• Europe
• tobacco use
• alcohol
• cannabis

Acknowledgement

This article includes data from a database produced within the European School Survey Project on Alcohol and Other Drugs (ESPAD). This article is written in line with the rules for the use of the ESPAD database. We thank the National Principal Investigators for providing data for this study (Bulgaria: Anina Chileva, Croatia: Marina Kuzman, Czech Republic: Ladislav Csèmy, Denmark: Svend Sabroe, Estonia: Airi-Alina Allaste, Faroe Islands:Pál Weihe, Finland: Salme Ahlström, France: Stéphane Legleye, Greece: Anna Kokkevi, Hungary: Zsuzsanna Elekes, Iceland: Thoroddur Bjarnason, Italy: Sabrina Molinaro, Latvia: Marcis Trapencieris, Lithuania: Tadas Tamosiunas, Malta: Sharon Arpa, Norway: Astrid Skretting, Poland: Janusz Sieroslawski, Romania: Silvia Florescu, Russia: Eugenia Koshkina, Slovakia: Alojz Nociar, Slovenia: Eva Stergar, Sweden: Björn Hibell, Ukraine: Olga Balakireva, United Kingdom: Mark Bellis). The analysis and interpretation of these data is our own.

Disclosure statement

The authors report no conflicts of interest.

Notes

1 ESPAD data is embargoed to non-ESPAD researchers for several years after collection. The 2011 data was available from July 1st 2015, and the 2007 data was available from July 1st 2013. To obtain access to these data, detailed applications outlining research projects are submitted to ESPAD and shared around ESPAD researchers to ensure originality in research.

Additional information

Funding

This research was supported by a small research grant from the British Academy (SG142822).