Within our own sample, rates of alcohol intoxication (58% of the total sample having been intoxicated) for 16- to 17-year-olds were greater than the annual prevalence of 10th graders in the USA (30%) (Monitoring the Future, 2008). Additionally, the 16- to 17-year-olds had a dramatically lower prevalence of illicit drug use (4.4% of the total sample) compared to the 12-month prevalence of 10th graders in the USA (27%) (Monitoring the Future, 2008). However, 10th-grader lifetime rates (12-month prevalence not assessed) of smoking (31.7%) were similar to the 12-month prevalence (22%) for our 16- to 17-year-olds (Monitoring the Future, 2008). These differences could impact the generalizability of results outside of a Swedish/European population. Importantly, our substance use rates appear in line with rates of use in Sweden. The European School Survey Project on Alcohol and Other Drugs (ESPAD, 2003) reported that 81% of Swedish 17- to 18-year-olds had been intoxicated, 8% had used marijuana, and 2% had used other illicit drugs in the previous 12 months.
