Toward a global view of alcohol, tobacco, cannabis, and cocaine use: findings from the WHO World Mental Health Surveys.
paper
Cited
Public
- Authors
- Degenhardt, Louisa; Chiu, Wai-Tat; Sampson, Nancy; Kessler, Ronald C; Anthony, James C; Angermeyer, Matthias; Bruffaerts, Ronny; de Girolamo, Giovanni; Gureje, Oye; Huang, Yueqin; Karam, Aimee; Kostyuchenko, Stanislav; Lepine, Jean Pierre; Mora, Maria Elena Medina; Neumark, Yehuda; Ormel, J Hans; Pinto-Meza, Alejandra; Posada-Villa, JosΓ©; Stein, Dan J; Takeshima, Tadashi; Wells, J Elisabeth
- Year
- 2008
- Journal
- PLoS medicine
- PMID
- 18597549
- DOI
- 10.1371/journal.pmed.0050141
- PMCID
- PMC2443200
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.
Figure 1
AOO of Drug Use among Those Reporting Any Use by CountryNote: Where lines are not presented for an individual country, either there was no assessment of the AOO of that drug, or fewer than 30 persons reported having used the drug (see Tables 2 and 5).
Figure 2
Age-Specific Cumulative Incidence of Drug Use by Birth CohortPooled (weighted) data from the WMHSs (n = 54,068).
1β20 of 53
Next β
| Name | Type |
|---|---|
| 18-29 year age range local | phenotype |
| adolescents | cohort |
| African | cohort |
| age | phenotype |
| Age cohort 18β29 local | cohort |
| Age cohort 30β44 local | cohort |
| Age cohort 45β59 local | cohort |
| Age cohort β₯60 local | cohort |
| Age group 18-29 local | cohort |
| Age group 18-29 years | cohort |
| Age group 30-44 local | cohort |
| Age group 45-59 local | cohort |
| Age group β₯60 local | cohort |
| age of first drug use local | phenotype |
| age of initiation of illegal drug use local | phenotype |
| age of onset | phenotype |
| Age of onset (AOO) local | phenotype |
| alcohol | phenotype |
| Alcohol Use | phenotype |
| alcohol use initiation | phenotype |
| Americas | cohort |
| Asian | cohort |
| Beijing local | cohort |
| Belgium | cohort |
| birth cohort | cohort |
| cannabis initiation | phenotype |
| cannabis use | phenotype |
| Chinese | cohort |
| cocaine | phenotype |
| Cocaine initiation local | phenotype |
| Cocaine use local | drug |
| cocaine use disorder | phenotype |
| Colombia local | cohort |
| countries | cohort |
| cross-national surveys local | cohort |
| Cumulative incidence local | phenotype |
| Currently married local | phenotype |
| death | phenotype |
| dependent use | phenotype |
| drug dependence | phenotype |
| drugs | drug |
| drug type local | drug |
| early alcohol use | phenotype |
| Early-onset use local | phenotype |
| education | phenotype |
| employment | phenotype |
| European ancestry | cohort |
| European population | cohort |
| Experimental use local | phenotype |
| first onset of use local | phenotype |
| France | cohort |
| full sample | cohort |
| GENACIS | cohort |
| Germany | cohort |
| Global Status Report on Alcohol local | cohort |
| Global Youth Tobacco Survey local | cohort |
| Heavier use | phenotype |
| High-average income local | phenotype |
| High income | phenotype |
| illegal drug involvement local | phenotype |
| Illegal drug use local | drug |
| illicit drug use | phenotype |
| incident drug use local | phenotype |
| Incident drug use local | phenotype |
| income | phenotype |
| Initiating drug use local | phenotype |
| Intermediate-aged cohort local | cohort |
| Israel | cohort |
| Italy | cohort |
| Japanese | cohort |
| Later-onset use local | phenotype |
| Lebanon local | cohort |
| Legal drugs | phenotype |
| Liberal Drug Policies local | drug |
| lifetime alcohol use | phenotype |
| lifetime cannabis use | phenotype |
| lifetime cocaine use local | phenotype |
| Lifetime prevalence local | phenotype |
| Lifetime risk local | phenotype |
| lifetime smoking | phenotype |
| Liver cirrhosis | phenotype |
| Low-average income local | phenotype |
| Low-income local | phenotype |
| lung cancer | phenotype |
| Male-female differences local | phenotype |
| marital status | phenotype |
| men | cohort |
| Mexico | cohort |
| Middle East | cohort |
| mood disorders | phenotype |
| More recent cohorts local | cohort |
| Netherlands | cohort |
| New Zealand | cohort |
| Nigeria | cohort |
| older adults | cohort |
| older cohort | cohort |
| older persons local | cohort |
| Oldest cohort local | cohort |
| Oldest Cohort local | cohort |
| PACARDO local | cohort |
| panic disorder | phenotype |
| participants | cohort |
| Part II local | cohort |
| Past year use local | phenotype |
| People's Republic of China local | cohort |
| Peoples' Republic of China local | cohort |
| Population surveys local | cohort |
| Previously married local | phenotype |
| Recent cohort local | cohort |
| relationship status | phenotype |
| response bias local | phenotype |
| Second oldest cohort local | cohort |
| Second Oldest Cohort local | cohort |
| Secular Community Leaders local | cohort |
| Self-reported drug use local | phenotype |
| sex | phenotype |
| Sex-by-cohort interaction local | phenotype |
| Shanghai local | cohort |
| South Africa | cohort |
| Spain | cohort |
| Stringent Drug Policies local | drug |
| study cohort | cohort |
| Study Organizers local | cohort |
| substance use | phenotype |
| survey nonresponse local | phenotype |
| Third Cohort local | cohort |
| Tobacco or Health: Global Status Report local | cohort |
| tobacco smoker local | phenotype |
| tobacco use | phenotype |
| Two youngest cohorts local | cohort |
| Ukraine local | cohort |
| United States | cohort |
| urbanicity local | phenotype |
| US | cohort |
| Western European surveys local | cohort |
| WMHS local | cohort |
| WMHS initiative local | cohort |
| WMH surveys | cohort |
| women | cohort |
| World Mental Health Survey Initiative local | cohort |
| World Mental Health Surveys local | cohort |
| World Regions local | cohort |
| young adults | cohort |
| Young adults (22β29 y) local | cohort |
| Younger adults | cohort |
| younger cohort | cohort |
| Youngest Cohorts local | cohort |
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