Toward a global view of alcohol, tobacco, cannabis, and cocaine use: findings from the WHO world mental health surveys
Open accessAbstract
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.
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Rates of drug use are not directly affected by harsher punishment of drug users.
“Despite international evidence that rates of drug use are not directly affected by harsher punishment of drug users (Reuter and Stevens 2007;Degenhardt et al. 2008)”
From What Can We Learn From The Portuguese Decriminalization of Illicit Drugs? (2010) · cites this paper as Degenhardt et al. 2008
The Discussion reports that the US had high drug-use levels despite punitive policies and concludes that punitive possession-and-use policies account for limited variation in national rates. That supports a weak relationship, but the paper does not establish that harsher punishment has no direct effect on drug-use rates. (LLM, conf=0.86)
Experimental — accuracy not yet measuredYoung adulthood is marked by increased experimentation and risk-taking behaviours such as drug use.
“Young adulthood is also marked by increased experimentation and risk-taking behaviours such as drug use.15”
Young adulthood (age 18-24 years) is the peak life stage for drug use, with higher rates among young men.
“Young adulthood (age 18–24 years) is the peak life stage for drug use, with higher rates among young men.15”
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- Authors
- Degenhardt, L., Chiu, W.-T., Sampson, N., Kessler, R. C., Anthony, J. C., Angermeyer, M., Bruffaerts, R., de Girolamo, G., Gureje, O., Huang, Y., Karam, A., Kostyuchenko, S., Lepine, J. P., Mora, M. E. M., Neumark, Y., Ormel, J. H., Pinto-Meza, A., Posada-Villa, J., Stein, D. J., Takeshima, T., & Wells, J. E.
- Affiliations
- UNSW Sydney (AU)
- Harvard University (US)
- Michigan State University (US)
- Leipzig University (DE)
- Universitair Ziekenhuis Leuven (BE)
- University College Hospital, Ibadan (NG)
- Peking University (CN)
- Hôpital Fernand-Widal (FR)
- Hebrew University of Jerusalem (IL)
- University Medical Center Groningen (NL)
- University of Cape Town (ZA)
- National Center of Neurology and Psychiatry (JP)
- Corresponding author
- Degenhardt, Louisa
- ORCID
- Venue
- PLoS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2008-07-01
- Volume
- 5
- Issue
- 7
- Pages
- e141
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC2443200
- OpenAlex
- W2107259975
- Semantic Scholar
- 90e7ee9dda3312a2c5053ef1a0d37a9952e6c701
- Cited by
- 796
- References
- 55
- Citations by year
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- FWCI
- 35.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Open University of Cape Town (University of Cape Town) (submittedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
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- Open University of Cape Town (University of Cape Town) (submittedVersion, cc-by)
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- Funders
- Robert Wood Johnson Foundation (044708, Grant 044708)
- John W. Alden Trust (R01-MH069864, R13-MH066849)
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- GlaxoSmithKline
- World Health Organization
- University of Michigan
- Australian Government
- European Commission (1999-01042, QLG5–1999-01042, SANCO2004123, 2004123)
- Generalitat de Catalunya (01042, CB06/02/0046)
- Bundesministerium für Gesundheit
- National Insurance Institute of Israel (H13-SHOGAI-023, H16-KOKORO-013, H14-TOKUBETSU-026)
- Ministry of Health, Labour and Welfare (H16-KOKORO-013, H14-TOKUBETSU-026, H13-SHOGAI-023)
- Regione Piemonte (00/0028)
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
- Substance Abuse and Mental Health Services Administration (044708)
- Pfizer Foundation (R01‐MH069864, R01-DA016558, R13-MH066849)
- Pan American Health Organization
- Medical Research Council
- National Health and Medical Research Council
- Instituto de Salud Carlos III (CB06/02/0046, FIS 00/0028, CIBER CB06/02/0046)
- Departament de Salut, Generalitat de Catalunya (CB06/02/0046)
- National Institute of Mental Health (R13-MH-066849, RO1-MH61905, R0 1-MH61905, R01‐MH070884, MH61905, U01-MH-60220, R01MH061905, R01MH059575, MH60220, MH069864, MH066849, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (K05DA015799, R01DA016558, U01-MH60220)
- Fogarty International Center (FIRCA R01-TW006481, R01-TW006481, R03TW006481)
- Cilag
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- alcohol consumption, tobacco use, cannabis use, cocaine use, substance use prevalence, sex differences in drug use, cross-national comparison, lifetime substance use
- MeSH terms
- Adolescent, Adult, Cannabis, Marijuana Abuse, Female, Health Surveys, Humans, Male, Mental Health, Tobacco Use Disorder, Global Health, World Health Organization, Cohort Studies, Cocaine-Related Disorders, Alcohol-Related Disorders, Internationality
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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