Wednesday, 26 February 2014

Cannabis Use among Adolescents in Europe, 2002-2010: Overall Decrease, but Increasing Inequalities

This blog, written ­by Dr. Margaretha de Looze (researcher and lecturer at Utrecht University, the Netherlands), discusses HBSC's study on cannabis use among adolescents in Europe. The post is part of the Wikichild series on Adolescent health, examining cross-national changes in frequent adolescent cannabis use (40+ times consumed over life-time at age 15) over time and relating these trends to societal wealth, family affluence and gender.

Cannabis use among adolescents in wealthy European countries is decreasing, while in poorer European countries it is on the rise. In particular, Russia, Latvia, Lithuania, and FYR Macedonia experienced increased cannabis consumption amongst adolescents between 2002 and 2010. These findings come from a recent publication by members of the Health Behaviour in School-aged Children (HBSC) study and research network.

Decrease in wealthy countries


This analysis, from 14 members of the international WHO collaborative study, looked at trends over time in frequent adolescent cannabis use (40+ times consumed over lifetime at age 15) in 2002, 2006 and 2010. We found that frequent cannabis use has decreased among adolescents in the more affluent western and southern European and North American countries. In some of these countries, the decreases were dramatic. For example, in 2010, frequent cannabis use among German boys decreased from 6.6% in 2002 to 1.2%, and  among Dutch girls it decreased from 4.1% in 2002 to 1.5%.  

This decline in frequent cannabis use in the wealthier countries of Europe is consistent with a general decrease in a range of other risk behaviours among these young people. In many of these countries, adolescent tobacco use, alcohol consumption, sexual risk behaviors and fighting have also declined.

How can this decline in adolescent risk behaviours be explained? One possible answer lies in substance use policies. Legislations to limit underage access and to restrict illicit substance use in general are enforced in all Western countries, with stricter substance use prevention policies coming into action in recent years. Additionally, a stronger focus on educating young people on the harmful effects of substance use has changed social norms leading to lower tolerance and acceptance of substance use among teenagers. 

Increase in Russia, Latvia, Lithuania, and FYR Macedonia


In contrast to Western European countries, frequent cannabis use stabilized or increased between 2002 and 2010 in the poorer Eastern European countries. For example, frequent cannabis use among boys in Latvia increased from 1.1% to 3.3%, with Russian girls showing an increase from 0.2% to 0.8%. 

Although the rates in these countries are still lower than those in Western Europe, the increasing trends over time are steady - and thus alarming. Adolescents from less affluent countries seem to be adopting consumption patterns consistent with their peers in richer countries. 

The growing wealth of Eastern European countries appears to have fostered adolescent substance use due to the increased availability of substances and the emergence of a flourishing youth culture. However, this apparent effect of national wealth seems to have leveled off in Western European countries, potentially due to the implementation of stricter cannabis use policies.

Importantly, adolescent cannabis use appears not only to have ‘trickled down’ from richer to developing countries, but also from more affluent to less affluent youth within countries. While cannabis consumption emerged as a central component of the ‘Bohemian’ ideals of the 1960’s and 1970’s and was first popularized by middle class youth, it now appears to have spread to the youth population of a lower socioeconomic status.

Girls do not catch up with boys

While one might have expected that gender differences would narrow between 2002 and 2010, as a result of girls’ and women’s continuing liberation, cannabis use has actually become (even) more characteristic of males during this period. This rather surprising finding might be explained by the de-normalization of cannabis use over the past decade. While cannabis use was widespread and quite ‘normalized’ among well-adjusted, non-risk-taking young people at the end of the 20th century, the recent declining rates may have changed young people’s perception of cannabis use as de-normalized and highly risky behaviour. As risk-taking increases social status among boys but less so for girls, it may be easier for boys to remain part of a cannabis-using scene.

Although it is reassuring that, overall, cannabis use has decreased for both genders, male adolescents have always been, and remain, at higher risk for excessive use, dependence and associated health problems.

What next?

Future studies should closely monitor tendencies for ‘trickle down’ and ‘de-normalization’ effects in frequent cannabis use as fundamental indicators of substance use and health in adolescent populations. Currently, data for the new HBSC cycle are being collected in more than 40 countries in Europe and North America. Within a year, we will be able to conclude whether the observed trends have continued into 2014

The HBSC Study

The HBSC research network is an alliance of researchers who collaborate to collect data on the health, well-being, health behaviours, social environments and economic contexts of adolescents. The HBSC study is currently conducted in 44 countries across Europe and North America, and the network includes over 450 experts from a wide range of disciplines. Members of the HBSC network collaborate to develop a standardized questionnaire, which is used to survey nationally representative samples of school-aged children in each participating country.
HBSC's research themes currently include: chronic conditions, eating and dieting, electronic media, family culture, gender, medicine-use, peer culture, physical activity, positive health, puberty, risk behaviours, school, sexual health, social inequality, and violence and injuries. 

- Dr. Margaretha de Looze
Researcher and lecturer at Utrecht University, the Netherlands 

For more information visit 

See also:
- Injury Among Young Canadians: A national study of contextual determinants
- Health Behaviour in School-Aged Children

- Adolescence

1 comment:

  1. I think this article is very important for people to know about. It's not just about the legalisation of cannabis, but the effective management and monitoring of the population. It's not an entirely evil substance.