Progression of a general substance use pattern among adolescents in Switzerland? Investigating the relationship between alcohol, tobacco, and cannabis use over a 12-year period.

Many studies have shown that different risk or problem behaviors in adolescence are interrelated. Given the increased use of various substances among adolescents in the United States and in most European countries, the question emerges whether there are more substance use "specialists" or a progression of a general substance use pattern. If the latter is the case, the interrelatedness of the different substances should remain stable over time in a representative sample and among subgroups characterized by gender and language. Data from 4,146 15-year-olds in Switzerland surveyed in 1986, 1994 and 1998 were analyzed, using confirmatory factor analyses based on polychoric correlations. Smoking, drunkenness and cannabis use greatly increased over the 12-year period. However, in the different survey years, the factor structure did not differ for all 15-year-olds in general or for subgroups. This progression of a general pattern refers to an increased normalization of recreational substance use in general, not only of cannabis use. Favorable attitudes towards general substance use are a challenge to substance use prevention in adolescence, and reveal a need for more research on such a progression in other countries. Copyright 2004 S. Karger AG, Basel