Broad Differences in Alcohol, Tobacco
and Illegal Drug Use Across Countries
A survey conducted by the World Health Organization (WHO) research
consortium found that the United States had among the highest lifetime
rates of tobacco and alcohol use and led in the proportion of participants
reporting cannabis (marijuana) or cocaine use at least once during
their lifetime. The study, led by Dr. Louisa Degenhardt of the
University of New South Wales, Sydney, Australia and colleagues,
looked at patterns in the use of alcohol, tobacco, cannabis and
cocaine in 17 countries representing all six WHO regions (the Americas,
Europe, Asia, the Middle East, Africa and Oceania). The study,
funded in part by the National Institute on Drug Abuse (NIDA),
part of the National Institutes of Health (NIH) is published in
the July 1, 2008 issue of the open access journal PLoS Medicine.
"These findings add to our understanding of substance abuse
world-wide, and suggest that drug use is still a major problem
in this country, pointing to the need for more effective prevention
interventions," said Dr. Elias A. Zerhouni, NIH director.
"A survey of lifetime use does not provide the entire picture;
however, because it does not reflect current use or trends over
time," said Dr. Volkow, sounding a note of caution. "For
example, although lifetime use of tobacco was reported by this
study to be 74 percent in the U.S., current use has been documented
at approximately 30 percent. Moreover, NIDA’s Monitoring the Future
survey has been consistently reporting a decrease in the past year
use of illicit drugs over the past decade, so this survey may reflect
a longer history of drug use in certain countries relative to others,
but not necessarily current trends."
Among the significant findings of this study were:
- Across countries and across the drug types in this survey,
drug use is becoming more common over time.
- Males were more likely than females to have used all drug types
in all countries and all age groups.
- Younger adults were more likely than older adults to have used
- Those with higher incomes were more likely to have used legal
and illegal drugs.
- Alcohol had been used by the vast majority of survey participants
in the Americas, Europe, Japan, and New Zealand, compared to
smaller proportions in the Middle East, Africa and China.
- Alcohol use by age 15 was far more common in European countries
than in the Middle East or Africa.
- Lifetime tobacco use was most common in the United States (74
percent), Lebanon (67 percent) Mexico and the Ukraine (60 and
61 percent), followed by the Netherlands (58 percent.)
"In addition to the factors measured in this study, the role
of culture, drug availability and knowledge about drug use are
likely to be important in the types and patterns of drug use throughout
the world," said Dr. Nora D. Volkow, NIDA director. "Even
within the United States, rates and patterns of substance use differ
based on geographical location and ethnicity, among other factors."
The authors point out that the survey is limited to those countries
that had the resources and willingness to participate, and that
efforts were made to account for possible cultural differences
in participants’ willingness to answer truthfully, which could
impact measures of actual drug use. For more information about
the survey Toward a Global View of Alcohol, Tobacco, Cannabis
and Cocaine Use: Findings from the WHO Mental Health Surveys, go
The National Institute on Drug Abuse is a component of the National
Institutes of Health, U.S. Department of Health and Human Services.
NIDA supports most of the world’s research on the health aspects
of drug abuse and addiction. The Institute carries out a large
variety of programs to inform policy and improve practice. Fact
sheets on the health effects of drugs of abuse and information
on NIDA research and other activities can be found on the NIDA
home page at www.drugabuse.gov.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and Centers
and is a component of the U.S. Department of Health and Human Services.
It is the primary federal agency for conducting and supporting basic,
clinical and translational medical research, and it investigates
the causes, treatments, and cures for both common and rare diseases.
For more information about NIH and its programs, visit www.nih.gov.