A cross-national comparison of risk and protective factors for adolescent substance use: the United States and Australia

J Adolesc Health. 2004 Jul;35(1):3-16. doi: 10.1016/j.jadohealth.2003.08.015.

Abstract

Purpose: To compare risk and protective factors that influence youth substance use in Australia and the United States. The two countries have different policy orientations toward substance use: Australia has adopted harm-reduction policies, and the United States has adopted abstinence-focused policies.

Methods: Cross-sectional survey data were collected from independent samples of adolescents in the states of Maine (N = 16,861; 53% female, 7% Non-white) and Oregon (N = 15,542; 51% female, 24% Non-white) in the United States and Victoria in Australia (N = 8442; 54% Female, 11% Non-white) in 1998 (Maine and Oregon) and 1999 (Victoria). Chi-square tests, t-tests, effect size comparisons, and logistic regression analyses that accounted for age and gender were used to investigate cross-national similarities and differences in: (a) rates of cigarette, alcohol, and marijuana use; (b) levels of risk and protective factors; and (c) magnitudes of associations between risk and protective factors and substance use.

Results: More adolescents in Victoria reported using cigarettes and alcohol, whereas more of the U.S. adolescents reported using marijuana. Exposure to risk and protective factors was generally similar in the cross-national samples. However, adolescents in Maine and Oregon perceived handguns to be more readily available, reported more participation in religious activities, and were higher in sensation-seeking and social skills; and adolescents in Victoria had more favorable attitudes toward drug use and reported community norms and parental attitudes more favorable to drug use. Most of the risk and protective factors were strongly associated with substance use to a similar degree in Victoria, Maine, and Oregon. However, among adolescents in Maine and Oregon peer/individual risk and protective factors associated with social detachment were more strongly related to substance use, and among adolescents in Victoria, family protective factors were less strongly related to alcohol use.

Conclusions: Inter-country influences on youth substance use are generally similar despite different policy directions. Existing differences suggest that the abstinence policy context is associated with higher levels of illicit drug use and stronger relations between individual indicators of social detachment and substance use, whereas the harm reduction policy context is related to more cigarette and alcohol use, possibly from exposure to normative influences that are more tolerant of youth drug use.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology*
  • Age Distribution
  • Child
  • Cross-Cultural Comparison
  • Cross-Sectional Studies
  • Drug and Narcotic Control / legislation & jurisprudence
  • Drug and Narcotic Control / methods*
  • Female
  • Health Behavior*
  • Health Surveys
  • Humans
  • Logistic Models
  • Maine / epidemiology
  • Male
  • Oregon / epidemiology
  • Parent-Child Relations
  • Peer Group
  • Risk Factors
  • Sex Distribution
  • Social Environment*
  • Substance-Related Disorders* / epidemiology
  • Substance-Related Disorders* / ethnology
  • Substance-Related Disorders* / prevention & control
  • Substance-Related Disorders* / psychology
  • Victoria / epidemiology