Alcohol, Tobacco and Cannabis Use Among Culturally Diverse French Adolescents

Abstract

Objectives: We investigate the relation between cultural origin, using language spoken at home as a proxy, and drug use in French adolescents.Study design: A cross-sectional nationwide survey (n=13,314 adolescents aged 17-18.5, first generation immigrants excluded). Adolescents who spoke no foreign language at home were considered the reference.Methods: Regressions were used to compute risk ratio (RR) for at least 3 episodes of heavy drinking (HED3+), daily smoking (SMOKE) and at least 10 uses of cannabis in the last 30 days (CAN10). Nested models were run, adjusting first for sex and age, then adding school and family (including parental alcohol and tobacco use) and socioeconomic context at the city level.Results: 5.2% speak a Maghreb/Middle-Eastern language, 4.1% a Southern European language, and 4.6% English or German. Speaking a Maghreb/Middle Eastern language was associated with less reports of HED3+ (RR=0.36 [0.24; 0.53]), and although not significantly, less frequent SMOKE and CAN10; speaking a Southern European language was associated with HED3+ (RR=1.41 [1.19; 1.66]) and SMOKE (RR=1.33 [1.18; 1.49]. Speaking English or German was associated with HED3+ (RR=1.18 [1.00; 1.38]), SMOKE (RR=1.13 [0.99; 1.29]) and CAN10 (RR=1.45 [1.14; 1.83]). Adjustment for co-variables had little effect on the estimates.Discussion: Language spoken at home is a dominant factor for adolescent substance use and easy to collect. Drug prevention programs for teenagers should build more on cultural factors and support adolescents from non-Western backgrounds in maintaining healthy behaviors traditionally valued by their communities.

Keywords: adolescents, language, Culture, substance use