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Socioeconomic Inequalities in Adolescent Substance Use: Evidence From Twenty-Four European Countries

Abstract Background: While there is evidence for socioeconomic inequalities in some adolescent substance use behaviors, there is limited information on how socioeconomic inequalities compare across European countries and over time. Objectives: To compare socioeconomic inequalities in problematic adolescent substance use (regular smoking, heavy episodic drinking, and cannabis use) across 24 European countries at two time points. Methods: We use the European School Survey Project on Alcohol and Other Drugs (ESPAD) to examine socioeconomic inequalities in problematic adolescent substance use across 24 European countries in 2007 (n = 73,877) and 2011 (n = 71,060) using within country logistic regressions. Socioeconomic inequalities are measured using a relative index of inequality based on highest level of parental education relative to country of residence within survey year. Countries are ranked according to socioeconomic differentials. Results: In 2007, lower socioeconomic status (SES) adolescents had significantly higher odds of heavy episodic drinking in 10 countries, regular smoking in 12 countries, and recent cannabis use in 1 country. In 2011, the number of countries were 11, 15, and 0, respectively. In 2007, lower SES adolescents had a significantly lower odds of heavy episodic drinking in one country, regular smoking in one country, and cannabis use in four countries. In 2011, the number of countries were two, one, and six, respectively. There was little evidence for changes in socioeconomic inequalities over time. Conclusions: There are large country level differences in socioeconomic inequalities in adolescent substance use.