Pejnović Franelić Iva, Kuzman Marina, Pavić Simetin Ivana, Kern Josipa
School and Adolescent Medicine and Addiction Prevention Service, Croatian National Institute of Public Health, Rockefellerova 7, 10 000 Zagreb, Croatia.
Croat Med J. 2011 Aug 15;52(4):446-57. doi: 10.3325/cmj.2011.52.446.
To investigate the association between environmental factors (perceived availability of marijuana, perceived use among friends and siblings, use of alcohol and tobacco, family structure, parental control, school performance) and lifetime prevalence and frequent and early marijuana use in high school students.
We used self-reported data from 15-16 years old participants of the 2003 European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted in 11 countries: Denmark, Estonia, Norway, Croatia, Slovenia, Germany, Switzerland, Bulgaria, Czech Republic, Russian Federation, and Ukraine. Multivariate logistic regression was used for data analysis.
Countries varied according to lifetime prevalence (8.7%-47.8%) and frequent (8.7%-23.9%) and early (3.0%-13.0%) marijuana use. Daily tobacco smoking was most strongly associated with lifetime marijuana use for boys in 7 and for girls in 5 countries, with highest odds ratio (OR, 95% and confidence interval - CI) for boys in Denmark (OR, 13.52; 95% CI, 8.16-22.4), and for girls in the Czech Republic (OR, 21.21; 95% CI, 12.99-34.62). Perceived marijuana availability was most strongly associated with frequent marijuana use for boys in 4 countries (highest in Slovenia: OR, 19.28; 95% CI, 6.52-57.02) and girls in 5 (highest in Slovenia: OR, 19.05; 95% CI, 5.18-70.04). Perceived use of marijuana among friends was most strongly associated with frequent marijuana use in 5 countries, both for boys (highest in Norway: OR, 23.91; 95% CI, 4.16-137.48) and girls (highest in Denmark: OR, 75.42; 95% CI, 13.11-433.90). Perceived use of marijuana among friends was most strongly associated with early marijuana use in 8 countries for boys (highest in Norway: OR, 54.03; 95% CI, 3.34-875.19) and 3 countries for girls (highest in Denmark: OR, 7.29; 95%CI, 1.77-30.12).
In each country, marijuana use was associated with similar factors, regardless of marijuana use prevalence in that country.The influence of peer group and perceived availability of marijuana seemed more important than parental control and family structure.
调查环境因素（对大麻可获得性的认知、对朋友及兄弟姐妹使用大麻情况的认知、酒精和烟草的使用、家庭结构、父母管控、学业成绩）与高中生大麻终生患病率、频繁使用及早期使用之间的关联。
我们使用了来自2003年在11个国家（丹麦、爱沙尼亚、挪威、克罗地亚、斯洛文尼亚、德国、瑞士、保加利亚、捷克共和国、俄罗斯联邦和乌克兰）开展的欧洲学校酒精及其他药物调查项目（ESPAD）中15 - 16岁参与者的自我报告数据。采用多变量逻辑回归进行数据分析。
各国在大麻终生患病率（8.7% - 47.8%）、频繁使用率（8.7% - 23.9%）和早期使用率（3.0% - 13.0%）方面存在差异。在7个国家，每日吸烟与男孩大麻终生使用的关联最为紧密，在5个国家与女孩大麻终生使用的关联最为紧密，丹麦男孩的优势比（OR，95%置信区间 - CI）最高（OR，13.52；95% CI，8.16 - 22.4），捷克共和国女孩的优势比最高（OR，21.21；95% CI，12.99 - 34.62）。在4个国家，对大麻可获得性的认知与男孩频繁使用大麻的关联最为紧密（斯洛文尼亚最高：OR，19.28；95% CI，6.52 - 57.02），在5个国家与女孩频繁使用大麻的关联最为紧密（斯洛文尼亚最高：OR，19.05；95% CI，5.18 - 70.04）。在5个国家，对朋友使用大麻情况的认知与频繁使用大麻的关联最为紧密，对男孩（挪威最高：OR，23.91；95% CI，4.16 - 137.48）和女孩（丹麦最高：OR，75.42；95% CI，13.11 - 433.90）均是如此。在8个国家，对朋友使用大麻情况的认知与男孩早期使用大麻的关联最为紧密（挪威最高：OR，54.03；95% CI，3.34 - 875.19），在3个国家与女孩早期使用大麻的关联最为紧密（丹麦最高：OR，7.29；95% CI，1.77 - 3,0.12）。
在每个国家，无论该国大麻使用患病率如何，大麻使用都与相似的因素相关。同伴群体的影响以及对大麻可获得性的认知似乎比父母管控和家庭结构更为重要。
