Son Yejun, Hong Seohyun, Yim Yesol, Kim Soeun, Lee Hojae, Lee Kyeongmin, Kim Hyeon Jin, Jo Hyesu, Park Jaeyu, Oh Jiyeon, Lee Sooji, Lee Hayeon, Nehs Christa J, Smith Lee, Yon Dong Keon, Kang Jiseung
Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
World J Pediatr. 2025 Mar;21(3):291-305. doi: 10.1007/s12519-025-00883-w. Epub 2025 Mar 20.
Adolescent drug use poses significant public health challenges worldwide, with detrimental effects on mental and physical health. Most existing research focuses on Western countries, holding a gap in understanding drug use in low- and middle-income countries. Thus, we aimed to assess the prevalence of cannabis and amphetamine or methamphetamine use among school-going adolescents aged 12-15 years across 47 countries globally.
We used data from the Global School-based Student Health Survey from 47 countries (2009-2018) to analyze cannabis and amphetamine/methamphetamine use and age at first drug use among adolescents (n = 220,362). A meta-analysis utilizing random-effects models estimated prevalence rates and weighted linear regression analyzed trends. Student's t tests were used to compare two-subgroup categories, while one-way ANOVA was employed for analyses involving the four-subgroup category. Stratification analysis by sex, World Bank income category, region, and country-specific characteristics based on World Health Organization data were also performed.
The study included a total of 220,362 school-going adolescents aged 12-15 years (49.96% girls) from 47 countries. The overall prevalence of cannabis use was 7.02% [95% confidence interval (CI) 6.16-7.89], with higher usage among boys [9.20% (95% CI 8.05-10.36)] compared to girls [4.20% (95% CI 3.68-4.72)]. Amphetamine/methamphetamine use prevalence was 4.05% (95% CI 3.51-4.60), also higher among boys [5.14% (95% CI 4.45-5.84)] than girls [2.34% (95% CI 2.00-2.69)]. The region of the Americas exhibited the highest prevalence of cannabis use [11.31% (95% CI 8.44-14.17)], while the African region showed the highest prevalence of amphetamine use [4.34% (95% CI 3.14-5.53)]. High-income countries reported the highest prevalence of cannabis use [9.45% (95% CI, 6.06 to 12.84)], whereas low-income countries had the lowest [3.46% (95% CI 2.01-4.91)]. Higher prevalence rates were associated with countries having higher homicide rates, better sanitation services, and higher health expenditures.
Cannabis use among adolescents is more prevalent than amphetamine or methamphetamine use, with significant sex differences showing higher prevalence among boys. The highest prevalence of cannabis use was observed in Latin America, while Africa exhibited the highest rates of amphetamine use. Findings from the present study indicate a need for public policies and programs targeting adolescents to effectively reduce adolescent drug use.
青少年药物使用在全球范围内构成了重大的公共卫生挑战，对身心健康产生有害影响。大多数现有研究集中在西方国家，在理解低收入和中等收入国家的药物使用情况方面存在差距。因此，我们旨在评估全球47个国家12至15岁在校青少年中大麻、安非他明或甲基苯丙胺的使用流行率。
我们使用了来自47个国家（2009 - 2018年）的全球学校学生健康调查数据，以分析青少年（n = 220,362）中大麻、安非他明/甲基苯丙胺的使用情况以及首次使用药物的年龄。利用随机效应模型进行的荟萃分析估计了流行率，加权线性回归分析了趋势。采用学生t检验比较两个亚组类别，而单向方差分析用于涉及四个亚组类别的分析。还根据世界卫生组织的数据按性别、世界银行收入类别、地区和国家特定特征进行了分层分析。
该研究共纳入了来自47个国家的220,362名12至15岁在校青少年（49.96%为女孩）。大麻使用的总体流行率为7.02% [95%置信区间（CI）6.16 - 7.89]，男孩的使用率[9.20%（95% CI 8.05 - 10.36）]高于女孩[4.20%（95% CI 3.68 - 4.72）]。安非他明/甲基苯丙胺的使用流行率为4.05%（95% CI 3.51 - 4.60），同样男孩[5.14%（95% CI 4.45 - 5.84）]高于女孩[2.34%（95% CI 2.00 - 2.69）]。美洲地区大麻使用的流行率最高[11.31%（95% CI 8.44 - 14.17）]，而非洲地区安非他明使用的流行率最高[4.34%（95% CI 3.14 - 5.53）]。高收入国家报告的大麻使用流行率最高[9.45%（95% CI，6.06至12.84）]，而低收入国家最低[3.46%（95% CI 2.01 - 4.91）]。较高的流行率与凶杀率较高、卫生服务较好以及卫生支出较高的国家相关。
青少年中大麻的使用比安非他明或甲基苯丙胺的使用更为普遍，存在显著的性别差异，男孩的流行率更高。大麻使用流行率最高的地区是拉丁美洲，而非洲安非他明的使用率最高。本研究结果表明需要针对青少年制定公共政策和项目，以有效减少青少年药物使用。
