Tobacco, alcohol and cannabis among adolescents

France figures among the European countries most affected by teenage alcohol and drug abuse (www.espad.org). In 2017, 25% of young people aged 17 reported smoking every day; 16% had experienced at least 3 episodes of occasional heavy drinking (defined as having at least 5 glasses on a single occasion) in the previous 30 days; and 7% reported smoking cannabis regularly (at least 10 times in the previous 30 days). 

The transition from adolescence to adulthood is a key stage in the establishment of individuals’ health-related behaviors and lifestyles. The findings of this study show a strong association between tobacco, alcohol, and cannabis use in adolescence and family living arrangement. Having experienced family reconfiguration—the case for young people living in single-parent or blended families—is associated with more frequent use. However, this correlation does not mean there is a causal link between parental breakup and substance use. Adolescents may have started using substances before the change in family living arrangement, perhaps as a means to cope with the conflicts and stress that often precede breakup; it could also be that parental surveillance in the new family arrangement is simply not as strict, making substance use easier for teenage children. 

Overall, use variations by family situation are much greater for cannabis and tobacco than for alcohol (Figure 1 below). Taking teenagers living with both parents as the reference category, more young people living in other family configurations report regularly using cannabis. In those non-reference situations, young people living in a shared parental custody arrangement seem to consume the least cannabis, whereas those living solely with their father or in complex situations seem to consume the most. Daily smoking is more widespread in non-reference-type families, but the disparities between the different types are smaller than for smoking than regular cannabis consumption. Regarding cannabis, the increase in substance use risk (compared to the reference) is lower for young people in shared custody or living solely with their mother, and slightly higher for young people living solely with their father, a stepparent, or in other situations. Last, for occasional heavy drinking, the increase is slighter and overall differences with living-with-both-parents arrangements smaller than for the other substances, particularly for children living solely with their mother. 

Teenage tobacco, alcohol, and cannabis use is also associated with socioeconomic group or milieu. However, that association is not as strong as the one found for family living arrangement. And it varies by substance. In less privileged family contexts, everyday smoking is more common—a finding comparable to what is generally observed for adults. Conversely, occasional heavy drinking is more frequently found in well-off families. It should be noted that family arrangement and socioeconomic milieu can be interdependent in several ways: risk of divorce differs in by socioeconomic group, and family breakup impacts a household’s economic situation. The study’s analyses take these interdependencies into account. 

Adolescence is a developmental period characterized by an increase in risky behaviors, and the study’s results clarify the importance of adapting substance use prevention policies to the specificities of this age group. Such an approach would benefit in particular by taking into account family living situation and functioning.