Changes in co-use of alcohol and cannabis among Nordic adolescents in the 21st century: Results from the European School Survey Project on Alcohol and Other Drugs study

Kirsimarja Raitasalo; Ingeborg Rossow; Inger Synnøve Moan; Elin K. Bye; Johan Svensson; Siri Thor; Ola Ekholm; Veronica Pisinger; Ársæll Arnarsson; Kim Bloomfield

doi:10.1111/dar.13672

Changes in co-use of alcohol and cannabis among Nordic adolescents in the 21st century: Results from the European School Survey Project on Alcohol and Other Drugs study

Kirsimarja Raitasalo^*, Ingeborg Rossow, Inger Synnøve Moan, Elin K. Bye, Johan Svensson, Siri Thor, Ola Ekholm, Veronica Pisinger, Ársæll Arnarsson, Kim Bloomfield

^*Corresponding author for this work

Department of Psychology and Behavioural Sciences - Centre for Alcohol and Drug Research, Copenhagen

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

3 Citations (Scopus)

Abstract

Introduction: In the 21st century, there has been a decline in alcohol use among adolescents in most Nordic countries, while trends of cannabis use have diverged. We explore how alcohol and cannabis use, respectively, and co-use of the two substances, have changed among Nordic adolescents. Three hypotheses are used to frame the study: (i) cannabis use has substituted alcohol use; (ii) there has been a parallel decline in both substances; and/or (iii) there has been a ‘hardening’ of users, implying that alcohol users increasingly use cannabis. Methods: Data from the European School Survey Project on Alcohol and Other Drugs, conducted among 15- to 16-year-olds in Denmark, Finland, Iceland, Norway and Sweden (N = 74,700, 49% boys), were used to explore trends of past-year alcohol and cannabis use in the period 2003–2019. Results: The proportion of adolescents reporting alcohol use decreased significantly in all Nordic countries except Denmark. The proportion of those using cannabis only was low (0.0%–0.7%) and stable in all countries. The total number of substance use occasions declined among all adolescents in all countries but Denmark. Among alcohol users, cannabis use became increasingly prevalent in all countries but Denmark. Discussion and Conclusions: We found no support for the ‘parallel decline hypothesis' in alcohol and cannabis use among Nordic adolescents. Partially in line with the ‘substitution hypothesis’, cannabis use accounted for an increasing proportion of all substance use occasions. Our results suggests that the co-use of alcohol and cannabis has become more common, thus also providing support to the ‘hardening’ hypothesis.

Original language	English
Journal	Drug and Alcohol Review
Volume	43
Issue	3
Pages (from-to)	616-624
Number of pages	9
ISSN	0959-5236
DOIs	https://doi.org/10.1111/dar.13672
Publication status	Published - Mar 2024

Keywords

alcohol use
cannabis use
co-use
Nordic countries
time trends

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Raitasalo, K., Rossow, I., Moan, I. S., Bye, E. K., Svensson, J., Thor, S., Ekholm, O., Pisinger, V., Arnarsson, Á., & Bloomfield, K. (2024). Changes in co-use of alcohol and cannabis among Nordic adolescents in the 21st century: Results from the European School Survey Project on Alcohol and Other Drugs study. Drug and Alcohol Review, 43(3), 616-624. https://doi.org/10.1111/dar.13672

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title = "Changes in co-use of alcohol and cannabis among Nordic adolescents in the 21st century: Results from the European School Survey Project on Alcohol and Other Drugs study",

abstract = "Introduction: In the 21st century, there has been a decline in alcohol use among adolescents in most Nordic countries, while trends of cannabis use have diverged. We explore how alcohol and cannabis use, respectively, and co-use of the two substances, have changed among Nordic adolescents. Three hypotheses are used to frame the study: (i) cannabis use has substituted alcohol use; (ii) there has been a parallel decline in both substances; and/or (iii) there has been a {\textquoteleft}hardening{\textquoteright} of users, implying that alcohol users increasingly use cannabis. Methods: Data from the European School Survey Project on Alcohol and Other Drugs, conducted among 15- to 16-year-olds in Denmark, Finland, Iceland, Norway and Sweden (N = 74,700, 49% boys), were used to explore trends of past-year alcohol and cannabis use in the period 2003–2019. Results: The proportion of adolescents reporting alcohol use decreased significantly in all Nordic countries except Denmark. The proportion of those using cannabis only was low (0.0%–0.7%) and stable in all countries. The total number of substance use occasions declined among all adolescents in all countries but Denmark. Among alcohol users, cannabis use became increasingly prevalent in all countries but Denmark. Discussion and Conclusions: We found no support for the {\textquoteleft}parallel decline hypothesis' in alcohol and cannabis use among Nordic adolescents. Partially in line with the {\textquoteleft}substitution hypothesis{\textquoteright}, cannabis use accounted for an increasing proportion of all substance use occasions. Our results suggests that the co-use of alcohol and cannabis has become more common, thus also providing support to the {\textquoteleft}hardening{\textquoteright} hypothesis.",

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author = "Kirsimarja Raitasalo and Ingeborg Rossow and Moan, {Inger Synn{\o}ve} and Bye, {Elin K.} and Johan Svensson and Siri Thor and Ola Ekholm and Veronica Pisinger and {\'A}rs{\ae}ll Arnarsson and Kim Bloomfield",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors. Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.",

year = "2024",

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Raitasalo, K, Rossow, I, Moan, IS, Bye, EK, Svensson, J, Thor, S, Ekholm, O, Pisinger, V, Arnarsson, Á & Bloomfield, K 2024, 'Changes in co-use of alcohol and cannabis among Nordic adolescents in the 21st century: Results from the European School Survey Project on Alcohol and Other Drugs study', Drug and Alcohol Review, vol. 43, no. 3, pp. 616-624. https://doi.org/10.1111/dar.13672

Changes in co-use of alcohol and cannabis among Nordic adolescents in the 21st century: Results from the European School Survey Project on Alcohol and Other Drugs study. / Raitasalo, Kirsimarja; Rossow, Ingeborg; Moan, Inger Synnøve et al.
In: Drug and Alcohol Review, Vol. 43, No. 3, 03.2024, p. 616-624.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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T2 - Results from the European School Survey Project on Alcohol and Other Drugs study

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AU - Rossow, Ingeborg

AU - Moan, Inger Synnøve

AU - Bye, Elin K.

AU - Svensson, Johan

AU - Thor, Siri

AU - Ekholm, Ola

AU - Pisinger, Veronica

AU - Arnarsson, Ársæll

AU - Bloomfield, Kim

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N2 - Introduction: In the 21st century, there has been a decline in alcohol use among adolescents in most Nordic countries, while trends of cannabis use have diverged. We explore how alcohol and cannabis use, respectively, and co-use of the two substances, have changed among Nordic adolescents. Three hypotheses are used to frame the study: (i) cannabis use has substituted alcohol use; (ii) there has been a parallel decline in both substances; and/or (iii) there has been a ‘hardening’ of users, implying that alcohol users increasingly use cannabis. Methods: Data from the European School Survey Project on Alcohol and Other Drugs, conducted among 15- to 16-year-olds in Denmark, Finland, Iceland, Norway and Sweden (N = 74,700, 49% boys), were used to explore trends of past-year alcohol and cannabis use in the period 2003–2019. Results: The proportion of adolescents reporting alcohol use decreased significantly in all Nordic countries except Denmark. The proportion of those using cannabis only was low (0.0%–0.7%) and stable in all countries. The total number of substance use occasions declined among all adolescents in all countries but Denmark. Among alcohol users, cannabis use became increasingly prevalent in all countries but Denmark. Discussion and Conclusions: We found no support for the ‘parallel decline hypothesis' in alcohol and cannabis use among Nordic adolescents. Partially in line with the ‘substitution hypothesis’, cannabis use accounted for an increasing proportion of all substance use occasions. Our results suggests that the co-use of alcohol and cannabis has become more common, thus also providing support to the ‘hardening’ hypothesis.

AB - Introduction: In the 21st century, there has been a decline in alcohol use among adolescents in most Nordic countries, while trends of cannabis use have diverged. We explore how alcohol and cannabis use, respectively, and co-use of the two substances, have changed among Nordic adolescents. Three hypotheses are used to frame the study: (i) cannabis use has substituted alcohol use; (ii) there has been a parallel decline in both substances; and/or (iii) there has been a ‘hardening’ of users, implying that alcohol users increasingly use cannabis. Methods: Data from the European School Survey Project on Alcohol and Other Drugs, conducted among 15- to 16-year-olds in Denmark, Finland, Iceland, Norway and Sweden (N = 74,700, 49% boys), were used to explore trends of past-year alcohol and cannabis use in the period 2003–2019. Results: The proportion of adolescents reporting alcohol use decreased significantly in all Nordic countries except Denmark. The proportion of those using cannabis only was low (0.0%–0.7%) and stable in all countries. The total number of substance use occasions declined among all adolescents in all countries but Denmark. Among alcohol users, cannabis use became increasingly prevalent in all countries but Denmark. Discussion and Conclusions: We found no support for the ‘parallel decline hypothesis' in alcohol and cannabis use among Nordic adolescents. Partially in line with the ‘substitution hypothesis’, cannabis use accounted for an increasing proportion of all substance use occasions. Our results suggests that the co-use of alcohol and cannabis has become more common, thus also providing support to the ‘hardening’ hypothesis.

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Changes in co-use of alcohol and cannabis among Nordic adolescents in the 21st century: Results from the European School Survey Project on Alcohol and Other Drugs study

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