Alcohol, tobacco, marijuana and hallucinogen use in Samoan adolescents.
Adolescent substance use has increased with globalisation, and yet few data exist from lower- and middle-income countries and the Pacific Islands.This study examines the prevalence of three aspects of substance use over the past 30 days in Samoan adolescents (i) use of alcohol, tobacco and other drugs (ii) polysubstance use and (iii) possible substance use problems. A survey was administered to secondary school children (n 879) between 12 and 19 years of age at a single school in Apia, the capital of Samoa, in August 2008. There were important gender differences in substance use with boys reporting significantly higher rates of any use of each substance and polysubstance use. Boys were also three times more likely to report behaviours indicative of substance use problems. There were no significant differences in regular use of any substance with the exception of marijuana. Although the use of hallucinogens is prominent for boys and girls in the younger age group (12–15), consumption decreases with age. Boys showed substantial increases in any use of alcohol and marijuana and daily use of tobacco by age.There was also a significant increase in the number of boys reporting behaviours indicative of disordered use by age to 21% of 16- to 19-year-old boys. One of few studies on substance use in Samoa, the data provide a basis for setting priorities to address health risks posed by adolescent use and understanding the influence of rapid change.