Social Determinants of Smoking, Alcohol and Drug Use Among Lithuanian School-Aged Children: Results From 5 Consecutive HBSC Surveys, 1994–2010

The aim of this study was to analyze the changes in the prevalence of smoking, alcohol and drug use among Lithuanian school-aged children in relation to the place of residence, family affluence, and family structure.
Material and Methods. National surveys (26 556 anonymous questionnaires analyzed) of schoolchildren aged 11, 13, and 15 years were conducted in 1994, 1998, 2002, 2006, and 2010 in the framework of the international Health Behaviour in School-aged Children (HBSC) study.
Results. In 1994–2010, a significant increase in smoking prevalence was observed both among boys (11.3% to 21.5%, P<0.05) and girls (3.6% to 14.8%, P<0.05). Weekly alcohol consumption increased from 9.6% to 12.9% (P<0.05) among boys and from 4.3% to 7.9% (P<0.05) among girls. The prevalence of “ever use” of any psychoactive substance (data for 15-year-old group only) increased both in boys (14.6% to 33.5%) and girls (6.7% to 18.4%). Urban girls smoked more often than their rural peers. For both genders, such a residential gradient was observed in the use of alcohol and drugs. The respondents from intact families used drugs less frequently than the adolescents from not intact families. The adolescents from affluent families smoked less often, while the prevalence of alcohol and drug use was higher (except weekly alcohol use in girls).
Conclusions. The study has demonstrated a significant increase in the prevalence of smoking, drinking, and drug use among Lithuanian school-aged children during the period of transition to market economy. This study provides some insight that should be addressed in equity-oriented control policies of substance use.