Use of addictive substances and distress among 15-year-olds in Estonia, Latvia, Lithuania, and Poland

This presentation is about the use of addictive substances (cigarette smoking, use of alcohol, and use of e-ciga­rettes), their interrelations, and their associations with psychological distress among adolescents. We used data from 4 countries: Estonia, Latvia, Lithuania, and Poland. Data are from the 2021/22 data collection of the HBSC study. We used data pertaining to 15-year-olds only (n = 7595).
For tobacco smoking, we distinguished between 3 groups: having smoked cigarettes at least 6 days during the last 30 days (regular use), having smoked 1-5 days during the last 30 days (occasional use), or not having smoked any day during the last 30 days (non-use). Use of alcohol and e-cigarettes were categorised the same way.
Use of alcohol is more common in Poland with 11% of regular users, versus 4-7% in the other 3 countries. The proportion of regular and experimental drinkers in Poland is as high as 36%. Estonia has lower proportions of tobacco smokers (regular or experimental) than the other 3 countries, at 12% versus 19-23%. Again, Poland is the country with the highest prevalence, but only marginally higher than Latvia and Lithuania. Regu­lar use of e-cigarettes is more widespread than tobacco smoking and use of alcohol in all 4 countries, with numbers varying from 14% (Estonia) to 22% (Lithuania).
It turns out that all 3 behaviours are highly intercorrelated. Among non-users of alcohol, 3% were regular smokers, versus 47% among regular drinkers. Among non-users of alcohol, 7% were regular users of e-cigarettes, versus 68% among regular drinkers.
Use of e-cigarettes has been recommended as a less harmful alternative to smoking tobacco (harm reduction). If e-cigarettes really were an alternative behaviour, there could hypothetically be a negative association between them. This is not the case in our data. Forty-two per cent of the regular e-cigarette users were regular smokers, as opposed to only 1% among the never users of e-cigarettes. The total association between use of e-ciga­rettes and tobacco smoking corresponds to a gamma value as high as 0.89.
In the HBSC data collection there is a scale for the measurement of psychological and somatic distress (the HBSC Health Complaints Scale) with items covering aspects such as depression, anxiety, and headache. All 3 potentially addictive behaviours examined in this study (use of alcohol, tobacco smoking, and use of e-cigarettes) are associated with health complaints....


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