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Research Summary

Adolescent Substance Abuse in the US and Australia

While the United States' national drug control policy advocates for reducing drug use, Australia's supports reducing the harms of use. To explore potential cross-national differences in the prevalence of, and risk and protective factors for, adolescent substance use that may be associated with these policies, researchers analyzed survey data from 40,845 adolescents in the United States (US) and Australia.

  • More Australian youths reported regular cigarette and alcohol use than did US adolescents, whereas more US youths reported current marijuana use.
  • Generally, risk and protective factors were similar in both the US and Australia. However, community norms, youth attitudes, and parental attitudes favorable to drug use were more common in Australia. Sensation seeking and possessing stronger social skills were more common in the US.
  • Peer/individual risk and protective factors were more strongly related to substance use in the US; family factors protective against regular alcohol use were also stronger in the US.


This study is an interesting initial effort to understand the implications of differing national drug control strategies on adolescent substance use. The US-supported abstinence strategy may heighten the risk of adolescent rebelliousness that may lead to substance use. In contrast, the harm-reduction model of Australia may contribute to more tolerant youth, parental, and community attitudes, which in turn may also increase use. However, these interpretations, which relate observed cross-national differences to policy differences, must be considered speculative (as the authors admit), but they are a useful first step.

Jeffrey H. Samet, MD, MA, MPH


Beyers JM, Toumbourou JW, Catalano RF, et al. A cross-national comparison of risk and protective factors for adolescent substance use: the United States and Australia. J Adolesc Health. 2004;35(1):3–16.
(view abstract)