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PEDIATRICS Vol. 111 No. 3 March 2003, pp. 535-540

Violence Exposure and Substance Use in Adolescents: Findings From Three Countries

Robert Vermeiren, MD*,{ddagger}, Mary Schwab-Stone, MD{ddagger}, Dirk Deboutte, MD, PhD*, Peter E. Leckman{ddagger} and Vladislav Ruchkin, MD, PhD{ddagger}

* University Department of Child and Adolescent Psychiatry, Middelheimhospital, University of Antwerp, Antwerp, Belgium
{ddagger} Child Study Center, Yale Medical School, New Haven, Connecticut

--> Objective. To investigate relationships between exposure to community violence (witnessing and victimization) and reported substance use (cigarettes, alcohol, marijuana, and hard drugs) in a cross-national sample of adolescents, after controlling for the level of the adolescents’ own violent behavior.

Method. A self-report survey was conducted in 3380 14- to 17-year-old adolescents in urban communities of 3 different countries: Antwerp, Belgium (N = 958); Arkangelsk, Russia (N = 1036); and New Haven, Connecticut (N = 1386).

Results. In all 3 countries, levels of reported smoking, alcohol use, marijuana use, and hard drug use showed increases with adolescent exposure to violence. Although positively related, substance use was increased less markedly in US adolescents who witnessed violence.

Conclusion. Current findings further emphasize the association between violence exposure and potential severe physical and psychosocial health problems in adolescents. In addition, the findings suggest that violence exposure and its consequences are a worldwide urban phenomenon. Cross-national differences were found, however, that warrant additional research, and prospective studies are needed to investigate the pathways from violence exposure to substance abuse.

Key Words: violence exposure • substance use • adolescents

Abbreviations: SAHA, Social and Health Assessment • OR, odds ratio • CI, confidence interval

Received for publication Aug 20, 2001; Accepted Jul 23, 2002.


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