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This study investigates the evolution of educational disparities in smoking uptake across cohorts for men and women in three countries. Nationally representative surveys of adults in France, Germany and the United States in 2009-2010 include retrospective measures of age of uptake that are compared for three cohorts (born 1946-1960, 1961-1975, and 1976-1992). Discrete logistic regressions and a relative measure of education are used to model smoking histories until age 34. The following patterns are found: a strengthening of educational disparities in the timing of uptake from older to younger cohorts; an earlier occurrence of the strengthening for men than women and for the United States than France or Germany; a faster pace of the epidemic in France than in the United States, and; a divide between the highest level of education and the others in the United States, as opposed to a gradient across categories in France. Those differences in smoking disparities across cohorts, genders and countries help identify the national and temporal circumstances that shape the size and direction of the relationship between education and health and the need for policies that target educational disparities., (Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Cannabis is the most popular illicit drug in the world, but the process of its diffusion through the population has rarely been studied. The unfolding of the tobacco epidemic was accompanied by a shift in the educational gradient of users across generations. As a consequence, cannabis may show the same pattern of widening social inequalities. We test the diffusion hypotheses that a positive value in older cohorts - the more educated experimenting more - shifts to a negative one in younger cohorts - the more educated experimenting less, first for males and then females., Methods: Three nationwide subsamples (18-64 years old) of representative surveys conducted in France (n=21,818), Germany (n=7887) and USA (n=37,115) in 2009-2010 recorded age at cannabis experimentation (i.e., first use), educational level, gender, and age. Cumulative prevalence of experimentation was plotted for three retrospective cohorts (50-64, 35-49, 18-34 years old at data collection) and multivariate time-discrete logistic regression was computed by gender and generation to model age at experimentation adjusted on age at data collection and educational level. This latter was measured according to four categories derived from the International Standard Classification of Education (ISCED) and a relative (rather than absolute) index of education., Results: The findings demonstrate a consistent pattern of evolution of the prevalence, gender ratio and educational gradient across generations and countries that support the hypothesis of an "epidemic" of cannabis experimentation that mimics the epidemic of tobacco., Conclusion: We provide evidence for a cannabis epidemic model similar to the tobacco epidemic model. In the absence of clues regarding the future of cannabis use, our findings demonstrate that the gender gap is decreasing and, based on the epidemic model, suggest that we may expect widening social inequalities in cannabis experimentation if cannabis use decreases in the future., (Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: In order to better understand trends in cannabis use, this study estimates independent and non-confounded age, period and cohort effects on 12-month cannabis use prevalence and frequency., Methods: Data from seven waves of the German Epidemiological Survey of Substance Abuse (ESA) conducted between 1990 and 2009 were used. The total sample included 29,836 men and 34,877 women aged 18-65 years. Cross-classified random effects models were conducted to estimate fixed effects of age and random effects of periods and birth cohorts. Analyses were stratified by gender., Results: With regard to 12-month prevalence, substantial age variations were identified with a peak of cannabis use in young adulthood. The overall effects of periods and birth cohorts were not significant. With regard to frequency of use, there were no significant influences of either variable. The results were largely identical for men and women., Conclusions: This study identified little variation in trend data of current cannabis use. When confounding influences of period and ageing are controlled, the widely reported increases in cannabis consumption in recent birth cohorts cannot be demonstrated.