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International audience; Background : Increasing evidence suggests an association between short sleep with adverse health outcomes: obesity, type 2 diabetes and hypertension. But there are few or no data on “who these short sleepers are” in the general population. Objectives To describe short sleepers and the associated sleep disorders in young adults. Methods Cross-sectional telephone survey in a representative sample of 1004 French young adults (25–45 years old). Total sleep time (TST), insomnia, snoring, sleepiness and daytime consequences were assessed using subjective validated tools. Short sleepers were defined as sleeping 10 h per day, smoking and drinking coffee after 5 p.m. were also significantly associated with short sleep. Short sleepers had higher Epworth sleepiness scale ESS scores (7.8 vs 6.7; p = 0.0058) and more sleepiness while driving (11.5% vs 2.9%; p < 0.0001). Conclusion Short sleep is highly prevalent in young adults but is not an homogeneous group, including both insomniacs and subjects with or without sleep debt. Short sleep has to be defined more precisely in order to better understand its impact on public health.

Aims This study investigates the evolution of educational inequalities in smoking initiation and cessation in France according to gender and birth cohort. Methods We used a 2005 nationwide survey comprising 25,239 subjects aged 18–75 years. Three cohort groups were defined (born 1930–1945, 1946–1965 or 1966–1987). We compared their smoking histories until age 40 years with time-discrete logistic regressions. Educational differences in initiation and cessation were quantified using odds ratios and relative indices of inequality (RII), and the gender gap using odds ratios (gender ratios). Results For smoking initiation, in the oldest cohorts, no educational gradient appeared in men, but there was a positive gradient in women (RII = 0.19); in the middle cohorts, a negative gradient emerged in men (RII = 1.55), while the positive gradient reduced in women (RII = 0.74); in the youngest cohorts, there was a strengthening of the negative gradient in men (RII = 2.72), and the emergence of a negative gradient for women (RII = 1.86). The gender ratio narrowed from the oldest cohorts (3.23) to the youngest (1.09), and diminished with increasing educational level within each cohort. For smoking cessation, the educational gradients were negative in both genders, with wider gaps in the youngest cohorts, and gender ratios below 1 reflecting more marked cessation dynamics in women. Conclusion Women are at an earlier stage in the tobacco epidemic than men for initiation and at a later stage for cessation and social inequalities are widening. We believe that they will not decrease unless gender and the psycho-social aspects of smoking are considered in prevention campaigns.

International audience

International audience; National level smoke-free legislation is implemented to protect the public from exposure to second-hand tobacco smoke (SHS). The first aim of this study was to investigate how successful the smoke-free hospitality industry legislation in Ireland (March 2004), France (January 2008), the Netherlands (July 2008), and Germany (between August 2007 and July 2008) was in reducing smoking in bars. The second aim was to assess individual smokers’ predictors of smoking in bars post-ban. The third aim was to examine country differences in predictors and the fourth aim was to examine differences between educational levels (as an indicator of socioeconomic status). This study used nationally representative samples of 3147 adult smokers from the International Tobacco Control (ITC) Europe Surveys who were surveyed pre- and post-ban. The results reveal that while the partial smoke-free legislation in the Netherlands and Germany was effective in reducing smoking in bars (from 88% to 34% and from 87% to 44%, respectively), the effectiveness was much lower than the comprehensive legislation in Ireland and France which almost completely eliminated smoking in bars (from 97% to 3% and from 84% to 3% respectively). Smokers who were more supportive of the ban, were more aware of the harm of SHS, and who had negative opinions of smoking were less likely to smoke in bars post-ban. Support for the ban was a stronger predictor in Germany. SHS harm awareness was a stronger predictor among less educated smokers in the Netherlands and Germany. The results indicate the need for strong comprehensive smoke-free legislation without exceptions. This should be accompanied by educational campaigns in which the public health rationale for the legislation is clearly explained.

International audience; Cigarettes, alcohol and cannabis are the three psychoactive products most often experienced with and consumed in late adolescence. Today, many studies allow to shed light on the period of adolescence and to observe among other things the evolution of psychoactive products consumption. It is indeed during adolescence that the first experiences of products intake occur – be it lawful or not – and that a recurring pattern of consumption sometimes establishes itself.; Le tabac, l’alcool et le cannabis sont les trois produits psychoactifs les plus souvent expérimentés et consommés à la fin de l’adolescence. Aujourd’hui, de nombreuses études permettent d’éclairer la période de l’adolescence et d’observer notamment l’évolution des consommations de produits psychoactifs. C’est, en effet, durant l’adolescence qu’ont lieu les premières expériences de prises de produits, licites ou non, et que peuvent s’installer leurs consommations régulières.

International audience; No abstract available

International audience; Background : To assess associations among young adults between suicidal ideation in the previous year and adverse childhood events, occupation, education, tobacco use, alcohol abuse, cannabis use in the previous month, illicit drug use, sexual orientation and activity, depression, physical violence in the previous year, and lifetime forced sexual intercourse. METHODS: A subsample of 4075 French adults aged 18-30 years was drawn from a random national telephone survey in 2005. Major depressive episode and alcohol abuse were assessed using CIDI-SF and AUDIT-C (score above 4). Data were analysed with logistic regressions. RESULTS: Suicidal ideation affected 5.7% of men and 4.9% of women. Among men depression had the highest adjusted odds ratio (ORa=8.06, 5.07-12.79), followed by homosexual intercourse (3.37, 1.62-7.04), absence of sexual activity (2.83, 1.80-4.44); ORa between 1.6 and 2.0 were observed for living alone, daily tobacco smoking, being unemployed, serious health event concerning the father, age 26-30 and bad relationships between parents. Among women, depression had the highest ORa (7.60, 4.70-12.29), followed by lifetime experience of forced sexual intercourse (5.37, 2.89-9.96), having consumed illicit drugs other than cannabis (4.01, 1.48-10.89); ORa between 1.7 and 2.5 were observed for living alone, being unemployed, bad relationship between parents and age 26-30. LIMITATIONS: Cross-sectional survey, sexual orientation inferred from sexual activity. CONCLUSION: Suicide prevention should integrate the fact that besides depression, unemployment, family history, age, and sexual activity and orientation are specific risk factors among men, whereas illicit drug use, violence and forced sexual intercourse are more important among women.

Les usages de drogues ont longtemps été un objet relativement délaissé par les sciences sociales en France. Cet article se propose à la fois de resituer la mise en place de la construction d’un savoir sociologique sur le thème des addictions en prenant pour point d’entrée les usages des jeunes et de rendre compte des principales connaissances acquises par le biais de ces travaux. Si les jeunes ont cristallisé une grande part des inquiétudes liées aux drogues dans les instances politiques et les médias, et ont fait l’objet des premières études sociologiques, ils ont perdu cette place centrale dans les enquêtes en sciences sociales, alors principalement ethnologiques, jusqu’à la fin des années 1990, au profit de populations identifiées comme toxicomanes. Les jeunes sont redevenus un objet d’analyse spécifique depuis les années 2000, à la faveur du développement d’enquêtes quantitatives, représentatives de la population adolescente. Ces adaptations se sont faites au gré de l’évolution des représentations du jeune usager de drogues mais aussi grâce à l’appropriation par les sociologues de méthodes et d’outils jusqu’alors détenus par les épidémiologistes. Les résultats de ces enquêtes et le recours à la sociologie quantitative ont contribué à influencer les politiques publiques et à introduire un regard différent, plus distancié et moins moralisateur sur les pratiques addictives des jeunes. Drug users have for a long time been neglected by social sciences in France. The aim of this article is to recount the implementation of the construction of a sociological knowledge on addictions by in youth, as well as to report main knowledge acquired by means of these works. Youth has been the central point of anxieties generated by drug addiction in most policy makers and in the media. It has also been at the core of the first sociological studies, after what they lost this central place in social sciences surveys, then mainly ethnological, till the late 1990s, for the benefit of groups identified as drug addicts. Adolescents became again an object of specific analysis since the 2000s, thanks to the development of quantitative surveys which were representative of the adolescent population. These adaptations were made according to the evolution of representations of young drug users, but also thanks to the appropriation by sociologists of methods until then restricted to epidemiology. Those quantitative sociology studies have contributed to influence public policies and to introduce a different and less moralizing glance on adolescent addictive behaviours.

International audience; Il est aujourd’hui établi qu’une alimentation saine et la pratique d’une activité physique régulière contribuent à un vieillissement réussi. Les années autour de la retraite ont été identifiées par les pouvoirs publics comme une période propice à la promotion de ces comportements favorables à la santé. En 2008, l’Institut national de prévention et d’éducation pour la santé (INPES) a mené le troisième exercice du Baromètre santé nutrition, enquête dont l’objectif est d’analyser et de suivre les perceptions, les connaissances et les comportements en matière d’alimentation et d’activité physique. Cet article présente les spécificités des personnes âgées de 55 à 75 ans relatives à la dimension de l’alimentation. Les résultats révèlent des perceptions de l’alimentation plus orientées vers la santé dans cette population que chez les plus jeunes, des connaissances des recommandations moins bonnes pour les fruits et légumes, les produits laitiers et le groupe des « viandes, produits de la pêche et œufs » (VPO) mais meilleures pour le poisson et l’activité physique. Les consommations alimentaires s’avèrent plus favorables à la santé pour les fruits et légumes, le poisson et les féculents. Ces résultats plutôt encourageants sont susceptibles de se modifier au-delà de 75 ans, période qui nécessite des recherches complémentaires

Resume Objectif Etude des liens entre evenements de vie et troubles du sommeil en population generale Patients et methode L’enquete Evenements de vie et sante (EVS) 2005 a interroge en face a face 10 000 personnes de 18 a 75 ans residant en France en menage ordinaire (hors institutions). Cette enquete representative interroge les domaines de la sante, des violences subies et les evenements difficiles survenus au cours de la vie entiere. Resultats Environ quatre personnes sur dix declarent subir de facon recurrente au moins un trouble du sommeil parmi cinq des principaux symptomes de l’insomnie. Ces troubles apparaissent lies aux difficultes financieres et a l’âge, meme si, selon l’âge considere, leur nature differe. Le sentiment de fatigue au reveil semble en particulier recouvrir une large palette de situations qui impliquent davantage les jeunes generations. Les violences subies apparaissent comme des evenements favorisant la survenue de troubles reguliers du sommeil, avec toutefois quelques nuances selon la nature de ces violences. Discussion Si le genre apparait egalement lie a la survenue de troubles du sommeil, le recours a une modelisation permet d’observer que les femmes n’apparaissent pas plus vulnerables pour des raisons hormonales ou genetiques, mais parce qu’elles endossent un role social susceptible de peser sur leur qualite de vie, notamment en termes de souffrance mentale. Conclusion Les troubles du sommeil sont lies a des situations precaires et a certains evenements de vie difficiles tels que les violences subies. A sante mentale equivalente, hommes et femmes seraient egaux face au sommeil.

International audience; Background : Research has shown that cannabis use contributes to school dropout, but few studies have distinguished the age at onset of use from the age at progression to daily use neither their interaction with grade repetition. Methods: This study is based on a French representative cross-sectional survey (N = 29 393 teenagers aged 17 years) and uses retrospective data. The influence of drug-use patterns

Aims This paper aimed to assess whether the increase of social differentiation of smoking is observed in France. Design and setting Five cross-sectional telephone surveys conducted in France between 2000 and 2007. Participants The surveys were conducted among national representative samples of French subjects aged 18–75 years (n = 12 256, n = 2906, n = 27 499, n = 2887, n = 6007 in 2000, 2003, 2005, 2006 and 2007, respectively). We focused on three groups: executives, manual workers and the unemployed. Measurements Time trends of smoking prevalence were assessed, and socio-economic factors (especially occupation and job status) associated with smoking were identified and compared in 2000 and 2005. We also computed respondents' equivalized household consumption (EHI) and their cigarette budget to assess the financial burden of smoking. Findings Between 2000 and 2007, smoking prevalence decreased by 22% among executive managers and professionals and by 11% among manual workers, and did not decrease among the unemployed. Indicators of an underprivileged social situation were associated more markedly with smoking in 2005 than in 2000. In addition, the falling-off of smoking initiation occurred later and was less marked among manual workers than it was among executive managers and professionals. Finally, in 2005 15% of French smokers devoted at least 20% of their EHI to the purchase of cigarettes, versus only 5% in 2000, and smoking weighted increasingly heavily on the poorest smokers' budgets. Conclusions While these results point out an increased social differentiation in tobacco use, they underline the need to design and implement other forms of action to encourage people to quit, in particular targeting individuals belonging to underprivileged groups.

Cocaine has become an essential part of the French drug scene and is the most commonly abused stimulant worldwide. The principal routes of cocaine administration are intranasal ("snorting"), intravenous ("injecting"), and inhalation ("smoking" freebase or crack cocaine). Distinct classes of primary cocaine users were identified in the literature. Cocaine dependence is a multifactorial disorder, variable in its manifestations, and heritable. It comprises distinct clinical phenomena that drive a cycle of addiction: cocaine-induced euphoria, acute withdrawal, cue-induced craving (people, places, things), loss of control with poor decision making, cocaine seeking behaviour with multiple risks taken and cocaine administration.

International audience; Data are from the European School Survey Project on Alcohol and other Drugs (ESPAD) in eight countries (Sweden, United Kingdom, France, Malta, Slovenia, Hungary, Bulgaria, and the Czech Republic) in spring 2003. Two scales were constructed, measuring beliefs that alcohol and cannabis harm people. Relationships of these scales with measures of parental control, parental attitudes, respondent's own drug use, friend's drug use, and gender were assessed within each country. Both at the country and the individual level, subject's own drug use showed strong inverse relationships with risk perceptions. Parental control and parental attitudes also showed associations with risk perception but these seemed largely mediated by the parental influence on subject's own use and by choice of friends. In countries with low prevalence of drug use the extent to which the predictor variables accounted for risk perceptions was lowest. Also the predictor variables showed greater associations with cannabis risk perception than with alcohol risk perception. For cannabis the explained variance in risk of harm varied from 8.1% in Sweden to 30.4% in the Czech Republic. For alcohol harm this range was from 3.1% in Bulgaria to 15.1% in Malta.

International audience; Data from the surveys in eight countries of the European Schools Project on Alcohol and other Drugs in the years 1995, 1999, and 2003 were available. Changes over time in the perceptions of the risk of using alcohol, cigarettes, cocaine, marijuana, LSD, amphetamines, ecstasy, and inhalants were assessed. On average the overall proportions of the samples seeing use of these substances as 'very risky' fell between 1995 and 2003 in all eight countries as prevalences rose slightly in most of the countries. However, there was a tendency for the gap to widen over time between the proportions seeing regular use of illicit substances as very risky and the proportions seeing occasional use as very risky. Relative to other substances cigarette smoking and heavy weekend drinking were ranked more risky in 2003 than in 1995.

International audience; En France, en 2005, 18 % des personnes âgées de 12-75 ans se déclarent insatisfaites de la qualité de leur sommeil et 46 % disent avoir eu des problèmes de sommeil au cours des huit derniers jours. Même si l’on note une stabilisation depuis 2000, la prévalence des troubles apparaît en hausse par rapport à 1995, en particulier parmi les adolescents. Les individus n’apparaissent pas égaux face au sommeil : les femmes s’avèrent plus touchées par ces troubles. Certains critères sociodémographiques, tels que l’âge, le statut matrimonial ou la situation de chômage s’avèrent particulièrement discriminants : la séparation et le veuvage mais aussi le fait d’être à la recherche d’un emploi apparaissent comme des situations de vie susceptibles de nuire à la qualité du sommeil. La catégorie socioprofessionnelle ne semble pas en revanche jouer de manière très importante sur les problèmes de sommeil déclarés. La déclaration d’une insatisfaction dans la qualité du sommeil ou de troubles ressentis au cours de la semaine s’avère particulièrement élevée après 45 ans. Un plus haut niveau d’insatisfaction est également constaté parmi les 15-19 ans, sans pour autant que la prévalence des troubles apparaisse plus élevée que pour les individus plus âgés.

International audience; Background : Individual experience with substance use is considered as one of the principal factors influencing risk perception and attitudes of young people towards substance use. The Aim : of this paper is to show the relationship between self-reported prevalence and the subjectively perceived risks of substance use, both for individuals and at the country level. Methodology: The relationships were analyzed on a sample of students participating in the ESPAD survey in 8 European countries. The sample of 22 899 students was divided into five groups: abstainers (9.3%), experimental alcohol consumers (52.0%), regular alcohol consumers (14.2%), experimental drug users (12.3%) and regular drug users (12.2%). Findings: Significant differences were observed in the risk perception of use of selected substances among 5 types of users. The percentage of students perceiving moderate or great risks of substance use tends to fall across the groups with increasing prevalence of more risky patterns of substance use. Highest perceived risks of alcohol and illicit drugs use were found among abstainers and experimental alcohol consumers while both experimental and regular drug users tend to perceive lower risks. Regular alcohol consumers perceive relatively high risks of illicit drug use; however, they underestimate the risks of alcohol consumption. Country differences were observed in the level of perceived risks. These differences correspond to a different distribution of types of users and to the overall prevalence of substance use in individual countries.

International audience; Objective: To study the relationships between working conditions, job dissatisfaction and smoking behaviors among clerks and manual workers. Methods: We used data from the French Health Barometer, a cross-sectional telephone survey conducted among a national random sample (N = 4825). Regarding working conditions, the questionnaire dealt with reported job satisfaction, psychological demands and mental workload, physical demands, latitude decision and work schedule. Results: Manual workers and clerks who reported strong dissatisfaction toward unhealthy working conditions also reported more frequently current smoking, tobacco dependence, potential alcohol dependence and perceived stress. After adjusting for socio-demographic confounders, perceived working conditions and job dissatisfaction remained correlated with smoking and tobacco dependence. Conclusions: Poor working conditions may heavily contribute to health inequalities, as they are likely to fuel both stress and unhealthy behaviors, which combine to increase morbidity and mortality. (C)2009The American College of Occupational and Environmental Medicine

International audience; Objet Plusieurs études récentes affirment la présence d’une haute prévalence de troubles du sommeil et d’insomnie dans la population française mais ces études ayant été dédiées spécifiquement à l’insomnie ne nous permettent pas de bien appréhender les caractéristiques des adultes présentant des troubles du sommeil. L’objet de cette étude est de caractériser les personnes présentant actuellement (dans les derniers huit jours) des troubles du sommeil à partir d’une vaste enquête de santé (Baromètre santé, Institut national pour l’éducation à la santé [INPES]) réalisée en population générale. Méthode Quatorze mille sept cent trente-quatre adultes de 18 à 65 ans ont été interrogés par téléphone et les personnes présentant « beaucoup de problèmes de sommeil dans les huit derniers jours » ont été comparées aux autres sur les plans socioprofessionnels et vis-à-vis des comorbidités psychiatriques. Les items « sommeil » des questionnaires de Duke et du WHOQOL-bref ont été utilisés pour cette analyse. Les indicateurs utilisés pour la survenue d’un épisode dépressif ont été construits à partir du composite international diagnostic interview (CIDI) short-form (CIDI-SF) de la CIM 10. Résultats Parmi les sujets, 12,5 % répondent à ce critère de mauvais sommeil. Ce sont plutôt les femmes, les sujets de moins de 25 ans ou de plus de 45 ans, ceux avec un revenu plus faible, les employés ou les chômeurs qui sont significativement les plus touchés. Ces troubles du sommeil sont également significativement liés aux antécédents dépressifs, à l’état anxieux et aux idées suicidaires. Conclusion La recherche de troubles du sommeil au cours des huit derniers jours permet d’identifier un groupe de sujets sévèrement touché lors d’enquêtes en population générale.

International audience; The study examines data from teenagers from 35 countries taking part in surveys conducted within the European School Survey Project on Alcohol and Other Drugs (ESPAD). The main hypothesis tested was that the higher the prevalence of use of a particular drug the fewer will be the respondents who perceive great harm in using it. The hypothesis was tested for cannabis, alcohol, ecstasy, and inhalants, and was strongly confirmed for the former two in the data from the 1999 and 2003 surveys. For cannabis, the perceived risk of harm changed in the expected direction as prevalence changed between 1999 and 2003. The results, although always in the expected direction, were inconclusive regarding ecstasy and inhalants.

International audience; Les députés ont voté début mars l’interdiction de vente d’alcool aux moins de 18 ans, relevant ainsi de deux ans l’âge minimum jusqu’alors. Cette décision, prise dans le cadre du volet prévention et santé publique du projet de loi « Hôpital, patients, territoire, santé », fait également écho à une forte médiatisation récente des pratiques d’alcoolisation des adolescents et jeunes adultes. L’objectif est ici de restituer ce débat public dans une perspective quantitative qui s’appuie principalement sur les enquêtes déclaratives récentes menées en population générale.

The levels of drug use among youths under 14 have remained extremely low for the past few years, as well as in most European countries. Yet, patterns of early drug use are often related to high-risk behaviours that require specific public policy strategies. Over the last years, the Government has set the target of reducing levels of drug use among specific groups such as young people: an awareness-raising media campaign has been launched and a specific outpatients clinics setting has been implemented for cannabis users in particular. This paper examines the relationship between health service providers and criminal justice authorities underlying the effectiveness of the current system. It underlines the need for an early screening and early interventions so as to avoid the shift from simple use to misuse or dependence.

The French figure among the largest consumers of cannabis in Europe, both according to general population surveys of adults from various European countries and the European School Survey Project on Alcohol and Other Drugs (ESPAD survey) carried out among more than 100,000 15-16 year old adolescents from most countries in Europe. Among the countries surveyed who have the most strict and suppressive policies concerning the use of psychotropic drugs, the level of consumption of cannabis appears particularly high in France and lowest in Sweden; although in a country diametrically opposed in terms of policy measures in this regard, The Netherlands (a country which carries the image of much freedom and leeway in this matter), actually occupies the position of average consumption rates in the middle of the two extreme cases aforementioned. Even more important than legislation is the presence of networks of close-knit relationships between young people; this is a critical aspect which has a strong influence in determining the choice whether or not to consume a product such as cannabis. In this manner, adolescents' behaviour and practices are integrally linked to the opinions, perceptions and use of his/her peers.

Objectif : Il s'agit dans cet article de quantifier différentes formes de polyconsommation de drogues au sein de la population française, ainsi que les principaux facteurs qui y sont associés.Méthode : A partir des données d'une enquête en population générale récente portant en partie sur les usages de drogues, le Baromètre santé 2005, la polyconsommation peut être abordée par le biais de deux indicateurs, la polyconsommation régulière d'au moins deux produits parmi l'alcool, le tabac et le cannabis, et le cumul de consommation, au cours de l'année, d'au moins deux drogues illicites hors cannabis, sans qu'il soit possible d'affirmer qu'il s'agisse d'usages concomitants.Résultat : La polyconsommation régulière d'alcool, de tabac ou de cannabis concerne 8,3 % de la population. Elle culmine parmi les 20-24 ans, qui se révèle être une des tranches d'âges les plus consommatrices de tabac et de cannabis, avec 11,6 %. La polyconsommation régulière des trois produits apparaît particulièrement rare, puisqu'elle n'est le fait que de moins de 1 % des individus de 15 à 64 ans ; elle culmine parmi les 20-29 ans, avec moins de 2 % de la tranche d'âge. La principale association de ces produits reste donc celle de l'alcool et du tabac, qui est majoritaire dès l'âge de 35 ans. Les polyconsommations incluant le cannabis deviennent en effet très rares au-delà de 34 ans. Il existe par ailleurs un lien fort entre consommation de cannabis et usages d'autres produits psychoactifs illicites. Le cumul d'usage au cours de la vie de produits psychoactifs illicites hors cannabis concerne 10,9 % des 15-34 ans ; pour l'usage au cours de l'année, il s'élève à 3,0 %. Les facteurs associés à ces pratiques sont les situations de chômage, le fait d'être un homme et d'être jeune, tandis que l'inscription dans des études supérieures apparaissent plutôt être des situations éloignant les jeunes adultes des différentes formes de polyconsommation.Discussion : Les situations de polyconsommation se traduisent souvent par des situations de prise de risque ou de vulnérabilité qui justifient une attention particulière à porter à ces pratiques. Les enquêtes en population générale ne couvrent pas les populations les plus vulnérables et les plus désocialisées et ne permettent pas de décrire les formes problématiques des polyconsommations. En revanche, elles fournissent des éléments de cadrage utiles pour apprécier la diffusion des polyconsommations les plus courantes dans la population et en évaluer les retombées sanitaires et sociales probables.

Adolescence is often the time of experimentation with psychoactive substances, sometimes leading to more regular use. This paper gives an update of drug consumptions by the young adolescents, from results of recent general population surveys in France, and focuses on the specificity of this consumption when compared to that of older adolescents. It shows that regular uses of such substances usually do not start before the age of 14, but that early initiated adolescents show a higher risk of moving towards more intensive or problematic uses. Through presenting the limitations of such surveys, the authors discuss the nature of the link observed between early experimentation and level of use: while acknowledging the unquestionable prognostic value of early initiation to predict future problematic use, they show that its interpretation should be made with caution when based on such transversal epidemiological surveys.

Adolescents and young adults seeing a nurse or physician for any reason should be screened for psychoactive substance use. Several English-language questionnaires are available to screen for and assess harmful use of psychoactive substances among adolescents, but to our knowledge, no such instrument exists in French. The aim of the ADOTECNO study was therefore to develop simple and efficient tools for this purpose.Two questionnaires widely used in French epidemiologic studies (CRAFFT-ADOSPA to screen for harmful use and POSIT to assess the seriousness of consumption from physical, psychological and social viewpoints) were completed by 1728 secondary and post-secondary school students. Statistical analyses assessed correlations between the questionnaires and calibrated optimal cutoff points for the different tools included in ADOTECNO.Correlations between psychoactive substance consumption, responses to the CRAFFT-ADOSPA questionnaire, and POSIT factor A scores showed that CRAFFT-ADOSPA provided early detection of regular alcohol intoxication and of regular and daily cannabis use. At a score of 2, CRAFFT-ADOSPA detects harmful substance use, and at a score higher than or equal to 3 it demonstrates serious substance use.These findings enabled us to recommend useful cutoff values for the CRAFFT-ADOSPA tools for screening subjects at moderate or high risk of substance abuse. This simple broad screening should be complemented for the subjects found to be at risk by a computer-assisted POSIT to guide practitioners in selecting an approach (educational, school, family, psychological, psychiatric, etc.) to care and management according to the specific types of impairment resulting from substance use.

Background: Past studies on smokers’ risk perception have produced mixed results. We endorsed a new approach to assess smokers’ perceptions of risk by asking them to estimate threshold values for the cancer risk associated with daily consumption of tobacco and number of smoking years. We expected that many smokers would endorse a “risk denial” attitude, with threshold estimates higher than their own smoking consumption and duration. Methodology: A French national telephone survey (n = 3820; 979 current smokers) included several questions about smoking behaviours and related beliefs. Results: Among current smokers, 44% considered that smoking can cause cancer only for a daily consumption higher than their own consumption, and an additional 20% considered that the cancer risk becomes high only for a smoking duration higher than their own. Most smokers also agreed with other “risk denial” statements (“smoking is not more dangerous than air pollution,” “some people smoke their whole life but never get sick”). Those who considered they smoked too few cigarettes to be at risk were less likely to report personal fear of smoking related cancer. Conclusion: Risk denial is quite widespread among smokers and does not simply reflect a lack of information about health risks related to tobacco. Fully informing smokers about their risks may necessitate changing the way they process information to produce beliefs and limiting their capacity to generate self exempting beliefs.

International audience; Les Français figurent parmi les premiers consommateurs de cannabis en Europe, que se soit selon les enquêtes en population générale adulte des différents pays européens ou selon l'enquête Espad menée auprès de plus de cent mille adolescents de 15-16 ans dans la plupart des pays d'Europe. Parmi les nations présentant les politiques les plus répressives en matière d'usage de stupéfiants, le niveau de consommation du cannabis apparaît particulièrement élevé en France et au plus bas en Suède, alors qu'à l'opposé les Pays-Bas, archétype de la libéralité en la matière, occupent une place médiane. Plus que la législation, ce sont d'avantage les réseaux de relation noués entre les jeunes qui déterminent les choix de consommation d'un produit comme le cannabis, dans la mesure où les pratiques d'un adolescent s'avèrent très liées aux représentations et aux usages de ses pairs.

This study examines attitudes to smoking among adolescents. Data for the study is derived from a large quantitative French cross- sectional survey of school students. Attitudes toward smoking were found to be associated with regularity and quantity of consumption, and the type of school attended. These associations are explained according to Becker's concept of a 'moral career', for attitudes differ among occasional, regular and heavy smokers. The association with school type indicates advanced formal schooling enables students to offer sophisticated rationalisations for smoking, combining an acknowledgement of health-related risks of smoking, emphasis on personal benefits derived from smoking, and claims that smoking is a private matter. (author abstract)

BackgroundHealth behaviors, as important modifiable determinants of health, are consistently targeted by prevention messages. Teachers, as educators and role models, may play a key-role in bringing such messages to children and adolescents. It is not clear which areas of prevention could be improved in collaboration with teachers to promote healthy behaviors at the population level through health education in schools.Methodsto evaluate teacher's health awareness, we compared their health/risk behaviors to those of non-teachers, taking into account demographic and socioeconomic factors that could confound crude differences. We used data from the 2010 Health Barometer, a cross-sectional nationally-representative French survey conducted by telephone among 27,653 persons aged 15-85. Adjusting sequentially for potential confounders, we compared six indicators of lifestyle and risky conducts (at-risk drinking, current smoking, cannabis use, gambling, corpulence, sleep duration) between teachers (n = 725) and two comparison groups: other occupations (n = 12,483) on the one hand, and other intermediate and managerial/professional occupations (n = 6,026) on the other.ResultsIn the fully-adjusted models, teachers were less likely than other occupations to smoke, to have used cannabis in the last 12 months, to gamble regularly and to be overweight or obese. When restricting the comparison group to other occupations belonging to the same socio-professional category, differences were attenuated, but remain highly significant for tobacco, cannabis and gambling. No significant differences were observed between teachers and non-teachers regarding alcohol use and sleep duration, once important confounders had been adjusted for.ConclusionsOur results suggest that teachers behave on the whole more healthily than other adults with a similar demographic and socioeconomic profile. The absence of a teacher distinction toward at-risk drinking needs to be examined in more detail.

Objectif Suivre l’evolution des habitudes de sommeil des actifs francais et interroger la relation entre leur sommeil et les trajets qu’ils effectuent quotidiennement entre leur domicile et leur lieu de travail. Methodes Enquete par Internet administree du 3 au 12/12/13 aupres d’un echantillon national de 1032 actifs de 18 ans et plus constitue selon la methode des quotas, au regard des criteres de sexe, d’âge, de categorie socioprofessionnelle, de regions de residence et categorie d’agglomeration. Questionnaire elabore par le conseil scientifique de l’INSV. Resultats Les actifs francais dorment en moyenne 6 h 55 en semaine et 8 h 02 le week-end. En semaine, 36 % dorment moins de 6 h et 67 % se reveillent au moins une fois par nuit. Un actif sur 3 effectue au moins une sieste par semaine d’une duree moyenne de 47 minutes. Quatre actifs sur 10 declarent souffrir d’au moins un trouble du sommeil : insomnie (19 %), trouble du rythme veille-sommeil (16 %), syndrome des jambes sans repos (7 %), syndrome d’apnee du sommeil (6 %). Seulement 13 % d’entre eux declarent etre traites. Environ 1 actif sur 5 est victime de somnolence. En moyenne, 18 km separent les Francais de leur lieu de travail et une duree de 30 minutes pour 2/3 d’entre eux. Pour ces trajets, 77 % des actifs empruntent un vehicule en tant que conducteur, 21 % les transports en commun et 8 % aucun. Dans l’ensemble, 70 % jugent leurs trajets agreables, essentiellement les conducteurs de vehicule et les actifs de province. Lorsqu’ils sont passagers (covoiturage, transport en commun) 39 % s’endorment, en moyenne 23 minutes. Sur le trajet du travail, 17 % des conducteurs disent somnoler au volant au mois une fois par mois, 10 % au point de s’arreter. Neuf pour cent se sont endormis au volant au moins une fois dans l’annee et 7 % d’entre eux ont eu un accident mineur, sans dommage materiels ou corporels. Aucun reseau n’est epargne, 40 % des endormissements ont eu lieu sur des grands axes routiers (4 voies, autoroutes), 26 % sur des routes nationales ou departementales, 19 % sur des routes secondaires et 15 % en ville. Conclusion Cette enquete met en exergue la privation de sommeil et le risque de somnolence dont sont victimes les actifs francais, notamment sur le trajet domicile-travail. Si les usagers des transports en commun recuperent un peu de sommeil, les actifs au volant somnolents s’exposent a un risque d’accident.

To quantify the different forms of polydrug use in the French population and the principal factors associated with it.Data came from the Baromètre Santé 2005, a general population study. Polydrug use was approached by 2 indicators: regular use of at least 2 products among alcohol, tobacco and cannabis, and the use during the year of at least 2 illegal drugs besides cannabis (not necessarily concomitantly).Regular use of some combination of alcohol, tobacco and cannabis was reported by 8.3% of the population. Those aged 20-24 years combined tobacco and cannabis most frequently, with 11.6% reporting this joint use. Regular consumption of all 3 products was rare, reported by less than 1% of those aged 15-64 years. It was highest among those aged 20-29 years, but still less than 2% of the age group. The principal combination for those aged 35 years or older was alcohol and tobacco, and those in this group rarely combined cannabis with another substance. There was a strong association between cannabis use and use of other illicit psychoactive substances. Lifetime use of illicit psychoactive substances except for cannabis was reported by 10.0% of the 15-34 year-olds; for use during the previous year, it was 2.3%. The factors associated with these practices were unemployment, male gender, and youth. Postsecondary education appeared to distance young adults from the different forms of polydrug use.Because use of multiple psychoactive substances is often associated with risk-taking or vulnerability, particular attention to these practices is justified. Surveys in the general population do not cover the most vulnerable or most "desocialized" populations and do not allow the most dangerous forms of polydrug use to be described. They supply useful information for assessing the extent of the most common combined uses in the population and their probable health and social repercussions.

Many alcohol-related problems at adolescence occur during or as a result of peer-oriented activities, so it is necessary to understand how drinking habits are embedded in sociability and lifestyle. OBJECTIVE: to study patterns of peer-oriented activities among heavy drinkers, and to investigate factors associated with these patterns. STUDY GROUP: A national random sample of 13,623 French adolescents aged 17-18 years, and a subgroup of 762 heavy drinkers (reporting either 20 drinking occasions or more during the prior 30 days, or 20 episodes of drunkenness or more during the previous 12 months). METHODS: Respondents answered to a self-administered closed-ended questionnaire. Questions on peer-oriented activities were used for conducting a cluster analysis among heavy drinkers. Logistic regressions were used for studying factors associated with the resulting clusters. RESULTS: Among heavy drinkers the dominant pattern was characterized by the combination of heavy drinking and peer-oriented activities. But in two other profiles heavy drinking was associated with either strong involvement in formal sporting practice or low participation in peer-oriented activities. The expected relationship between heavy drinking, mood disorders, other drug use, violence and victimization depended on which pattern was considered. CONCLUSIONS: The strong links observed between drinking habits and sociability underline the need to counteract the social acceptability of drinking and focus on the social contexts in which it occurs, but preventive action programs should also take into account the diversity of sociability patterns among heavy drinkers. Language: en

This study aimed at increasing understanding of the relationship between sporting activities and alcohol, cigarette and cannabis use among adolescents, by examining gender, age and the context of sporting practice.The study was a national school survey (n=10807; ages 14-19 years) conducted in France in 1999.Respondents were asked confidentially by self-administered questionnaire (pen and paper) about their use of licit and illicit drugs and life-style (including sporting activities outside school: hours per week, registration in a club, type of sport).The U-shaped curve between the intensity of physical activities and licit and illicit drug use appeared not to be systematic. It depended mainly on the product and the level of use. It only remained significant for boys and heavy smoking once gender and age effect were taken into account.The results stress the need to control for age and gender when the survey participants are teenagers. The relationship between drug use and sporting activity also depends on the type of sport.

International audience; BACKGROUND: Prior studies have demonstrated that time perspective---the propensity to consider short-versus long-term consequences of one's actions---is a potentially important predictor of health-related behaviors, including smoking. However, most prior studies have been conducted within single high-income countries. The aim of this study was to examine whether time perspective was associated with the likelihood of being a smoker or non-smoker across five countries that vary in smoking behavior and strength of tobacco control policies. METHODS: The data were from the International Tobacco Control (ITC) Surveys in five countries with large probability samples of both smokers (N=10,341) and non-smokers (N=4,955): Scotland, France, Germany, China, and Malaysia. The surveys were conducted between 2005--2008. Survey respondents indicated their smoking status (smoker vs. non-smoker) and time perspective (future oriented vs. not future-oriented) and provided demographic information. RESULTS: Across all five countries, non-smokers were significantly more likely to be future-oriented (66%) than were smokers (57%), chi2(1, N = 15,244) = 120.64, p < .001. This bivariate relationship between time perspective and smoking status held in a multivariate analysis. After controlling for country, age, sex, income, education, and ethnicity (language in France), those who were future-oriented had 36% greater odds of being a non-smoker than a smoker (95% CI: 1.22 to 1.51, p

International audience; Une féminisation du public reçu pour usage de cannabis dans les dispositifs d'aide ? En 2007, près de 20 % de la population des usagers de drogues reçus dans les « Consultations jeunes consommateurs » sont des femmes. L'article décrit les spécificités de ce public féminin, en faisant ressortir les différences de structure avec les usagers masculins, du point de vue des profils sociodémographiques, des pratiques d'usage et des motivations à consommer. Le public féminin, en moyenne plus âgé, comprend de plus fortes proportions de demandes spontanées et de demandes d'aide à la réduction de la consommation. Les femmes accueillies dans le dispositif déclarent, de fait, des niveaux d'usage de cannabis élevés, souvent plus intensifs et associés à des polyconsommations de substances illicites ou de médicaments psychotropes. Les usages féminins de cannabis sont plus nettement centrés sur des motivations « auto-thérapeutiques » en lien avec la régulation d'une angoisse. À l'inverse, le public masculin recouvre une majorité d'usagers de cannabis adressés par la justice, le plus souvent âgés de 18 à 25 ans, socialement insérés, rapportant leur usage à des considérations hédonistes et à un contexte de sociabilité.