Emerging burden of alcohol, drug, and tobacco use initiations among 303,519 school-going adolescents in 92 countries

Adolescent alcohol, drug, and tobacco use is an emerging public health concern in low and middle-income countries (LMICs) and high-income countries (HICs). Yet, there is a lack of reliable, national-level data to inform policies and prevention interventions. This study aimed to provide the best available associations of global and regional risk and protective factors of the early initiation of alcohol, drugs, and tobacco use (before 14 years or 14–17 years old) amongst school–going adolescents. A total of 303,519 adolescents participated in this study. They were drawn from 92 countries in the latest Global School–based Student Health Survey of school children aged 14–17 years. Our analysis covered the period between 2003 and 2015 for which data are available, grouped according to the six World Health Organization (WHO) regions. The pooled weighted prevalence of early initiation of alcohol, drug and tobacco use amongst adolescents (aged