Medium Socioeconomic School and Area Environments Had Higher Cannabis Use Than Low-SES Settings in Croatia
Among Croatian 15-year-olds, medium school-level and area-level socioeconomic status was associated with higher cannabis use compared to low SES, while low individual and school SES were protective against most risk behaviors.
Quick Facts
What This Study Found
Multilevel analysis of 1,601 Croatian secondary school students (age 15) from the WHO Health Behavior in School-aged Children study examined how individual, school, and area socioeconomic status related to risk behaviors. Individual SES explained the majority of differences across all risk behaviors.
For cannabis use specifically, school heterogeneity (vs. homogeneity) and medium school-level SES (vs. low) were associated with higher probability. Medium area-level SES was also associated with higher cannabis use compared to low area-level SES. Counter-intuitively, lower individual, school, and area SES played a protective role against most risk behaviors.
Key Numbers
1,601 pupils aged 15. Low individual SES: protective for tobacco, drunkenness. Medium school SES and school heterogeneity: higher cannabis use. Medium area SES: higher cannabis use and fighting. Gymnasium (advanced school) attendance: protective against fighting.
How They Did This
Multilevel logistic regression analysis of WHO HBSC data from Croatia (2006). 1,601 pupils aged 15 in secondary schools. Three levels: individual, school, area. Risk behaviors: tobacco, drunkenness, cannabis, early sexual initiation, fighting. Census data for area-level SES.
Why This Research Matters
This study challenges the assumption that drug use is primarily a problem of disadvantaged communities. For cannabis specifically, medium-SES environments had higher use, suggesting that prevention programs need to target middle-class schools and neighborhoods as well.
The Bigger Picture
The counterintuitive finding that medium SES is associated with higher cannabis use may reflect greater disposable income, more exposure to social environments where cannabis is available, or cultural factors specific to transitional economies. This challenges one-dimensional prevention approaches focused solely on disadvantaged communities.
What This Study Doesn't Tell Us
Croatian-specific findings may not generalize to other countries. Cross-sectional design cannot establish causation. Self-reported risk behaviors subject to social desirability bias. Only one age group (15-year-olds) studied. The WHO HBSC data are from 2006, and patterns may have changed.
Questions This Raises
- ?Why is medium SES associated with higher cannabis use?
- ?Does school heterogeneity increase exposure to substance-using peers?
- ?Would these patterns hold in other European countries?
- ?Are prevention programs adequately targeting middle-SES environments?
Trust & Context
- Key Stat:
- Medium SES environments had higher cannabis use than low SES environments
- Evidence Grade:
- Large multilevel analysis with appropriate methodology; preliminary evidence for SES-cannabis patterns in one country.
- Study Age:
- Published in 2013 (data from 2006). Socioeconomic patterns of adolescent drug use continue to be studied.
- Original Title:
- Inequalities in Croatian pupils' risk behaviors associated to socioeconomic environment at school and area level: a multilevel approach.
- Published In:
- Social science & medicine (1982), 98, 154-61 (2013)
- Database ID:
- RTHC-00713
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Does poverty cause teen drug use?
This study found the opposite for cannabis: medium socioeconomic environments (both at school and area level) had higher cannabis use than low-SES environments. Low individual SES was protective against tobacco use and drunkenness. This suggests the relationship between socioeconomic status and drug use is more complex than "poor communities = more drugs."
Why might middle-class teens use more cannabis?
The study did not explain the mechanism, but possibilities include greater disposable income to purchase cannabis, more exposure to social environments where cannabis is normalized, less parental supervision, and cultural factors where some risk-taking is seen as normal in middle-class adolescent peer groups.
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Cite This Study
https://rethinkthc.com/research/RTHC-00713APA
Pavic Simetin, Ivana; Kern, Josipa; Kuzman, Marina; Pförtner, Timo-Kolja. (2013). Inequalities in Croatian pupils' risk behaviors associated to socioeconomic environment at school and area level: a multilevel approach.. Social science & medicine (1982), 98, 154-61. https://doi.org/10.1016/j.socscimed.2013.09.021
MLA
Pavic Simetin, Ivana, et al. "Inequalities in Croatian pupils' risk behaviors associated to socioeconomic environment at school and area level: a multilevel approach.." Social science & medicine (1982), 2013. https://doi.org/10.1016/j.socscimed.2013.09.021
RethinkTHC
RethinkTHC Research Database. "Inequalities in Croatian pupils' risk behaviors associated t..." RTHC-00713. Retrieved from https://rethinkthc.com/research/pavic-2013-inequalities-in-croatian-pupils
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.