Smoking, Urban Housing and Work-Aggravated Asthma are Associated with Asthma Severity in a Cross-Sectional Observational Study.

Purpose: Severe asthma affects 5 to 10% of asthmatics and accounts for a large part of asthma-related morbidity and costs. The determinants of asthma severity are poorly understood. We tested the hypothesis that asthma severity was associated with 1) atopy and allergy and 2) markers associated with environmental exposure. Patients and Methods: Data from the FASE-CPHG study, a cross-sectional, observational, multicenter investigation, were analyzed to identify markers associated with asthma severity. Asthma severity was gauged using the ASSESS score, encompassing symptom control, exacerbations, FEV1 and therapeutic load. Bivariate and multivariate analyses were used to identify patient characteristics associated with the ASSESS score. Results: The analysis involved 948 patients, with 592 women, of which 447 patients (47%) had severe asthma. Among these, 491 patients (52%) had at least one positive aeroallergen skin prick test and 525 (55%) had at least one allergic disease among atopic dermatitis, chronic rhinitis and food allergy. The mean±SD ASSESS score was 11.2±3.4. Characteristics associated with a higher ASSESS score were female sex, secondary or lower education, unemployed occupational status, smoking, work-aggravated asthma and urban housing. There was no association between the ASSESS score and allergic diseases, aeroallergen-specific skin prick tests and IgEs, or blood eosinophil counts. Conclusion: While atopy and allergy were frequent among asthmatics, neither was associated with asthma severity. Modifiable environmental factors such as smoking, urban housing and work-aggravated asthma were independently associated with asthma severity.

Evaluation of performance of two SARS-CoV-2 Rapid IgM-IgG combined antibody tests on capillary whole blood samples from the fingertip.

BACKGROUND: The SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus 2) is responsible for the infectious respiratory disease called COVID-19 (COronaVIrus Disease 2019). In response to the growing COVID-19 pandemic, point-of-care (POC) tests have been developed to detect specific antibodies, IgG and IgM, to SARS-CoV-2 virus in human whole blood. We conducted a prospective observational study to evaluate the performance of two POC tests, COVID-PRESTO® and COVID-DUO®, compared to the gold standard, RT-PCR (real-time reverse transcriptase polymerase chain reaction). METHODS: RT-PCR testing of SARS-Cov-2 was performed from nasopharyngeal swab specimens collected in adult patients visiting the infectious disease department at the hospital (Orléans, France). Capillary whole blood (CWB) samples from the fingertip taken at different time points after onset of the disease were tested with POC tests. The specificity and sensitivity of the rapid test kits compared to test of reference (RT-PCR) were calculated. RESULTS: Among 381 patients with symptoms of COVID-19 who went to the hospital for a diagnostic, 143 patients were RT-PCR negative. Results of test with POC tests were all negative for these patients, indicating a specificity of 100% for both POC tests. In the RT-PCR positive subgroup (n = 238), 133 patients were tested with COVID-PRESTO® and 129 patients were tested with COVID-DUO® (24 patients tested with both). The further the onset of symptoms was from the date of collection, the greater the sensitivity. The sensitivity of COVID-PRESTO® test ranged from 10.00% for patients having experienced their 1st symptoms from 0 to 5 days ago to 100% in patients where symptoms had occurred more than 15 days before the date of tests. For COVID-DUO® test, the sensitivity ranged from 35.71% [0-5 days] to 100% (> 15 days). CONCLUSION: COVID-PRESTO® and DUO® POC tests turned out to be very specific (none false positive) and to be sensitive enough after 15 days from onset of symptom. These easy to use IgG/IgM combined test kits are the first ones allowing a screening with CWB sample, by typing from a finger prick. These rapid tests are particularly interesting for screening in low resource settings.

Association between cumulating substances use and cumulating several school, violence and mental health difficulties in early adolescents.

Multiple substances (alcohol, tobacco, cannabis and other illicit drugs (OID)) have been frequently used in early adolescents maybe due to school, violence and mental-health difficulties. We investigated the associations between substance-use patterns and related difficulties among 1559 middle-school adolescents from north-eastern France (mean age 13.5 ±â€¯1.3). They completed a questionnaire including socioeconomic features, school, violence and mental-health difficulties (school grade repetition, sustained physical/verbal violence, sexual abuse, perpetrated violence, poor social support, depressive symptoms and suicide attempt; cumulated number noted SVMDscore) and the time of their first occurrence during the life course. Data were analyzed using logistic and negative binomial regression models. Alcohol, tobacco, cannabis and OID use affected 35.2, 11.2, 5.6 and 2.8% of the subjects respectively. The risk of using tobacco only, alcohol and tobacco, alcohol plus tobacco and cannabis, or all alcohol, tobacco, cannabis and OID strongly increased with the SVMDscore (socioeconomic features-adjusted odds ratio reaching 85). The risk began in early years in middle schools and then steadily increased, more markedly for elevated SVMDscore. Exposure to several SVMDs may be a transmission vector towards the substance use, starting mostly with alcohol/tobacco, and then shifting to cannabis/OID. These findings help to understand substance-use risk patterns and identify at-risk adolescents.

[From early adolescence to adulthood]. / De la preadolescence å l'âge adulte.

In industrialized countries, the transition from early adolescence to adulthood takes a long time (over 10 years) and is a diversified process. Puberty marks the starting point of adolescence, while the end of the adolescent process is defined by social factors, such as integration in the world of work, leaving the parents' home, and living with a stable partner. During adolescence, the difference between boys and girls becomes progressively well established, not only concerning physical growth and body changes, but also concerning lifestyle and health behavior, including risky behavior. On these aspects, the gender gap is more important in France (as in southern European countries) than in most Nordic or Anglo-Saxon countries. Most young people have no major problems, but nearly 10% present emotional and behavioral disorders.

Early substance use initiation and suicide ideation and attempts among students in France and the United States.

OBJECTIVE: In response to recent research documenting a link between early substance use and suicidal behaviors among youth, the current study sought to examine the associations between ages of substance use initiation and suicidal behavior among students in France and the USA. METHODS: Cross-sectional logistic regression analyses based on the 2003 European School Survey Project on Alcohol and Other Drugs (ESPAD) survey (France; n = 13,187) and the 2003 Youth Risk Behavior Survey (YRBS) (United States; n = 15,136) assessed associations between early substance use initiation (i.e., alcohol, cigarette and cannabis/marijuana) and suicide ideation and attempts while controlling for potential confounders. RESULTS: Early alcohol use initiation (OR(adj) = 1.52; 95% CI 1.17-1.97) and early cannabis/marijuana use initiation (OR(adj) = 2.90; 95% CI 2.20-3.83) were associated with suicide attempt in France. Early smoking was associated with suicide attempt in both France (OR(adj) = 1.92; 95% CI 1.55-2.37) and the USA (OR(adj) = 1.53; 95% CI 1.02-2.28). Sex differences were also noted. CONCLUSIONS: The associations between substance use initiation and suicidal behaviors differed in the United States and France. These findings, placed into context, can assist the development and implementation of prevention strategies that seek to reduce the harmful consequences of early substance use among youth.

Are occupational factors and mental difficulty associated with occupational injury?

OBJECTIVE: To evaluate the associations between biomechanical, physical, and psychological demands and occupational injury according to depressive symptoms severity. METHODS: Two thousand eight hundred eighty-two French working people completed a questionnaire covering sociodemographic characteristics, smoking, alcohol consumption, obesity, job, chronic diseases, depressive symptoms, and injuries during the previous 2-year period. Data were analyzed using logistic regression. RESULTS: Occupational injury (9.2%) strongly related to biomechanical, physical, and psychological demands among depressive-symptoms-free workers (odds ratios ranging from 1.35 to 3.15). These relationships were stronger among the workers with depressive symptoms without medical treatment (11.9%) and among those with persistent symptoms despite a treatment (1.7%), with odds ratios up to 12. These associations were partially confounded (up to 51%) by unhealthy behaviors, health status, and chronic diseases. CONCLUSIONS: High-occupational demands and depressive symptoms can be early identified and monitored to prevent injury.

First positive reactions to cannabis constitute a priority risk factor for cannabis dependence.

AIM: To assess the association between first reactions to cannabis and the risk of cannabis dependence. DESIGN: A cross-sectional population-based assessment in 2007. SETTING: A campus in a French region (Champagne-Ardennes). PARTICIPANTS: A total of 1472 participants aged 18-21 years who reported at least one life-time cannabis consumption, of 3056 students who were screened initially [the Susceptibility Addiction Gene Environment (SAGE) study]. MEASUREMENTS: Positive and negative effects of first cannabis consumptions, present cannabis dependence and related risk factors were assessed through questionnaires. FINDINGS: The effects of first cannabis consumptions were associated dose-dependently with cannabis dependence at age 18-21 years, both according to the transversal approach of the SAGE study and to the prospective cohort of the Christchurch Health and Development Study (CHDS) assessed at the age of 25 years. Participants of the SAGE study who reported five positive effects of their first cannabis consumption had odds of life-time cannabis dependence that were 28.7 (95% confidence interval: 14.6-56.5) higher than those who reported no positive effects. This association remains significant after controlling for potentially confounding factors, including individual and familial variables. CONCLUSIONS: This study suggests an association between positive reactions to first cannabis uses and risk of life-time cannabis dependence, this variable having a central role among, and through, other risk factors.

Relationship of physical job demands to initiating smoking among working people: a population-based cross-sectional study.

This study assessed the relationships of lifetime smoking and initiating smoking with job demands among 2,888 randomly selected workers, aged 15 yr or over, using a post-mailed questionnaire. Cumulated job demands (CJD) was defined as the number of: using pneumatic tools, other vibrating hand tools, hammer, tasks at height, working in adverse climate, pace of working, cold, heat, and noise exposure. Lifetime smoking was reported by 63.8% of subjects, and 5.9% initiated smoking during present job. Logistic model shows that lifetime smoking related to the CJD: OR adjusted for years with job 2.47 (95%CI 1.69-3.60) for CJD> or =4, 1.50 (1.21-1.85) for CJD2-3, and 1.20 (1.00-1.44) for CJD1, vs. CJD0. Initiating smoking also related to the CJD: ORs 3.72 (1.95-7.11), 1.51 (0.96-2.39) and 1.47 (0.97-2.24), respectively. These associations were partly confounded by gender, income, obesity and job. Smoking related to job demands and their limitation should help preventing smoking.

Asthma, obesity, and eating behaviors according to the diagnostic and statistical manual of mental disorders IV in a large population-based sample of adolescents.

BACKGROUND: Obesity is related to asthma, but factors influencing this relation have not been clearly defined. OBJECTIVE: This study was designed to assess the role of eating behaviors and weight concerns in the association between obesity and asthma. DESIGN: A population-based sample of 11,710 adolescents, recruited from 186 secondary schools of 8 educational districts in France, completed a self-administered standardized questionnaire including DSM IV (Diagnostic and Statistical Manual of Mental Disorders) questions on eating disorders. RESULTS: Obesity (body mass index >/=95th percentile according to age and sex) was associated with asthma in girls (odds ratio: 1.48; 95% CI: 1.05, 2.08) but not in boys (odds ratio: 1.07; 95% CI: 0.75, 1.54). Both obese and asthmatic adolescents were more likely to have abnormal eating behaviors and weight concerns (P < 0.05). In an adjusted polytomous logistic model with 4 categories based on the presence and/or the absence of asthma and obesity as the dependent variable, the odds ratio for weight concerns increased from a minimum value for asthmatic nonobese adolescents (odds ratio: <1.5; P < 0.03) to a maximum value for asthmatic obese adolescents (odds ratio: >6.3; P < 0.001) with nonasthmatic, nonobese adolescents as the reference group. Similar patterns were observed for overweight. CONCLUSIONS: Our data suggest that, besides well-known factors such as genetic background, direct mechanical effects, and reduced physical activity, abnormal eating behaviors and weight concerns might intervene in the relation between obesity and asthma. Psychosocial dimension has to be considered to disentangle the complex relation between obesity and asthma in adolescence in view of prevention.

Fatigue, insomnia and nervousness: gender disparities and roles of individual characteristics and lifestyle factors among economically active people.

BACKGROUND: Individuals with certain personal, family and job characteristics are at elevated risk of poor mental health. Yet, the respective role of obesity, smoking, alcohol abuse, low education, income, living and family conditions, and socio-occupational category in fatigue/insomnia (FI), nervousness (N) and frequent drug use for those disorders (DFI and DN) among men and women and in gender disparities are not well known. METHODS: We studied gender differences in FI, N, DFI, DN, and in their correlated, and whether the gender differences were mediated by individual and lifestyle factors among 3,450 active subjects aged 18-64, randomly selected from North-eastern France. Subjects completed a post-mailed questionnaire. Data were analyzed via adjusted odds ratio (ORa) computed with the logistic regression model. RESULTS: Women were more affected than men for FI (21.3 vs. 13.1%, OR adjusted for age ORa 1.80, 95% CI 1.50-2.16), DFI (11.6 vs. 7.1%, ORa 1.74, 1.38-2.21), N (14.7 vs. 9.9%, ORa 1.58, 1.28-1.94), and for DN (12.1 vs. 5.7%, ORa 2.29, 1.79-2.94). These differences were not mediated by the individual characteristics studied. Multivariate analysis showed that the risk patterns varied between the two sexes. Smoking was related to N in men as well as in women; alcohol abuse to DFI in men only; lack of family support to all outcome variables in men and women; low educational level to DFI in men only; low income to FI, N and DN in men and to FI and DN in women; being unmarried to DN in men; being divorced/separated to N and DN in women; being a manual worker to FI and being a farmer to DFI in men; and being a manual worker to DN and being an employee to FI in women (1.50

Psychological distress in first year university students: socioeconomic and academic stressors, mastery and social support in young men and women.

PURPOSE: Little is known about the role of stressors associated with university life on psychological distress (PD). The aims of this article are to: (1) assess the prevalence of PD among students during their first year of university; (2) study its associations with stressors (socioeconomic and university-related) and protective factors (mastery, social support); and (3) to compare these factors according to gender. METHODS: Cross-sectional study of a random sample of students aged 18-24 years, in their first year of university in 2005-2006, enrolled in the 6 universities of southeastern France. Standardised questionnaire, by self-administration or telephone interview. Overall, 1,743 students agreed to participate (71.0%). RESULTS: PD prevalence was estimated at 15.7% (95% CI: 12.9-18.5) among the young men and 33.0% (95% CI: 30.2-35.9) among the young women. Multiple logistic regressions adjusted for social and demographic variables, mode of questionnaire administration, psychiatric history, and recent adverse life events, showed that among men PD was associated with lack of adjustment to the university academic environment (OR = 1.08; 95% CI: 1.00-1.17, P = 0.04), and mastery (OR = 0.73; 95% CI: 0.68-0.79). Among women, the prevalence of PD was associated with medical studies (OR = 2.46; 95% CI: 1.50-4.05), lack of adjustment to the university academic environment (OR = 1.07; 95% CI: 1.03-1.12), mastery (OR = 0.78; 95% CI: 0.75-0.82), and social support (OR = 0.68; 95% CI: 0.54-0.85), with a strong negative statistical interaction between mastery and lack of adjustment. CONCLUSIONS: This study shows an intermediate prevalence of PD among French first-year university students compared with those observed in university students in other countries. It suggests that PD is related to university-related stressors but failed to find a relation to socioeconomic factors. Risk and protective factors for PD in first-year university students differed somewhat according to gender. However, mastery appeared to have a protective role in both genders. Further research is necessary to confirm these results in other universities and years.

Has occasional cannabis use among adolescents also to be considered as a risk marker?

BACKGROUND: The association between cannabis use and health or behaviour problems is quite well established. Little is known about the risk markers related to occasional or former use. This work aims to explore associations between well-being in life and different levels of cannabis use. METHODS: A total of 16 934 French adolescents completed self-administered multi-choice questionnaires (from the European Study ESPAD 2003) on substance consumption, psychopathology, socio-demographics and schooling. Four groups were defined according to cannabis use: Never-Users (no lifetime consumption and no consumption during the last month), Former Users (at least one lifetime consumption but none in the last month), Current Occasional Users (<5 times during the previous month) and Current Heavy Users (> or =5 times during the previous month). Analyses were performed with SAS 8.2 software and adjusted for gender and age. RESULTS: A total of 68.2% of students aged 12-19 years were Never-Users, 15.5% Former Users, 8.3% Current Occasional Users and 8.0% Current Heavy Users. When Former Users were compared with Never-Users, significant differences were found with regard to suicide attempt, odds ratio (OR) = 2.9 (2.4-3.4); multiple acts of violence, OR = 6.4 (5.4-7.7) and running away from home, OR = 3.1 (2.5-3.8). These differences were greater when Current Occasional Users were compared with Never-Users: suicide attempt, OR = 4.2 (3.5-5.0); multiple acts of violence, OR = 12.6 (10.2-15.5) and running away from home OR = 4.2 (3.4-5.4). Differences remain even after adjustment for alcohol and tobacco consumption. CONCLUSIONS: These results showed that occasional and even former marijuana use is associated with risky behaviour among adolescents.

Social inequalities and correlates of psychotropic drug use among young adults: a population-based questionnaire study.

BACKGROUND: Use of psychotropic drugs is widespread in Europe, and is markedly more common in France than elsewhere. Young adults often fare less well than adolescents on health indicators (injury, homicide, and substance use). This population-based study assessed disparities in psychotropic drug use among people aged 18-29 from different socio-occupational groups and determined whether they were mediated by educational level, health status, income, health-related behaviours, family support, personality traits, or disability. METHODS: A total of 1,257 people aged 18-29, randomly selected in north-eastern France completed a post-mailed questionnaire covering sex, date of birth, height, weight, educational level, occupation, smoking habit, alcohol abuse, income, health-status, diseases, reported disabilities, self-reported personality traits, family support, and frequent psychotropic medication for tiredness, nervousness/anxiety or insomnia. The data were analyzed using the adjusted odds ratios (ORa) computed with logistic models. RESULTS: Use of psychotropic drugs was common (33.2%). Compared with upper/intermediate professionals, markedly high odds ratios adjusted for sex were found for manual workers (2.57, 95% CI 1.02-6.44), employees (2.58, 1.11-5.98), farmers/craftsmen/tradesmen (4.97, 1.13-21.8), students (2.40, 1.06-5.40), and housewives (3.82, 1.39-10.5). Adjusting for all the confounders considered reduced the estimates to a pronounced degree for manual workers (adjusted OR 1.49, non-significant) but only slightly for the other socio-occupational groups. The odds ratio for unemployed people did not reach statistical significance. The significant confounders were: sex, not-good health status, musculoskeletal disorders and other diseases, being worried, nervous or sad, and lack of family support (adjusted odds ratios between 1.60 and 2.50). CONCLUSION: There were marked disparities among young adults from different socio-occupational groups. Sex, health status, musculoskeletal diseases, family support, and personality traits were related to use of psychotropic drugs. These factors mediated the higher risk strongly among manual workers and slightly among the other groups.

Perceived parenting styles and tobacco, alcohol and cannabis use among French adolescents: gender and family structure differentials.

AIMS: To assess associations between parental control or parental emotional support and current tobacco, alcohol or cannabis use among 12-18-year-old students, according to gender and family structure (intact family, reconstituted family, single-parent family). METHODS: A cross-sectional survey was conducted in a national representative sample in France (2003) of 6-12th grade students (N = 16,532), as a part of the ESPAD study (European Study Project on Alcohol and Other Drugs). The self-administered questionnaire included questions on last 30 days' consumption of alcohol, tobacco and cannabis as well as on socio-demographic characteristics, school characteristics, and some simple questions on parental control and parental emotional support. Logistic modelling was carried out and (adjusted Odds Ratio) Ora calculated, adjusted for age, parental educational and characteristics of the school. RESULTS: A negative relationship exists between parental control and substance use, but this relationship is more marked for tobacco (OR a between 1.8 and 5.6 according to level of control, family status and gender) and cannabis (OR between 1.5 and 6.4) than for alcohol (OR a between 1.0 and 2.7). Parental control is more markedly related to substance use in girls than in boys. These tendencies were observed for intact families as well as for single-parent families or reconstituted families. Parental control has a greater impact than emotional support. Among girls, emotional support has a greater impact than among boys. CONCLUSIONS: There is a gradient relationship between parental control and current consumption, especially among girls. Thus, there may be a need for parental control, whatever the family structure.

Associations of social and material deprivation with tobacco, alcohol, and psychotropic drug use, and gender: a population-based study.

BACKGROUND: The aim was to assess the relationships between social and material deprivation and the use of tobacco, excessive alcohol and psychotropic drugs by both sexes and in various age groups. Greater knowledge concerning these issues may help public health policy-makers design more effective means of preventing substance abuse. METHODS: The sample comprised 6,216 people aged > or 15 years randomly selected from the population in north-eastern France. Subjects completed a post-mailed questionnaire covering socio-demographic characteristics, occupation, employment, income, smoking habit, alcohol abuse and "psychotropic" drug intake (for headache, tiredness, nervousness, anxiety, insomnia). A deprivation score (D) was defined by the cumulative number of: low educational level, manual worker, unemployed, living alone, nationality other than western European, low income, and non-home-ownership. Data were analysed using adjusted odds ratios (ORa) computed with logistic models. RESULTS: Deprivation was common: 37.4% of respondents fell into category D = 1, 21.2% into D = 2, and 10.0% into D > or 3a re men than women reported tobacco use (30.2% vs. 21.9%) and alcohol abuse (12.5% vs. 3.3%), whereas psychotropic drug use was more common among women (23.8% vs. 41.0%). Increasing levels of deprivation were associated with a greater likelihood of tobacco use (ORa vs. D = 0: 1.16 in D = 1, 1.49 in D = 2, and 1.93 in D > or = 3), alcohol abuse (1.19 in D = 1, 1.32 in D = 2, and 1.80 in D > or = 3) and frequent psychotropic drug intake (1.26 in D = 1, 1.51 in D = 2, and 1.91 in D > or = 3). These patterns were observed in working/other non-retired men and women (except for alcohol abuse in women). Among retired people, deprivation was associated with tobacco and psychotropic drug use only in men. CONCLUSION: Preventive measures should be designed to improve work conditions, reduce deprivation, and help deprived populations to be more aware of risk and to find remedial measures.

School injury and gender differentials: a prospective cohort study.

This study assessed the role of certain individual characteristics in school injury among male and female adolescents. The sample included 2,398 subjects attending middle schools and high schools. Respondents completed a self-administered questionnaire at the beginning of the school year. School nurse completed a questionnaire on injury for each school injury occurred during the school year. The data was analyzed with the adjusted odds ratios (ORa) computed via the logistic models. The school injury was common (13% for both sexes). Sports/physical training injury was more frequent among girls (8.8% vs. 6.6%, P < 0.05) contrarily to the other types of injury (4.6% vs. 8.8%, P = 0.001). Sports/physical training injury was strongly associated with age <15 years (ORa 3.42) and presence of previous injury (2.63) among boys, and with age <15 years (2.02), presence of previous injury (2.94), not easily irritated (1.89), and irresponsible (1.59) among girls. The other types of injury were highly related to age <15 years (ORa 4.18), frequent use of psychotropic drugs (1.76), not living with both parents (1.65), being not calm (2.03), and presence of previous injury (1.82) among boys, and to age <15 years (2.59), obesity (3.24), and being not calm (1.84) among girls. The present study identified a number of potential risk factors for school injury among male and female adolescents. Preventive measures should be taken to make adolescents, their parents and teachers more aware of the risks and to find remedial measures.

Culture as an explanation for substance-related problems: a cross-national study among French and Dutch adolescents.

Our main goal was to establish whether French and Dutch adolescents differ in rates of substance-related adverse events (e.g. fights, robbery), problems with peers or socializing agents even when controlling for pattern of substance use. For problems with peers and socializing agents due to alcohol we hypothesized that, because of stronger informal control of drinking in France, French adolescents are more likely to report problems with peers and socializing agents. For adverse events due to alcohol no difference was expected after controlling for consumption patterns. For drug-related problems, the hypothesis was that, due to the more restrictive drug policy in France, French adolescents are more likely to report problems with peers, socializing agents and adverse events. Comparable surveys based on samples of adolescent schoolchildren in France (n=9646) and the Netherlands (n=4291) were used. Data were analysed using multilevel logistic regression in which school, age and gender, indicators of substance use and country were used as predictors of substance-related problems. The outcomes show that French adolescents are more likely to report problems with peers and socializing agents due to alcohol even when consumption pattern is controlled for. For adverse events due to alcohol no difference was found between French and Dutch adolescents. For drug-related problems the expected differences were found; i.e. French adolescents are more likely to report problems with peers, socializing agents and adverse events even when controlling for pattern of drug use. It is concluded that there are culturally embedded differences in the rates of some types of problems due to alcohol or drug use. With respect to alcohol use, these differences are most likely due to culturally embedded differences in the informal social control of alcohol use. The differences in rates of drug-related problems are interpreted in the context of national differences in drug policy.

Do male and female adolescents differ in the effect of individual and family characteristics on their use of psychotropic drugs?

This study assesses the effects of individual and family characteristics on psychotropic drug use among male and female adolescents. The sample included 2,396 subjects attending two middle schools and two high schools. Respondents completed self-administered questionnaires covering gender, age, body mass index, smoking, alcohol use, illicit drug use, tiredness during the daytime, self-reported personality traits, family conditions, and psychotropic drug use. The data were analyzed using logistic models. The prevalence of frequent psychotropic drug use (for headache, tiredness, nervousness, anxiety, insomnia) was 43.0% overall; twice as high among girls than boys. Among the girls, frequent psychotropic drug use was associated with frequent tiredness during the daytime (adjusted odds ratio OR 2.03, 95% CI 1.61-2.57), smoking (2.02, 1.50-2.71), alcohol use (1.34, 1.04-1.74), higher body mass index (>18 kg/m(2), 1.54, 1.16-2.04), poor family atmosphere (1.33, 1.03-1.72), and being worried (1.93, 1.53-2.43) or easily becoming irritable (1.28, 1.01-1.62). In boys the factors with significant ORs were frequent tiredness during the daytime (2.21, 1.67-2.93), alcohol use (1.52, 1.15-2.01), and being worried (1.70, 1.28-2.26) or easily becoming irritable (1.42, 1.06-1.89); univariate analysis revealed a significant relationship with smoking and family atmosphere. An association was also observed for illicit drugs in both sexes and for age > or = 17 years in girls. Individual and family characteristics have marked influence on psychotropic drug use among both male and female adolescents. Preventive measures should be taken to make adolescents and their parents more aware of the risks and to improve their living conditions.

Is alcohol, tobacco, and cannabis use as well as polydrug use increasing in France?

Two school surveys measured the consumption of alcohol, tobacco and cannabis among French adolescents (7-12th grades), one in 1993 (N=8435, 48.8% males), another in 1999 (N=11,331, 47.9% males). Increase in all substance use and polydrug use was observed (total sample, by gender and by age). The increase was important (1) for lifetime consumption of cannabis, "tobacco+cannabis," "alcohol+tobacco" and "alcohol+tobacco+cannabis" (OR=3.0); (2) for regular consumption of cannabis and "tobacco+cannabis" (OR=3.0); (3) among girls; (4) among youngsters aged 15 and more. In summary, these patterns of increase were quite different from those we expected for France, a wet and masculine culture.