Perceived Risk for Cannabis, Tobacco and Alcohol : Comparison of US and Swedish High School Students

• Aims: Perceived risk is related to use of cannabis, alcohol, and tobacco among youth. Sweden and US have different policies and customs related to these substances thatmay influence both risk perception and behavior regarding use of these substances. Differences in perceived risk of cannabis, cigarettes, chewing tobacco and alcohol in Sweden and the US have been reported but no direct systematic comparison has been performed. Design and setting: The ATLAS Project is a long-term longitudinal study comparing the development of substance use from high school to the young adult life period (18–23 years) in the US and Sweden. Participants: Baseline data for 3352 17–19 year-old high school students (65%from Sweden, 56% women, mean age 17.8, 35%from US 58%women,mean age 17.6). Measurements: Surveys of perceived risk items, ever use of cannabis, cigarettes and alcohol, as well as conduct problems, mental health symptoms, and impulsivity. Findings: The largest differences between the countries were found for the risk of cannabis use. Swedish participants reported much higher perceived risk both for continuous and occasional use than US students. For cigarettes, chewing tobacco and alcohol students from the US reported higher risk perception than the Swedish students did. Females reported higher perceived risk for all substances than male students.Conduct problems were associated with less perceived risk in all examples and impulsivity in cannabis and alcohol issues. Increasedmental health symptoms were associated with increased perceived risk for alcohol. Those who have used the specific drug reported lower levels of risk for that drug butmostly not for other drugs. Conclusions: Perceived risk for cannabis was higher in Swedish students than in US students while cigarette smoking, chewing tobacco and alcohol use were perceived as more risky in the US. One possibility could be that Sweden has much tougher drug laws than the US while less stringent alcohol and tobacco laws.

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