Elsevier

Public Health

Volume 120, Issue 4, April 2006, Pages 329-338
Public Health

Original research
Illicit and traditional drug use among ethnic minority adolescents in East London

https://doi.org/10.1016/j.puhe.2005.10.009Get rights and content

Summary

Objectives

To explore ethnic variations in the use of illicit and traditional drugs, and the association of indicators of acculturation with drug use among an ethnically diverse representative sample of early adolescents in East London.

Study design

A cross-sectional questionnaire survey.

Methods

Confidential questionnaires were used to assess 2789 male and female pupils in years 7 and 9, aged 11–14 years old, from a representative sample of 28 secondary schools in East London.

Results

In total, 10.8% reported having ever tried illicit drugs and 7.3% reported ever using cannabis. Compared with white British adolescents, cannabis use in the previous month was significantly higher amongst black Caribbean adolescents. Lifetime cannabis use was significantly higher amongst black Caribbean and mixed ethnicity young people, but was lower amongst Bangladeshi, Indian and Pakistani adolescents. Living in UK for 5 years or less markedly reduced the risk of lifetime and recent cannabis use when controlled for ethnicity and social class. Glue or solvent use was reported in 3.2% of adolescents, with use significantly higher amongst Bangladeshi young people. Lifetime paan use was reported by 14.1% of the sample, and was almost completely confined to South Asian or mixed ethnicities.

Conclusions

Ethnic differences in illicit drug use were found in the study population, and significant differences were found between ethnic groups often identified as ‘black.’ Further research is needed in understanding cultural-specific risk and protective factors in different ethnic groups, and the importance of cultural identity in mediating health risk behaviors. The high use of paan and glue/gas/solvents by Bangladeshi young people poses an unappreciated public health problem that may require targeted interventions.

Introduction

Illicit drug misuse amongst young people is a significant public health concern. While substance use rates amongst adolescents appear to have stabilized recently after significant increases through the 1990s, UK national surveys suggest that over one-quarter of 11–15 year olds have ever tried illicit drugs.1, 2, 3

Children aged 14 years and under make up 30% of ethnic minority groups in UK, with 40% of Bangladeshis being aged 14 years or under, compared with 19% of the white British population.4 Half of ethnic minority people live in London,4 where drug use rates are the highest in England.5 Despite these figures and substantial research on smoking and drinking amongst ethnic minority adolescents,6, 7 little is known about illicit drug use in these groups in UK. Additionally, attempts to address ethnicity in national samples have grouped adolescents into ‘white’, ‘black’ or ‘Asian’ categories;1 a practice that may conceal significant differences in health behaviours between ethnic groups.8 In a small study of 132 young people from inner London,9 white adolescents were most likely to report the highest levels of substance misuse, with Bangladeshi adolescents reporting the lowest levels, and black African and Caribbean adolescents reporting intermediate rates. Given in UK Government's targets of reducing the use of Class A drugs and the frequent use of all illicit drugs by all young people by 2008,10 a more detailed understanding is needed of drug use amongst black and ethnic minority adolescents in order to ensure that interventions are culturally sensitive and therefore effective in such communities.

In addition, little is known about British adolescents' use of substances traditionally used recreationally in some cultures, such as paan and khat. Paan, a chewed or smoked mix of areca nut, an acacia extract and inorganic lime wrapped in betel leaf and sun-dried tobacco is traditionally used in many South Asian countries and is known to be highly prevalent in Asian immigrant communities in UK.11 Small studies have suggested that some British Asian children are experienced paan users; 12 however, few young people are aware of the health risks associated with paan use,13 which include those associated with tobacco use and an independently increased risk for oral cancer.14 Less is known about the use of khat (quat, qat, qaadka, chat), a drug predominantly used by those from the Arabian peninsula and Horn of Africa (Somalia, Ethiopia) that produces amphetamine-like effects by chewing, brewing or smoking the leaves of the Catha edulis plant.15, 16

Acculturation, defined as ‘phenomena which result when groups of individuals having different cultures come into continuous first-hand contact, with subsequent changes in the original culture patterns of either or both groups’,17 is believed to be a mediating factor in adolescents' adaptation to their environment and their adoption of the health risk behaviours of their peers. Acculturation has been measured in different ways including duration of residence, country of birth, languages spoken and cultural participation.18 Research from the USA on the effect of migration status on adolescent health has found that foreign-born young people are at a lower risk of health problems and risk behaviours than those born in the host country, but the protective effect diminishes over three generations.19 However, the effects of the process of acculturation on health risk behaviours, such as substance use, has been little studied in UK.

In this study, data from a representative ethnically diverse sample of young people aged 11–14 years were used to examine the hypotheses that the prevalence of illicit and traditional drug use varies by ethnicity, and that indicators of acculturation are associated with drug use.

Section snippets

Methods

Research with East London Adolescent Community Health Survey (RELACHS) is a school-based epidemiological study of a representative sample of 2790 adolescents from year 7 (11–12 years) and year 9 (13–14 years) attending 28 schools in East London in 2001.20 All 42 eligible schools in Hackney, Tower Hamlets and Newham were stratified by borough and school type (comprehensive, voluntary, other). Thirty schools were selected at random and balanced to ensure representation of single-sex and mixed-sex

Results

The cohort consisted of 25% Bangladeshi, 21% white British, 10% black African, 9% Asian Indian, 7% Pakistani, 7% mixed ethnicity, 6% black Caribbean, 6% white other, 4% black British and 4% other ethnic groups. In total, 22% of males and 20% of females were born outside in UK. Data on illicit drug use were available for 2723 (98%) adolescents, of whom 295 (10.8%) had tried illicit drugs of any type at least once in their lifetime. Data on paan use were available for 2687 (96%) adolescents.

Discussion

This study reports distinct patterns of illicit and traditional drug use among young adolescents of different ethnicities from a recent large population-based sample. Overall, the prevalence of drug use was low; 11% of the sample aged 11–14 years reported having tried illicit drugs, whereas recent UK national data suggest that 11% of 11 year olds rising to 34% of 14 year olds have tried illicit drugs.1 However, this probably reflects low prevalence amongst the large Bangladeshi, Pakistani and

Conclusions

Patterns of use of illicit and traditional drugs by young people vary between ethnicities and within groups commonly categorized as ‘black’ and ‘Asian’ groupings, with black Caribbean and mixed ethnicity young people at highest risk for cannabis use. The high use of paan and glue/gas/solvents by Bangladeshi young people may pose an unappreciated public health problem. Identified variations may reflect cultural differences in sanctioned and restricted substances, and may result in different

Acknowledgements

RELACHS was commissioned by East London and The City Health Authority to inform their Health Action Zone and the authors thank them for their financial support. The authors also thank Tower Hamlets, Newham and City and Hackney Primary Care Trusts for additional funding. Russell Viner is funded by a Fellowship from the Health Foundation.

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