A Cross National Investigation of Adolescent Substance Use in Mumbai, India; Melbourne, Australia and Seattle in Washington State, USA

Introduction: India’s emergence as a rapidly growing economic power has brought with it forces of modernization and globalization that could have adverse implications for youth. Mumbai city is seen as harbinger of what is to come in rest of India. Previous cross-national comparative papers from the present study have reported lower rates of alcohol use in Mumbai adolescents, relative to matched samples in Seattle, in the US, and Melbourne, in Australia. The present paper will extend prior findings to report the cross-national prevalence rates of life time substance use among adolescents in Mumbai India, Melbourne Australia and Seattle in Washington State, United States and their co-occurrence with risk factors such as laws and norms favourable to drug use; perceived availability of drugs; poor family management; parental attitude favourable towards drug use and peer risk factor for Drugs.

Methods: This study is based on a total sample of around 9911 adolescent school students in the age range of 12-15 drawn from Mumbai, India (n = 4486) Victoria, Australia (n=2734) and Washington, United States (n=2691).  Sampling methods, survey procedures and instruments were matched to enable cross-national comparison with matched age and gender cohorts surveyed in three nations. The student survey protocol consisted of a matched self-report instrument - The International Youth Development Study. The present analysis reports on levels of substance use and associated risk factors. Multivariate logistic regression is used to examine predictors of life time substance use.

Results: Prevalence rates for substance use was much lower in Mumbai among younger cohort, but highest among middle and older cohort when compared with Melbourne and Seattle cohorts. The results reveal country and cohort differences. Relatively low rates of substance use were reported by the Mumbai younger cohorts (age 11, Grade 5) (Mumbai 17%, 95% Confidence Interval CI 12 to 24%; Melbourne 33%, CI 26 to 41; Seattle/ Tacoma 34%, CI 26 to 42%). Cross-national associations were generally in the same direction, however there were country and cohort differences in levels. Risk factor predictor associations tended to be generally weaker in Mumbai.

Conclusions: These analyses are discussed with reference to differing policy options for adolescent substance use that are adopted in Mumbai, Seattle and Melbourne. The findings have implications for scientific understanding of adolescent development and for planning international prevention programs.