Youth alcohol and other drug use in the United States and Australia: a cross-national comparison of three state-wide samples J. W. TOUMBOUROU 1 , J. M. BEYERS 2 , R. F. CATALANO 2 , J. D. HAWKINS 2 , M. W. ARTHUR 2 , T. EVANS-WHIPP 1 , L. BOND 1 & G. C. PATTON 1 1 Centre for Adolescent Health, Murdoch Children’s Research Institute and Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia and 2 Social Development Research Group, University of Washington, USA Abstract Although youth drug and alcohol harm minimization policies in Australia are often contrasted with the abstinence and zero tolerance policies adopted in the United States, there has been little research directly comparing youth substance use behaviour in the two countries. Three state representative samples in Victoria, Australia (n ¼ 7898) and in the US states of Oregon (n ¼ 15 224) and Maine (n ¼ 16 245) completed a common cross-sectional student survey. Rates of alcohol use (lifetime alcohol use, recent use in the past 30 days), alcohol use exceeding recommended consumption limits (binge drinking: five or more drinks in a session), other licit drug use (tobacco use), and norm-violating substance use (substance use at school, use in the past 30 days of marijuana or other illicit drug use) were compared for males and females at ages 12 – 17. Rates were lower (odds ratios 0.5 – 0.8) for youth in Maine and Oregon compared to Victoria for lifetime and recent alcohol use, binge drinking and daily cigarette smoking. However, rates of recent marijuana use and recent use of other illicit drugs were higher in Maine and Oregon, as were reports of being drunk or high at school. In contradiction of harm minimization objectives, Victoria, relative to the US states of Oregon and Maine, demonstrated higher rates of alcohol use exceeding recommended consumption limits and daily tobacco use. However, findings suggested that aspects of norm-violating substance use (substance use at school, marijuana use and other illicit drug use) were higher in the US states compared to Victoria. [Toumbourou JW, Beyers JM, Catalano RF, Hawkins JD, Arthur MW, Evans-Whipp T, Bond L, Patton GC. Youth alcohol and other drug use in the United States and Australia: a cross-national comparison of three state-wide samples. Drug Alcohol Rev 2005;24:515 – 523] Key words: adolescence, adolescent development, alcohol abuse, alcohol drinking patterns, cross-cultural differences. Introduction Compared to other age groups, a relatively large pro- portion of young people drink alcohol at levels that risk harm [1,2]. For young people, alcohol use is particu- larly associated with acute harms resulting from intoxication, including accidents, injuries, crime, health, and social problems [1,2]. A considerable body of research has investigated the characteristics and predictors of youth substance use and theoretical frameworks based on this literature are being used to guide policy and interventions [3,4]. Much of this research has originated in the US and for this reason there are advantages in conducting studies comparing drug use in other countries with the US to establish similarities and differences that may have policy relevance. The identification of cross-national similarities and differences in adolescent substance use behaviours could further inform intervention efforts and policy. Differences in drug policy between Australia and the US mean that studies comparing the two countries may be particularly pertinent. In the US, J. W. Toumbourou PhD, Centre for Adolescent Health, Murdoch Children’s Research Institute and Department of Paediatrics, University of Melbourne, Australia, J. M. Beyers PhD, Social Development Research Group, University of Washington, USA, R. F. Catalano PhD, Social Development Research Group, University of Washington, USA, J. D. Hawkins PhD, Social Development Research Group, University of Washington, USA, M. W. Arthur PhD, Social Development Research Group, University of Washington, USA, T. Evans-Whipp PhD, Centre for Adolescent Health, Murdoch Children’s Research Institute and Department of Paediatrics, University of Melbourne, Australia, L. Bond PhD, Centre for Adolescent Health, Murdoch Children’s Research Institute and Department of Paediatrics, University of Melbourne, Australia, G. C. Patton MBBS, MD, FRANZCP, Centre for Adolescent Health, Murdoch Children’s Research Institute and Department of Paediatrics, University of Melbourne, Australia. Correspondence to Dr J. W. Toumbourou, Centre for Adolescent Health, 2 Gatehouse Street, Parkville, Vic, Australia, 3052. Received 4 June 2004; accepted for publication 1 July 2005. Drug and Alcohol Review (November 2005), 24, 515 – 523 ISSN 0959-5236 print/ISSN 1465-3362 online/05/060515–09 ª Australasian Professional Society on Alcohol and Other Drugs DOI: 10.1080/09595230500293779