Prevalence and Correlates of Substance Use Among High School Students in South Africa and the United States

OBJECTIVES: We compared prevalence rates and correlates of substance use among high school students in South Africa and the United States. METHODS: We used weighted data from 2 nationally representative surveys of high school students. We conducted bivariate and multivariate analyses and examined between-country differences in rates and correlates of substance use were examined. RESULTS: Rates of past-month alcohol and marijuana use were lower among South African students than among US students, but rates of illicit hard drug use were higher. Correlates of use in the 2 countries differed. For example, female gender was protective against tobacco, alcohol, and marijuana use in South Africa, whereas in the United States it was protective only against marijuana use. Black race/ethnicity was associated with lower rates of past-month cigarette and alcohol use in both countries, but the protective effect for alcohol use was stronger in South Africa. CONCLUSIONS: Crosscultural studies can elucidate common and culturally unique pathways to drug use. Our results can inform future research, policies, and behavioral interventions in South Africa.