• Ben J Smith, Philayrath Phongsavan, Adrian E Bauman, Drew Havea, and Tien Chey.
• School of Public Health, Lev 2, Medical Foundation Blg K25, University of Sydney, New South Wales 2006, Australia. bens@health.usyd.edu.au
• Drug Alcohol Depend. 2007 Apr 17; 88 (1): 9-18.

BackgroundMany Pacific Island countries are in social and epidemiological transition, but there are little population data about drug and alcohol usage among adolescents in this region.MethodsRandom samples of school students aged 11-17 years completed surveys in three populations: Pohnpei State in the Federated States of Micronesia (n=1495), Tonga (n=2808) and Vanuatu (n=4474).ResultsAmong 15-year-olds, boys in Tonga reported the highest prevalence of weekly smoking (29%), followed by boys in Pohnpei (17%). Kava use at a potentially harmful level (i.e. daily) was low in all countries. Drunkenness on two or more occasions was much more common among 15-year-old boys in Pohnpei (51%) than same-age youth in the other countries. Marijuana use was most often reported by boys (20%) and girls (20%) in Pohnpei, while solvents had been used most often by boys in Pohnpei (15%), and methylated spirits by boys in Tonga (20%). In all countries bullying of other students was independently related to regular smoking, while bullying behaviour and strong relationships with peers and others outside of the family were related to past drunkenness and use of illegal drugs in Tonga and Vanuatu.ConclusionsOverall, levels of adolescent substance use were consistently higher in Tonga and Pohnpei than in Vanuatu. These unique data provide a basis for setting priorities and evaluating action to address the health risks posed by substance use in these Pacific Island societies.

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