ABSTRACT
Introduction
Drug control policy
Survey method
Prevalence of cannabis use
Current cannabis use
Peer group influence
Use of other psycho-active substances
Attitudes and opinions
Unemployment and cannabis use
Discussion
Author: G. SYLBING, J. M. G. PERSOON
Pages: 51 to 60
Creation Date: 1985/01/01
A nation-wide survey of cannabis use, based on a representative sample of 1,306 young people in the 15-to-24 age group, carried out in the Netherlands in 1983, showed that cannabis had been used or tried by 12.2 per cent of the respondents (13 per cent males and 11 per cent females). These results, compared with the results of a study carried out by the Central Bureau of Statistics in 1979 and 1980, showed an increase in cannabis use. In the three largest cities, the percentage of cannabis users (25 per cent) was double that of the country as a whole. The percentage of cannabis use was higher among the older age groups of respondents; the study also showed that the lower the age at first cannabis use the higher the risk of continuing and becoming involved with more dangerous drugs such as cocaine, heroin and amphetamines. The rates of alcohol drinking, tobacco smoking and the use of heroin, amphetamines, cocaine, sleeping pills and tranquillizers were significantly higher among cannabis users than among respondents who were not using cannabis. The rate of cannabis use was significantly higher among the unemployed respondents than among those who had a job. The authors suggest that these findings should be taken into account in designing preventive measures and other forms of intervention programmes to deal with cannabis-related problems among young people .
The widespread use of cannabis in the Netherlands commenced in the late 1960s and reached a peak in 1971 [ 1] . It was strongly associated with several subculture movements which were in part local, but had international counterparts. During a period from 1969 to 1973 studies of cannabis use conducted among students of high schools and higher vocational schools [ 2,3] revealed that the number of those who had ever used or tried cannabis increased from 11 per cent in 1969 to 20 per cent in 1971 and stabilized in the period from 1971 to 1973, levelling off at 20 per cent. In 1976 a study of cannabis use carried out among youth aged 12-18 in Utrecht [ 4] showed that only 3 per cent of the respondents had ever used cannabis. Since the average age of the respondents and the methods of the two studies differed, caution should be exercised in comparing their results. Another study carried out in 1979 and 1980 by the Central Bureau of Statistics among youth aged 13 - 24 years showed that 7 per cent of the respondents reported having used cannabis [ 5] . A questionnaire used in that study, which was designed to yield information on the general well-being of Dutch youth, contained only one question on the use of cannabis.
This study has been supported by the Dutch Ministry of Welfare, Health and Cultural Affairs.
Dutch drug control policy is based on the Opium Act, which was revised in 1976. The revision introduced a differentiation between drugs according to the potential risks involved, placing the highest priority on the control of heroin and cocaine. This revision has consequently led to a change in sentencing policies and practices for persons convicted of drug-related offences. The penalties for illicit trafficking in drugs were increased from a maximum of four years to a maximum of 12 years, and the penalties for possession of small quantities of cannabis for personal use were reduced. The change in the cannabis control policy was intended to prevent a situation in which users of cannabis might suffer more damage from criminal proceedings than from the use of cannabis. It should be borne in mind that the whole Dutch legal system is highly "tolerant", so that there is no discrepancy between the legislative practice and drug legislation.
Another feature that the legislative change in 1976 entailed were the guidelines for the operation of so called house-dealers in youth centres. Youth centres are intended to help the more vulnerable groups of young people to spend their leisure time in healthy activities and to provide them with educational opportunities. Gradually the management of youth centres began to adopt the practice of permitting certain individuals, who enjoyed their confidence, to sell limited quantities of cannabis to regular and well known visitors of the centres. This practice was intended to hinder young people from becoming involved in the illicit drug market and to prevent them from becoming addicted to more dangerous drugs.
In October 1982 the Municipal Council of Enschede, a middle-sized town near the border of the Federal Republic of Germany, decided to allow the house-dealers to sell cannabis products in a youth centre. That decision attracted international publicity and, consequently, the youth centre was increasingly visited by young people from the Federal Republic of Germany and Sweden. That situation prompted government authorities to forbid the sale of cannabis products on 17 November 1982. It should be stressed that the sale of cannabis by the house-dealer is currently punishable under the provisions of article 11, paragraph 2, of the Opium Act.
In 1983 the Lower House of Parliament asked questions concerning the nature and extent of cannabis use in the Netherlands and wanted to know whether the policy and practice that followed the 1976 revision of the Opium Act concerning cannabis control had resulted in a reduction of risks to individuals and the community. That enquiry prompted the Dutch authorities to undertake in May 1983 a nation-wide survey of the extent of cannabis use among young people in the Netherlands. The Foundation for the Scientific Study of Alcohol and Drug Use (SWOAD) was asked to carry out the survey, the results of which are summarized in this article.
A national probability sample of 1,500 young people in the 15-to-24 age group was drawn for a household survey of drug use carried out in 1983. After applying the weighting procedure, the sample was reduced to 1,306. Respondents were interviewed according to a structured questionnaire by trained interviewers. The questionnaire was designed to elicit information on the use of cannabis, alcohol and tobacco, and one question was included to obtain information on the use of other drugs, such as cocaine, heroin and amphetamines. The questionnaire was also designed to elicit information on the demographic characteristics of the respondents and their attitudes towards cannabis use, as well as on their perception of the extent of drinking, smoking and cannabis use by their friends and peers.
The results of the survey showed that 159 respondents, or 12.2 per cent, had used or tried cannabis at least once. Table 1 shows that, with the exception of the 21-to-22 age group, the percentage of cannabis users steadily increased with the age of the respondents.
There was a small difference between the rates of cannabis use among males and females: 13 per cent of the males and 11 per cent of the females had used cannabis at least once in their lifetime. It is interesting to note that the youngest cannabis users were predominantly females. The use of cannabis was far more common in cities than in rural areas. In the three largest cities, Amsterdam, Rotterdam and The Hague, the percentage of the respondents who had used cannabis at least once was twice as high (25 per cent) as in the country as a whole (12.2 percent).
Breakdown by age and sex (percentage) |
|||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
15-16 |
17-18 |
19-20 |
21-22 |
23-24 |
|||||||
Use of cannabis |
Percentage of total sample a |
M |
F |
M |
F |
M |
F |
M |
F |
M |
F |
Once or twice
|
9 | 1 | 3 | 6 | 4 | 15 | 16 | 14 | 10 | 23 | 17 |
Often
|
3 |
-
|
1 | 2 |
-
|
3 | 3 | 5 | 2 | 10 | 9 |
Never used
|
88 | 99 | 96 | 92 | 96 | 82 | 81 | 81 | 88 | 67 | 74 |
Note: M = male, F = female.
aTotal sample = 1,306.
Many of the cannabis users were not attached to a church: 70 per cent claimed to have no specific religious belief, compared with 41 per cent in the whole sample.
Compared with the results of studies conducted in some other countries [ 6] , the results of this survey among young people in the Netherlands showed that the prevalence of cannabis use was at a relatively low level.
Of the 159 respondents who had used cannabis at least once, 88 respondents, or 55.3 per cent, were no longer using it at the time of the survey. Of the total sample, 71 respondents, or 5.4 per cent, were still using cannabis at the time of the survey (see table 2).
Frequency of cannabis use |
Number of years |
Percentage of users |
Percentage of total sample |
---|---|---|---|
Daily
|
7 | 9.9 | 0.5 |
A few times a week
|
10 | 14.1 | 0.8 |
Once a week
|
4 | 5.6 | 0.3 |
A few times a month
|
12 | 16.9 | 0.9 |
Once a month
|
6 | 8.4 | 0.5 |
Less than once a month
|
32 | 45.1 | 2.4 |
Total
|
71 | 100 | 5.4 |
Frequency group |
Number of users |
Average age of first-time users |
---|---|---|
At least one-time users
a
|
159 | 17.1 |
Ex-users
|
88 | 17.5 |
Current users
|
71 | 16.7 |
Occasional users
b
|
32 | 17.2 |
Regular users
c
|
18 | 16.7 |
Frequent users
d
|
21 | 15.8 |
aThose who have used or tried cannabis at least once in their lifetime.
bLess than once a month.
cA few times a month or once a month.
dOnce a week or more often.
Table 3 shows that those users of cannabis who discontinued its use had commenced using it at an average age of 17.5 years, while current users commenced cannabis use at 16.7 years and frequent users at 15.8 years. This finding indicates that commencing cannabis use at a younger age increases the likelihood of continuing use and also of moving on to other more dangerous drugs [ 7] . Those respondents who used other illicit drugs commenced using cannabis even earlier than frequent cannabis users. The average age of first-time cannabis users who reported having later used other drugs was 15.3 years for cocaine users, 14.9 years for heroin users and 14.7 years for amphetamine users.
The survey showed that frequent cannabis use was more common among males than females (see table 4).
Percentage distribution |
||||
---|---|---|---|---|
Group |
Frequent users |
Regular users |
Occasional users |
Total |
Male
|
76 | 56 | 44 | 56 |
Female
|
24 | 44 | 56 | 44 |
Approximately 30 per cent of the respondents who had ever used cannabis in their lifetime had done so at the homes of their friends, while 54 per cent had their first contact with cannabis at parties with friends. Approximately 1l per cent of those who had used cannabis at least once began using it at school. These data clearly show that peer group influence is important in becoming involved with cannabis. Current cannabis users reported that approximately 61 per cent of their friends approved cannabis use, while ex-users of cannabis said that 29 percent of their friends approved it. Only 10 per cent of the respondents in the total sample approved cannabis use.
The respondents reported that there was a high percentage of cannabis users among friends of current users. The percentage distribution of the level of cannabis use among friends of respondents is given in table 5.
Percentage breakdown by reporting group |
|||
---|---|---|---|
Cannabis use among friends |
Total sample a |
Current cannabis users b |
Ex-users c of cannabis |
Hardly anyone
|
86 | 11 | 61 |
Fewer than half
|
7 | 37 | 18 |
About half
|
3 | 21 | 13 |
More than half
|
1 | 18 | 6 |
Almost all
|
1 | 13 | 2 |
Not known
|
2 |
-
|
-
|
a1,306.
b71 respondents.
c88 respondents.
Use of cannabis cannot be viewed as an isolated problem. A number of social and psychological characteristics, as well as so-called "problem behaviour", were common variables found among alcohol, tobacco and drug users [ 8] . The National Commission on Marijuana and Drug Abuse of the United States of America [ 9] has stated the following: "Study after study which the commission reviewed invariably reported an association between the use of tobacco and to a lesser extent of alcohol with the use of marijuana and other drugs". The results of the SWOAD study clearly showed that the percentage of alcohol use and tobacco-smoking was much higher among cannabis users than among the respondents who were not involved with cannabis: 80 per cent of cannabis users were tobacco smokers, compared with 34 per cent among the respondents who had not used cannabis; 96 per cent of cannabis users drank alcohol, compared with 72 per cent among the non-users of cannabis.
The percentage rates of the use* of other drugs among cannabis users and non-users of cannabis are given in table 6.
Drug used |
Percentage of cannabis users a |
Percentage of non-users b of cannabis |
---|---|---|
Heroin
|
6.3 | 0.4 |
Amphetamines
|
7.5 | 0.4 |
Tranquillizers
|
17.0 | 5.4 |
Sleeping pills
|
14.0 | 6.3 |
Cocaine
|
14.0 | 1.3 |
a159 respondents.
b1,147 respondents.
The tendency of non-users of cannabis to avoid using other drugs is an important finding [ 10] from the point of view of prevention. Non-users were asked if they would use cannabis if offered at a party. Approximately 86 per cent of non-users and 44 per cent of ex-users reported that they would not use the drug. Explaining the reasons for not doing so, 66 per cent of non-users said that they had no need for the drug, 29 per cent found it unhealthy and 12 per cent were afraid of becoming addicted (since more than one answer could be given, the percentages did not add up to 100).
The survey revealed that 83 per cent of cannabis users, and 55 per cent of non-users felt that everyone had to decide for himself or herself whether or not to use cannabis; 23 per cent of cannabis users and 91 per cent of non-users said that it would not be wise to use cannabis; and 18 per cent of cannabis users and 62 per cent of non-users thought that cannabis use would eventually lead to loss of interest in their job, school work or career. The survey also revealed that 6 per cent of cannabis users and 47 per cent of non-users believed that cannabis use would eventually lead to experimentation with more dangerous drugs; 81 per cent of cannabis users and 24 per cent of non-users believed that occasional cannabis use would have no harmful effects; and 10 per cent of cannabis users and 35 per cent of non-users believed that all regular cannabis users would become psychologically weak.
Referring to those who have used or tried any one of the drugs listed in table 6 at least once in their lifetime.
The foregoing figures clearly show that the attitudes and opinions of cannabis users differ in many respects from non-users of cannabis. It is important to take these differences into account in designing drug abuse prevention programmes for young people.
As in many other countries, the rate of unemployment among young people has increased in the Netherlands during the last decade. According to data of the Central Bureau of Statistics, the percentage rate of unemployment among young in the 15-to-24 age group in the Netherlands increased for males from 7.8 in 1979 to 29.0 in 1984, and for females from 9.9 in 1979 to 26.0 in 1984. These trends give rise to pessimistic feelings among young people with regard to their prospects for employment, which in turn may be one of the factors leading to the involvement with drugs. Available evidence suggests that drug use is often linked to unemployment [ 11] . The results of this study showed that the percentage rate of unemployment among cannabis users was 30.6 and among non-users of cannabis 18.9. The rate of unemployment was significantly higher among current users than among ex-users of cannabis. Using a multivariate technique called logistic regression, other variables such as age, sex, area of residence, alcohol drinking and tobacco smoking were tested to determine whether the relationships between unemployment and cannabis use could be attributed to the influence of those variables. The analysis of data showed that the relationships between unemployment and cannabis use were independent of such influence and that the rates of cannabis use were significantly higher among the unemployed respondents than among those who had a job.
The SWOAD survey carried out in 1983 showed that the number of persons who had ever used or tried cannabis in their lifetime increased from the late 1970s to 1983. A survey carried out in 1979 and 1980 [ 5] showed that 7 per cent of the respondents in the 13-to-24 age group were cannabis users, while the SWOAD survey found 12.2 per cent of cannabis users in the 15-to-24 age group. The increase in cannabis use was particularly marked in the 19-to-24 age group. The survey in 1970 and 1980 [ 5] found that there were 11 percent of cannabis users, while the SWOAD survey in 1983 found 21 per cent of cannabis users. Certain methodological differences between the two surveys should, however, be taken into account in interpreting their results. The data are consistent with the findings of the Dutch police, who noticed an increase in cannabis availability on the illicit drug market during that period.
It is interesting to note that the rates of cannabis use in the Netherlands do not seem to be higher than in some of the neighbouring countries where a more strict cannabis control policy is enforced. For example, a study carried out in the Federal Republic of Germany showed that 18 per cent of young people aged 15-to-24 had used cannabis in 1982 [ 12] , but there were certain methodological differences in the studies conducted in the two countries. This does not, however, answer the question whether the same level of cannabis use would have been found in the Netherlands had a more restrictive cannabis control policy been followed.
In the Netherlands, as in other countries, such as Egypt [ 13] , the Federal Republic of Germany [ 12] and Switzerland [ 14] , a larger part of initial cannabis users discontinued the use of cannabis. The results of the survey considered in this article show that 55.3 per cent of those who had ever used or tried cannabis in their lives were not using cannabis at the time of the survey. Cannabis use was continued by 5.4 per cent of the total sample.
The age at first cannabis use appears to be an important variable suggesting whether the user will continue or discontinue its use. There seems to be a strong relationship between early onset of cannabis use and the increased risk of using more dangerous drugs, such as heroin, cocaine and amphetamines.
There is a close relationship between the use of cannabis and the use of alcohol and tobacco. Such a relationship must be taken into account in developing preventive measures and other forms of intervention to deal with these types of addiction. Cannabis use should not be viewed as an isolated kind of behaviour. Holding a job appears to be an important factor in the prevention of cannabis use among young people, and being unemployed seems to lead to a higher risk of getting involved with cannabis. European countries confronted with increasing youth unemployment should be aware of that risk.
It should also be noted that school drop-out rates are rather high and suicide rates are increasing among adolescents [ 15] . There is also evidence of increased alcohol drinking, tobacco smoking and the use of tranquillizers among youth [ 16] . The study has shown that frequent cannabis users as a group are at risk not only of becoming unemployed but also of getting involved with cocaine, alcohol, tobacco, tranquillizers, sleeping pills and other psycho-active substances.
In conclusion, it may be stated that although cannabis use has not reached epidemic proportions in the Netherlands, its incidence has undeniably increased.
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