Epidemiology of tobacco, alcohol and drug use

Tobacco, alcohol and drug use are very common in the general population. Population studies indicate that 30% of adults smoke tobacco, 88% of adults consume alcohol on a regular basis and nearly half the population drink more than twice a week (48%), and 21% of men and 12% of women drink four or more times a week. Nearly 1 in 4 smokers (24%) had used drugs in the past year, compared with 1 in 20 (5%) non-smokers. Similarly, those with a high AUDIT score were more likely to have ever used drugs: 19% of those with an AUDIT score below 8 reported drug use in the past year, compared with 47% of those with a score greater than 8. Nearly 1 in 4 of the English population (25%) reported ever using cannabis. The next most common drug reported was amphetamine, with 7% saying they had used it at some time. Lifetime prevalence rates for ecstasy, cocaine or LSD were all 4%. Crack cocaine, heroin and non-prescribed methadone were used by less than 1% of the population. In 1993, 5% of the population reported using any drug in the past year, but by 2000 this had risen to 12%. It is estimated 20% of the population are nicotine dependent, 4–7% are alcohol dependent and 4% are drug dependent. Being dependent on any drug was related to smoking and drinking, with heavy smokers having a 12-fold increase in the odds of dependence, and those scoring 16 or more on the AUDIT having a sixfold increase in the risk of drug dependence. These behaviours are associated with significant added mental and physical health problems.