AIMS – Our aim was to assess the demographic and social factors associated with lifetime use of tobacco, alcohol and cannabis among school students aged 15–16 in Albania in order to make information and knowledge available for health promotion specialists working on substance use prevention. DESIGN – This cross-sectional study was conducted in March–May 2011 in the framework of the European School Survey Project on Alcohol and Other Drugs (ESPAD). In total, 3189 students born in 1995 participated in the survey. The standardised ESPAD questionnaire was used to collect data about substance use. RESULTS – Our multivariable adjustment analysis showed that being a male and having easy access to cigarettes were the only universal factors significantly increasing the likelihood of ever using tobacco, alcohol or cannabis. Own smoking was strongly and significantly associated with alcohol and cannabis use. The associations of own substance use with peer substance consumption were weak to moderate. CONCLUSIONS – Own smoking seems to be the most important single independent risk factor which strongly and significantly predicted alcohol and cannabis use among Albanian school students. Policy makers need to strengthen the rule of law whereas health promotion professionals should firmly address smoking in adolescence through target interventions.
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