DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Substance Abuse and Mental Health Services Administration 

Office of Applied Studies 

Immigrants and Substance Use: 

Findings from the 1999–2001 National 

Surveys on Drug Use and Health 

Janice M. Brown 

Carol L. Council 

Michael A. Penne 

Joseph C. Gfroerer 
 ii

Acknowledgments 

This report was prepared by the Division of Population Surveys in the Office of Applied Studies (OAS), 

Substance Abuse and Mental Health Services Administration (SAMHSA), and by RTI International (a 

trade name of Research Triangle Institute), Research Triangle Park, North Carolina, under Contract No. 

283-99-9018. Joseph C. Gfroerer led the work on this report at SAMHSA. At RTI, Janice M. Brown was 

the task leader for production of the report, Carol L. Council and Michael A. Penne were its co-authors, 

and Mary Ellen Marsden and Scott P. Novak provided review comments. Also at RTI, Joyce Clay-Brooks 

and Loraine G. Monroe provided word-processing support for the report; Diane G. Caudill prepared the 

graphics; Teresa F. Gurley, Kim Cone, and Pamela Couch Prevatt readied its files for the SAMHSA 

printer and the Web; and Richard S. Straw, K. Scott Chestnut, and Jason Guder provided copyediting and 

proofreading support. Final report production was provided by Beatrice Rouse, Coleen Sanderson, and 

Jane Feldmann at SAMHSA. 

Public Domain Notice 

All material appearing in this report is in the public domain and may be reproduced or copied without 

permission from the Substance Abuse and Mental Health Services Administration (SAMHSA). However, 

this publication may not be reproduced or distributed for a fee without the specific, written authorization 

of the Office of Communications, SAMHSA, U.S. Department of Health and Human Services. Citation of 

the source is appreciated. Suggested citation: 

Brown, J. M., Council, C. L., Penne, M. A., & Gfroerer, J. C. (2005). Immigrants and 

substance use: Findings from the 1999–2001 National Surveys on Drug Use and Health

(DHHS Publication No. SMA 04-3909, Analytic Series A-23). Rockville, MD: Substance 

Abuse and Mental Health Services Administration, Office of Applied Studies. 

Obtaining Additional Copies of Publication 

Copies may be obtained, free of charge, from the National Clearinghouse for Alcohol and Drug 

Information (NCADI), a service of SAMHSA. Write or call NCADI at: 

National Clearinghouse for Alcohol and Drug Information 

P.O. Box 2345, Rockville, MD 20847-2345 

1-301-468-2600, 1-800-729-6686, TDD 1-800-487-4889 

Electronic Access to Publication 

This publication can be accessed electronically through the Internet connections listed below: 

http://www.samhsa.gov

http://www.oas.samhsa.gov

Originating Office 

SAMHSA, Office of Applied Studies 

1 Choke Cherry Road, Room 7-1044 

Rockville, MD 20857 

March 2005 
Table of Contents 

Chapter Page 

 iii

List of Figures..................................................................................................................... v 

List of Tables .................................................................................................................... vii 

Highlights....................................................................................................................................... 1

1. Introduction....................................................................................................................... 3

1.1. Background............................................................................................................. 3 

1.2. Summary of the NSDUH Methodology ................................................................. 4 

1.3. Format of Report and Explanation of Tables.......................................................... 5 

1.4. Description of the Sample....................................................................................... 5 

1.5. Methods................................................................................................................... 6 

1.5.1 Prevalence Estimation................................................................................. 6 

1.5.2 Regression Analyses ................................................................................... 7 

2. Demographic Characteristics of Immigrants................................................................. 9

2.1. Overview................................................................................................................. 9

2.2. Gender..................................................................................................................... 9 

2.3. Age.......................................................................................................................... 9 

2.4. Educational Attainment ........................................................................................ 10 

2.5. Current Employment............................................................................................. 10 

2.6. Household Income ................................................................................................ 10 

2.7. Government Assistance ........................................................................................ 10 

3. Substance Use among Immigrants................................................................................ 11

3.1. Alcohol Use .......................................................................................................... 11 

3.1.1 Alcohol Prevalence Rates ......................................................................... 11 

3.1.2 Alcohol Use, by Length of Time in the United States.............................. 11 

3.1.3 Alcohol Use, by Use in Country of Birth ................................................. 11 

3.2. Illicit Drug Use ..................................................................................................... 12 

3.2.1 Marijuana .................................................................................................. 12 

3.2.2 Any Illicit Drugs ....................................................................................... 13 

3.3. Tobacco Use.......................................................................................................... 13 

3.4. Substance Use, by Age, Gender, and Length of Time in the United States ......... 15 

3.5. Predictors of Substance Use among Immigrants .................................................. 15 

3.6. Summary............................................................................................................... 17 

4. Substance Use among Immigrants from Selected Countries...................................... 19

4.1. Substance Use among Immigrants from Selected Latin American 

Countries............................................................................................................... 19 

4.1.1 Alcohol Use .............................................................................................. 19 

4.1.2 Illicit Drug Use ......................................................................................... 20 

4.1.2.1 Marijuana..................................................................................... 22 

4.1.2.2 Any Illicit Drugs.......................................................................... 22 

4.1.3 Tobacco Use.............................................................................................. 22 

4.1.4 Summary................................................................................................... 22 
Table of Contents (continued) 

Chapter Page 

 iv

4.2. Substance Use among Immigrants from Selected Asian Countries...................... 23 

4.2.1 Alcohol Use .............................................................................................. 23 

4.2.2 Illicit Drug Use ......................................................................................... 24 

4.2.2.1 Marijuana..................................................................................... 24 

4.2.2.2 Any Illicit Drugs.......................................................................... 24 

4.2.3 Tobacco Use.............................................................................................. 26 

4.2.4 Summary................................................................................................... 26 

4.3. Substance Use among Immigrants from Selected European Countries................ 26 

4.3.1 Alcohol Use .............................................................................................. 26 

4.3.2 Illicit Drug Use ......................................................................................... 27 

4.3.2.1 Marijuana..................................................................................... 27 

4.3.2.2 Any Illicit Drugs.......................................................................... 29 

4.3.3 Tobacco Use.............................................................................................. 29 

4.3.4 Summary................................................................................................... 29 

4.4. Substance Use among Immigrants from Canada.................................................. 29 

4.4.1 Alcohol Use .............................................................................................. 29 

4.4.2 Illicit Drug Use ......................................................................................... 30 

4.4.2.1 Marijuana..................................................................................... 30 

4.4.2.2 Any Illicit Drugs.......................................................................... 30 

4.4.3 Tobacco Use.............................................................................................. 30 

4.4.4 Summary................................................................................................... 32 

References.................................................................................................................................... 33

Appendix 

A. Description of the Survey ................................................................................................. 37

B. Statistical Methods and Limitations of the Data............................................................... 43 

C. Tables................................................................................................................................ 51 
v

List of Figures 

Figure Page 

1. Past Month Alcohol, Marijuana, Any Illicit Drug, and Tobacco Use among U.S.-

Born and Foreign-Born Persons Aged 18 or Older Living in the United States .............. 14 

2. Past Year Alcohol, Marijuana, Any Illicit Drug, and Tobacco Use among U.S.-

Born and Foreign-Born Persons Aged 18 or Older Living in the United States .............. 14 

3. Past Month Alcohol, Marijuana, Any Illicit Drug, and Tobacco Use among Male 

and Female Immigrants Aged 18 or Older Living in the United States ........................... 16 

4. Past Year Alcohol, Marijuana, Any Illicit Drug, and Tobacco Use among Male 

and Female Immigrants Aged 18 or Older Living in the United States ........................... 16 

5. Past Month Alcohol Use among U.S. Residents Aged 18 or Older Who Are Either 

U.S.-Born Persons or Foreign-Born Persons from Selected Latin American 

Countries........................................................................................................................... 19 

6. Past Month Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Selected Latin American Countries ......................................................................... 21 

7. Past Year Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Selected Latin American Countries ......................................................................... 21 

8. Past Month Alcohol Use among U.S. Residents Aged 18 or Older Who Are Either 

U.S.-Born Persons or Foreign-Born Persons from Selected Asian Countries.................. 23 

9. Past Month Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Selected Asian Countries ......................................................................................... 25 

10. Past Year Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Selected Asian Countries ......................................................................................... 25 

11. Past Month Alcohol Use among U.S. Residents Aged 18 or Older Who Are Either 

U.S.-Born Persons or Foreign-Born Persons from Selected European Countries............ 27 

12. Past Month Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Selected European Countries ................................................................................... 28 

13. Past Year Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Selected European Countries ................................................................................... 28 

14. Past Month Alcohol Use among U.S. Residents Aged 18 or Older Who Are Either 

U.S.-Born Persons or Foreign-Born Persons from Canada .............................................. 30
vi

List of Figures (continued) 

Figure Page 

15. Past Month Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Canada...................................................................................................................... 31 

16. Past Year Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Canada...................................................................................................................... 31 

B.1 Required Effective Sample as a Function of the Proportion Estimated.............................46 
 vii

List of Tables 

Table Page 

B.1 Summary of NSDUH Suppression Rules ......................................................................... 44 

B.2 Weighted Percentages and Sample Sizes for 1999 to 2001 NSDUHs, by Screening 

Result Code....................................................................................................................... 48 

B.3 Weighted Percentages and Sample Sizes for 1999 to 2001 NSDUHs, by Final 

Interview Code, among Persons Aged 18 or Older .......................................................... 48 

C.1 Distributions of All Persons Aged 18 or Older, by Gender, Age, Length of Time 

in the United States, and Country of Origin: 1999–2001 ................................................. 53 

C.2 Percentage Distributions of All Immigrants and U.S.-Born Persons Aged 18 or 

Older, by Length of Time in the United States and Demographic Characteristics: 

1999–2001......................................................................................................................... 54 

C.3 Percentage Distributions of Persons Aged 18 or Older from Selected Latin 

American Countries and the United States, by Demographic Characteristics: 

1999–2001......................................................................................................................... 55 

C.4 Percentage Distributions of Persons Aged 18 or Older from Selected Asian 

Countries and the United States, by Demographic Characteristics: 1999–2001 .............. 56 

C.5 Percentage Distributions of Persons Aged 18 or Older from Selected European 

Countries, Canada, and the United States, by Demographic Characteristics: 

1999–2001......................................................................................................................... 57 

C.6 Estimated Numbers and Prevalence (with Standard Errors) of Past Month and 

Past Year Alcohol Use, Past Month Binge and Heavy Drinking, and Past Month 

Weekly Alcohol Consumption among All Immigrants Aged 18 or Older, by 

Length of Time in the United States and Gender: 1999–2001 ......................................... 58 

C.7 Linear Regression Model Results for Log-Transformed Past Month Weekly 

Alcohol Consumption among All Immigrants Aged 18 or Older Who Were 

Current Drinkers: 1999–2001 ........................................................................................... 59 

C.8 Estimated Numbers and Prevalence (with Standard Errors) of Past Month Illicit 

Drug and Tobacco Use among All Immigrants Aged 18 or Older, by 

Demographic Characteristics: 1999–2001........................................................................ 60 

C.9 Estimated Numbers and Prevalence (with Standard Errors) of Past Year Illicit 

Drug and Tobacco Use among All Immigrants Aged 18 or Older, by 

Demographic Characteristics: 1999–2001........................................................................ 61 

C.10 Adjusted Odds Ratios of Alcohol Use among All Immigrants Aged 18 or Older: 

1999–2001......................................................................................................................... 62
 viii

List of Tables (continued) 

Table Page 

C.11 Adjusted Odds Ratios of Tobacco Use among All Immigrants Aged 18 or Older: 

1999–2001......................................................................................................................... 63 

C.12 Adjusted Odds Ratios of Marijuana Use among All Immigrants Aged 18 or Older: 

1999–2001......................................................................................................................... 63 

C.13 Adjusted Odds Ratios of Any Illicit Drug Use among All Immigrants Aged 18 or 

Older: 1999–2001 ............................................................................................................. 64

C.14 Estimated Numbers and Prevalence (with Standard Errors) of Past Month Weekly 

Alcohol Consumption, Past Month and Past Year Alcohol Use, and Past Month 

Binge and Heavy Drinking among Immigrants from Selected Countries within 

Selected Regions and the United States: 1999–2001........................................................ 65 

C.15 Estimated Number of Drinks (with Standard Errors) for Past Month Weekly 

Alcohol Consumption among Immigrants from Selected Countries Who Were 

Past Month Alcohol Users, by Length of Time in the United States: 1999–2001............ 66 

C.16 Estimated Numbers and Prevalence (with Standard Errors) of Past Month 

Tobacco Use, Past Month Illicit Drug Use, and Past Month Marijuana Use among 

Immigrants from Selected Countries within Selected Regions and the United 

States: 1999–2001............................................................................................................. 67 

C.17 Estimated Numbers and Prevalence (with Standard Errors) of Past Year Tobacco 

Use, Past Year Illicit Drug Use, and Past Year Marijuana Use among Immigrants 

from Selected Countries within Selected Regions and the United States: 1999–

2001................................................................................................................................... 68 
1 

Highlights 

This report presents information on the prevalence of alcohol, tobacco, and illicit drug 

use among immigrants aged 18 or older in the United States during 1999-2001. The data are 

based on the National Survey on Drug Use and Health (NSDUH), a project of the Substance 

Abuse and Mental Health Services Administration. 

NSDUH is an annual survey of the civilian, noninstitutionalized population of the United 

States aged 12 years old or older. Conducted by the Federal Government since 1971, it is the 

primary source of statistical information on the use of illegal drugs by the U.S. population. 

Approximately 67,500 persons are interviewed each year. Estimates for immigrants in this report 

are based on data from adults in the 1999, 2000, and 2001 surveys who reported that they were 

born outside the United States. The sample includes 16,130 immigrants, representing 25 million 

people. Immigrant data overall and for 16 specific countries are compared with data from the 

sample of 116,629 U.S.-born adults, representing 174 million people. 

Substance Use among All Immigrants Aged 18 or Older 

! The rates of alcohol use were lower among immigrants than among U.S.-born adults. This 

was true for past year use (54.3 vs. 67.8 percent), past month use (39.5 vs. 52.4 percent), 

past month binge use (16.9 vs. 22.3 percent), past month heavy use (3.0 vs. 6.5 percent), 

and the average number of drinks per week among current drinkers (6.3 vs. 8.3). 

! Among adult immigrants who were current drinkers, per capita alcohol consumption in the 

country of birth was associated with the current weekly alcohol consumption. Current adult 

drinkers from countries with higher per capita alcohol consumption had a higher average 

number of drinks per week within the past month. 

! Rates of tobacco use were lower among immigrants than among U.S.-born adults. This was 

true for past year use (24.8 vs. 38.2 percent) and past month use (20.4 vs. 32.8 percent). 

! Rates of illicit drug use were lower among immigrants than among U.S.-born adults. This 

was true for past year marijuana use (3.5 vs. 8.8 percent), past month marijuana use (1.7 vs. 

5.1 percent), past year any illicit drug use (6.0 vs. 11.5 percent), and past month any illicit 

drug use (2.9 vs. 6.6 percent). 

! Rates of substance use were associated with the length of time immigrants had been in the 

United States. An analysis adjusting for demographic differences showed that immigrants 

who had been in the United States for 5 or more years were more likely than immigrants 

who had been in the United States for fewer than 5 years to use alcohol in the past year or 

past month, to binge drink, to use marijuana in the past year or month, and to use any illicit 

drug in the past year or month. Tobacco use was not significantly associated with length of 

time in the United States. 
2 

Substance Use among Adult Immigrants from Selected Countries 

! Estimates of substance use among immigrants from 16 selected countries revealed wide 

variation across these immigrant subgroups, even within geographic regions. These 

differences point out that comparisons based on broad regional groupings of immigrants, 

such as Latin Americans or Asians, can mask important within-region differences. 

! Past month alcohol use rates among immigrants from the United Kingdom (67.5 percent) 

and Canada (64.5 percent) were significantly higher than the rate among U.S.-born adults 

(52.4 percent). Immigrants born in the Philippines (24.1 percent), Vietnam (26.4 percent), 

India (26.6 percent), and China (28.4 percent) had rates significantly below rates among 

immigrants from other selected Asian countries (Japan, 62.1 percent; Korea, 53.2 percent) 

and among U.S.-born adults. 

! None of the 16 countries studied showed adult immigrant populations with past month 

tobacco use rates higher than the U.S. rate (32.8 percent). Among the Latin American 

countries studied, rates ranged from 12.1 percent among immigrants from Jamaica to 31.0 

percent among immigrants from Puerto Rico. Similarly, there was wide variation among 

Asian countries, with Korean-born immigrants having a rate of 30.2 percent, while the 

lowest rates were found among those born in China (10.1 percent), India (10.2 percent), 

and the Philippines (13.5 percent). Immigrants from the United Kingdom (31.7 percent) 

and Germany (30.0 percent) had rates similar to the U.S.-born rate. 

! Immigrants from several countries had rates of past month illicit drug use that were similar 

to the U.S.-born rate of 6.6 percent. These included Japan (8.0 percent), Puerto Rico (7.7 

percent), Korea (5.8 percent), Jamaica (5.6 percent), Poland (5.3 percent), Germany (5.1 

percent), and the United Kingdom (4.4 percent). Low rates of illicit drug use were found 

among immigrants from China, (0.2 percent), Cuba (0.5 percent), the Philippines (1.1 

percent), and India (1.2 percent). 
3 

1. Introduction 

1.1. Background 

An estimated 13 percent of the U.S. adult population was born outside the United States. 

These diverse immigrant populations bring with them the cultural norms related to substance use 

that exist in their respective countries of origin. As they adapt to life in the United States, they 

also may be differentially exposed to substance use norms and social challenges (i.e., language 

barriers, unfamiliar customs, and discrimination). One of the consequences of adapting to new 

circumstances may be an increased rate of substance use. The heterogeneity of immigrant 

populations, even among those from the same general regions of the world (e.g., Latin America, 

Europe), highlights the need to study the factors that may contribute to differential substance use 

rates. A more comprehensive understanding of the variability among racial/ethnic groups will 

contribute to the identification of at-risk populations that can be targeted for prevention/early 

intervention programs. This report presents the first available nationally representative estimates 

of substance use among adult immigrants to the United States. 

Immigrants are defined in this report as U.S. residents born outside the United States. A 

number of factors have been hypothesized to contribute to substance use among immigrants. 

Acculturative stress, or the challenge of assimilating into the dominant culture, has been 

implicated as a mechanism for increased substance use among immigrants (Alaniz, 2002; 

Castillo & Henderson, 2002). In addition, immigrants often face language and communication 

barriers, cultural differences, discrimination, lack of social support, difficulties related to access 

to health care, and poverty (Caetano, Clark, & Tam, 1998; Elder et al., 2000; Makimoto, 1998). 

Substance use rates also may vary by length of time in the United States. Research 

findings on substance use patterns among immigrant populations are mixed, with some studies 

indicating that substance use increased with increased time in the United States (Alaniz, 2002; 

Caetano et. al., 1998; Gfroerer & Tan, 2003; Ortega, Rosenheck, Alegria, & Desai, 2000). Other 

studies showed decreased substance use (Johnson, VanGeest, & Cho, 2002) and mental health 

problems (Escobar, Nervi, & Gara, 2000) over time and with increased levels of acculturation 

(Hines & Caetano, 1998). One explanation for these discrepant findings is the heterogeneity of 

immigrant populations. Even within subgroups of immigrants, there is wide variability in 

substance use patterns. For example, Randolph, Stroup-Benham, Black, and Markides (1998) 

found significant differences in the frequency and volume of drinking among MexicanAmerican, Puerto Rican, and Cuban-American populations, with Mexican-American and Puerto 

Rican men having higher rates of heavy drinking than Cuban-American men. Caetano (1988) 

reported that Mexican-American men drank less frequently but in higher volumes than other 

Latin American immigrant men. 

Similarly, Makimoto (1998) demonstrated differences in drinking patterns among Asian 

Americans when comparing Chinese-, Japanese-, Korean-, and Filipino-American samples. 

Among adults, Japanese Americans had the highest and Chinese Americans had the lowest 

lifetime prevalence of drinking and heavy drinking. Alcohol abuse and dependence appear to be 

significant problems among Southeast Asians resettled in the United States, as a result of 

contributing factors, such as experiences of trauma during the refugee process and traditional 
4 

beliefs about alcohol as a health-promoting substance (Amodeo, Robb, Peou, & Tran, 1997). 

Other researchers have found that Asian Americans have shown a general increase in substance 

use patterns with length of time in the United States, and they have attributed the increase to the 

results of acculturation toward U.S. drinking norms (O'Hare & Van Tran, 1998). 

The reasons for this variability in drinking patterns are not well understood. Alaniz 

(1998) found that alcohol availability and advertising were disproportionately concentrated in 

low-income racial/ethnic minority communities, with 5 times more alcohol advertisements in 

Latino neighborhoods than in predominantly white neighborhoods. Variability in use patterns 

may arise from differential access to alcohol and other drugs, cultural mores limiting or 

supporting use, varying degrees of psychological stress, or differences in the use of alcohol in the 

country of origin. The variability in alcohol use rates could be due to a differential amount of 

time that immigrant groups have been in the United States or to the younger average age of some 

of the individuals within the regional groupings. 

Clearly, the heterogeneity of the immigrant population of the United States provides a 

challenge to the substance abuse prevention and treatment community and to early intervention 

programming. The mixed findings from research with immigrant and minority populations may 

point to the need for considering cultural values and acculturation in designing interventions. For 

example, if substance use increases with increased acculturation in some groups of immigrants, it 

may point to the need to intervene with new immigrants. 

An initial step in understanding the substance use patterns of immigrant populations is to 

document the prevalence of substance use in a national sample of immigrants and to examine 

patterns among immigrants from different countries. It is important to examine the epidemiology 

of substance use in this population, regardless of whether prevalence rates are higher or lower 

than U.S. rates, in order to adequately address potential problems. It is also crucial to have data 

that can be related to specific countries of origin. The National Survey on Drug Use and Health 

(NSDUH), formerly the National Household Survey on Drug Abuse (NHSDA), is the only 

source available that provides large samples of immigrants from specific countries. This report 

examines past month and past year alcohol, illicit drug, and tobacco use among a large sample of 

immigrants from NSDUH data for the combined years of 1999, 2000, and 2001. 

1.2. Summary of the NSDUH Methodology 

Conducted by the Federal Government since 1971, NSDUH collects data by 

administering questionnaires to a representative sample of the population aged 12 or older 

through face-to-face interviews at their place of residence. This section briefly describes the 

survey methodology. A more complete description is provided in Appendix A. 

NSDUH collects information from residents of households, noninstitutional group 

quarters (e.g., shelters, rooming houses, dormitories), and civilians living on military bases. 

Persons excluded from the survey include homeless people who do not use shelters, active 

military personnel, and residents of institutional group quarters, such as jails and hospitals. 

Since 1999, NSDUH has been carried out using a computer-assisted interviewing (CAI) 

methodology. The survey uses a combination of computer-assisted personal interviewing (CAPI) 
5 

conducted by the interviewer and audio computer-assisted self-interviewing (ACASI). Use of 

ACASI is designed to increase the privacy of the interview and appears to increase the level of 

honesty in the reporting of illicit drug use and other sensitive behaviors. 

The 1999, 2000, and 2001 samples employed a 50-State design with an independent, 

multistage area probability sample for each of the States and the District of Columbia. The eight 

most populous States (which together account for 48 percent of the total U.S. population aged 12 

or older) were designated as large sample States (California, Florida, Illinois, Michigan, New 

York, Ohio, Pennsylvania, and Texas). For these States, the design provided a sample large 

enough to support direct State estimates. For the remaining 42 States and the District of 

Columbia, smaller, but adequate, samples were selected to support State estimates using small 

area estimation (SAE) techniques. The design also oversamples youths and young adults so that 

each State's sample is approximately equally distributed among three major age categories: 12 to 

17 years, 18 to 25 years, and 26 years or older. To enhance the precision of trend measurements, 

half of the first-stage sampling units, or area segments, in each survey also are included in the 

subsequent survey. However, all households included in the sample each year are new. 

In 2002, the name of the survey was changed to the National Survey on Drug Use and 

Health (NSDUH), and several improvements and modifications were made. Respondents were 

offered a $30 incentive payment for participation in the survey, and quality control procedures 

were enhanced. These improvements resulted in changes in respondent reporting of substance 

use. Therefore, estimates from 2002 and later NSDUHs should not be compared with estimates 

from 1999-2001, shown in this report, for assessing trends in substance use. A discussion of 

survey methodology and results from the 2002 NSDUH are presented in OAS (2003). 

1.3. Format of Report and Explanation of Tables 

This report is divided into four chapters. Chapter 1 includes background information on 

substance use among immigrant populations and the methods for the current report. Chapter 2 

provides descriptive information for the total immigrant sample used for this report. Chapter 3 

focuses on alcohol, illicit drug, and tobacco use among all immigrants. The alcohol measures 

include past month weekly alcohol consumption, prevalence of past month alcohol use, past 

month binge drinking, past month heavy drinking, and past year alcohol use. The use of 

marijuana and other illicit drugs is detailed for past month and past year use. And past month and 

past year tobacco use rates are examined. Chapter 4 contains information on alcohol, illicit drug, 

and tobacco use for immigrants from countries with the highest numbers of immigrants in the 

United States. For ease of presentation, these selected countries have been broadly grouped in 

regional areas: Latin America, Asia, Europe, and Canada. Appendix A contains technical details 

about the survey methodology, Appendix B discusses the statistical methods and limitations of 

the data, and Appendix C provides detailed prevalence and standard error tables. 

1.4. Description of the Sample 

Analyses presented in this report are based on annual averages of the 1999 to 2001 

NSDUHs for persons aged 18 or older. Persons born outside the United States were classified as 

foreign born, and others were classified as U.S. born on the basis of answers to the question, 

"Were you born in the United States?" Foreign-born respondents also were asked, "In what 
6 

country or U.S. territory were you born?" and "About how long have you lived in the United 

States?" The total sample of 132,759 adults across the three surveys represented 199 million 

adults in the United States, of whom about 13 percent were foreign born. The total sample size 

for U.S.-born adults was 116,629 representing 174 million adults. The total sample size for all 

immigrants aged 18 or older was 16,130 representing 25 million adults. 

This report presents data for the estimated 25 million adult immigrants overall and by 

specific country of birth for countries with sample sizes sufficient to produce reliable estimates. 

These countries and their estimated proportions of all adult immigrants are Mexico (32.1 

percent), the Philippines (4.2 percent), India (4.0 percent), Germany (3.3 percent), Puerto Rico 

(3.2 percent), El Salvador (2.8 percent), Canada (2.7 percent), the United Kingdom (2.2 percent), 

Cuba (2.1 percent), Korea (2.1 percent), Vietnam (1.9 percent), China (1.8 percent), Colombia 

(1.7 percent), Japan (1.5 percent), Jamaica (1.4 percent), and Poland (1.1 percent). Immigrants 

from these individual countries were grouped into four regions: Latin America (Mexico, Puerto 

Rico, Cuba, El Salvador, Jamaica, Colombia), Asia (Japan, Korea, China, the Philippines, 

Vietnam, India), Europe (Germany, United Kingdom, Poland), and Canada. These regional 

groupings of immigrants represent nearly 17 million adult immigrants, or 68 percent of the total 

adult immigrant population. The groupings considered here do not represent all countries within 

each region. Eighty-two percent of the total adult foreign-born population had been in the United 

States for 5 or more years. 

1.5. Methods 

1.5.1 Prevalence Estimation 

The statistical package SUDAAN® (RTI, 2001) was used for the analyses to take into 

account the complex survey design of NSDUH. Prevalence estimates were computed for past 

month use of alcohol (any, binge, heavy), marijuana, any illicit drugs (marijuana, cocaine, 

heroin, hallucinogens, inhalants, and nonmedical use of prescription-type pain relievers, 

tranquilizers, stimulants, and sedatives), and tobacco. Past month use of each substance is 

defined as use of the substance at least one time during the 30 days prior to the interview. Binge 

alcohol use is defined as drinking five or more drinks on the same occasion (i.e., at the same time 

or within a couple of hours of each other) at least once during the past 30 days. Heavy alcohol 

use is defined as drinking five or more drinks on the same occasion on 5 or more days in the past 

30 days. The past month weekly average number of drinks was calculated by multiplying the 

average number of drinks consumed per day in the past 30 days by the number of days drinking 

during the past month and dividing by 4.286, the number of weeks in a 30-day period, among 

past month drinkers. NSDUH includes a series of questions on the use of any tobacco product, 

including cigarettes, chewing tobacco, snuff, cigars, and pipe tobacco in the past 30 days. 

Cigarette use is counted if respondents reported smoking "part of or all of a cigarette." 

NSDUH estimates considered to be unreliable due to unacceptably large sampling errors 

typically are not shown in reports. However, an exception is made in this report in the interest of 

presenting all data. Estimates with very large standard errors (SEs), normally suppressed, are 

indicated with an "*" beside them (see Section B.3.2 in Appendix B). 
7 

Tests of significance, such as t tests and chi-square tests, were conducted using Proc 

DESCRIPT and Proc CROSSTAB procedures, and linear and logistic regressions were 

conducted using the Proc REGRESS and Proc RLOGIST procedures. The terms "higher" or 

"lower" are used only when differences are statistically significant. Respondents with missing 

data for variables not subject to NSDUH imputation procedures were excluded from analyses. 

1.5.2 Regression Analyses 

Linear regression models were fitted to the data to assess the effect of per capita alcohol 

consumption in the country of origin on past month weekly consumption rates among 

immigrants from selected countries with controls for gender, age, family income, marital status, 

and length of time in the United States. Only immigrants from countries with known per capita 

alcohol consumption and who reported past month alcohol use (N = 5,115) were included in the 

model. Fitting a linear regression model to the outcome variable OBSERVED (defined as the 

numbers of drinks per week during the past 30 days) was first attempted. However, diagnostics 

for this model were poor, due to the skewed distribution of the outcome variable. The overall R2

(proportion of variance explained by the model) was approximately 2 percent, and the 

distribution of the residuals was highly skewed. Consequently, a log transformation was 

attempted. The linear regression model with log(OBSERVED) as the response variable achieved 

R2

 of over 10 percent, and the residuals' distribution was approximately normal. Although an R2

of 10 percent is still considered low, this is a considerable improvement over the model where 

OBSERVED was modeled directly. 

Logistic regression procedures were used for analyses based on all immigrants to the 

United States aged 18 or older to (1) determine the characteristics and predictors of alcohol, 

illicit drug, and tobacco use, and (2) examine the relationship between length of time in the 

United States and substance use patterns (e.g., binge drinking or heavy alcohol use). Odds ratio 

(OR) estimates derived from logistic regression procedures denote the estimated magnitude of an 

association between a binary outcome and a covariate. In this report, the p value equal to or less 

than 0.05 is considered statistically significant. The OR estimate greater than 1 indicates a 

positive association between the outcome of interest and the covariate; a value of less than 1 

reflects an inverse association. 
8 
9 

2. Demographic Characteristics of 

Immigrants 

This chapter presents findings on the demographic characteristics of all immigrants in the 

United States aged 18 or older, including gender, age, educational attainment, current 

employment, household income, and government assistance. Comparisons are made between 

immigrants and U.S.-born persons and between immigrants who lived in the United States for 

fewer than 5 years and for 5 years or more. Age, gender, and years-in-U.S. data also are shown 

for specific countries of birth. These data can be particularly informative because comparisons of 

prevalence rates for substance use are affected by the differing demographic characteristics of 

comparison groups. In particular, immigrant groups that are primarily recent immigrants who are 

young (e.g., Mexico) may have higher substance use rates than those with older immigrants (e.g., 

Cuba) because rates of use generally are higher among younger persons. 

2.1. Overview 

Among adults aged 18 or older, 12.7 percent of the estimated population in the United 

States for 1999, 2000, and 2001 were foreign born. Tables C.1 to C.5 in Appendix C present the 

demographic characteristics of immigrants in the United States by country of origin and by 

length of stay in the United States. 

2.2. Gender 

An estimated 48.6 percent of immigrants were male, similar to the 47.6 percent among 

U.S.-born persons. A larger percentage of immigrants residing in the United States for fewer 

than 5 years were male than those living in the United States for 5 years or more. The percentage 

who were male varied from 36.7 percent among immigrants from the Philippines to 54.9 percent 

among those from India. 

2.3. Age 

The percentage aged 18 to 25 among immigrants (14.2 percent) was similar to the 

percentage aged 18 to 25 among U.S.-born adults (14.6 percent). However, the U.S.-born 

population had a greater percentage of persons aged 50 or older compared with the foreign-born 

population (38.3 vs. 28.5 percent, respectively). An estimated 32.9 percent of all immigrants 

living in the United States for fewer than 5 years were between the ages of 18 and 25, while only 

10.6 percent were in the 50 or older age group. 

Among immigrants who had been in the United States for 5 years or more, only 10.1 

percent were aged 18 to 25 and 32.4 percent were aged 50 or older. The younger age of the more 

recent immigrants has important implications for substance use rates given the higher prevalence 

of use among younger persons in general. 

The youngest immigrant population was from Vietnam (average age 36.8), and the oldest 

was from Cuba (53.2). 
10 

2.4. Educational Attainment 

In general, immigrants had lower educational levels than the U.S.-born population, 

regardless of their length of stay in the United States. Immigrants were more likely than U.S.-

born persons to have less than a high school education (30.7 vs. 15.8 percent, respectively). 

Immigrants living in the United States for fewer than 5 years were equally as likely as 

immigrants who had been in the United States for 5 or more years to have less than a high school 

education (31.7 vs. 30.4 percent). More than 20 percent of both immigrants and U.S.-born 

persons indicated having college degrees. However, the percentage with less than a high school 

education ranged from 3.4 percent among Japanese immigrants to 66.2 percent among Mexican 

immigrants; the college graduation rate ranged from 4.6 percent (Mexico) to 71.1 percent (India). 

2.5. Current Employment 

Although the differences were small, immigrants were more likely to be employed full 

time and less likely to be employed part time compared with the U.S.-born population, regardless 

of their length of stay in the United States. Immigrants who had been in the United States for 5 or 

more years were equally likely to be unemployed (2.1 percent) as U.S.-born persons (2.2 

percent) and less likely to be unemployed than immigrants who had been in the United States for 

fewer than 5 years (4.1 percent). The rate of unemployment varied from 0.3 percent (Japan, 

Korea, United Kingdom) to 4.8 percent (Jamaica, Colombia). 

2.6. Household Income 

Immigrants were more likely than U.S.-born persons to have household incomes of less 

than $20,000 (28.2 vs. 19.9 percent, respectively) and less likely to have household incomes of 

$75,000 or more (17.1 vs. 21.6 percent). More recent immigrants were more likely to have 

household incomes of less than $20,000 than immigrants living in the United States for 5 or 

more years (44.3 vs. 24.7 percent). Overall, immigrants living in the United States for 5 or more 

years had incomes that were higher than those of newer immigrants, but not as high as those of 

U.S.-born residents. The percentage with incomes below $20,000 ranged from 10.7 percent 

(Poland) to 45.1 percent (Puerto Rico). 

2.7. Government Assistance 

If at least one family member received Supplemental Security Income (SSI), cash 

assistance or noncash assistance (Temporary Assistance for Needy Families, TANF), or the 

family received food stamps, respondents were classified as receiving government assistance. 

Immigrants were more likely than persons born in the United States to receive government 

assistance (13.2 vs. 12.2 percent, respectively). Among immigrants, those living in the United 

States for 5 years or longer were more likely to receive government assistance (14.0 percent) 

than those living in the country for fewer than 5 years (9.4 percent). The rate varied from 3.6 

percent (Japan) to 34.3 percent (Puerto Rico). 
11 

3. Substance Use among Immigrants 

This chapter presents findings from the National Survey on Drug Use and Health 

(NSDUH) on the prevalence of use of alcohol, illicit drugs, and tobacco among all immigrants in 

the United States aged 18 or older from 1999 to 2001. Substance use among immigrants is 

examined by age and gender, and results are compared by the length of time in the United States 

with the rates for U.S.-born persons aged 18 or older in Tables C.6 through C.13. Demographic 

characteristics for all immigrants and for immigrants from selected countries are presented in 

Tables C.1 through C.5 in Appendix C. 

3.1. Alcohol Use 

3.1.1 Alcohol Prevalence Rates 

Past month and past year alcohol use rates were examined for foreign-born individuals 

living in the United States and aged 18 or older and compared with prevalence rates for U.S.-

born residents aged 18 or older. The prevalence rates of past month alcohol use, past month 

binge drinking, past month heavy drinking, and past year alcohol use were lower for foreignborn compared with U.S.-born individuals. Among all foreign-born persons, men had higher 

rates of use across all alcohol measures than women, and younger age groups (18 to 25, 26 to 49) 

had higher rates of use than older individuals (50 or older). Prevalence rates for past month and 

past year alcohol use for all immigrants and U.S.-born persons are shown in Table C.6 in 

Appendix C (also see Figures 1 and 2 later in this chapter). 

The average number of drinks consumed on a weekly basis by current drinkers during the 

past month was calculated for U.S.- and foreign-born samples aged 18 or older. Foreign-born 

individuals drank fewer drinks on average each week than U.S.-born individuals (6.3 vs. 8.3 

drinks). The weekly average was calculated by multiplying the average number of drinks 

consumed per day in the past 30 days by the number of days drinking during the past month and 

dividing by 4.286, the number of weeks in a 30-day period (see Table C.6). 

3.1.2 Alcohol Use, by Length of Time in the United States 

Alcohol use rates among immigrants aged 18 or older also were examined by length of 

time in the United States. There were no statistically significant differences in past month 

alcohol use (39.1 vs. 39.6 percent), past month binge drinking (18.8 vs. 16.4 percent), past month 

heavy drinking (3.8 vs. 2.9 percent), or past year alcohol use (53.6 vs. 54.4 percent) when 

comparing immigrants who had been in the United States for fewer than 5 years with those who 

had been in the United States for 5 or more years (see Table C.6). 

3.1.3 Alcohol Use, by Use in Country of Birth 

It was hypothesized that among immigrants who were current drinkers, a portion of the 

variability in alcohol consumption was due to drinking patterns in one's home country. Annual 

per capita alcohol consumption for the country of origin was determined for each immigrant 

respondent whose country was listed in the Global Status Report on Alcohol (World Health 
12 

Organization [WHO], 2001). This variable then was used as a predictor in a linear regression 

model, with the logarithm1

 of past month weekly alcohol consumption (number of drinks per 

week) among current drinkers as the response variable. Along with the aforementioned country 

of origin consumption variable, the following variables were entered as predictors in the model: 

gender, age, total family income, marital status, education, and length of time in the United 

States. Results indicated that drinking in the country of origin was a significant predictor of past 

month weekly alcohol consumption, as were marital status (unmarried), education (completed 

less than high school), and gender (male). The regression coefficient for the country of origin per 

capita drinking rate was 0.04. Transformed back to the original scale, the model predicts a rise of 

approximately 4 percent in the current consumption rate for every liter increase in the country of 

origin per capita drinking rate (Table C.7). 

Per capita alcohol consumption was organized into countries that had rates similar to, 

higher than, or lower than U.S. rates. An analysis of variance (ANOVA) test then was performed 

to compare past month weekly consumption estimates for immigrants from countries with per 

capita alcohol consumption that was higher than, lower than, or similar to the per capita 

consumption for the United States (data not shown). Immigrants from countries with per capita 

rates that were similar to or lower than U.S. rates had significantly lower past month weekly 

alcohol consumption than U.S.-born persons, 5.7 and 5.9 drinks per week, respectively, when 

compared with the U.S.-born population (8.4 drinks per week). Past month weekly alcohol 

consumption was higher for individuals from countries with a higher per capita consumption rate 

than the U.S. rate, but consumption was still lower than among individuals born in the United 

States (7.0 vs. 8.4 drinks per week). 

3.2. Illicit Drug Use 

3.2.1 Marijuana 

Past month marijuana use was lower among foreign-born individuals living in the United 

States (1.7 percent) than among U.S.-born persons aged 18 or older (5.1 percent). Past month 

marijuana use did not differ among immigrants living in the United States for fewer than 5 years 

(1.8 percent) compared with those who resided in the United States for 5 years or more (1.6 

percent). However, past month marijuana use rates were significantly higher among immigrants 

aged 18 to 25 who had been in the United States for 5 years or more (6.5 percent) compared with 

immigrants aged 18 to 25 who had been in the United States for fewer than 5 years (3.1 percent). 

Past month marijuana use rates are shown in Table C.8 and Figure 1. 

Marijuana use rates for the past year also were lower among foreign-born persons when 

compared with U.S.-born individuals (3.5 vs. 8.8 percent, respectively). As with past month use, 

there were no differences in past year marijuana use among immigrants based on whether one 

had been in the United States for 5 years or more (3.4 percent) or for fewer than 5 years (3.9 

percent). Consistent with past month marijuana use findings, past year marijuana use rates were 

significantly higher among immigrants aged 18 to 25 residing in the United States for 5 years or 

more (12.0 percent) compared with immigrants aged 18 to 25 who had been in the United States 

 1

 A linear model where the weekly consumption rate was directly modeled resulted in poor diagnostics. In 

contrast, the final model where the logarithm of this rate was modeled performed considerably better. 
13 

for fewer than 5 years (7.0 percent). Past year marijuana use rates are shown in Table C.9 and 

Figure 2. 

3.2.2 Any Illicit Drugs 

Foreign-born persons living in the United States had lower rates of past month (2.9 

percent) and past year (6.0 percent) any illicit drug use when compared with U.S.-born 

individuals (6.6 percent for past month and 11.5 percent for past year use) (Tables C.8 and C.9, 

Figures 1 and 2). 

There was no significant difference among immigrants in past month illicit drug use by 

length of time in the United States, but there was a difference in past year illicit drug use. 

Immigrants who had been in the United States for fewer than 5 years showed a higher rate of 

past year illicit drug use (7.6 percent) than those who had been in the United States for 5 or more 

years (5.7 percent) (Table C.9). 

These findings are complicated by the demographic composition of the immigrant 

population. Among immigrants residing in the United States for fewer than 5 years, 32.9 percent 

were aged 18 to 25 while only 10.1 percent of immigrants living in the United States for 5 years 

or more were in this age group (Table C.2). Although a longer time residing in the United States 

was associated with lower past year illicit drug use overall, among persons aged 18 to 25 the 

prevalence rate was significantly higher for longer term residents (16.4 percent) compared with 

newer immigrants (12.2 percent) (Table C.9). 

3.3. Tobacco Use 

Tobacco use rates also were generally lower among immigrants than among U.S.-born 

persons aged 18 or older. Past month tobacco use prevalence was lower among foreign-born 

respondents living in the United States (20.4 percent) than among U.S.-born individuals (32.8 

percent) (Table C.8, Figure 1). The past month tobacco use rate was higher for immigrants who 

had been in the United States for fewer than 5 years (22.6 percent) than for those who had been 

in the United States for 5 or more years (19.9 percent). Consistent with illicit drug use findings, 

the higher rate of use among newer immigrants is not unexpected given the higher proportion of 

persons aged 18 to 25 among those residing in the United States for fewer than 5 years. Both past 

month and past year tobacco use were higher among immigrants aged 18 to 25 who had been in 

the United States for 5 years or more compared with those who had resided in the United States 

for fewer than 5 years (Tables C.8 and C.9). 

Similarly, the past year tobacco use rate was lower among foreign-born adults than 

among U.S.-born adults (24.8 vs. 38.2 percent) and lower among immigrants who had been in 

the United States for 5 years or longer (24.2 percent) compared with those who had been in the 

United States for fewer than 5 years (28.0 percent) (Table C.9, Figure 2). 
14 

Figure 1. Past Month Alcohol, Marijuana, Any Illicit Drug, and Tobacco Use among U.S.-

Born and Foreign-Born Persons Aged 18 or Older Living in the United States 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

Figure 2. Past Year Alcohol, Marijuana, Any Illicit Drug, and Tobacco Use among U.S.-

Born and Foreign-Born Persons Aged 18 or Older Living in the United States 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

52.4

22.3

6.5 5.1 6.6

32.8

16.9

3.0 1.7 2.9

20.4

39.5

0

10

20

30

40

50

60

Past

Month

Alcohol

Use

Past

Month

Binge

Alcohol

Use

Past

Month

Heavy

Alcohol

Use

Past

Month

Marijuana 

Use

Past

Month

Any Illicit

Drug Use

Past

Month

Tobacco

Use

U.S. Born

Foreign Born

Percent Using in Past Month

52.4

22.3

6.5 5.1 6.6

32.8

16.9

3.0 1.7 2.9

20.4

39.5

0

10

20

30

40

50

60

Past

Month

Alcohol

Use

Past

Month

Binge

Alcohol

Use

Past

Month

Heavy

Alcohol

Use

Past

Month

Marijuana 

Use

Past

Month

Any Illicit

Drug Use

Past

Month

Tobacco

Use

U.S. Born

Foreign Born

Percent Using in Past Month

67.8

8.8 11.5

38.2

54.3

3.5 6.0

24.8

0

10

20

30

40

50

60

70

80

Past Year

Alcohol Use

Past Year

Marijuana Use

Past Year Any

Illicit Drug Use

Past Year

Tobacco Use

U.S. Born

Foreign Born

Percent Using in Past Year

67.8

8.8 11.5

38.2

54.3

3.5 6.0

24.8

0

10

20

30

40

50

60

70

80

Past Year

Alcohol Use

Past Year

Marijuana Use

Past Year Any

Illicit Drug Use

Past Year

Tobacco Use

U.S. Born

Foreign Born

Percent Using in Past Year
15 

3.4. Substance Use, by Age, Gender, and Length of Time in the United 

States 

For adult immigrants, rates of substance use were generally higher among males than 

among females, and rates were higher among immigrants who had been in the United States for 

fewer than 5 years than among those who had been in the United States for 5 years or more. 

Prevalence rates also were generally higher among immigrants aged 18 to 25 compared with 

persons aged 26 to 49 or those aged 50 or older (see Tables C.6, C.8, and C.9, Figures 3 and 4). 

However, some subgroups differed from these general patterns. 

Among males, the prevalence rates for past month and past year tobacco use were higher 

among persons who had been in the United States for fewer than 5 years. There were no 

differences in past month and past year alcohol use rates or past month and past year marijuana 

use rates among males by length of time in the United States. 

For females, there were no differences in past month or past year alcohol or tobacco use 

by length of time in the United States. Past year marijuana and past year illicit drug use rates 

among females did not follow the same pattern as for males; rates were higher among females 

who had been in the United States for fewer than 5 years (3.3 and 6.3 percent) compared with 

females who had immigrated 5 or more years earlier (2.2 and 4.2 percent). 

3.5. Predictors of Substance Use among Immigrants 

This section reports the findings regarding predictors of alcohol, marijuana, illicit drug, 

and tobacco use among immigrants aged 18 or older. Modeling covariates included the 

following: duration in the United States, gender, age, and marital status. 

For the alcohol use variables (Table C.10), younger ages were associated with an 

increased risk of alcohol use across all measures (i.e., past month use, binge drinking, heavy use, 

and past year use). Gender and duration of residence in the United States also were found to be 

associated with alcohol use. Males had higher odds of alcohol use compared with females. Being 

married was associated with lower odds of alcohol use compared with other martial statuses, as 

was living in the United States for fewer than 5 years compared with living in the United States 

for 5 years or more. 

Similar patterns were found for past month and past year tobacco use, as well as for past 

month and past year marijuana and any illicit drug use among immigrants aged 18 or older 

(Tables C.11 to C.13). Males and younger age groups had higher odds of past month and past 

year marijuana and illicit drug use, while being married and living in the United States for fewer 

than 5 years both were associated with lower odds of use. Males and younger age groups also 

had higher odds of past month and past year tobacco use, and being married was associated with 

lower odds of use. However, duration in the United States was not associated with tobacco use. 

Thus, when controlling for age and other differences, longer duration of living in the United 

States is associated with higher use rates for alcohol, marijuana, and any illicit drug, but not 

tobacco. 
16 

Figure 3. Past Month Alcohol, Marijuana, Any Illicit Drug, and Tobacco Use among Male 

and Female Immigrants Aged 18 or Older Living in the United States 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

Figure 4. Past Year Alcohol, Marijuana, Any Illicit Drug, and Tobacco Use among Male 

and Female Immigrants Aged 18 or Older Living in the United States 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

49.1

2.3 3.8

27.8

30.4

1.1 2.1

13.4

0

10

20

30

40

50

60

Past Month

Alcohol Use

Past Month

Marijuana Use

Past Month Any

Illicit Drug Use

Past Month

Tobacco Use

Male

Female

Percent Using in Past Month

4.7

7.6

33.6

44.4

2.4 4.5

16.6

64.7

0

10

20

30

40

50

60

70

Past Year

Alcohol Use

Past Year

Marijuana Use

Past Year Any

Illicit Drug Use

Past Year

Tobacco Use

Male

Female

Percent Using in Past Year

4.7

7.6

33.6

44.4

2.4 4.5

16.6

64.7

0

10

20

30

40

50

60

70

Past Year

Alcohol Use

Past Year

Marijuana Use

Past Year Any

Illicit Drug Use

Past Year

Tobacco Use

Male

Female

Percent Using in Past Year
17 

3.6. Summary 

Although a preliminary examination of the data appears to indicate that the rates for 

substance use across all immigrants were higher among immigrants who had been in the United 

States for a shorter amount of time, this finding is complicated by the variability in age and the 

gender composition of groups of persons immigrating fewer than 5 years ago or 5 or more years 

ago. When controlling for age, gender, and marital status, tobacco use rates showed no 

differences when considering length of time in the United States. On the other hand, the risks for 

alcohol, marijuana, and any illicit drug use were significantly lower among newer immigrants, a 

finding that is not as apparent when examining direct estimates. Although this finding deserves 

further examination, it also highlights the importance of including age-adjusted estimates when 

possible. 
18 
19 

4. Substance Use among Immigrants from 

Selected Countries 

An accurate assessment of substance use patterns among immigrants requires going 

beyond national averages to the patterns of use among immigrants from individual countries of 

origin. Moving to this type of analysis underscores the importance of understanding the 

variability in substance use patterns among subpopulations of immigrants. This chapter presents 

findings on substance use patterns among immigrants from selected countries within four 

regions: Latin America, Asia, and Europe, as well as from Canada. 

4.1. Substance Use among Immigrants from Selected Latin American 

Countries 

4.1.1 Alcohol Use 

Alcohol use patterns were examined among selected Latin American countries with the 

largest immigrant samples. Immigrants from Mexico, Puerto Rico, Cuba, El Salvador, Jamaica, 

and Colombia were examined (see Table C.3 for demographic characteristics). These individual 

countries were compared on past month alcohol use (any, binge, and heavy), on past year alcohol 

use, and on past month weekly alcohol consumption among current drinkers (see Table C.14). 

Figure 5 shows past month alcohol use comparisons for immigrants from these selected countries 

within the Latin American region and U.S.-born persons. 

Figure 5. Past Month Alcohol Use among U.S. Residents Aged 18 or Older Who Are 

Either U.S.-Born Persons or Foreign-Born Persons from Selected Latin 

American Countries 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

34.9

41.3 42.4

33.5 35.8

41.8

52.4

16.3 14.9

19.7

9.9

22.3 23.7 22.3

1.3 2.6 1.3 2.0 3.5 3.3

6.5

0

10

20

30

40

50

60

United 

States

Mexico Puerto 

Rico

Cuba El 

Salvador

Jamaica Colombia

Percent Using in Past Month

Past Month Alcohol Use Past Month Binge Alcohol Use

Past Month Heavy Alcohol Use

Country of Birth

34.9

41.3 42.4

33.5 35.8

41.8

52.4

16.3 14.9

19.7

9.9

22.3 23.7 22.3

1.3 2.6 1.3 2.0 3.5 3.3

6.5

0

10

20

30

40

50

60

United 

States

Mexico Puerto 

Rico

Cuba El 

Salvador

Jamaica Colombia

Percent Using in Past Month

Past Month Alcohol Use Past Month Binge Alcohol Use

Past Month Heavy Alcohol Use

Country of Birth
20 

A larger percentage of Cuban immigrants reported past month alcohol use (42.4 percent) 

than did immigrants from Mexico (34.9 percent). There were no statistically significant 

differences between these two groups and Puerto Rican (41.3 percent) or Colombian immigrants 

(41.8 percent) in past month alcohol use. However, Cuban (9.9 percent) and Colombian (14.9 

percent) immigrants had lower rates of past month binge drinking when compared with Mexican 

(22.3 percent) immigrants. The 9.9 percent prevalence rate for binge drinking among Cuban 

immigrants was lower than among Puerto Rican (23.7 percent) and El Salvadoran (19.7 percent) 

immigrants. Cuban immigrants also had lower past month heavy drinking rates (1.3 percent) than 

immigrants from Mexico (3.5 percent). Immigrants from Puerto Rico had prevalence rates 

similar to Mexican immigrants with respect to binge drinking (23.7 vs. 22.3 percent) and heavy 

drinking rates (3.3 vs. 3.5 percent). 

Mexican, Puerto Rican, and El Salvadoran immigrants had a higher average number of 

drinks consumed per week (8.1, 6.8, and 7.4 drinks, respectively) than Jamaican immigrants (2.8 

drinks) or than immigrants from Cuba (3.3 drinks) (Table C.14). Thus, across most drinking 

measures, immigrants from Mexico, Puerto Rico, and El Salvador had higher prevalence rates 

than Cuban or Jamaican immigrants. Although a larger percentage of immigrants from Cuba 

reported drinking in the past month, they had a lower prevalence of both binge and heavy 

drinking, and they drank fewer drinks per week than most of the other selected Latin American 

immigrant groups. These differences in alcohol use rates may be partially explained by the older 

age of immigrants from Cuba, who were on average 53.2 years old compared with immigrants 

from Mexico (37.3 years), Puerto Rico (46.4 years), and El Salvador (38.6 years) (see Table 

C.1). 

Immigrants from Mexico, Puerto Rico, and El Salvador had binge drinking prevalence 

rates (22.3, 23.7, and 19.7 percent, respectively) and past month weekly consumption amounts 

(8.1, 6.8, and 7.4 drinks, respectively) that were equal to those for U.S.-born adults (22.3 percent 

and 8.3 drinks). Immigrants from Cuba, Jamaica, and Colombia had past month weekly 

consumption rates and binge drinking prevalence rates that were lower than the rates for U.S.-

born persons. These differential findings may be due to the age distributions of immigrants from 

the Latin American region. A higher percentage of immigrants from Mexico and El Salvador 

were among the younger age groups (18 to 25, 26 to 34) compared with immigrants from Cuba, 

Jamaica, and Colombia. With respect to length of time in the United States, immigrants from 

Puerto Rico and Jamaica who had been in the United States for 5 years or more drank less on a 

measure of past month weekly alcohol consumption compared with Puerto Rican and Jamaican 

immigrants living in the United States for fewer than 5 years (6.2 and 2.5 drinks vs. 15.9 and 7.9 

drinks, respectively; see Table C.15). Past month weekly alcohol consumption was similar 

among immigrants from Mexico, Cuba, El Salvador, and Colombia who had been in the United 

States for shorter or longer periods of time. 

4.1.2 Illicit Drug Use 

Figures 6 and 7 and Tables C.16 and C.17 show past month and past year illicit drug use 

rates for immigrants from selected countries within this region compared with the U.S.-born 

population. 
21 

Figure 6. Past Month Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Selected Latin American Countries 

 Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

Figure 7. Past Year Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Selected Latin American Countries 

 Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

20.8

31.0

17.6 17.6

12.1

18.2

2.0

7.7

2.7

32.8

0.9

5.5

1.4 0.2 0.9

5.1

2.1

5.6

0.5 2.2

6.6

0

5

10

15

20

25

30

35

United 

States

Mexico Puerto 

Rico

Cuba El 

Salvador

Jamaica Colombia

Percent Using in Past Month

Past Month Tobacco Use Past Month Marijuana Use

Past Month Any Illicit Drug Use

Country of Birth

20.8

31.0

17.6 17.6

12.1

18.2

2.0

7.7

2.7

32.8

0.9

5.5

1.4 0.2 0.9

5.1

2.1

5.6

0.5 2.2

6.6

0

5

10

15

20

25

30

35

United 

States

Mexico Puerto 

Rico

Cuba El 

Salvador

Jamaica Colombia

Percent Using in Past Month

Past Month Tobacco Use Past Month Marijuana Use

Past Month Any Illicit Drug Use

Country of Birth

38.2

26.2

35.7

23.3 24.1

13.7

23.4

4.7

1.8

13.6

2.3

0.8

6.4

2.9

8.8

4.9 6.8

4.6

2.6

5.5

11.5

0

5

10

15

20

25

30

35

40

45

United 

States

Mexico Puerto 

Rico

Cuba El 

Salvador

Jamaica Colombia

Percent Using in Past Year

Past Year Tobacco Use Past Year Marijuana Use

Past Year Any Illicit Drug Use

Country of Birth

38.2

26.2

35.7

23.3 24.1

13.7

23.4

4.7

1.8

13.6

2.3

0.8

6.4

2.9

8.8

4.9 6.8

4.6

2.6

5.5

11.5

0

5

10

15

20

25

30

35

40

45

United 

States

Mexico Puerto 

Rico

Cuba El 

Salvador

Jamaica Colombia

Percent Using in Past Year

Past Year Tobacco Use Past Year Marijuana Use

Past Year Any Illicit Drug Use

Country of Birth
22 

4.1.2.1 Marijuana 

Past month marijuana use rates were higher among immigrants from Mexico (0.9 

percent), Puerto Rico (2.0 percent), El Salvador (1.4 percent), and Jamaica (5.5 percent) 

compared with immigrants from Cuba (0.2 percent). With the exception of Jamaica, immigrants 

from all other selected Latin American countries had prevalence rates for past month and past 

year marijuana use that were lower than the rates for U.S.-born individuals. Foreign-born U.S. 

residents from Mexico (2.3 percent), Puerto Rico (4.7 percent), and Jamaica (6.4 percent) had 

higher past year marijuana use rates than those from Cuba (0.8 percent) or El Salvador (1.8 

percent). 

4.1.2.2 Any Illicit Drugs 

The prevalence rates for any illicit drug use for both the past month and past year were 

higher among persons immigrating from Puerto Rico (7.7 and 13.6 percent, respectively) when 

compared with past month and past year rates for persons from Mexico (2.2 and 5.5 percent), 

Cuba (0.5 and 2.6 percent), or Colombia (2.1 and 4.9 percent). Prevalence rates for past month 

and past year any illicit drug use among foreign-born persons from Puerto Rico equaled rates for 

U.S.-born persons, while immigrants from Mexico, Cuba, El Salvador, and Colombia had 

prevalence rates lower than those for U.S.-born individuals. Immigrants from Mexico (2.2 and 

5.5 percent) and El Salvador (2.7 and 4.6 percent) had significantly higher prevalence rates than 

immigrants from Cuba (0.5 and 2.6 percent) on both illicit drug use measures. 

4.1.3 Tobacco Use 

Tobacco use prevalence rates (see Figures 6 and 7 and Tables C.16 and C.17) were 

higher among persons from Puerto Rico for both past month (31.0 percent) and past year use 

(35.7 percent) when compared with individuals from Mexico (20.8 and 26.2 percent), Cuba (17.6 

and 23.3 percent), El Salvador (17.6 and 24.1 percent), Jamaica (12.1 and 13.7 percent), or 

Colombia (18.2 and 23.4 percent). Past month and past year tobacco use rates for immigrants 

from Puerto Rico were similar to rates for U.S.-born persons (32.8 and 38.2 percent). Immigrants 

from Mexico, Cuba, El Salvador, Jamaica, and Colombia had past month and past year tobacco 

use prevalence rates that were lower than those for persons born in the United States. 

4.1.4 Summary 

With the exception of past month alcohol use, immigrants from Cuba had lower 

prevalence rates across all measures of substance use (i.e., binge drinking, heavy drinking, 

marijuana use, any illicit drug use, and tobacco use). However, an examination of demographic 

characteristics reveals that more than half of the foreign-born persons from Cuba were aged 50 

or older, partially explaining the observed lower substance use rates. Immigrants from Puerto 

Rico had prevalence rates that were equal to rates for U.S.-born persons for past month weekly 

alcohol consumption, past month binge and heavy drinking, and past month and past year 

tobacco and any illicit drug use. 
23 

4.2. Substance Use among Immigrants from Selected Asian Countries 

4.2.1 Alcohol Use 

Alcohol use rates and past month weekly consumption of alcohol were examined for the 

following individual Asian countries among respondents aged 18 or older: Japan, Korea, the 

Philippines, China, Vietnam, and India. Table C.4 shows the demographic characteristics for 

immigrants from individual Asian countries. Table C.14 and Figure 8 show past month alcohol 

use comparisons for Asian immigrants and U.S.-born persons. 

Figure 8. Past Month Alcohol Use among U.S. Residents Aged 18 or Older Who Are 

Either U.S.-Born Persons or Foreign-Born Persons from Selected Asian 

Countries 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

Immigrants from Japan (62.1 percent) and Korea (53.2 percent) had a higher prevalence 

of past month alcohol use than immigrants from the Philippines (24.1 percent), China (28.4 

percent), Vietnam (26.4 percent), and India (26.6 percent). Korean and Japanese immigrants also 

reported a higher prevalence of past month binge drinking (27.9 and 18.6 percent, respectively) 

than immigrants from the Philippines (8.9 percent), China (7.5 percent), and India (7.8 percent). 

Immigrants from Korea had a higher prevalence of past month heavy drinking (3.5 percent) than 

immigrants from the Philippines (0.6 percent), China (0.7 percent), or Vietnam (0.6 percent). 

A somewhat different pattern was observed for past month weekly alcohol consumption. 

Although Korean immigrants had the highest level of consumption, consuming on average 7.5 

drinks per week, immigrants from Vietnam had the second highest past month weekly 

consumption rate of 5.1 drinks per week, followed closely by Filipino and Japanese immigrants 

52.4

62.1

53.2

24.1

28.4 26.4 26.6

22.3

18.6

27.9

8.9 7.5

11.7

7.8

0.7

4.2 6.5

3.5

0.6 0.6 3.3

0

10

20

30

40

50

60

70

United

States

Japan Korea Philippines China Vietnam India

Percent Using in Past Month

Past Month Alcohol Use Past Month Binge Alcohol Use

Past Month Heavy Alcohol Use

Country of Birth

52.4

62.1

53.2

24.1

28.4 26.4 26.6

22.3

18.6

27.9

8.9 7.5

11.7

7.8

0.7

4.2 6.5

3.5

0.6 0.6 3.3

0

10

20

30

40

50

60

70

United

States

Japan Korea Philippines China Vietnam India

Percent Using in Past Month

Past Month Alcohol Use Past Month Binge Alcohol Use

Past Month Heavy Alcohol Use

Country of Birth
24 

at 4.6 and 3.5 drinks per week on average, respectively. Past month weekly alcohol consumption 

was significantly lower for immigrants from China (1.5 drinks) when compared with Korean, 

Japanese, Vietnamese, and Filipino immigrants. For most Asian immigrant groups, past month 

weekly alcohol consumption was higher with longer time spent in the United States. Immigrants 

from Korea, Japan, Vietnam, and the Philippines showed higher levels of use, while immigrants 

from China and India reported no differences in past month weekly alcohol consumption with 

longer time spent in the United States (see Table C.15). China and India had the largest 

percentages of immigrants who had been in the United States for fewer than 5 years (32.7 and 

40.5 percent, respectively), which may contribute to their lower alcohol use rates (see Table 

C.4). 

When comparing rates for persons from individual Asian countries with rates for U.S.-

born individuals, Korean and Japanese immigrants had prevalence rates for past month alcohol 

use and past month heavy drinking that were similar to those for individuals born in the United 

States. Across all alcohol use measures, rates for immigrants from China, Vietnam, India, and 

the Philippines were lower than the rates for the U.S.-born population. 

4.2.2 Illicit Drug Use 

Figures 9 and 10 and Tables C.16 and C.17 show past month and past year illicit drug use 

rates for immigrants from the Asian region compared with rates for the U.S.-born population. 

4.2.2.1 Marijuana 

Prevalence rates for past month marijuana use were significantly higher among 

immigrants aged 18 or older from Japan (5.6 percent) and Korea (3.2 percent) when compared 

with adult immigrants from China (0.2 percent), the Philippines (0.9 percent), or India (0.1 

percent). Further, past month prevalence rates for Japanese immigrants were higher than those 

for Vietnamese immigrants (1.3 percent). Past year marijuana use rates showed a similar pattern, 

with immigrants from Japan (9.9 percent) and Korea (4.9 percent) exhibiting higher rates than 

those from China (1.1 percent), the Philippines (1.3 percent), or India (0.3 percent). Japanese 

rates also exceeded those for Vietnamese immigrants (2.0 percent). Foreign-born persons from 

Japan and Korea had past month marijuana use rates that were similar to rates for U.S.-born 

persons. 

4.2.2.2 Any Illicit Drugs 

Past month and past year rates of any illicit drug use were higher among immigrants aged 

18 or older from Japan (8.0 and 12.9 percent, respectively) and Korea (5.8 and 8.3 percent) when 

compared with adult immigrants from India (1.2 and 2.3 percent), the Philippines (1.1 and 1.8 

percent), or China (0.2 and 2.2 percent). Japanese immigrants also had higher rates for past year 

use when compared with immigrants from Vietnam (4.1 percent). Foreign-born persons from the 

Philippines had higher rates of past month use of any illicit drug than did individuals born in 

China. Immigrants from Korea and Japan had past month and past year any illicit drug use rates 

that were similar to rates for U.S.-born individuals. 
25 

Figure 9. Past Month Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Selected Asian Countries 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

Figure 10. Past Year Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Selected Asian Countries 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

24.0

30.2

13.5

10.1

25.5

10.2

32.8

3.2

0.1 1.3 0.2 0.9

5.6

5.1

6.6 5.8

1.2 2.3

0.2 1.1

8.0

0

5

10

15

20

25

30

35

United

States

Japan Korea Philippines China Vietnam India

Percent Using in Past Month

Past Month Tobacco Use Past Month Marijuana Use

Past Month Any Illicit Drug Use

Country of Birth

24.0

30.2

13.5

10.1

25.5

10.2

32.8

3.2

0.1 1.3 0.2 0.9

5.6

5.1

6.6 5.8

1.2 2.3

0.2 1.1

8.0

0

5

10

15

20

25

30

35

United

States

Japan Korea Philippines China Vietnam India

Percent Using in Past Month

Past Month Tobacco Use Past Month Marijuana Use

Past Month Any Illicit Drug Use

Country of Birth

26.1

33.4

16.7

13.5

27.3

12.2

38.2

9.9

4.9

1.3 1.1 2.0 0.3

8.8

11.5 12.9

8.3

1.8 2.2

4.1

2.3

0

5

10

15

20

25

30

35

40

45

United

States

Japan Korea Philippines China Vietnam India

Percent Using in Past Year

Past Year Tobacco Use Past Year Marijuana Use

Past Year Any Illicit Drug Use

Country of Birth

26.1

33.4

16.7

13.5

27.3

12.2

38.2

9.9

4.9

1.3 1.1 2.0 0.3

8.8

11.5 12.9

8.3

1.8 2.2

4.1

2.3

0

5

10

15

20

25

30

35

40

45

United

States

Japan Korea Philippines China Vietnam India

Percent Using in Past Year

Past Year Tobacco Use Past Year Marijuana Use

Past Year Any Illicit Drug Use

Country of Birth
26 

4.2.3 Tobacco Use 

Past month tobacco use rates (see Figures 9 and 10 and Tables C.16 and C.17) were 

higher for immigrants aged 18 or older from Japan (24.0 percent), Korea (30.2 percent), and 

Vietnam (25.5 percent) compared with adult immigrants from the Philippines (13.5 percent) or 

China (10.1 percent). 

For past year tobacco use, foreign-born persons from Japan (26.1 percent), Korea (33.4 

percent), and Vietnam (27.3 percent) had higher rates than persons from China (13.5 percent). 

Past year tobacco use rates for individuals from Korea and Vietnam exceeded rates for persons 

from the Philippines (16.7 percent). 

4.2.4 Summary 

Clearly, there is wide variability among Asian immigrants in rates of substance use, with 

immigrants from Korea and Japan consistently showing the highest rates of alcohol use and 

Chinese, Vietnamese, Filipino, and Indian immigrants evidencing the lowest rates. Here again, 

demographic analysis provides some insight into a potential contributing factor for the observed 

higher rates. A higher proportion of immigrants from Korea and Japan were among the youngest 

age group, which consistently demonstrated higher rates of alcohol use among the immigrant 

sample and among U.S.-born populations. Tobacco and marijuana use rates followed this same 

pattern, with the countries comprised of the youngest age groups (Korea, Japan, and Vietnam) 

evidencing the highest rates of use. 

4.3. Substance Use among Immigrants from Selected European Countries 

4.3.1 Alcohol Use 

Alcohol use rates and past month weekly consumption among current drinkers were 

examined for three groups of European immigrants aged 18 or older. Immigrants from Germany, 

the United Kingdom (England, Scotland, Wales, and Ireland), and Poland were compared. Table 

C.5 shows the demographic characteristics for this regional grouping, and Figure 11 and Table 

C.14 show past month alcohol use comparisons for immigrants from these European countries. 

Immigrants from the United Kingdom had higher rates of past month alcohol use (67.5 

percent), past month binge drinking (31.3 percent), and past month heavy drinking (12.2 percent) 

when compared with German immigrants, whose past month alcohol use was significantly lower 

(49.3 percent), as were their rates for binge drinking (17.3 percent) and heavy drinking (5.3 

percent). The past month heavy drinking rate for United Kingdom immigrants exceeded that for 

Polish immigrants (4.4 percent). Past month alcohol use (55.9 percent) and past month binge 

drinking (23.8 percent) for immigrants from Poland were similar to those for immigrants from 

the United Kingdom. 

Past month weekly alcohol consumption amounts among current drinkers also were 

higher among immigrants from the United Kingdom (10.2 drinks) when compared with 

immigrants from Germany (5.3 drinks) and Poland (4.1 drinks). Immigrants from Germany who 

had been in the United States for 5 years or more had higher past month weekly consumption 
27 

Figure 11. Past Month Alcohol Use among U.S. Residents Aged 18 or Older Who Are 

Either U.S.-Born Persons or Foreign-Born Persons from Selected European 

Countries 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

rates (5.4 drinks) than those who had been in the United States for fewer than 5 years (3.6 drinks) 

(see Table C.15). Immigrants from the United Kingdom who had been in the United States for 5 

years or longer had similar past month weekly consumption rates than those who had been in the 

United States for less time (10.0 vs. 11.5 drinks). Immigrants from Poland showed no differences 

in past month weekly alcohol consumption amounts whether they had been in the United States 

for 5 or more or fewer than 5 years (4.0 vs. 4.6 drinks). 

Immigrants from the United Kingdom also had alcohol use rates that were higher than 

those for U.S.-born individuals. Their past month alcohol use (67.5 vs. 52.4 percent), past month 

binge drinking (31.3 vs. 22.3 percent), and past month heavy drinking (12.2 vs. 6.5 percent) rates 

all showed a pattern of higher use when compared with U.S.-born persons. Past month weekly 

consumption amounts were similar for immigrants from the United Kingdom (10.2 drinks) and 

U.S.-born individuals (8.3 drinks). 

4.3.2 Illicit Drug Use 

Past month and past year illicit drug use rates for immigrants from selected European 

countries are shown in Figures 12 and 13 and in Tables C.16 and C.17. 

4.3.2.1 Marijuana 

There were no significant differences in the rates for past month and past year marijuana 

use among immigrants from Germany (4.0 and 7.4 percent, respectively), the United Kingdom 

52.4 49.3

67.5

55.9

17.3

31.3

23.8

6.5 5.3

12.2

4.4

22.3

0

10

20

30

40

50

60

70

80

United States Germany United Kingdom Poland

Percent Using in Past Month

Past Month Alcohol Use Past Month Binge Alcohol Use

Past Month Heavy Alcohol Use

Country of Birth

52.4 49.3

67.5

55.9

17.3

31.3

23.8

6.5 5.3

12.2

4.4

22.3

0

10

20

30

40

50

60

70

80

United States Germany United Kingdom Poland

Percent Using in Past Month

Past Month Alcohol Use Past Month Binge Alcohol Use

Past Month Heavy Alcohol Use

Country of Birth
28 

Figure 12. Past Month Tobacco, Marijuana, and Any Illicit Drug Use among U.S. 

Residents Aged 18 or Older Who Are Either U.S.-Born Persons or ForeignBorn Persons from Selected European Countries 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

Figure 13. Past Year Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Selected European Countries 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

38.2

33.3 34.3

21.9

7.4 7.5

4.0

11.5

9.4 8.8 8.4 8.8

0

5

10

15

20

25

30

35

40

45

United States Germany United Kingdom Poland

Past Year Tobacco Use Past Year Marijuana Use

Past Year Any Illicit Drug Use

Country of Birth

Percent Using in Past Year

38.2

33.3 34.3

21.9

7.4 7.5

4.0

11.5

9.4 8.8 8.4 8.8

0

5

10

15

20

25

30

35

40

45

United States Germany United Kingdom Poland

Past Year Tobacco Use Past Year Marijuana Use

Past Year Any Illicit Drug Use

Country of Birth

Percent Using in Past Year

32.8

30.0 31.7

16.9

4.0 3.9

1.8

6.6 5.1 4.4 5.3 5.1

0

5

10

15

20

25

30

35

United States Germany United Kingdom Poland

Percent Using in Past Month

Past Month Tobacco Use Past Month Marijuana Use

Past Month Any Illicit Drug Use

Country of Birth

32.8

30.0 31.7

16.9

4.0 3.9

1.8

6.6 5.1 4.4 5.3 5.1

0

5

10

15

20

25

30

35

United States Germany United Kingdom Poland

Percent Using in Past Month

Past Month Tobacco Use Past Month Marijuana Use

Past Month Any Illicit Drug Use

Country of Birth
29 

(3.9 and 7.5 percent), and Poland (1.8 and 4.0 percent). The past year marijuana use rate for 

immigrants from Poland (4.0 percent) was lower than the rate for U.S.-born persons (8.8 

percent). 

4.3.2.2 Any Illicit Drugs 

Past month and past year any illicit drug use rates were nearly identical for immigrants 

from Germany (5.1 and 9.4 percent, respectively), the United Kingdom (4.4 and 8.4 percent), 

and Poland (5.3 and 8.8 percent). 

4.3.3 Tobacco Use 

Past month and past year tobacco use rates for immigrants from selected European 

countries are shown in Figures 12 and 13 and in Tables C.16 and C.17. Past month tobacco use 

rates showed significant differences among selected European immigrants aged 18 or older, with 

immigrants from Germany (30.0 percent) and the United Kingdom (31.7 percent) yielding higher 

rates than Polish immigrants (16.9 percent). There were similar differences in past year tobacco 

use rates, with immigrants from Germany (33.3 percent) and the United Kingdom (34.3 percent) 

demonstrating higher rates than Polish immigrants (21.9 percent). Past month and past year 

tobacco use rates among immigrants from Germany and the United Kingdom were similar to 

rates for U.S.-born persons (32.8 and 38.2 percent). 

4.3.4 Summary 

Substance use rates among immigrants from selected European countries were equal to or 

higher than rates for U.S.-born persons for the use of alcohol and tobacco. With respect to 

alcohol use, the United Kingdom and Poland had the highest rates for past month use (any past 

month use and past month binge drinking). Tobacco use rates were highest for immigrants from 

the United Kingdom and Germany. 

4.4. Substance Use among Immigrants from Canada 

4.4.1 Alcohol Use 

Alcohol use rates and past month weekly consumption of alcohol among current drinkers 

were examined for Canadian immigrants. Figure 14 shows past month alcohol use comparisons 

for Canadian immigrants and U.S.-born persons (see also Tables C.14 and C.15). Demographic 

characteristics for Canadian immigrants are shown in Table C.5. 

Immigrants from Canada reported higher rates of past month (64.5 percent) and past year 

alcohol use (78.3 percent) than U.S.-born persons, whose rates were 52.4 percent and 67.8 

percent. The average past month weekly consumption rate for immigrants from Canada (5.2 

drinks) was lower than that for U.S.-born individuals (8.3 drinks). Immigrants from Canada 

showed a similar pattern of past month binge drinking and past month heavy drinking (19.4 and 

5.3 percent, respectively) as U.S.-born persons (22.3 and 6.5 percent). Canadian-born persons 

living in the United States showed no differences in past month weekly alcohol consumption 

after being in the United States for 5 or more years. 
30 

Figure 14. Past Month Alcohol Use among U.S. Residents Aged 18 or Older Who Are 

Either U.S.-Born Persons or Foreign-Born Persons from Canada 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

4.4.2 Illicit Drug Use 

Past month and past year illicit drug use rates for Canadian immigrants are shown in 

Figures 15 and 16 and in Tables C.16 and C.17. 

4.4.2.1 Marijuana 

Past month and past year rates for marijuana use were similar when comparing 

immigrants from Canada (4.3 and 7.1 percent, respectively) with U.S.-born persons (5.1 and 8.8 

percent). 

4.4.2.2 Any Illicit Drugs 

There were no differences in past month or past year any illicit drug use rates when 

comparing Canadian immigrants (4.8 and 8.9 percent, respectively) with U.S.-born individuals 

(6.6 and 11.5 percent). 

4.4.3 Tobacco Use 

A comparison of the past month and past year tobacco use rates for immigrants from 

Canada and U.S.-born persons showed lower rates for the immigrant sample on both past month 

(25.9 vs. 32.8 percent) and past year use (30.6 vs. 38.2 percent) (see Figures 15 and 16 and 

Tables C.16 and C.17). 

52.4

64.5

19.4

6.5 5.3

22.3

0

10

20

30

40

50

60

70

United States Canada

Past Month Alcohol Use Past Month Binge Alcohol Use

Past Month Heavy Alcohol Use

Country of Birth

Percent Using in Past Month

52.4

64.5

19.4

6.5 5.3

22.3

0

10

20

30

40

50

60

70

United States Canada

Past Month Alcohol Use Past Month Binge Alcohol Use

Past Month Heavy Alcohol Use

Country of Birth

Percent Using in Past Month
31 

Figure 15. Past Month Tobacco, Marijuana, and Any Illicit Drug Use among U.S. 

Residents Aged 18 or Older Who Are Either U.S.-Born Persons or ForeignBorn Persons from Canada 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

Figure 16. Past Year Tobacco, Marijuana, and Any Illicit Drug Use among U.S. Residents 

Aged 18 or Older Who Are Either U.S.-Born Persons or Foreign-Born Persons 

from Canada 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

32.8

25.9

4.3

6.6

5.1 4.8

0

5

10

15

20

25

30

35

United States Canada

Past Month Tobacco Use Past Month Marijuana Use

Past Month Any Illicit Drug Use

Country of Birth

Percent Using in Past Month

32.8

25.9

4.3

6.6

5.1 4.8

0

5

10

15

20

25

30

35

United States Canada

Past Month Tobacco Use Past Month Marijuana Use

Past Month Any Illicit Drug Use

Country of Birth

Percent Using in Past Month

38.2

30.6

7.1

11.5

8.8 8.9

0

5

10

15

20

25

30

35

40

45

United States Canada

Past Year Tobacco Use Past Year Marijuana Use

Past Year Any Illicit Drug Use

Country of Birth

Percent Using in Past Year

38.2

30.6

7.1

11.5

8.8 8.9

0

5

10

15

20

25

30

35

40

45

United States Canada

Past Year Tobacco Use Past Year Marijuana Use

Past Year Any Illicit Drug Use

Country of Birth

Percent Using in Past Year
32 

4.4.4 Summary 

Although Canadian immigrants had higher past month and past year alcohol use rates 

than U.S.-born persons, other indices of alcohol, marijuana, and illicit drug use essentially 

mirrored substance use rates for U.S.-born persons. This may be a reflection of the close 

proximity of Canada to the United States or perhaps is due to the demographic similarities 

between the two countries. Education, employment, and household income rates for immigrants 

from Canada were similar to rates for U.S.-born individuals. 
33 

References 

Alaniz, M. L. (1998). Alcohol availability and targeted advertising in racial/ethnic minority 

communities. Alcohol Health & Research World, 22, 286-289. 

Alaniz, M. L. (2002). Migration, acculturation, displacement: Migratory workers and "substance 

abuse." Substance Use & Misuse, 37, 1253-1257. 

Amodeo, M., Robb, N., Peou, S., & Tran, H. (1997). Alcohol and other drug problems among 

southeast Asians: Patterns of use and approaches to assessment and intervention. Alcoholism 

Treatment Quarterly, 15(3), 63-77. 

Aquilino, W. S. (1994). Interview mode effects in surveys of drug and alcohol use: A field 

experiment. Public Opinion Quarterly, 58, 210-240. 

Bennett, L. A., Campillo, C., Chandrashekar, C. R., & Gureje, O. (1998). Alcoholic beverage 

consumption in India, Mexico, and Nigeria: A cross-cultural comparison. Alcohol Health & 

Research World, 22, 243-252. 

Bray, R. M., Hourani, L. L., Rae, K. L., Dever, J. A., Brown, J. M., Vincus, A. A., Pemberton, 

M. R., Marsden, M. E., Faulkner, D. L., & Vandermaas-Peeler, R. (2003, July). 2002 

Department of Defense Survey of Health Related Behaviors Among Military Personnel: Final 

report (Report No. RTI/7034/006-FR, prepared for the Assistant Secretary of Defense [Health 

Affairs], U.S. Department of Defense, Cooperative Agreement No. DAMD17-96-2-6021). 

Research Triangle Park, NC: RTI International. 

Bray, R. M., & Marsden, M. E. (Eds.). (1999). Drug use in metropolitan America. Thousand 

Oaks, CA: Sage Publications. 

Caetano, R. (1988). Alcohol use among Hispanic groups in the United States. American Journal 

of Drug and Alcohol Abuse, 14, 293-308. 

Caetano, R., Clark, C. L., & Tam, T. (1998). Alcohol consumption among racial/ethnic 

minorities: Theory and research. Alcohol Health & Research World, 22, 233-238. 

Castillo, M., & Henderson, G. (2002). Hispanic substance abusers in the United States. In G. X. 

Ma & G. Henderson (Eds.), Ethnicity and substance abuse: Prevention and intervention (pp. 

191-206). Springfield, IL: Charles C Thomas, Ltd. 

Deville, J. C., & Särndal, C. E. (1992). Calibration estimating in survey sampling. Journal of the 

American Statistical Association, 87, 376-382. 

Elder, J. P., Campbell, N. R., Litrownik, A. J., Ayala, G. X., Slymen, D. J., Parra-Medina, D. , & 

Lovato, C. Y. (2000). Predictors of cigarette and alcohol susceptibility and use among Hispanic 

migrant adolescents. Preventive Medicine, 31(2 Pt 1), 115-123. 
34 

Escobar, J. I., Nervi, C. H., & Gara, M. A. (2000). Immigration and mental health: Mexican 

Americans in the United States. Harvard Review of Psychiatry, 8(2), 64-72. 

Folsom, R. E., & Singh, A. C. (2000). The generalized exponential model for sampling weight 

calibration for extreme values, nonresponse, and poststratification. In Proceedings of the 2000 

Joint Statistical Meetings, American Statistical Association, Survey Research Methods Section,

Indianapolis, IN (pp. 598-603). Alexandria, VA: American Statistical Association. [Available as 

a PDF at http://www.amstat.org/sections/SRMS/proceedings/] 

Gfroerer, J. (1993). An overview of the National Household Survey on Drug Abuse and related 

methodological research. In Proceedings of the Survey Research Section of the American 

Statistical Association, Joint Statistical Meetings, Boston, Massachusetts, August 1992 (pp. 464-

469). Alexandria, VA: American Statistical Association. 

Gfroerer, J. C., & Tan, L. L. (2003). Substance use among foreign-born youths in the United 

States: Does the length of residence matter? American Journal of Public Health, 93, 1892-1895. 

Gfroerer, J., Wright, D., & Kopstein, A. (1997). Prevalence of youth substance use: The impact 

of methodological differences between two national surveys. Drug and Alcohol Dependence, 

47(1), 19-30. 

Harrell, A. V. (1997). The validity of self-reported drug use data: The accuracy of responses on 

confidential self-administered answer sheets. In L. Harrison & A. Hughes (Eds.), The validity of 

self-reported drug use: Improving the accuracy of survey estimates (pp. 37-58, NIH Publication 

No. 97-4147, NIDA Research Monograph 167). Rockville, MD: National Institute on Drug 

Abuse. [Available at http://165.112.78.61/pdf/monographs/monograph167/download167.html] 

Harrison, L., & Hughes, A. (Eds.). (1997). The validity of self-reported drug use: Improving the 

accuracy of survey estimates (NIH Publication No. 97-4147, NIDA Research Monograph 167). 

Rockville, MD: National Institute on Drug Abuse. [Available at 

http://165.112.78.61/pdf/monographs/monograph167/download167.html] 

Hennessy, K. H., & Ginsberg, C. (Eds.). (2001). Substance use survey data collection 

methodologies and selected papers [Special issue]. Journal of Drug Issues, 31(3), 595-808. 

Hines, A. M., & Caetano, R. (1998). Alcohol and AIDS-related sexual behavior among 

Hispanics: Acculturation and gender differences. AIDS Education and Prevention, 10, 533-547. 

Johnson, T. P., VanGeest, J. B., & Cho, Y. I. (2002). Migration and substance use: Evidence 

from the U.S. National Health Interview Survey. Substance Use & Misuse, 37, 941-972. 

Makimoto, K. (1998). Drinking patterns and drinking problems among Asian-Americans and 

Pacific Islanders. Alcohol Health & Research World, 22, 270-275. 

Manly, B. F. J. (1986). Multivariate statistical methods: A primer. London, England: Chapman 

and Hall. 
35 

Office of Applied Studies. (2003). Results from the 2002 National Survey on Drug Use and 

Health: National findings (DHHS Publication No. SMA 03-3836, NSDUH Series H-22). 

Rockville, MD: Substance Abuse and Mental Health Services Administration. [Available at 

http://www.oas.samhsa.gov/p0000016.htm#Standard] 

O'Hare, T., & Van Tran, T. (1998). Substance abuse among Southeast Asians in the U.S.: 

Implications for practice and research. Social Work in Health Care, 26(3), 69-80. 

Ortega, A. N., Rosenheck, R., Alegria, M., & Desai, R. A. (2000). Acculturation and the lifetime 

risk of psychiatric and substance use disorders among Hispanics. Journal of Nervous and Mental 

Disease, 188, 728-735. 

Randolph, W. M., Stroup-Benham, C., Black, S. A., & Markides, K. S. (1998). Alcohol use 

among Cuban-Americans, Mexican-Americans, and Puerto Ricans. Alcohol Health & Research 

World, 22, 265-269. 

Rao, J. N. K., & Wu, C. F. J. (1985). Inference from stratified samples: Second-order analysis of 

three methods of nonlinear statistics. Journal of the American Statistical Association, 80, 620-

630. 

Rouse, B. A., Kozel, N. J., & Richards, L. G. (Eds.). (1985). Self-report methods of estimating 

drug use: Meeting current challenges to validity (NIDA Research Monograph 57, DHHS 

Publication No. ADM 85-1402). Rockville, MD: National Institute on Drug Abuse. 

RTI. (2001). SUDAAN user's manual: Release 8.0. Research Triangle Park, NC: Author. 

RTI International. (2003). 2001 National Household Survey on Drug Abuse: Methodological 

resource book (Report No. RTI 7190, prepared for the Substance Abuse and Mental Health 

Services Administration, Office of Applied Studies, under Contract No. 283-98-9008, 

Deliverable No. 28). Research Triangle Park, NC: Author. [Available as a PDF at 

http://www.oas.samhsa.gov/nhsda/methods.cfm#2k1] 

Shah, B. V., Barnwell, B. G., & Bieler, G. S. (1996). SUDAAN software for the statistical 

analysis of correlated data. Research Triangle Park, NC: Research Triangle Institute. 

Turner, C. F., Lessler, J. T., & Gfroerer, J. C. (Eds.). (1992). Survey measurement of drug use: 

Methodological studies (DHHS Publication No. ADM 92-1929). Rockville, MD: National 

Institute on Drug Abuse. 

World Health Organization. (2001, June). A summary of the global status report on alcohol

(Report No. WHO/NCD/MSD/2001.2). Geneva, Switzerland: Management of Substance 

Dependence, Non-Communicable Diseases, World Health Organization. [Available as a PDF at 

http://www.who.int/substance_abuse/publications/alcohol/en/, then

http://www.who.int/substance_abuse/publications/en/globalstatussummary.pdf] 
36 
37 

Appendix A: Description of the Survey 

A.1. Sample Design 

The 1999, 2000, and 2001 National Survey on Drug Use and Health (NSDUH)2 sample 

designs were part of a coordinated 5-year sample design to provide estimates for all 50 States 

plus the District of Columbia for the years 1999 through 2003. The coordinated design facilitates 

50 percent overlap in first-stage sampling units between each 2 successive years. 

For the 5-year 50-State design, eight States were designated as large sample States 

(California, Florida, Illinois, Michigan, New York, Ohio, Pennsylvania, and Texas), with 

samples large enough to support direct State estimates. For the remaining 42 States and the 

District of Columbia, smaller, but adequate, samples were selected to support State estimates 

using small area estimation (SAE) techniques. 

States were first stratified into a total of 900 field interviewer (FI) regions (48 regions in 

each large sample State and 12 regions in each small sample State). These regions were 

contiguous geographic areas designed to yield the same number of interviews on average. Within 

FI regions, adjacent census blocks were combined to form the first-stage sampling units, called 

area segments. A total of 96 segments per FI region were selected with probability proportional 

to population size in order to support the 5-year sample and any supplemental studies that the 

Substance Abuse and Mental Health Services Administration (SAMHSA) may choose to field. 

Eight sample segments per FI region were fielded during the 2000 survey year. Of these, four 

segments were retained in the 2001 year and four new segments were added, bringing the 

number of segments per FI region back to eight. 

These sampled segments were allocated equally into four separate samples, one for each 

3-month period during the year, so that the survey was essentially continuous in the field. In each 

of these area segments, a listing of all addresses was made, from which a sample of addresses 

was selected. In these sample units (which can be either households or units within group 

quarters), sample persons were randomly selected using an automated screening procedure 

programmed in a handheld computer carried by the interviewers. Youths aged 12 to 17 years and 

young adults aged 18 to 25 years were oversampled at this stage. Targeted sample sizes for 

youths aged 12 to 17 in 2000 and 2001 were 25,000 and 22,500, respectively. Targeted sample 

sizes in both years for both groups, the young adults aged 18 to 25 and those aged 26 or older, 

were 22,500 in both years. Thus, the total targeted sample sizes were 70,000 and 67,500 in 2000 

and 2001, respectively. 

The survey covers (a) residents of households living in houses/townhouses, apartments, 

condominiums, and so on; (b) residents living in noninstitutional group quarters, such as shelters, 

rooming/boarding houses, college dormitories, migratory workers' camps, and halfway houses; 

and (c) civilians living on military bases. Although the survey covers these types of units (they 

are given a nonzero probability of selection), sample sizes of most specific groups are too small 

to provide separate estimates. Persons excluded from the survey include homeless people who do 

 2

 Prior to 2002, the survey was known as the National Household Survey on Drug Abuse (NHSDA). 
38 

not use shelters, active military personnel, and residents of institutional group quarters, such as 

correctional facilities, nursing homes, mental institutions, and hospitals. 

A.2. Data Collection Methodology 

The data collection method used in NSDUH involves in-person interviews with sample 

persons, incorporating procedures that would be likely to increase respondents' cooperation and 

willingness to report honestly about their illicit drug use behavior. Confidentiality is stressed in 

all written and verbal communications with potential respondents, respondents' names are not 

collected with the data, and computer-assisted interviewing (CAI), including audio computerassisted self-interviewing (ACASI), is used to provide a private and confidential setting to 

complete the interview. 

Introductory letters are sent to sampled addresses, followed by an interviewer visit. A 5-

minute screening procedure conducted using a handheld computer involves listing all household 

members along with their basic demographic data. The computer uses the demographic data in a 

preprogrammed selection algorithm to select 0 to 2 sample persons, depending on the 

composition of the household. This selection process is designed to provide the necessary sample 

sizes for the specified population age groupings. 

Interviewers attempt to immediately conduct the NSDUH interview with each selected 

person in the household. The interviewer requests the selected respondent to identify a private 

area in the home away from other household members to conduct the interview. The interview 

averages about an hour and includes a combination of computer-assisted personal interviewing 

(CAPI) and ACASI. The interview begins in CAPI mode with the FI reading the questions from 

the computer screen and entering the respondent's replies into the computer. The interview then 

transitions to the ACASI mode for the sensitive questions. In this mode, the respondent can read 

the questions silently on the computer screen and/or listen to the questions read through 

headphones and enter his or her responses directly into the computer. At the conclusion of the 

ACASI section, the interview returns to the CAPI mode with the interviewer completing the 

questionnaire. 

No personal identifying information is captured in the CAI record for the respondent. At 

the end of the day when an interviewer has completed one or more interviews, he or she 

transmits the data to RTI International (a trade name of Research Triangle Institute) in Research 

Triangle Park, North Carolina, via home telephone lines. 

In identifying foreign-born respondents for these analyses, three questions were utilized: 

QD14 Were you born in the United States? 

 1 YES 

 2 NO 

 DK/REF 
39 

QD15 [IF QD14 = 2] In what country or U.S. territory were you born? 

 COUNTRY OR US TERRITORY: _______________________ 

 DK/REF 

QD16 [IF QD14 = 2] About how long have you lived in the United States? 

1 6 MONTHS OR LESS 

2 MORE THAN 6 MONTHS BUT LESS THAN 1 YEAR 

3 AT LEAST 1 YEAR BUT LESS THAN 5 YEARS 

4 AT LEAST 5 YEARS BUT LESS THAN 10 YEARS 

5 AT LEAST 10 YEARS BUT LESS THAN 15 YEARS 

6 15 YEARS OR MORE 

 DK/REF 

The first step in identifying foreign-born respondents was to note respondents who 

indicated that they were not born in the United States (QD14 = 2). Respondents who did not give 

a substantive answer (i.e., refused, answered "Don't Know," or responded with a nonexistent 

country) to QD15 were removed from the analysis. Given that comparisons between duration of 

time in United States were utilized, any respondents who failed to give an answer to QD16 also 

were removed from the analysis. Final sample sizes for these items among respondents aged 18 

or older are presented in Appendix B, Section B.3.2. 

A.3. Data Processing 

Interviewers initiate nightly data transmissions of interview data and call records on days 

when they work. Computers at RTI direct the information to a raw data file that consists of one 

record for each completed interview. Even though much editing and consistency checking is 

done by the CAI program during the interview, additional, more complex edits and consistency 

checks are completed at RTI. Resolution of most inconsistencies and missing data is done using 

machine-editing routines developed specifically for the CAI instrument. Cases are retained only 

if the respondent provided data on lifetime use of cigarettes and at least nine other substances. 

A.4. Statistical Imputation 

For some key variables that still have missing values after the application of editing, 

statistical imputation is used to replace missing data with appropriate response codes. 

Considerable changes in the imputation procedures used in prior surveys were introduced 

beginning with the 1999 CAI sample. Three types of statistical imputation procedures are used: 

(a) a standard unweighted sequential hot-deck imputation, (b) a univariate combination of 

weighted regression imputation and a random nearest neighbor hot-deck imputation (which 

could be viewed as a univariate predictive mean neighborhood method), and (c) a combination of 

weighted regression and a random nearest neighbor hot-deck imputation using a neighborhood 

where imputation is accomplished on several response variables at once (which could be viewed 

as a multivariate predictive mean neighborhood method). Because the primary demographic 
40 

variables (e.g., age, gender, race/ethnicity, employment, education) are imputed first, few 

variables are available for model-based imputation. Moreover, most demographic variables have 

a very low level of missingness. Hence, unweighted sequential hot deck is used to impute 

missing values for demographic variables. The demographic variables then can be used as 

covariates in models for drug use measures. These models also include other drug use variables 

as covariates. For example, the model for cocaine use includes cigarette, alcohol, and marijuana 

use as covariates. The univariate predictive mean neighborhood method is used as an 

intermediate imputation procedure for recency of use, 12-month frequency of use, 30-day 

frequency of use, and 30-day binge drinking frequency for all drugs where these variables occur. 

The final imputed values for these variables are determined using multivariate predictive mean 

neighborhoods. The final imputed values for age at first use for all drugs and age at first daily 

cigarette use are determined using univariate predictive mean neighborhoods. 

Hot-deck imputation involves the replacement of a missing value with a valid code taken 

from another respondent who is "similar" and has complete data. Responding and nonresponding 

units are sorted together by a variable or collection of variables closely related to the variable of 

interest Y. For sequential hot-deck imputation, a missing value of Y is replaced by the nearest 

responding value preceding it in the sequence. With random nearest neighbor hot-deck 

imputation, the missing value of Y is replaced by a responding value from a donor randomly 

selected from a set of potential donors close to the unit with the missing value according to some 

distance metric. The predictive mean neighborhood imputation involves determining a predicted 

mean using a model, such as a linear regression or logistic regression, depending on the response 

variable, where the models incorporate the design weights. In the univariate case, the 

neighborhood of potential donors is determined by calculating the relative distance between the 

predicted mean for an item nonrespondent and the predicted mean for each potential donor, and 

choosing those within a small preset value (this is the "distance metric"). The pool of donors is 

further restricted to satisfy logical constraints whenever necessary (e.g., age at first crack use 

must not be younger than age at first cocaine use). Whenever possible, more than one response 

variable was considered at a time. In that (multivariate) case, the Mahalanobis distance (Manly, 

1986) across a vector of several response variables' predicted means is calculated between a 

given item nonrespondent and each candidate donor. The k smallest Mahalanobis distances, say 

30, determine the neighborhood of candidate donors, and the nonrespondent's missing values in 

this vector are replaced by those of the randomly selected donor. A respondent may only be 

missing some of the responses within this vector of response variables; in that case, only the 

missing values were replaced, and donors were restricted to be logically consistent with the 

response variables that were not missing. 

Although statistical imputation could not proceed separately within each State due to 

insufficient pools of donors, information about the State of residence of each respondent is 

incorporated in the modeling and hot-deck steps. For most drugs, respondents were separated 

into three State usage categories for each drug depending on the response variable of interest; 

respondents from States with high usage of a given drug were placed in one category, 

respondents from medium usage States into another, and the remainder into a third category. 

This categorical "State rank" variable was used as one set of covariates in the imputation models. 

In addition, eligible donors for each item nonrespondent were restricted to be of the same State 

usage category (the same "State rank") as the item nonrespondent. 
41 

A.5. Development of Analysis Weights 

The general approach to developing and calibrating analysis weights involved developing 

design-based weights, k d , as the inverse of the selection probabilities of the households and 

persons. Adjustment factors, ( ), ak λ then were applied to the design-based weights to adjust for 

nonresponse, to poststratify to known population control totals, and to control for extreme 

weights when necessary. In view of the importance of State-level estimates with the 50-State 

design, it was necessary to control for a much larger number of known population totals. Several 

other modifications to the general weight adjustment strategy that had been used in past 

NSDUHs also were implemented for the first time beginning with the 1999 CAI sample. 

Weight adjustments were based on a generalization of Deville and Särndal's (1992) logit 

model. This generalized exponential model (GEM) (Folsom & Singh, 2000) incorporates unitspecific bounds ( , ), , A k k u ks ∈ for the adjustment factor ( ) ak λ as follows: 

( ) ( )exp( ) () , ( ) ( )exp( )− +− λ′ λ =

−+− λ′

A A

A

k k k k k k kk

k

k k k k kk

u c u c Ax

a

u c c Ax

where k c are prespecified centering constants, such that A kkk < c u < and 

=− − − ( ) / ( )( ). A A A u u cc k k k k kk k The variables , A k k c , and k u are user-specified bounds, and λ is 

the column vector of p model parameters corresponding to the p covariates x. The λ-parameters 

are estimated by solving 

i ∑ ( ) 0, λ − =x kkk s xda T

where i

Tx denotes control totals that could be either nonrandom, as is generally the case with 

poststratification, or random, as is generally the case for nonresponse adjustment. 

The final weights, ( ), w da k kk = λ minimize the distance function∆( ) w,d defined as 

( ) ( )log ( )log . ∈

⎧ ⎫ − − ∆ = − +− ⎨ ⎬ ⎩ ⎭ − − ∑ A A

A

k kk kk

kk kk

k s k k k kk

d a ua w,d a u a A c uc

This general approach was used at several stages of the weight adjustment process, 

including (1) adjustment of household weights for nonresponse at the screener level, (2) 

poststratification of household weights to meet population controls for various demographic 

groups by State, (3) adjustment of household weights for extremes, (4) poststratification of 

selected person weights, (5) adjustment of person weights for nonresponse at the questionnaire 

level, (6) poststratification of person weights, and (7) adjustment of person weights for extremes. 

Every effort was made to include as many relevant State-specific covariates (typically 

defined by demographic domains within States) as possible in the multivariate models used to 

calibrate the weights (nonresponse adjustment and poststratification steps). Because further 
42 

subdivision of State samples by demographic covariates often produced small cell sample sizes, 

it was not possible to retain all State-specific covariates (even after meaningful collapsing of 

covariate categories) and still estimate the necessary model parameters with reasonable 

precision. Therefore, a hierarchical structure was used in grouping States with covariates defined 

at the national level, at the census division level within the Nation, at the State-group within 

census division, and, whenever possible, at the State level. In every case, the controls for total 

population within State and the five age groups (12–17, 18–25, 26–34, 35–49, 50+) within State 

were maintained. Census control totals by age, race, gender, and Hispanicity were required for 

the civilian, noninstitutionalized population of each State. The Population Estimates Branch of 

the U.S. Bureau of the Census produced the necessary population estimates. 

Beginning with the 1999 survey, control of extreme weights through separate bounds for 

adjustment factors was incorporated into the GEM calibration processes for both nonresponse 

and poststratification. This is unlike the traditional method of winsorization in which extreme 

weights are truncated at prespecified levels and the trimmed portions of weights are distributed 

to the nontruncated cases. In GEM, it is possible to set bounds around the prespecified levels for 

extreme weights, and then the calibration process provides an objective way of deciding the 

extent of adjustment (or truncation) within the specified bounds. An additional step poststratified 

the selected person sample to conform with the adjusted roster estimates. This additional step 

takes advantage of the inherent two-phase nature of the NSDUH design. The final step 

poststratified the respondent person sample to external census data (defined within State 

whenever possible as discussed above). For more detailed information, see the 2001 NHSDA 

Methodological Resource Book (RTI International, 2003). 

As is standard in all NSDUH analyses that combine data across multiple years, the final 

analysis weights are divided by the number of years combined in order to produce an average 

population estimate across the years of interest. In the case of this report on immigrants and 

substance use, which combines data from the 1999 through 2001 surveys, the final analysis 

weights of each year are divided by 3. 
43 

Appendix B: Statistical Methods and 

Limitations of the Data 

B.1. Target Population 

An important limitation of National Survey on Drug Use and Health (NSDUH)3 estimates 

of drug use prevalence is that they are designed to describe only the target population of the 

survey (e.g., civilian, noninstitutionalized persons aged 12 or older). Although this population 

includes almost 98 percent of the total U.S. population aged 12 or older, it does exclude some 

important and unique subpopulations who may have very different drug-using patterns. The 

survey excludes active military personnel, who have been shown to have significantly lower 

rates of illicit drug use (Bray et al., 2003). Persons living in institutional group quarters, such as 

prisons and residential drug treatment centers, are not included in NSDUH and have been shown 

in other surveys to have higher rates of illicit drug use (Bray & Marsden, 1999). Also excluded 

are homeless persons not living in a shelter on the survey date, another population shown to have 

higher than average rates of illicit drug use. 

B.2. Sampling Error and Statistical Significance 

The sampling error of an estimate is the error caused by the selection of a sample instead 

of conducting a census of the population. Sampling error is reduced by selecting a large sample 

and by using efficient sample design and estimation strategies, such as stratification, optimal 

allocation, and ratio estimation. 

With the use of probability sampling methods in NSDUH, it is possible to develop 

estimates of sampling error from the survey data. These estimates have been calculated for all 

prevalence estimates presented in this report using a Taylor series linearization approach that 

takes into account the effects of the complex NSDUH design features. The sampling errors are 

used to identify unreliable estimates and to test for the statistical significance of differences 

between estimates. 

B.2.1 Variance Estimation 

Estimates of proportions, such as drug use prevalence rates, take the form of nonlinear 

statistics where the variances cannot be expressed in closed form. Variance estimation for 

nonlinear statistics is performed using a first-order Taylor series approximation in RTI's 

SUDAAN® software package (Shah, Barnwell, & Bieler, 1996). The approximation is unbiased 

for sufficiently large samples and has proven to be at least as accurate as and less costly to 

implement than its competitors, such as balanced repeated replication or jackknife methods (Rao 

& Wu, 1985). 

 3

 Prior to 2002, the survey was known as the National Household Survey on Drug Abuse (NHSDA). 
44 

B.2.2 Suppression Rules for Unreliable Estimates 

In NSDUH reports, survey estimates considered to be unreliable due to large sampling 

errors generally are not shown. For this report, to give the most complete results possible, 

unreliable estimates are shown, with an asterisk beside each estimate. The number of unreliable 

estimates is small, and standard errors (SEs) are presented along with all estimates of substance 

use so readers can make their own assessment of the reliability. The criteria normally used for 

suppressing estimates are based on the relative standard error (RSE), which is defined as the ratio 

of the SE over the estimate, as well as on nominal sample size and on effective sample size. The 

criteria are summarized in Table B.1. 

Table B.1 Summary of NSDUH Suppression Rules 

Estimate Suppress if: 

Prevalence rate, pˆ , 

with nominal sample 

size, n, and design 

effect, deff

The estimated prevalence rate, pˆ , is < 0.00005 or $ 0.99995, or 

> 0.175 -ln( ˆ)

SE( ˆ) / ˆ

p

p p when pˆ ≤ 0.5 , or 

> 0.175 -ln(1 - ˆ)

SE( ˆ) / (1 - ˆ)

p

p p when pˆ > 0.5 , or 

Effective n < 68 , or 

n <100 , 

where

deff

n Effective n = . 

Note: The rounding portion of this suppression rule for prevalence rates will produce 

some estimates that round at one decimal place to 0.0 or 100.0 percent but are 

not suppressed from the tables. 

Estimated number 

(numerator of pˆ ) 

The estimated prevalence rate, pˆ , is suppressed. 

Note: In some instances when pˆ is not suppressed, the estimated number may appear 

as a 0 in the tables; this means that the estimate is > 0 but < 500 (estimated 

numbers are shown in thousands). 

Means not bound 

between 0 and 1, x , 

with nominal sample 

size, n

RSE(x) > 0.5 , or 

n <10 . 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health. 

Proportion estimates ( pˆ ) within the range [0 < pˆ < 1], rates, and corresponding 

estimated number of users were suppressed if 

RSE[-ln( pˆ )] > 0.175 when pˆ # 0.5 

or 

RSE[-ln(1 - pˆ )] > 0.175 when pˆ > 0.5. 
45 

Using a first-order Taylor series approximation to estimate RSE[-ln( pˆ )] and RSE[-ln(1 - 

pˆ )], the following was obtained and used for computational purposes: 

ln( ˆ)

( ˆ)/ ˆ

p

SE p p

− > 0.175 when pˆ ≤ 0.5 

or 

( ˆp )

SE( ˆp )/( ˆp )

− −

−

ln 1

1 > 0.175 when pˆ > 0.5. 

The separate formulas for pˆ # 0.5 and pˆ > 0.5 produce a symmetric suppression rule 

(i.e., if pˆ is suppressed, then 1 - pˆ will be as well). This ad hoc rule requires an effective sample 

size in excess of 50. When 0.05 < pˆ < 0.95, the symmetric property of the rule produces a local 

maximum effective sample size of 68 at pˆ = 0.5. Thus, estimates with these values of pˆ along 

with effective sample sizes falling below 68 typically are suppressed. See Figure B.1 for a 

graphical representation of the required minimum effective sample sizes as a function of the 

proportion estimated. 

A minimum nominal sample size suppression criterion (n = 100) that protects against 

unreliable estimates caused by small design effects and small nominal sample sizes is usually 

employed. Prevalence estimates also are normally suppressed if they were close to 0 or 100 

percent (i.e., if pˆ < 0.00005 or if pˆ >  0.99995). 

Estimates of other totals (e.g., number of initiates) along with means and rates (both not 

bounded between 0 and 1) were suppressed if RSE( pˆ ) > 0.5 or if the sample size was smaller 

than 10 respondents. 

The typical suppression criteria for various NSDUH estimates are summarized in Table 

B.1. Values that would normally meet these criteria are noted with an asterisk (*) in the tables 

for this report. 

B.2.3 Statistical Significance of Differences

This section describes the methods used to compare prevalence estimates in this report. 

Customarily, the observed difference between estimates is evaluated in terms of its statistical 

significance. "Statistical significance" refers to the probability that a difference as large as that 

observed would occur due to random error in the estimates if there were no difference in the 

prevalence rates for the population groups being compared. The significance of observed 

differences in this report is examined at the 0.05 level and below. In this report, the terms 

"higher" or "lower" are used only when differences are statistically significant at the 0.05 level or 

below. When comparing prevalence estimates, the null hypothesis (no difference between 

prevalence rates) can be tested against the alternative hypothesis (there is a difference in 

prevalence rates) using the standard difference in proportions test expressed as follows: 

var( ˆp ) var( ˆp ) cov( ˆp ,ˆp )

ˆ

p ˆp Z

1 2 1 2

1 2

+ − 2

− = , 
46 

0

20

40

60

80

100

120

140

160

180

1 8 15 22 29 36 43 50 57 64 71 78 85 92 99

Proportion Estimated (P)

Required Effective Sample Size

Figure B.1 Required Effective Sample as a Function of the Proportion Estimated 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health. 

where 1 ˆp = first prevalence estimate, 2 ˆp = second prevalence estimate, var( 1 ˆp ) = variance of 

first prevalence estimate, var( 2 ˆ

p ) = variance of second prevalence estimate, and cov( 1 ˆp , 2 ˆp ) = 

covariance between 1 ˆ

p and 2 ˆp . 

Under the null hypothesis, Z is asymptotically distributed as a normal random variable. 

Calculated values of Z can therefore be referred to as the unit normal distribution to determine 

the corresponding probability level (i.e., p value). The covariance term in the formula for Z will 

not always be 0. Estimates of Z, along with its p value, were calculated in SUDAAN®, using the 

analysis weights and accounting for the sample design as described in Appendix A (RTI 

International, 2001). A similar procedure and formula for Z were used for estimated totals. 

Using the published estimates and standard errors to perform independent t tests for the 

difference of proportions will usually provide the same results as tests performed in SUDAAN®. 

However, where the significance level is borderline, results may differ for two reasons: (1) the 

covariance term is included in SUDAAN® tests whereas it is not included in independent t tests, 

and (2) the reduced number of significant digits shown in the published estimates may cause 

rounding errors in the independent t tests. 

B.3. Nonsampling Errors 

Nonsampling errors can occur from nonresponse, coding errors, computer processing 

errors, errors in the sampling frame, reporting errors, and other errors not due to sampling. 

Nonsampling errors are reduced through data editing, statistical adjustments for nonresponse, 
47 

close monitoring and periodic retraining of interviewers, and improvement in various quality 

control procedures. 

Although nonsampling errors can often be much larger than sampling errors, 

measurement of most nonsampling errors is difficult or impossible. However, some indication of 

the effects of some types of nonsampling errors can be obtained through proxy measures, such as 

response rates, and from other research studies. 

B.3.1 Response Rates 

Response rates for NSDUH were stable for the period from 1994 to 1998, with the 

screening response rate at about 93 percent and the interview response rate at about 78 percent 

(response rates discussed in this appendix are weighted). In 1999, the computer-assisted 

interviewing (CAI) screening response rate was 89.6 percent, and the interview response rate 

was 68.6 percent. A more stable and experienced field interviewer (FI) workforce improved 

these rates in 2000 and continued in 2001. Of the 171,519 eligible households sampled for the 

2001 NSDUH main study, 157,471 were successfully screened for a weighted screening 

response rate of 91.9 percent (Table B.2). 

In these screened households, a total of 61,557 sample persons aged 18 or older were 

selected, and completed interviews were obtained from 44,751 of these sample persons, for a 

weighted interview response rate of 72.3 percent. A total of 9,714 (16.9 percent) sample persons 

were classified as refusals, 3,876 (5.6 percent) were not available or never at home, and 2,216 

(5.2 percent) did not participate for various other reasons, such as physical or mental 

incompetence or language barrier (Table B.3). 

The overall weighted response rate, defined as the product of the weighted screening 

response rate and weighted interview response rate, was 60.4 percent in 1999, 67.7 percent in 

2000, and 66.4 percent in 2001 for persons aged 18 or older. Nonresponse bias is a function of 

the weighted nonresponse rate and the difference in the characteristic of interest between 

respondents and nonrespondents in the population (Pr - Pnr). Assuming the quantity (Pr - Pnr) is 

fixed over time, the improvement in response rates in 2000 and 2001 over 1999 will result in 

estimates with lower nonresponse bias. 

B.3.2 Inconsistent Responses and Item Nonresponse 

Among survey participants, item response rates were above 98 percent for most 

questionnaire items. However, inconsistent responses for some items, including the drug use 

items, are common. Estimates of substance use from NSDUH are based on the responses to 

multiple questions by respondents, so that the maximum amount of information is used in 

determining whether a respondent is classified as a drug user. Inconsistencies in responses are 

resolved through a logical editing process that involves some judgment on the part of survey 

analysts and is a potential source of nonsampling error. Because of the automatic routing through 

the CAI questionnaire (e.g., lifetime drug use questions that skip entire modules when answered 

"no"), there is less editing of this type than in the paper-and-pencil interviewing (PAPI) 

questionnaire used prior to 1999. 
48 

Table B.2 Weighted Percentages and Sample Sizes for 1999 to 2001 NSDUHs, by 

Screening Result Code 

1999 2000 2001 

Screening Result 

Sample 

Size 

Weighted 

Percentage

Sample 

Size 

Weighted 

Percentage 

Sample 

Size 

Weighted 

Percentage 

Total Sample 223,868 100.00 215,860 100.00 203,544 100.00 

Ineligible cases 36,026 15.78 33,284 15.09 32,025 15.40 

Eligible cases 187,842 84.22 182,576 84.91 171,519 84.60 

Ineligibles 36,026 100.00 33,284 100.00 32,025 100.00 

Vacant 18,034 49.71 16,796 50.76 16,489 51.71 

Not a primary residence 4,516 12.90 4,506 13.26 4,706 14.69 

Not a dwelling unit 4,626 12.70 3,173 9.33 2,913 8.66 

All military personnel 482 1.22 414 1.21 327 0.93 

Other, ineligible 8,368 23.46 8,395 25.43 7,590 24.00 

Eligible Cases 187,842 100.00 182,576 100.00 171,519 100.00 

Screening complete 169,166 89.63 169,769 92.84 157,471 91.86 

No one selected 101,537 54.19 99,999 55.36 90,530 52.11 

One selected 44,436 23.63 46,981 25.46 43,601 25.94 

Two selected 23,193 11.82 22,789 12.03 23,340 13.82 

Screening not complete 18,676 10.37 12,807 7.16 14,048 8.14 

No one home 4,291 2.38 3,238 1.82 3,383 1.90 

Respondent 

unavailable 651 0.36 415 0.24 392 0.24 

Physically or mentally 

incompetent 419 0.24 310 0.16 357 0.20 

Language barrier—

Hispanic 102 0.06 83 0.05 130 0.09 

Language barrier—

other 486 0.28 434 0.27 590 0.39 

Refusal 11,097 5.92 7,535 4.14 8,525 4.93 

Other, access denied 1,536 1.08 748 0.45 613 0.35 

Other, eligible 38 0.02 7 0.00 9 0.00 

Other, problem case 56 0.03 37 0.02 49 0.03 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999, 2000, and 2001. 

Table B.3 Weighted Percentages and Sample Sizes for 1999 to 2001 NSDUHs, by Final 

Interview Code, among Persons Aged 18 or Older 

1999 2000 2001 

Final Interview Code

Sample 

Size

Weighted 

Percentage

Sample 

Size

Weighted 

Percentage

Sample 

Size

Weighted 

Percentage

Total Selected Persons 57,872 100.00 60,719 100.00 61,557 100.00 

Interview complete 41,322 67.41 46,008 72.92 45,751 72.29 

No one at dwelling unit 1,473 2.25 1,498 2.16 1,474 2.12 

Respondent unavailable 3,025 4.71 2,441 3.69 2,402 3.43 

Breakoff 37 0.07 54 0.09 62 0.13 

Physically/mentally 

incompetent 773 2.85 819 2.78 801 2.62 

Language barrier—Spanish 153 0.13 99 0.09 172 0.18 

Language barrier—Other 422 1.62 391 1.16 436 1.43 

Refusal 9,468 19.41 8,654 16.22 9,714 16.92 

Parental refusal 3 0.00 14 0.01 0 0.00 

Other 1,196 1.55 741 0.89 745 0.88 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999, 2000, and 2001. 
49 

In addition, less logical editing is used because with the CAI data, statistical imputation is 

relied upon more heavily to determine the final values of drug use variables in cases where there 

is the potential to use logical editing to make a determination. The combined amount of editing 

and imputation in the CAI data is still considerably less than the total amount used in prior PAPI 

surveys. For the 2000 CAI data, for example, 3.2 percent of the estimate of past month 

hallucinogen use is based on logically edited cases and 5.4 percent on imputed cases, for a 

combined amount of 8.6 percent. The combined amount of editing and imputation for the 

estimate of past month heroin use is 5.0 percent for the 2000 CAI. 

No statistical imputation was performed on the three questions utilized to identify 

foreign-born respondents; however, when possible, logic edits were implemented. The following 

displays the frequency distributions of the three questions of interest among the 133,192 

respondents aged 18 or older from the 1999, 2000, and 2001 survey years. 

QD14 Were you born in the United States? 

1 = YES 116,591

2 = NO 16,339

3 = YES (Logically Assigned) 38

94 = DON'T KNOW 6

97 = REFUSED 74

98 = BLANK (NO ANSWER) 144

Logical skip patterns included only respondents who indicated being foreign-born to be routed 

through questions QD15 and QD16. All other respondents were logically edited as either 

legitimate skips (where QD14 = 1), or their assigned QD15 and QD16 values were maintained as 

the same as their QD14 responses (e.g., if QD14 = 97, then assigned values for QD15 and QD16 

also will be 97). Hence, because the latter respondents were routed out of QD15 and QD16, their 

sample counts are excluded from the following distributions. 

QD15 [IF QD14 = 2] In what country or U.S. territory were you born? 

554 = At sea 1

555 = Abroad, country not reported 14

801 = Born on U.S. military base; outside U.S. 18

985 = BAD DATA Logically assigned 118

994 = DON'T KNOW 18

997 = REFUSED 18

998 = BLANK (NO ANSWER) 9

There were 16,339 respondents who answered 2 = No to QD14 and therefore proceeded 

to answer QD15. Of those 16,339, a total of 16,143 gave a substantive answer to QD15. 
50 

QD16 [IF QD14 = 2] About how long have you lived in the United States? 

1 = 6 MONTHS OR LESS 690 

2 = MORE THAN 6 MONTHS BUT LESS THAN 1 YEAR 728 

3 = AT LEAST 1 YEAR BUT LESS THAN 5 YEARS 3,616 

4 = AT LEAST 5 YEARS BUT LESS THAN 10 YEARS 3,433 

5 = AT LEAST 10 YEARS BUT LESS THAN 15 YEARS 2,634 

6 = 15 YEARS OR MORE 5,220 

94 = DON'T KNOW 4 

97 = REFUSED 7 

98 = BLANK (NO ANSWER) 7 

Hence, of the 16,339 respondents who answered 2 = No to QD14, a total of 16,321 gave 

a substantive answer to QD16. 

Respondents who did not provide a substantive response to any of the QD14 to QD16 

questions were excluded from the analysis. This accounts for a net loss of 433 respondents, in 

which 224 cases are from QD14 and an additional 209 cases are foreign-born respondents who 

did not give a substantive response to either QD15 or QD16 or both. The final sample sizes used 

in the analysis include 116,629 U.S.-born respondents aged 18 or older and 16,130 foreign-born 

respondents aged 18 or older. 

B.3.3 Validity of Self-Reported Use 

NSDUH estimates are based on self-reports of drug use, and their value depends on 

respondents' truthfulness and memory. Although many studies have generally established the 

validity of self-report data and the NSDUH procedures were designed to encourage honesty and 

recall, some degree of underreporting is assumed. No adjustment to NSDUH data is made to 

correct for this due to a number of studies addressing the validity of self-reported drug use data 

(e.g., Harrell, 1997; Harrison & Hughes, 1997; Rouse, Kozel, & Richards, 1985). The 

methodology used in NSDUH has been shown to produce more valid results than other selfreport methods (e.g., by telephone) (Aquilino, 1994; Turner, Lessler, & Gfroerer, 1992). 

However, comparisons of NSDUH data with data from surveys conducted in classrooms suggest 

that underreporting of drug use by youths in their homes may be substantial (Gfroerer, 1993; 

Gfroerer, Wright, & Kopstein, 1997; Hennessy & Ginsberg, 2001). 
51 

Appendix C: 

Tables 
52 
53

Table C.1 Distributions of All Persons Aged 18 or Older, by Gender, Age, Length of Time in the United S

of Origin: 1999–2001 

Weighted

Country of Origin Sample Size 

Population 

(in 1,000s) % Male 

% Under Age 

35 

Total United States  Born in United States 116,629 173,976 47.6 30.3  Born outside United States 16,130 25,214 48.6 36.3 

Selected Latin American Countries 

 Mexico 5,181 6,759 53.9 48.1  Puerto Rico 515 862 42.1 22.7  Cuba 334 779 46.3 10.9  El Salvador 454 518 49.4 42.2  Jamaica 233 406 46.8 32.3  Colombia 267 411 48.3 28.9 

Selected Asian Countries 

 Japan 234 262 39.6 47.4  Korea 344 523 41.7 43.3  Philippines 675 1,519 36.7 21.9  China 291 589 46.4 31.3  Vietnam 310 530 49.6 47.6  India 647 1,060 54.9 43.4  Selected European Countries  Germany 526 958 39.3 22.5  United Kingdom 359 723 44.5 25.1  Poland 171 323 45.3 25.9 

Canada 439 683 43.5 25.6 

N/A = not applicable. Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
54 

Table C.2 Percentage Distributions of All Immigrants and U.S.-Born Persons Aged 18 or 

Older, by Length of Time in the United States and Demographic 

Characteristics: 1999–2001 

All Immigrants

Demographic Characteristics All Immigrants <5 Years >5 Years U.S. Born

Total 100.0 17.7 82.3 100.0 

Gender 

Male 48.6 52.0 47.8 47.6 

Female 51.4 48.0 52.2 52.4 

Age Group 

18-25 14.2 32.9 10.1 14.6 

26-34 22.2 34.5 19.5 15.8 

35-49 35.2 22.0 38.0 31.4 

50+ 28.5 10.6 32.4 38.3 

Adult Education 

< High school 30.7 31.7 30.4 15.8 

High school graduate 23.4 19.6 24.2 34.9 

Some college 18.6 17.1 19.0 25.3 

College graduate 27.3 31.6 26.4 24.1 

Current Employment 

Full-time 59.9 56.8 60.6 56.8 

Part-time 10.1 9.6 10.2 12.4 

Unemployed 2.4 4.1 2.1 2.2 

Other1 27.6 29.5 27.2 28.5 

Household Income 

< $20,000 28.2 44.3 24.7 19.9 

$20,000 – $49,999 40.1 34.7 41.3 39.7 

$50,000 – $74,999 14.6 10.2 15.5 18.8 

≥ $75,000 17.1 10.8 18.5 21.6 

Government Assistance2 

Yes 13.2 9.4 14.0 12.2 

No 86.8 90.6 86.0 87.8 

1

 Retired, disabled, homemaker, student, or "other." 

2 At least one family member received Supplemental Security Income (SSI), cash assistance or noncash assistance 

(Temporary Assistance for Needy Families, TANF), or the family received food stamps. 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
55

Table C.3 Percentage Distributions of Persons Aged 18 or Older from Selected Latin American Countrie

States, by Demographic Characteristics: 1999–2001 

Demographic Characteristic Mexico Puerto Rico Cuba El Salvador Jamaica ColomTotal 100.0 100.0 100.0 100.0 100.0 100.0 Gender

Male 53.9 42.1 46.3 49.4 46.8 48.3 Female 46.1 57.9 53.7 50.6 53.2 51.7 

Age Group

18-25 19.9 9.1 3.1 17.7 13.5 12.3 26-34 28.2 13.6 7.9 24.5 18.8 16.6 35-49 33.2 34.2 37.5 44.0 33.6 44.3 50+ 18.8 43.1 51.5 13.8* 34.1* 26.8 

Adult Education

< High school 66.2 45.9 32.8 58.7 27.0 22.5High school graduate 18.3 27.3 33.9 24.7 34.6 26.3 Some college 10.9 17.7 14.1 11.8 19.0 21.8 College graduate 4.6 9.2 19.1 4.8 19.3 29.4 

Current Employment1

Full-time 61.2 52.6 58.0 70.9 69.6 64.7 Part-time 8.0 8.1 4.5 8.4 6.0 11.5 Unemployed 3.4 2.0 1.7 2.2 4.8* 4.8 Other2 27.3 37.3 35.7 18.5 19.7 19.0 

Household Income 

< $20,000 42.9 45.1 31.6 28.8 16.8 35.5$20,000 – $49,999 46.4 40.2 40.6 52.6 44.8 36.3 $50,000 – $74,999 7.6 7.9 9.4* 14.1 17.7 12.3 ≥ $75,000 3.1 6.7 18.4 4.5 20.7* 15.8

Government Assistance3

Yes 17.5 34.3 20.5 13.9 8.6 4.4 No 82.5 65.7 79.5 86.1 91.4 95.6 

Duration in United States 

< 5 years 21.1 6.7 10.9 16.3 10.2 19.9 > 5 years 78.9 93.3 89.1 83.7 89.8 80.1 

* Low precision; estimate normally suppressed. N/A = not applicable. 1 Estimates for 2000 and 2001 are based on a revised definition of employment and are not comparable with estimates by employment 

NSDUH reports. 

2 Retired, disabled, homemaker, student, or "other." 3 At least one family member received Supplemental Security Income (SSI), cash assistance or noncash assistance (Temporary Assista

TANF), or the family received food stamps. 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
56

Table C.4 Percentage Distributions of Persons Aged 18 or Older from Selected Asian Countries and the U

Demographic Characteristics: 1999–2001 

Demographic Characteristic Japan Korea Philippines China Vietnam India Total 100.0 100.0 100.0 100.0 100.0 100.0 Gender

Male 39.6 41.7 36.7 46.4 49.6 54.9 Female 60.4 58.3 63.3 53.6 50.4 45.1 

Age Group

18-25 22.9 14.2 7.3 6.8 15.9 11.6 26-34 24.6 29.1 14.6 24.5 31.7 31.8 35-49 35.1 36.3 34.3 36.0 41.7 31.1 50+ 17.5* 20.3* 43.8 32.7 10.8* 25.5* 

Adult Education

< High school 3.4 9.5 7.1 6.4* 12.2 6.3 High school graduate 25.5 18.1 17.0 14.0 34.1 7.0 Some college 36.5 20.5 20.9 21.1* 25.1 15.7 College graduate 34.6 51.9 55.1 58.5* 28.6 71.1 

Current Employment1

Full-time 51.4* 48.8 67.5 55.1 65.7 65.2 Part-time 15.7 15.9 10.5 10.8 9.4 8.9 Unemployed 0.3 0.3 1.4 1.3 1.6 1.1 Other2 32.5* 35.0 20.7 32.8 23.3* 24.9 

Household Income 

< $20,000 27.9 19.4 12.0 15.6 21.3 13.2 $20,000 – $49,999 32.0 32.7 30.9 37.9 31.4 34.5 $50,000 – $74,999 12.1 22.7 27.4 23.3 24.4 21.9 ≥ $75,000 28.0* 25.2* 29.7 23.1 22.9* 30.4 

Government Assistance3

Yes 3.6 5.1 14.5 10.1* 16.1 5.1 No 96.4 94.9 85.5 89.9* 83.9 94.9 

Duration in United States 

<5 years 27.1 11.6 10.7 32.7 4.2 40.5 > 5 years 72.9 88.4 89.3 67.3 95.8 59.5 

* Low precision; estimate normally suppressed. N/A = not applicable. 1 Estimates for 2000 and 2001 are based on a revised definition of employment and are not comparable with estimates by employment 

NSDUH reports. 

2 Retired, disabled, homemaker, student, or "other." 3 At least one family member received Supplemental Security Income (SSI), cash assistance or noncash assistance (Temporary Assista

TANF), or the family received food stamps. Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
57

Table C.5 Percentage Distributions of Persons Aged 18 or Older from Selected European Countries, Can

and the United States, by Demographic Characteristics: 1999–2001 

Demographic Characteristic Germany United Kingdom Poland Canada United STotal 100.0 100.0 100.0 100.0 100.0 Gender

Male 39.3 44.5 45.3 43.5 47.6 Female 60.7 55.5 54.7 56.5 52.4 

Age Group

18-25 8.7 8.6 13.4 8.7 14.6 26-34 13.8 16.5 12.5 16.9 15.8 35-49 37.6 29.7 29.4 26.0 31.4 50+ 39.9 45.2 44.7 48.4 38.3 

Adult Education

< High school 8.9 7.6 7.7 14.9 15.8 High school graduate 30.8 30.4 27.7 24.1 34.9 Some college 28.5 27.9 29.8 24.0 25.3 College graduate 31.8 34.1 34.7 36.9 24.1 

Current Employment1

Full-time 54.7 59.0 50.2 49.5 56.8 Part-time 11.4 11.6 11.9 8.8 12.4 Unemployed 1.1 0.3 0.6 0.9 2.2 Other2 32.9 29.1 37.3 40.8 28.5 

Household Income 

< $20,000 14.8 16.7 10.7* 13.4 19.9 $20,000 – $49,999 41.3 29.0 37.8 35.3 39.7 $50,000 – $74,999 18.9 18.6 26.0 20.4 18.8 ≥ $75,000 25.1 35.6 25.4 30.9 21.6 

Government Assistance3

Yes 7.1 6.6 6.0* 9.8 12.2 No 92.9 93.4 94.0* 90.2 87.8 

Duration in United States 

< 5 years 6.7 12.2 5.4 21.7 N/A > 5 years 93.3 87.8 94.6 78.3 N/A 

* Low precision; estimate normally suppressed. N/A = not applicable. 1 Estimates for 2000 and 2001 are based on a revised definition of employment and are not comparable with estimates by employment 

published in prior NSDUH reports. 

2 Retired, disabled, homemaker, student, or "other." 3 At least one family member received Supplemental Security Income (SSI), cash assistance or noncash assistance (Temporary Assista

Needy Families, TANF), or the family received food stamps.

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
58

Table C.6 Estimated Numbers and Prevalence (with Standard Errors) of Past Month and Past Year Alco

Month Binge and Heavy Drinking, and Past Month Weekly Alcohol Consumption among All IAged 18 or Older, by Length of Time in the United States and Gender: 1999–2001 

Past Month 

Alcohol Use 

Past Year 

Alcohol Use 

Past Month Binge 

Drinking 

Past Month 

Heavy Drinkin

Sociodemographic Characteristic

Estimated 

Population 

(in 1,000s) % SE % SE % SE % SE 

Total Foreign Born 25,214 39.5 0.72 54.3 0.76 16.9 0.51 3.0 0.21 

Gender

Male 12,244 49.1 1.13 64.7 0.95 25.2 0.93 5.0 0.39 Female 12,969 30.4 0.94 44.4 1.02 9.0 0.48 1.2 0.18 

Age Group 

18-25 3,570 41.1 0.88 58.0 0.87 24.7 0.75 5.3 0.39 26-49 14,457 41.3 0.93 56.4 0.92 18.0 0.70 3.3 0.31 50+ 7,187 35.0 1.63 48.1 1.80 10.8 1.12 1.4 0.43 

Foreign Born in United States < 5 Years 4,466 39.1 1.44 53.6 1.58 18.8 1.06 3.8 0.50 

Gender

Male 2,323 48.6 2.01 65.0 1.90 27.4 1.76 5.6 0.88 Female 2,144 28.9 1.97 41.2 2.12 9.3 0.95 1.8 0.41 

Age Group 

18-25 1,471 37.1 1.32 53.4 1.41 22.0 1.11 4.7 0.61 26-49 2,522 39.7 1.79 54.1 1.92 17.3 1.30 3.5 0.72 50+ 474 42.3* 7.88* 51.9* 7.99* 16.6* 5.82* 2.3* 2.25

Foreign Born in United States > 5 Years 20,747 39.6 0.79 54.4 0.85 16.4 0.59 2.9 0.24 

Gender

Male 9,921 49.2 1.28 64.7 1.13 24.7 1.07 4.8 0.44 Female 10,826 30.7 1.02 45.0 1.11 8.9 0.56 1.1 0.21 

Age Group 

18-25 2,099 43.9 1.05 61.3 0.99 26.5 0.94 5.7 0.47 26-49 11,935 41.7 1.02 56.9 1.00 18.1 0.77 3.3 0.34 50+ 6,713 34.5 1.64 47.9 1.83 10.3 1.15 1.4 0.43 

Born in United States 173,976 52.4 0.28 67.8 0.27 22.3 0.21 6.5 0.11 

Gender

Male 82,766 60.0 0.37 72.4 0.35 31.1 0.34 10.5 0.21 Female 91,210 45.5 0.36 63.5 0.37 14.4 0.22 2.9 0.10 

Age Group 

18-25 25,320 60.0 0.32 77.3 0.26 40.1 0.32 14.4 0.25 26-49 82,097 58.6 0.37 75.2 0.32 26.0 0.31 7.0 0.18 50+ 66,559 41.7 0.54 54.9 0.53 11.0 0.32 2.8 0.16 

* Low precision; estimate normally suppressed. Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
59 

Table C.7 Linear Regression Model Results for Log-Transformed Past Month Weekly 

Alcohol Consumption among All Immigrants Aged 18 or Older Who Were 

Current Drinkers: 1999–2001 

Model Covariates β SE p value 

Country Alcohol Consumption Rate1 0.04 0.01 <0.0001 

Gender 

 Male 0.77 0.07 <0.0001 

 Female 0.00 0.00 -- 

Age Groups 

 18-25 0.10 0.10 0.3051 

 26-49 0.03 0.09 0.7203 

 50 or older 0.00 0.00 -- 

Total Family Income 

 <$20,000 -0.03 0.11 0.7791 

 $20,000 - $49,999 -0.01 0.10 0.9092 

 $50,000 - $74,999 -0.11 0.11 0.3085 

 >$75,000 0.00 0.00 -- 

Marital Status 

 Married -0.38 0.07 <0.0001 

 Single (divorced/separated) 0.00 0.00 -- 

Adult Education 

 <High school 0.36 0.09 <0.0001 

 High school graduate 0.30 0.09 0.0006 

 Some college 0.20 0.09 0.0214 

 College graduate 0.00 0.00 -- 

Duration in the United States 

 <5 years 0.03 0.07 0.6147 

 > 5 years 0.00 0.00 -- 

Note: Past month weekly alcohol consumption was calculated by multiplying the average number of 

drinks consumed per day in the past 30 days by the number of days drinking during the past 

month among persons who had used alcohol in the past 30 days, and dividing by 4.286, the number of 

weeks in a 30-day period. 1 The rates for country of origin per capita alcohol consumption were found in the Global Status Report 

(World Health Organization [WHO], 2001). Only immigrants from countries with known per capita alcohol 

consumption were included. 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
60

Table C.8 Estimated Numbers and Prevalence (with Standard Errors) of Past Month Illicit Drug and Tob

All Immigrants Aged 18 or Older, by Demographic Characteristics: 1999–2001 

Past Month Tobacco Use Past Month Marijuana Use 

Past Mo

Sociodemographic Characteristic

Estimated 

Population 

(in 1,000s) % SE % SE % 

Total Foreign Born 25,214 20.4 0.57 1.7 0.12 2.9 

Gender

Male 12,244 27.8 0.92 2.3 0.20 3.8 Female 12,969 13.4 0.65 1.1 0.13 2.1 

Age Group 

18-25 3,570 25.4 0.69 5.1 0.34 7.2 26-49 14,457 22.0 0.69 1.6 0.18 2.9 50+ 7,187 14.8 1.24 0.1 0.07 0.9 

Foreign Born in United States < 5 Years 4,466 22.6 1.24 1.8 0.29 3.2 

Gender

Male 2,323 31.5 1.90 1.9 0.40 3.4 Female 2,144 13.0 1.32 1.6 0.42 3.0 

Age Group 

18-25 1,471 23.3 1.12 3.1 0.45 5.0 26-49 2,522 22.5 1.55 1.3 0.43 2.7 50+ 474 20.9* 7.06* 0.0* 0.00* 0.1

Foreign Born in United States > 5 Years 20,747 19.9 0.64 1.6 0.13 2.9 

Gender

Male 9,921 27.0 1.08 2.3 0.23 3.9 Female 10,826 13.5 0.70 1.0 0.14 2.0 

Age Group 

18-25 2,099 27.0 0.87 6.5 0.46 8.7 26-49 11,935 21.9 0.76 1.6 0.20 3.0 50+ 6,713 14.3 1.24 0.1 0.07 0.9 

Born in United States 173,976 32.8 0.25 5.1 0.10 6.6 

Gender

Male 82,766 39.7 0.36 7.0 0.17 8.5 Female 91,210 26.7 0.32 3.4 0.10 4.9 

Age Group 

18-25 25,320 46.4 0.29 16.0 0.24 18.4 26-49 82,097 37.4 0.36 5.4 0.17 7.2 50+ 66,559 22.0 0.44 0.6 0.08 1.3 

* Low precision; estimate normally suppressed. Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
61

Table C.9 Estimated Numbers and Prevalence (with Standard Errors) of Past Year Illicit Drug and Toba

Immigrants Aged 18 or Older, by Demographic Characteristics: 1999–2001 

Past Year Tobacco Use Past Year Marijuana Use 

P

Sociodemographic Characteristic

Estimated 

Population 

(in 1,000s) % SE % SE 

Total Foreign Born 25,214 24.8 0.63 3.5 0.17 

Gender

Male 12,244 33.6 1.02 4.7 0.29 Female 12,969 16.6 0.69 2.4 0.21 

Age Group 

18-25 3,570 33.8 0.79 10.0 0.53 126-49 14,457 26.7 0.79 3.3 0.26 50+ 7,187 16.7 1.33 0.6 0.24 

Foreign Born in United States < 5 Years 4,466 28.0 1.26 3.9 0.39 

Gender

Male 2,323 38.1 1.91 4.5 0.58 Female 2,144 17.0 1.44 3.3 0.49 

Age Group 

18-25 1,471 31.9 1.15 7.0 0.71 126-49 2,522 27.0 1.62 2.8 0.59 50+ 474 21.1* 7.07* 0.0* 0.00* 

Foreign Born in United States > 5 Years 20,747 24.2 0.71 3.4 0.19 

Gender

Male 9,921 32.5 1.20 4.7 0.32 Female 10,826 16.5 0.75 2.2 0.23 

Age Group 

18-25 2,099 35.2 1.03 12.0 0.68 126-49 11,935 26.6 0.89 3.4 0.29 50+ 6,713 16.4 1.35 0.7 0.26 

Born in United States 173,976 38.2 0.26 8.8 0.14 1

Gender

Male 82,766 46.4 0.37 11.4 0.21 1Female 91,210 30.9 0.33 6.5 0.14 

Age Group 

18-25 25,320 56.0 0.30 27.1 0.29 326-49 82,097 43.6 0.36 9.5 0.22 150+ 66,559 24.8 0.46 1.0 0.10 

* Low precision; estimate normally suppressed. Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
62

Table C.10 Adjusted Odds Ratios of Alcohol Use among All Immigrants Aged 18 or Older: 1999–2001 

Past Month Alcohol Use Past Month Binge Drinking Past Month Heavy Drinking Pa

Model Covariates

Adjusted 

Odds Ratio

95% Confidence 

Interval

Adjusted 

Odds 

Ratio

95% Confidence 

Interval

Adjusted 

Odds Ratio

95% Confidence 

Interval

Adjus

Odds R

Intercept 0.41 0.34 0.49 0.07 0.05 0.09 0.01 0.00 0.02 0.72 Duration in United States 

< 5 years 0.86 0.75 0.99 0.83 0.69 0.99 0.90 0.64 1.27 0.85+ years 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 

Gender 

Male 2.21 1.96 2.51 3.43 2.94 3.99 4.08 2.93 5.69 2.3Female 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 

Age Group 

18-25 1.22 1.02 1.46 2.55 1.98 3.28 2.71 1.46 5.03 1.43 26-34 1.49 1.24 1.79 2.40 1.84 3.14 2.52 1.32 4.81 1.69 35-49 1.21 1.01 1.45 1.50 1.13 1.99 2.14 1.06 4.30 1.28 50+ 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 

Marital Status 

Married 0.86 0.75 0.98 0.82 0.70 0.96 0.53 0.38 0.73 0.84 Other 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
63 

Table C.11 Adjusted Odds Ratios of Tobacco Use among All Immigrants Aged 18 or 

Older: 1999–2001 

Past Month Tobacco Use Past Year Tobacco Use 

Model Covariates

Adjusted Odds 

Ratio

95% Confidence 

Interval

Adjusted Odds 

Ratio

95% Confidence 

Interval

Intercept 0.15 0.12 0.19 0.17 0.14 0.21 

Duration in United 

States 

< 5 years 0.97 0.81 1.15 0.94 0.81 1.10 

5+ years 1.00 1.00 1.00 1.00 1.00 1.00 

Gender 

Male 2.53 2.19 2.92 2.58 2.25 2.96 

Female 1.00 1.00 1.00 1.00 1.00 1.00 

Age Group 

18-25 1.51 1.20 1.90 2.02 1.62 2.51 

26-34 1.64 1.32 2.03 1.91 1.54 2.36 

35-49 1.65 1.32 2.06 1.82 1.46 2.26 

50+ 1.00 1.00 1.00 1.00 1.00 1.00 

Marital Status 

Married 0.58 0.50 0.68 0.59 0.51 0.68 

Other 1.00 1.00 1.00 1.00 1.00 1.00 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 

Table C.12 Adjusted Odds Ratios of Marijuana Use among All Immigrants Aged 18 or 

Older: 1999–2001 

Past Month Marijuana Use Past Year Marijuana Use 

Model Covariates

Adjusted Odds 

Ratio

95% Confidence 

Interval

Adjusted Odds 

Ratio

95% Confidence 

Interval

Intercept 0.00 0.00 0.01 0.01 0.00 0.02 

Duration in United 

States 

< 5 years 0.51 0.35 0.75 0.57 0.45 0.72 

5+ years 1.00 1.00 1.00 1.00 1.00 1.00 

Gender 

Male 1.95 1.43 2.67 1.88 1.51 2.36 

Female 1.00 1.00 1.00 1.00 1.00 1.00 

Age Group 

18-25 32.92 10.04 107.89 13.48 6.08 29.89 

26-34 19.99 5.80 68.87 8.10 3.67 17.85 

35-49 12.57 3.44 45.88 4.86 2.14 11.03 

50+ 1.00 1.00 1.00 1.00 1.00 1.00 

Marital Status 

Married 0.26 0.17 0.41 0.33 0.23 0.48 

Other 1.00 1.00 1.00 1.00 1.00 1.00 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
64

Table C.13 Adjusted Odds Ratios of Any Illicit Drug Use among All Immigrants Aged 18 or Older: 1999–

Past Month Any Illicit Drug Use Past Year Any Illicit Drug U

Model Covariates Adjusted Odds Ratio 95% Confidence Interval Adjusted Odds Ratio 95% ConfideIntercept 0.01 0.01 0.02 0.02 0.01 Duration in United States 

< 5 years 0.64 0.47 0.86 0.78 0.64 5+ years 1.00 1.00 1.00 1.00 1.00 

Gender 

Male 1.74 1.31 2.31 1.65 1.34 Female 1.00 1.00 1.00 1.00 1.00 

Age Group 

18-25 6.62 3.13 13.99 6.63 3.92 26-34 4.26 1.92 9.45 3.95 2.24 35-49 3.16 1.33 7.50 2.83 1.58 50+ 1.00 1.00 1.00 1.00 1.00 

Marital Status 

Married 0.41 0.29 0.56 0.47 0.37 Other 1.00 1.00 1.00 1.00 1.00 

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
65

Table C.14 Estimated Numbers and Prevalence (with Standard Errors) of Past Month Weekly Alcohol C

Month and Past Year Alcohol Use, and Past Month Binge and Heavy Drinking among ImmigCountries within Selected Regions and the United States: 1999–2001 

Past Month 

Weekly Alcohol 

Consumption 

among Past 

Month Drinkers 

Past Month 

Alcohol Use 

Past Year 

Alcohol Use 

Past Month B

Drinking 

Country of Origin

Estimated 

Population 

(in 1,000s) Drinks SE % SE % SE % 

Selected Latin American Countries  Mexico 6,759 8.1 0.66 34.9 1.16 50.3 1.23 22.3 0 Puerto Rico 862 6.8 1.38 41.3 4.30 57.5 4.49 23.7 4 Cuba 779 3.3 0.29 42.4 3.20 56.4 3.02 9.9 1 El Salvador 518 7.4 1.61 33.5 4.54 48.9 5.09 19.7 4 Jamaica 406 2.8 0.65 35.8 5.42 62.1 4.83 16.3 4 Colombia 411 3.8 1.38 41.8 4.47 60.9 5.62 14.9 2Selected Asian Countries  Japan 262 3.5 0.46 62.1 5.40 69.9 5.49 18.6 3 Korea 523 7.5 2.93 53.2 5.12 63.1 5.09 27.9 4 Philippines 1,519 4.6 1.02 24.1 3.33 37.2 3.82 8.9 1 China 589 1.5 0.29 28.4 4.09 45.9 5.49 7.5 2 Vietnam 530 5.1 1.69 26.4 4.25 43.7 4.82 11.7 3 India 1,060 2.4 0.44 26.6 3.31 39.6 3.68 7.8 1Selected European Countries  Germany 958 5.3 0.81 49.3 3.72 72.5 3.20 17.3 2 United Kingdom 723 10.2 1.67 67.5 4.02 73.3 3.97 31.3 3 Poland 323 4.1 0.81 55.9 5.74 75.4 5.00 23.8 4Canada 683 5.2 0.62 64.5 3.83 78.3 3.29 19.4 2United States 173,976 8.3 0.19 52.4 0.28 67.8 0.27 22.3 0Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
66

Table C.15 Estimated Number of Drinks (with Standard Errors) for Past Month Weekly Alcohol 

Consumption among Immigrants from Selected Countries Who Were Past Month Alcohol Users, by Length of Time in the United States: 1999–2001 

NSDUH Past Month Weekly Alcohol Consumption 

Time Lived in the United States 

<5 Years >5 Years 

Country of Origin

Estimated Population 

(in 1,000s) Drinks SE Drinks SE

Selected Latin American Countries  Mexico 6,759 8.04 1.35 8.11 0.73  El Salvador 518 4.83 1.93 7.98 1.89  Puerto Rico 862 15.87 4.56 6.19 1.33  Cuba 779 3.28 1.76 3.35 0.31  Jamaica 406 7.89 3.24 2.48 0.59  Columbia 411 3.16 0.76 3.89 1.63 Selected Asian Countries  Japan 262 2.32 0.53 4.10 0.60  Korea 523 2.46 0.51 8.16 3.34  Philippines 1,519 3.02 1.18 4.85 1.16  China 589 1.45 0.39 1.55 0.40  Vietnam 530 2.34 0.94 5.16 1.73  India 1,060 2.84 0.65 2.16 0.56 Selected European Countries  Germany 958 3.56 1.01 5.43 0.88  United Kingdom 723 11.52 3.35 9.98 1.90  Poland 323 4.64 1.37 4.00 0.87 Canada 683 4.51 0.97 5.45 0.75 Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
67

Table C.16 Estimated Numbers and Prevalence (with Standard Errors) of Past Month Tobacco Use, Past 

Use, and Past Month Marijuana Use among Immigrants from Selected Countries within SelecUnited States: 1999–2001 

Past Month Tobacco Use Past Month Marijuana Use Pa

Country of Origin Estimated Population % SE % SE Selected Latin American Countries  Mexico 6,759 20.8 1.15 0.9 0.16  Puerto Rico 862 31.0 3.76 2.0 0.66  Cuba 779 17.6 2.20 0.2 0.10  El Salvador 518 17.6 2.94 1.4 0.55  Jamaica 406 12.1 3.41 5.5 2.53  Colombia 411 18.2 3.39 0.9 0.45 Selected Asian Countries  Japan 262 24.0 4.27 5.6 1.92  Korea 523 30.2 4.89 3.2 1.03  Philippines 1,519 13.5 2.91 0.9 0.30  China 589 10.1 3.14 0.2 0.17  Vietnam 530 25.5 4.61 1.3 0.84  India 1,060 10.2 2.79 0.1 0.05 Selected European Countries  Germany 956 30.0 3.13 4.0 1.22  United Kingdom 723 31.7 3.94 3.9 1.09  Poland 323 16.9 3.18 1.8 0.64 Canada 683 25.9 3.47 4.3 1.14 United States 173,976 32.8 0.25 5.1 0.10 Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001. 
68

Table C.17 Estimated Numbers and Prevalence (with Standard Errors) of Past Year Tobacco Use, Past Y

and Past Year Marijuana Use among Immigrants from Selected Countries within Selected ReStates: 1999–2001 

Past Year Tobacco Use Past Year Marijuana Use P

Country of Origin Estimated Population % SE % SE Selected Latin American Countries  Mexico 6,759 26.2 1.23 2.3 0.26  Puerto Rico 862 35.7 3.89 4.7 1.29  Cuba 779 23.3 2.93 0.8 0.30  El Salvador 518 24.1 4.05 1.8 0.61  Jamaica 406 13.7 3.47 6.4 2.64  Colombia 411 23.4 3.88 2.9 1.07 Selected Asian Countries  Japan 262 26.1 4.30 9.9 2.65  Korea 523 33.4 5.00 4.9 1.19  Philippines 1,519 16.7 3.05 1.3 0.34  China 589 13.5 3.66 1.1 0.57  Vietnam 530 27.3 4.57 2.0 0.98  India 1,060 12.2 2.83 0.3 0.19 Selected European Countries  Germany 958 33.3 3.13 7.4 1.75  United Kingdom 723 34.3 4.02 7.5 1.61  Poland 323 21.9 3.62 4.0 1.04 Canada 683 30.6 3.58 7.1 1.35 United States 173,976 38.2 0.26 8.8 0.14 Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 1999-2001.