Berten et al. BMC Public Health 2012, 12:215 http://www.biomedcentral.com/1471-2458/12/215 R E S E A R C H A R T I C L E Open Access Alcohol and cannabis use among adolescents in Flemish secondary school in Brussels: effects of type of education Hans Berten1*, Dries Cardoen1, Ruben Brondeel2 and Nicole Vettenburg1 Abstract Background: Research regarding socio-economic differences in alcohol and drug use in adolescence yields mixed results. This study hypothesizes that (1) when using education type as a proxy of one’s social status, clear differences will exist between students from different types of education, regardless of students’ familial socio- economic background; (2) and that the effects of education type differ according to their cultural background. Methods: Data from the Brussels youth monitor were used, a school survey administered among 1,488 adolescents from the 3rd to 6th year of Flemish secondary education. Data were analyzed using multilevel logistic regression models. Results: Controlling for their familial background, the results show that native students in lower educational tracks use alcohol and cannabis more often than students in upper educational tracks. Such a relationship was not found for students from another ethnic background. Conclusion: Results from this study indicate that research into health risks should take into account both adolescents’ familial background and individual social position as different components of youngsters’ socio- economic background. Background Despite recent signs of a decline in the prevalence of legal and illegal drugs, the use of alcohol and cannabis remains widespread among adolescents and young adults in contemporary European society [1,2]. Many people initiate alcohol and drug use during their years as a teenager [3,4]. According to a recent research report, 75.4% of the Flemish scholars (12-18 years) have drunk alcohol at least once during their lifetime [5]. A vast majority of these respondents (63.4%) even used alcohol during the past 12 months, of which 22% drank alcohol on a regular basis, that is, more than once a week. The same research reported a last year prevalence rate of cannabis among Flemish students of 11.7% of which 2.7% used it on a weekly basis. Approximately one out of five students had smoked cannabis once dur- ing their lifetime [5]. This substance use is however not * Correspondence: hans.berten@ugent.be 1Department of Social Welfare Studies, H. Dunantlaan 2, 9000 Ghent, Belgium Full list of author information is available at the end of the article without harm. Many studies acknowledge the acute and longer range health implications of this behavior, both on a personal and societal level [6,7]. Conceivable short- term consequences of adolescent’s substance (mis)use are an increased risk of accidental injury and death, of engaging in criminal and delinquent behavior, violence victimization, engaging in unsafe sexual practices, edu- cational failure and depression and suicidal ideation. Beyond these immediate “threats”, early alcohol and cannabis consumption is frequently associated with a heightened chance of developing substance use and dependence disorders, major depressive symptoms and other undesirable health outcomes in later adulthood. Notwithstanding these health implications, for most teenagers it holds that adolescence is a phase of experi- mentation in the first place. A striking observation is that age specific rates of alcohol and drug use, and related to this conformity to peer pressure and fear of peer rejection, peak in adolescence and drop sharply when entering adulthood [8-10]. Nevertheless, given the possible health consequences, the (ab)use of alcohol and © 2012 Berten et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.