Epidemiol Rev 2004;26:36-52
© 2004 by the Oxford University Press
The Social Epidemiology of Substance Use
1 Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY.
2 Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
3 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Correspondence to Dr. Sandro Galea, Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029 (e-mail: sgalea@nyam.org).
Received for publication January 29, 2004; accepted for publication March 8, 2004.
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INTRODUCTION |
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Tobacco, alcohol, and illicit substance use continue to result in substantial morbidity and mortality and significant societal economic costs despite considerable efforts to minimize use of licit substances and prevent use of illicit substances. Each year, more than 400,000 Americans die from cigarette smoking, and one in every five deaths in the United States is believed to be smoking related (1). Consequences of alcohol and illicit substance abuse include, among others, cirrhosis, job loss, and criminal behavior related to the acquisition and sale of illicit drugs. The economic costs of addiction were estimated as $400 billion yearly in the United States in 1999 (2). Substance use is associated with a wide range of risk behaviors. For the more commonly used substances, risk behavior includes symptoms of both dependence (e.g., reducing important activities because of use of the substance) and abuse (e.g., driving a car more than
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REVIEW OF THE LITERATURE |
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FINDINGS |
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Initiation
Cigarettes and alcohol. Illicit drugs. Use and misuse
Cigarettes and alcohol. Illicit drugs. Cessation, abstinence, and relapse
Cigarettes and alcohol. Illicit drugs.
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METHODOLOGICAL ISSUES |
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SUMMARY AND FUTURE RESEARCH |
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ACKNOWLEDGMENTS |
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