Changes in Swedish adolescents’ illicit drug attitudes and cannabis use, 2003–2026
Abstract
Background: Public discourse often suggests that adolescents have become more liberal in their attitudes towards illicit drugs. However, empirical evidence on long-term changes in attitudes and their relationship with cannabis use remains limited. This study examines changes in Swedish adolescents’ attitudes towards drugs between 2003 and 2026 and analyses the changes in the association between attitudes and cannabis use.
Methods: Data were drawn from nationally representative school surveys conducted in Sweden among 9th-grade students (15-16 years old) in 2003 (n = 5,110), 2019 (n = 5,214) and 2026 (n = 5,390). Attitudes were measured using six items capturing perceptions of drugs as a societal problem and restrictive attitudes towards use. Two indices (range 0–12) were constructed. Associations between attitudes and self-reported cannabis use were analyzed using Poisson regression models, including interaction terms to assess changes in the association over time.
Results: Adolescents in 2026 reported lower levels of perceiving drugs as a major societal problem compared to those in 2003 (mean index decreased from 9.6 to 7.8). Restrictive attitudes also declined (mean index from 8.6 to 7.6). Despite these changes, most students still expressed restrictive views. Stronger perceptions of drugs as a problem (IRR 0.905, 95% CI: 0.89-0.92) and more restrictive attitudes (IRR IRR 0.791, 95% CI: 0.77-0.81) were significantly associated with a lower likelihood of cannabis use. However, the strength of the associations weakened significantly over time. All results are preliminary.
Conclusions: Swedish adolescents have become less restrictive towards drugs over time. Although attitudes are associated with cannabis use at the individual level, the strength of the associations appears to have weakened. These findings highlight the need for further research into the broader social, environmental, and individual factors associated with adolescent cannabis use.
Key messages: • Swedish adolescents have become less restrictive in their attitudes towards drugs over time, although most still express restrictive views.
• Restrictive attitudes are linked to lower cannabis use, but this association has weakened over time, suggesting that attitudes may play a smaller role in explaining cannabis use in recent years.
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BibTeX
@article{gripe2026changes,
title = {{Changes in Swedish adolescents’ illicit drug attitudes and cannabis use, 2003–2026}},
author = {I Gripe and S Thor},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.232},
url = {https://doi.org/10.1093/eurpub/ckag169.232},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Changes in Swedish adolescents’ illicit drug attitudes and cannabis use, 2003–2026
AU - I Gripe
AU - S Thor
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.232
UR - https://doi.org/10.1093/eurpub/ckag169.232
AB - Background: Public discourse often suggests that adolescents have become more liberal in their attitudes towards illicit drugs. However, empirical evidence on long-term changes in attitudes and their relationship with cannabis use remains limited. This study examines changes in Swedish adolescents’ attitudes towards drugs between 2003 and 2026 and analyses the changes in the association between attitudes and cannabis use. Methods: Data were drawn from nationally representative school surveys conducted in Sweden among 9th-grade students (15-16 years old) in 2003 (n = 5,110), 2019 (n = 5,214) and 2026 (n = 5,390). Attitudes were measured using six items capturing perceptions of drugs as a societal problem and restrictive attitudes towards use. Two indices (range 0–12) were constructed. Associations between attitudes and self-reported cannabis use were analyzed using Poisson regression models, including interaction terms to assess changes in the association over time. Results: Adolescents in 2026 reported lower levels of perceiving drugs as a major societal problem compared to those in 2003 (mean index decreased from 9.6 to 7.8). Restrictive attitudes also declined (mean index from 8.6 to 7.6). Despite these changes, most students still expressed restrictive views. Stronger perceptions of drugs as a problem (IRR 0.905, 95% CI: 0.89-0.92) and more restrictive attitudes (IRR IRR 0.791, 95% CI: 0.77-0.81) were significantly associated with a lower likelihood of cannabis use. However, the strength of the associations weakened significantly over time. All results are preliminary. Conclusions: Swedish adolescents have become less restrictive towards drugs over time. Although attitudes are associated with cannabis use at the individual level, the strength of the associations appears to have weakened. These findings highlight the need for further research into the broader social, environmental, and individual factors associated with adolescent cannabis use. Key messages: • Swedish adolescents have become less restrictive in their attitudes towards drugs over time, although most still express restrictive views. • Restrictive attitudes are linked to lower cannabis use, but this association has weakened over time, suggesting that attitudes may play a smaller role in explaining cannabis use in recent years.
SN - 1101-1262
SN - 1464-360X
ER -