Substance use prevalence among immigrants by generational status in Europe: A systematic review and meta-analysis

Immigration has increased globally, particularly in Europe. While past research has looked into substance use among immigrants, there is a gap in understanding how generational status affects these patterns. This systematic review aimed to synthesize existing data on the differences in prevalence rates of substance use among immigrants by generational status to provide a thorough understanding of how substance use rates and trends vary between generations.

We systematically searched PubMed, PsycINFO, Web of Science, Medline, Cochrane, and Embase for cohort studies until June 2024 with no language restrictions. We included studies published between 1990 and 2023, conducted in Europe, that examined substance use prevalence among first-generation immigrants (FGIs) and second-generation immigrants (SGIs). Following the data extraction, the data were pooled using random-effects meta-analyses with odds ratios (OR) and 95% confidence intervals (CI) calculated.

We identified 10 records from 157,426 articles screened, covering 2,652,732 individuals. The summary OR for alcohol use was 1.68 (95% CI: 1.32-2.13) with some variability in the results of individual studies, and women of second generation were found to be at higher risk, OR 1.85 (95% CI: 0.54-6.40). The OR for tobacco use was 1.18 (95% CI: 0.45-3.08), based on three effect estimates indicating an absence of significant difference between FGIs and SGIs. Regarding drug use, the OR was 2.50 (95% CI: 2.06-3.03), highlighting a significant association between drug use and SGI status.

The findings of this meta-analysis indicate a higher risk of substance use among SGIs compared to FGIs, particularly for drug use and among women for alcohol use. These results highlight the need for further data on consumption patterns across generations to develop effective, culturally tailored intervention and prevention strategies.