Cities are increasingly organised according to socio-spatial divisions in which groups with similar characteristics live in the same areas. This social polarisation is associated with differences in living conditions, health, morbidity and mortality. Traditionally, ‘areas of disadvantage’ have also been associated with increased risk of harmful substance use. However, some recent studies suggest that ‘areas of affluence’ may socialise adolescents into high levels of alcohol consumption. Using a combination of city district-level socio-economic data and surveys of adolescents, we investigated patterns of substance use in different city districts of Oslo, Norway, with the aim to shed more light on these conflicting previous findings. We found that adolescents in the affluent parts of Oslo West reported the highest levels of recreational smoking, snus use and alcohol use. Those in the poorer Oslo Central East reported the highest levels of daily smoking, alcohol problems and cannabis use. After controlling for individual- and family-based risk factors, significant area differences remained, except with regard to alcohol problems and cannabis use. We conclude that adolescents living in affluent areas report the highest use of several psychoactive substances, but in a manner that is usually compatible with a rather health-oriented lifestyle. By contrast, those from socio-economically disadvantaged districts near the city centre use substances in a manner that may have greater potential for social marginalisation, morbidity and mortality.
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