2003
Revue française de sociologie
How Does one Become a Cannabis Smoker ?
A Quantitative Approach
[*]
Patrick Peretti-watel
Observatoire Régional de la Santé Provence-Alpes-Côtes d’Azur (ORS-PACA) INSERM U 379 23, rue Stanislas Torrents–13006 Marseille France
Howard S. Becker’s study of the “career” of marijuana smokers became a reference for
later ethnographic studies but has hardly been an inspiration for epidemiologists’ statistical
studies. This article aims first to better understand this apparent incompatibility by pointing
out the pitfalls epidemiologists are exposed to when they analyze drug use. It then reexamines available data, with the purpose of drawing from Becker’s theses a set of hypotheses
that can be statistically validated. Lastly, these hypotheses are validated on the basis of responses to a self-administered questionnaire survey of 12,113 teenage pupils conducted in
1999 in mainland France. The results confirm the relevance of Becker’s sequential approach
for cannabis use, since they show that 1) use-related factors, namely type of supply point
and use among peers, vary by cannabis consumption level; 2) the neutralization techniques
Becker hypothesized may be seen to be operative in respondents’ stated opinions. More generally, the article illustrates the possible complementarity between statistical and ethnographic approaches.
First published in 1963, Howard Becker’s Outsiders quickly became a reference work, a classic in the sociology of deviance, which discipline it helped
to renew. The chapters on marijuana smokers gave rise to several
ethnographic studies of illegal drug users and their “careers”, and Becker’s
theses still resonate and provoke debate today. In an overview of French
research on drug use, C. Faugeron and M. Kokoreff (1999) examine
ethnographic studies, then epidemiological surveys, particularly those conducted in schools by means of self-administered questionnaires; they criticize
the studies for being too “soft” and the surveys for not making stimulating use
of sociological variables. It is worth remarking that these two distinct empirical approaches do not stand in the same relation to Becker’s analyses. Most
ethnographic studies refer explicitly to Becker and claim to be working from
the same perspective, whereas quantitative studies based on epidemiological
surveys don’t even mention him. An examination of the international scientific literature confirms this, particularly the apparent incompatibility between
the quantitative approach and that developed by Becker. It should be said that
for his part Becker has often been critical of the statistical approach, deeming,
for example, that multivariate analysis is ill-adapted to the study of deviance
because it cannot grasp the sequentiality of a “career”; multivariate analysis
in Becker’s view wrongly assumes a synchronic relation between a dependent
variable (deviant behavior) and independent variables, all understood to act
simultaneously (1985, ch. 2). For Becker, on the contrary, a variable that is
well influential at a given stage in a career of deviance may not be at the next
one (and vice versa). Be that as it may, statisticians do have modeling methods that make it possible to handle sequentiality (Gollac, 1997). But Becker
doesn’t so much criticize the quantitative methods themselves as the use made
of them in a certain school of American sociology (school qualified by
Sorokin as “quantophrenic”). In Becker’s view, all research raises the problem of specific methods and interpretations, and sociologists must do their
best to resolve these problems, being fully aware that each choice along the
way may prove a source of error. He criticizes quantitativists for wanting to
overstandardize procedures and research tools; this can lead them to commit
the worst of errors, namely believing that their mathematical methods are
“transparent”, induce no bias or arbitrariness, protect them from all risk of error (Becker, 1970, ch. 1). In this article I shall be looking at some of Becker’s
analyses in Outsiders from a quantitative perspective, making use of a recent
epidemiological survey. My approach will not involve a genre mix-up, however–quite the contrary. As Becker himself pointed out, what may seem
highly antagonistic approaches often fuel each other; on the one hand, statistical data is precious in orienting and delimiting ethnographers’ research; on
the other, we must be knowledgeable of the “softest”, least formalized
methods if we wish to be able to interpret quantitative results.
[1]
It is important first of all to grasp the difficulties involved in a quantitative
approach to cannabis use. The statistical instruments required for data analysis are widely available today, and survey data abound, but the difficulties involved in analyzing them are perhaps greater now than they were when
Becker was writing Outsiders. In my view they have to do with the bias introduced by the language and methods particular to epidemiologists, who invested this research field earlier than sociologists and made their mark on it.
Epidemiological language and methods are not neutral; they implicitly attribute a certain identity to cannabis users. This bias is aggravated by the way epidemiological statistical models are constructed to “explain” cannabis use. In
aiming to eliminate “confounding factors”, they in fact make indiscriminate
use of highly heterogeneous variables, thus making the mistake of confounding factors and often, in the process, producing tautological results and ambiguous interpretations.
After specifying these difficulties, I shall return briefly to Becker’s chapters on marijuana smokers and illustrate their current relevance with references to recent scientific literature. I shall note which aspects of Becker’s
analysis may be used in a quantitative investigation; then develop a set of empirically testable hypotheses. Becker himself favors a two-part, objectivesubjective sequential model organized around the notion of “career”. A career is
concretely composed of a succession of positions, realizations, or lifestyles
that may be influenced by certain circumstances or personal characteristics.
The development over stages depends on the individual’s choices; between
any two stages he may reorient his trajectory. On the subjective level, at every
stage the individual undertakes a moral commitment, and must justify her
choices and practices; this may imply recomposing her identity by reinterpreting her personal history.
[2]
Lastly, I shall test the hypotheses proposed using the ESPAD survey (European School Survey on Alcohol and Other Drugs), part of the permanent program for observing drug use, and attitudes and opinions relative to drugs,
established in 1997 by the Observatoire Français des Drogues et des
Toxicomanies (OFDT) [French monitoring center for drugs and drug addictions].
The survey data were collected from March to May 1999 through a self-ad-ministered questionnaire filled out by 12,113 mainland France middle school
and high school pupils in classes selected by a two-degree stratified random
survey.
[3] Working from data for the 14-19 age group (10,810 individuals), I
first define different cannabis user categories, then study their “objective” and
“subjective” careers–in other words, determinants for moves from one user
category to another– and lastly look at variations in stated opinions and attitudes toward self and drugs by user category.
The difficulties involved in a quantitative approach to cannabis use
The “epidemiological bias”
Becker opens Outsiders with an overview of existing definitions of deviance. After speedily dismissing statistical definitions as irrelevant, he moves
on to criticize in some detail a widespread conception of deviance that follows
the medical analogy : deviance has its source in the individual, which necessarily means the deviant has particular characteristics. In this conception, deviance is likened to a pathology, an “evil” that alienates the individual and
whose “etiology” must be discovered (Becker, [1963] 1985, pp. 27-30 and p. 45).
Such a conception is incompatible with a sequential approach in terms of career, since that approach assumes an actor with a certain degree of free will
shaping his own trajectory through choices made in accordance with the circumstances he finds himself in. The medical metaphor presents the deviant as
a diseased person in whom the disease acts, rather than as the actor of his own
deviance. According to this “illness model” (Valleur, 1994), the addict in particular is the victim of a more or less irreversible, morbid or incurable process
that develops independently of her will. In this perspective, the pathogenic
agent, not the individual, has the leading role, and is understood to bring
about the addict’s inevitable physical, moral, and social degeneration. For
Becker it was important to assert that a cannabis smoker could very well be a
“normal” individual who did not suffer from particular psychological problems. Above all he underlined the fact that marijuana does not cause physical dependence. This point, still regularly confirmed today (Zimmer and Morgan, 1997; Roques, 1999), is essential to his argument. In effect, absence of
dependence makes it possible to reject the stereotype of the compulsive addict
enslaved to his vice.
[4] In methodological terms, no dependence justifies use
of the career notion, and with it the rejection of determinist theories of deviance.
[5] From this perspective it is no longer a matter of demonstrating why a
given individual necessarily became a cannabis user, but how it was possible
for him or her to become a user (Becker, 1994).
But what of epidemiologists, who for several decades have massively invested the field of quantitative study of drug use, introducing notions such as
incidence and prevalence. To quantify the spread of cannabis use within a
given group, for example, epidemiologists calculate the flux of new users
during a given time period (incidence), while the sum of “incidences” is used
to measure user “stock” (prevalence).
[6] Epidemiologists define their discipline as research into the causes of diseases, or more broadly, health phenomena (Rumeau-Rouquette et al., 1993; Saliou and Dupuis, 1995). Drug use
undeniably involves “attitudes toward health and health-related behavior”
(Arènes et al., 1997); still, this is not all it is. In fact, through professional deformation, some epidemiologists studying cannabis use tend to assimilate it to
a disease and work to find causes and effects, relating it to “other” physical
and psychological troubles. By means of costly longitudinal surveys, they aim
to establish the chronological order in which a number of troubles appeared
(including cannabis consumption) in order to deduce a causal relation (cause
preceding effect); in other words to identify the pathologies leading to cannabis use and, conversely, the pathologies cannabis use leads to. Among the
causes suggested to explain cannabis consumption are symptoms of depression (Kandel and Davies, 1992), psychopathological factors, emotional disorders, and early trauma (Höfler et al., 1999). Proposed consumption
consequences include mental disorders (McGee et al., 2000) and suicide attempts (Beautrais et al., 1999). The vocabulary used in these studies is likewise symptomatic of the “epidemiological bias”. On the basis of a
longitudinal study, A. Perkonigg et al. (1999) calculate a “remission rate”
–that is, the proportion of heavy users (defined as smoking cannabis at least
three times a week) that significantly reduce their consumption over the
course of the study. It should be remembered that in medical terms being in
remission means the patient’s symptoms have disappeared but that the disease
may still be active and the patient may fall sick again.
[7]
Naturally, I do not attribute to these researchers any hostile intention toward cannabis users. The fact is that the medical analogy so often used by
epidemiologists tends to present cannabis consumption as a disease and users
as sick persons. This in turn plays into the hands of people who hold highly
unscientific opinions, describe drugs and their use with the metaphor of contagion, and assimilate cannabis users to contagious sick persons who have lost
their free will and must be treated before they get caught in the gears of dependence and “escalation” and contaminate those around them (Nahas, 1976;
Hovnanian, 1999).
[8] Sociologists are perhaps more accustomed than
epidemiologists to this type of problem : they know their studies may be used
and possibly deformed in social and political discourse, “especially since it is
in the interest of certain actors to dramatize the danger” (Faugeron and
Kokoreff, 1999, p. 6). When sociologists invest a research field, they are immediately confronted with power relations, and competing vocabularies; if
they opt indiscriminately for the language of one of the groups on the scene,
they introduce a bias into their work from the outset. Becker underlined this
danger during a recent conference, citing Goffman’s Asylums : Goffman had
avoided it by not defining individuals interned in psychiatric hospitals with
vocabulary used by the hospital personnel. Becker likewise underlined the
power of words in studying cannabis. Should we speak of addiction or use ?
Do we get “intoxicated by” or “high on” marijuana ?, and so forth.
[9] Assimilating cannabis consumption to a disease is a way of choosing the vocabulary
of addiction and intoxication that in itself presents the consumer as an individual who has become dependent and is no longer in control of himself.
In France the “epidemiological bias” is perhaps less pronounced than in
English-speaking countries. There are also fewer quantitative analyses of cannabis use or other illegal drugs. Studies by INSERM researchers, undoubtedly
the reference, attest to a certain circumspection with regard to etiological
analyses. Before presenting the results of a study of factors associated with
drug use (primarily cannabis) in a sample of teenage pupils, M. Choquet,
S. Ledoux, and C. Maréchal warned the reader as follows : “Highly diverse
factors may play an etiological role in the consumption process : they may be
socio-demographic, related to social and family environment, or otherwise relational. We will look successively at some of these factors, without making
conclusive judgments about their causal value. In effect, the cross-sectional
data available do not permit such conclusions. Moreover, extreme caution is
necessary in this area; often, etiological power is too readily attributed to an
associated factor. To avoid this kind of slippage, our result analysis will be
deliberately descriptive, leaving it to the reader to conclude, given the great
number of operative factors and the complexity of the phenomenon.”
(Choquet et al., 1990, p. 31). The authors were entirely right to warn the
reader against hasty conclusions about cause-effect relations. However, if researchers forbid themselves to conclude, they should also forbid readers to, or
at least advise them against it, especially for such a “sensitive” subject, where
any figure results, results which thus appear scientific, are quickly reinterpreted by actors in the political debate.
In sum, because epidemiologists study cannabis use in the same way that
disease etiology is studied, they should be attentive to the unfounded interpretations their results may give rise to.
Confounding factors and making the mistake of confounding factors
Epidemiologists today use multifactorial causal models; they no longer
look for a unique determining cause for a given disease, but rather a cluster of
causes that are neither necessary or sufficient; that is, “risk factors” for the
disease. The multifactorial aspect requires the researcher to be attentive to
confounding factors : the more variables there are, the more likely that some
are statistically linked, meaning that the apparent influence of a given variable
on the phenomenon may very well mediate the influence of another variable,
then disappear as soon as this other variable is taken into account. In this case
the first variable is the confound and must be closely controlled for. For example, “serious” suicide attempts are more frequent among cannabis “abusers”. Nonetheless, if we take sociodemographic profile and user’s personal
history into account and then compare two individuals with the same profile
and history, one a cannabis “abuser” and the other not, the risk that the second
will seriously attempt suicide is only slightly lower than for the first
(Beautrais et al., 1999). To neutralize confounds and have valid “otherthingsbeingequal” results to interpret, statisticians use analysis of variance methods. When a variable of interest is dichotomous (eg, whether or not to consume a substance) or, more generally, qualitative, they most often use logistic
regression.
[10] This method makes it possible to take numerous variables into
account in a single model and measure the impact of each one on the dependent variable while controlling for the others.
The validity of results thus obtained is nonetheless subject to caution. It is
perhaps useful to recall here the criticism formulated earlier against quantitative studies aimed at modeling knowledge, attitudes, beliefs, and practices relative to AIDS.
[11] These studies have often used logistic models (to explain
condom use, for example) into which numerous highly heterogeneous variables had been introduced. For J.-P. Moatti et al. (1993), this approach “accentuates the mechanistic character of the analyses if there is not sufficient
critical reflection on the fact that variables as statutorily different as those
pertaining to biology, socio-demography, psychology, and social representations are being treated as if they had the same status. Clearly, there is a great
danger that a mass of raw data and a sophisticated statistical apparatus will
lead to largely tautological results, where pseudo-independent factors are in
reality nothing more than another way of presenting the dependent variable
they claim to explain” (p. 1512). The criticism is valid for many studies of
drug use in general and cannabis use in particular. Surveying the scientific literature, R. R. Clayton draws up what is clearly an absurd list of disconnected
independent variables, often considered simultaneously : impulsiveness, lack
of religious feeling, early alcohol consumption, living in a rowdy neighborhood, family conflicts, being in a vulnerable socio-economic situation, hormonal and neurophysiological traits, etc.
[12] For some of these factors, such
as “positive attitude toward drug use” (Clayton, 1992) or “intention not to
consume drugs in the future” (Höfler et al., 1999), we can even wonder to
suggest that they are redundant with the variable to be explained : drug use itself.
When the analyst carelessly mixes highly disparate independent factors,
factors that are not at the same reality level, controlling for confounding variables seems to lead to confounding variables. In effect, the clear distinction
statisticians make between dependent and independent variables may well obscure the fact that the significant statistical links brought to light correspond
to relations that are not necessarily causal and whose meaning is not always
self-evident. Peer pressure is understood as an incentive factor, product accessibility an enabling factor, playing pinball in cafés merely an associated factor, and cigarette smoking a necessary condition (since cannabis is almost
always consumed that way). These “independent variables” refer to relations
that do not have the same meaning. It is not at all clear that the relation between ordinary cigarette smoking and cannabis use is a causal one : it is likely
that in certain cases repeated cannabis use can lead to regular cigarette smoking, not the reverse. Brochu and Brunelle’s 1997 analysis illustrates the wide
variety of possible meanings for the sole statistical relation between drug use
and delinquency : drug use may cause delinquency, or simply precede it; the
two may be concurrent or together constitute a syndrome, or else they may be
two facets of a single lifestyle. This confusion, which has come about with increased use of surveys and the development of new statistical tools for analyzing them, renews and enlarges the pitfalls noted by Becker in the 1950s when
he criticized multivariate analysis for implicitly postulating the simultaneity
of covariable effects on the dependent variable.
A quantitative study of cannabis use that takes off from Becker’s analyses
in Outsiders must therefore first and foremost avoid two pitfalls : first the “epidemiological bias” that tends to represent cannabis consumption as a disease
whose “etiology” must be established, an analogy incompatible with the career notion central to Becker’s approach; second, the mistake of confounding
factors, mistake due to overly systematic use of multivariate analysis, which
tends to eclipse the diversity of possible meanings of statistical relations obtained. In studying cannabis quantitatively, then, variables must by carefully
chosen and their status defined in the analysis and interpretations, with care
taken to avoid overly deterministic commentaries and medical analogies.
With these methodological precautions in mind, I can now summarize
Becker’s analysis and draw a set of empirically testable hypotheses from it.
A marijuana smoker’s career according to Becker
Career stages and their determinants
As explained, Becker developed a sequential approach to marijuana use
that involves two axes : gradual learning about the product’s effects and moving from initiation to occasional use to regular use. Becker wanted to break
with what he saw as an over-“psychologizing” research tradition; for him
marijuana use is not determined by psychological characteristics or motivations because motivations themselves are modified with use. Experimentation
is due above all to curiosity, and the sought-after effects do not become a motivation until the individual has learned to bring them on, perceive them, and
enjoy them. It is “learning” to use that produces motivation, rather than the
other way around. Later qualitative studies have confirmed the existence of a
learning process for cannabis (Green and Miller, 1975; Hirsch et al., 1998;
Aquatias et al., 1999) as well as other substances, particularly heroin (Duprez
and Kokoreff, 2000). Closed-ended-question questionnaires are probably not
a well-adapted means of observing this process. We should note, however,
that pupil surveys confirm the primacy of curiosity as a motive for experimentation : this was the reason most often cited by Paris high school students
(Peretti and Leselbaum, 1999) as well as middle school and high school students in the ESPAD survey for whom cannabis was the first drug ever taken
(asked about their reasons for taking cannabis, 82% chose “I was curious”).
Moreover, since cannabis is most often smoked in the form of user-rolled cigarettes, learning how to use it is facilitated by having smoked tobacco. It is
hardly surprising that in the ESPAD study, almost all the respondents who
had already smoked cannabis had also already smoked a cigarette (98%). Tobacco is not so much a “risk factor” as a near-necessary condition of cannabis
use. In the learning process described by Becker, peer group in which a cannabis smoker was initiated plays an important role. Quantitative surveys produce an indication of peers’ role, in that the presence of cannabis users among
teenager’s immediate family and friends is more marked for regular consumers than experimenters (Peretti and Leselbaum, 1999).
One doesn’t then become a marijuana smoker overnight. Becker systematically differentiates three phases in a smoker’s career, corresponding to the
figures of beginner, occasional smoker, and regular smoker.
[14] Two conditions must be met for an individual to try marijuana. First, he/she has to be
open to trying; second, the product has to be accessible. Openness to trying
implies that the individual has called into question the operative social norms
according to which marijuana is a harmful product. Today these norms have
been weakened, and there is a relative “banalization” of cannabis, in terms of
both consumption and opinion (Beck, 1997), even though most French remain
hostile to legalization (Beck and Peretti-Watel, 2000). As is the case for other
illegal drugs, marijuana consumption is no longer restricted to a cultural protest movement confined to upper- and middle-class teenagers (Galland, 1993)
and no longer constitutes a “rite of passage” (Gendreau, 1998). Whether or
not a teenager calls into question norms proscribing cannabis use depends on
parents’ discourse on the matter – they may be more or less intransigent by
social milieu – and the teenager’s ability to distance himself from this discourse. Peer group plays an active role in calling norms into question, though
it would be inexact to speak of “peer pressure”: peers do not exercise moral
pressure; rather, discussions and practices among peers may be understood to
undermine conventional ideas (Aquatias et al., 1999). Moreover, the stronger
prevalence observed among boys could reflect girls’ greater respect for parental norms. Among young people aged 15 to 19, girls also refuse offers of illegal substances more often than boys, and when they do try, are less likely to
renew the experience (Velter and Arènes, 1999). These results also hold for
persons aged 18 to 75 (Grizeau et al., 1997).
An individual who is disposed to try must also have access to the product.
Statistical models that relate drug consumption to the fact of being offered
drugs (in both cases the drug in question is most often cannabis) illustrate this
necessary condition almost to a caricature : according to a recent secondary
analysis of the 1997/98 “Santé” [Health] barometer for young people–respondents were 15 to 19-year-olds in the Île-de-France department [including
Paris] (Embersin and Grémy, 2000)– being offered cannabis has five times
more impact on the probability of trying it than the combined effects of sex,
age, family type, and father’s occupational situation.
[15] Peer group still plays
a decisive role when it comes to access. The ESPAD survey tells us how adolescents whose first drug was cannabis first procured the substance : 51%
shared a joint with a group of friends; 39% received it for free from someone
close to them (generally a friend, sometimes an older brother or sister), while
only 5% bought it (here again, most often from a friend). For Becker,
first-time and occasional smokers have limited access to the product, as access is dependent on peer-presented occasions. The regular smoker, by contrast, has solved this problem; he has “learned” to procure marijuana by
himself. For each consumption phase, then, there is a corresponding supply
mode. The question of procurement enables us to grasp the particular importance of peer use for regular consumers : these consumers are often the ones
who organize group purchases, encouraged in this by dealers who charge
them less if they buy more (Ingold and Toussirt, 1998). This implies a
mobilizable friend-co-buyer network.
Two essential features of an approach focused on the notion of career may
be deduced from Becker’s analyses. First, while cannabis use involves a process associated with certain measurable variables (such as degree of acceptance of norms prohibiting it and product accessibility), the role of those
factors may well vary from one stage to another of the process. In other
words, factors associated with initiation don’t necessarily enable us to understand the shift to occasional or regular use. From a purely statistical perspective, the impact of “independent variables” itself varies by consumption level.
We observe, for example, that the overrepresentation of boys seems to increase with consumption level (Kandel and Davies, 1992; Peretti and
Leselbaum, 1999; Beck et al., 2000). Meaning, as well as intensity of statistical relation, may vary. We may therefore suppose that the importance of the
factor “presence of cannabis consumers among one’s peers” declines as one
moves through the process, but it is first and foremost to be interpreted differently depending on the stage under consideration. Peers’ first role is to facilitate initiation by helping call into question norms proscribing cannabis use
and providing occasions to consume. They next contribute to the starter’s
learning process, and offer the occasional smoker more occasions for use. The
regular consumer, however, only depends on his peers in the area of product
supply, where he can mobilize them to get a “group rate” on quantity purchases.
The second fundamental feature of this approach involves the “diachronic
flexibility” of the process–neither ineluctable or irreversible. Use may remain
at the occasional level; it doesn’t necessarily become regular; meanwhile, a
regular smoker can reduce or cease consumption, either temporarily or for the
long term. This feature helps Becker criticize psychological explanations of
deviance : because they are overly deterministic, they don’t allow us to take
account of variations in use. A recent study conducted in housing developments on the poor outskirts of Paris clearly illustrates diachronic flexibility :
the author stresses how easily the young people studied shift from one type of
use to another, allowing themselves occasional excesses, for example, or decreasing consumption to reconcile that aspect of their lives with working.
This leads him to call the substance a “slack drug” (Aquatias, 1999). Use
“malleability” has also been pointed up for other products, namely heroin
(Vedelago, 1994). A longitudinal survey on cannabis use among a sample of
German adolescents reveals frequent consumption variation over an average
period of 19 months, involving both increases and decreases (Perkonigg et al.,
1999). Use level can also be stable. After replicating Becker’s study, Hirsch et
al., 1998 observe that many cannabis smokers keep to an intermediate stage
and level, between occasional and regular. A longer-term Australian survey
conducted in rural areas with individuals who have been smoking for nearly
twenty years shows stabilization of their consumption levels (Reilly et al.,
1998).
A marijuana smoker’s “moral career”
According to Becker a starter must first and foremost get beyond the norms
condemning marijuana as a dangerous, toxic substance that causes the individual to lose control of himself. The individual’s opinion on whether marijuana is dangerous will change with use : if he moves from the occasional to
the regular phase, he will revise that opinion, specifically by deeming the sub-stance does not engender dependence. One user Becker questioned compared
marijuana to alcohol–to underline the advantages of the former. Another respondent, to convince himself that he was not dependent, that he was in control
of his consumption, decided to stop smoking for a week; afterward, reassured,
he began again. Yet another, sensitive to ideas presenting drug use as a sign of
psychological and moral weakness, ultimately concluded that because he was
aware of this risk he must still have it under control. In sum, to start, continue,
or increase consumption, a marijuana smoker has to “neutralize” the stereotypes condemning his practice by convincing himself that they reflect the
opinion of people who don’t know anything about the matter, and substituting
a more favorable interpretation, based on his own experience and that of his
peers.
Qualitative studies confirm that young users of illegal drugs have the feeling they are in control of their consumption, that they experience it as a
self-controlled succession of reflective, deliberately made choices (Boys et
al., 1999), self-control being, moreover, one of the informal rules in some
cannabis smoker groups (Aquatias, 1999). These studies also point up “neutralization” mechanisms, ways of rationalizing the practice, comparable to
those Becker mentions : young people reverse the relation between deviance
and normality (“everyone smokes”), affirm that cannabis does not endanger
health or cause dependence, and situate their practice in a recreational, collective framework, in contrast with heroin, which is understood to enslave, isolate, and ultimately destroy those who take it (Kokoreff, 1999; Duprez and
Kokoreff, 2000). Neutralizing conventional discourse that stigmatizes illegal
drugs thus also involves denying its relevance for cannabis while accepting it
for heroin. Available quantitative data partially confirm these observations. In
the survey of Paris high school students, the more cannabis a teenager consumed, the less likely he was to think the substance was dangerous (Peretti
and Leselbaum, 1999). Likewise, according to a survey conducted by
R. Ballion in six large French school districts (1999a), the higher students’
consumption, the more likely they were to distinguish between soft and hard
drugs and reject the “escalation” thesis. Surveys of the general population
tend instead to point up a more tolerant attitude toward heroin and its users
among respondents who have tried cannabis (Grizeau et al., 1997; Beck and
Peretti-Watel, 2000; Peretti-Watel, 2000), but this result cannot be refined by
consumption level with the data available.
Shifts in cannabis use level thus go hand in hand with shifts in opinion
about the substance. It would be simplistic to think that opinion determines
consumption, or conversely that consumption leads individuals to rationalize
their opinions. Opinion and consumption are constructed simultaneously, and
the individual makes sure there is no dissonance between them. From a statistical perspective, it would therefore be highly questionable to use one to “explain” the other.
Analysis of the 1999 ESPAD survey
Hypotheses
It should be specified from the outset that the ESPAD survey is crosssectional whereas Becker’s perspective is longitudinal, following the trajectory
of a given individual over time to apprehend the successive stages of the process leading, or not, to regular cannabis use. In sum, his approach is
diachronic. The ESPAD survey in contrast consists of data collected on a single date; it observes cannabis consumption among teenage respondents at that
instant and only that instant; it is synchronic. To reconcile the two approaches
I will hypothesize that the various use levels indicated by respondents correspond to different phases in the process Becker analyzed. In other words, the
ESPAD survey offers no more than a cross-section of the process but nonetheless can be assumed to provide information on the various stages in that, at
the moment of the survey, the different respondents were at different stages
(no stage at all or barely initiated for some, intermediate or “last” for others).
I will assume here that comparison of individuals who have identified themselves as being at levels that are clearly distinct from one another will enable
us to understand why a given individual moves from one level to another.
To adapt quantitative procedure to the sequential model presented in Outsiders, it is therefore necessary to choose empirical criteria that will make it
possible to categorize respondents by consumption level. Obviously these levels do not correspond to Becker’s use types. His types represent a synthesis
of his set of observations and take into account procurement modes and systems of self-justification. On the contrary, the consumption levels I shall propose are no more than analytic tools derived from number of times marijuana
was used during a given time period. This produced five different levels :
- Abstinence : “have never taken cannabis” (64.1% of the sample);
- Experimentation : “have already consumed cannabis, but not in the
course of the last 12 months” (6.3%);
- Occasional use : “have used cannabis in the course of the last 12 months
but fewer than 10 times” (16.1%);
- Repeated use : “have used cannabis at least 10 times in the course of the
last 12 months but fewer than 10 times in the last 30 days” (6.1%);
- Regular use : “have used cannabis at least 10 times in the last 30 days”
(6.2%).
With this breakdown into five levels, only 1.1% of respondents remain
uncategorizable due to non-responses or inconsistent ones. The percentages
indicated above reflect a partial recoding of non-responses (individuals stating they’d never taken cannabis in their lives and not responding to questions
on use over the preceding year or month were put with abstainers). The 1.1%
figure corresponds, therefore, to unrecodable inconsistencies, as it was not my
objective here to refine prevalence estimations.
In defining consumption levels, it is essential to take into account respondents’ age and sex, which are indispensable control variables since adolescence itself is characterized by an increasing number of “first times”, and moral
and social touchstones and lifestyles change more quickly and profoundly than
in any other life period, often on gender-differentiated time-tables (Galland,
1993). Type of school (academic, technical or mixed-academic-and-vocational
high school, vocational high school, middle school) and school location (ZEP
or non-ZEP)
[16] have also been integrated into the analysis, at least at first. In
effect, there is a widespread notion that more cannabis is consumed in vocational high schools and ZEPs than in other types of schools, though both parts
of this assertion have been invalidated by pupils’ responses (Choquet and
Ledoux, 1994; Peretti and Leselbaum, 1999; Ballion, 1999a invalidate the
first part; Ballion, 1999b invalidates the second). Second, given that Becker’s
analyses emphasize peer group influence and drug procurement mode, I shall
also be looking at use among peers –“How many of your friends smoke cannabis ?”: none, several, most, all– and procurement : “Is it easier to buy cannabis on the street or in a park, in middle school or high school, in a discotheque
or a café, at a dealer’s ?” (these different items are not mutually exclusive).
Lastly, given that we are concerned with a process, it’s important to take into
account how long respondent has been using by calculating the difference between age at time of survey and stated age for first use of cannabis. From
these variables, here considered determinants of consumption level, it should
be possible to verify the following three hypotheses :
Hypothesis 1 : The statistical relations observed between determinants and
consumption levels vary by level. For example, a variable that differentiates
between abstainers and experimenters will not necessarily differentiate between experimenters and occasional users.
Hypothesis 2 : Use among peers is determinant for experimentation but its
influence, though declining over the process, is also felt in shifts between
higher consumption levels.
Hypothesis 3 : Certain consumption levels are characterized by specific
supply modes.
Hypotheses 2 and 3 are in fact particular cases of Hypothesis 1. I shall
therefore be particularly concerned to check Hypothesis 1 for age and sex,
whereas these variables are not relevant for 2 and 3.
For the question of cannabis users’ moral “careers”, the ESPAD questionnaire contains a number of opinion questions relative to use of illegal sub-stances. Respondents were asked to give their opinion of persons trying
cannabis for the first time, and of occasional and regular cannabis users, as
well as of persons trying heroin or crack for the first time (responses to
choose from : “I’m not against it”, ”I’m against it”, and “I’m totally against
it”). They then had to estimate the level of risk involved for the same practices, plus those of regularly taking heroin, cocaine, or crack (responses to
choose from : “no risk”, “slight risk”, “moderate risk”, “high risk”). We obviously expect that cannabis users will express judgments about this substance
and users of it consistent with their own consumption level. For the other sub-stances, on the other hand, the neutralization techniques observed by Becker
and by Kokoreff and Duprez suggest that judgments about users and how dangerous a product is will vary differently. Specifically, risks perceived for heroin should not decrease and may even increase as cannabis consumption
level increases and it becomes necessary for the user, concerned to justify his
own practice, to distinguish sharply between his drug and “harder” ones.
Neutralization of stereotypes stigmatizing illegal substances and those who
consume them should enable the cannabis smoker to experience his practice
as a fully controlled and self-made choice rather than a vice to which he is enslaved. Consequently, cannabis use should not bring about self-deprecation or
be the consequence of low self-esteem : see Becker’s strong criticism of psychological explanations of deviance that liken drug use to a crutch used to forget one’s problems or failures and restore self-esteem (Miller, 1988; Kaplan,
1995). We should therefore not obtain a significant relation between consumption level and self-esteem, at least not once we have controlled for age
and sex effects.
[17] We can check for absence of relation thanks to a series of
questions in the ESPAD survey that makes faithful use of classic items from
American self-esteem studies (Rosenberg et al., 1995). The following two hypotheses may then be added to the first three :
Hypothesis 4 : Rationalizing cannabis use implies that judgments about
cannabis and what are known as “hard” substances will follow different tracks
by consumption level. The higher the level, the less likely respondents will
disapprove cannabis users or say that this substance involves risks for users.
On the other hand, these two relations should disappear or become reversed
for heroin, crack, and cocaine.
Hypothesis 5 : Self-esteem should not vary with cannabis consumption
level. Specifically, it should not diminish when consumption level increases.
Use among peers and procurement ease
TABLE I.
Characterization of cannabis consumption levels
TABLE I. – Characterization of cannabis consumption levels
At least Experimen- Occasional Repeated Regular
Abstinence once tation use use use
Age 16.1 17.0 17.1 16.8 17.2 17.3
Length of — 2.3 2.2 1.8 2.5 3.2
time using
Columns show %
Sex:
Boy 44.5 53.9 49.1 49.6 57.2 66.7
Girl 55.5 46.1 50.9 50.4 42.8 33.3
School type:
General and 37.1 57.3 50.0 56.0 64.5 61.0
technical high
school, mixed
high school
Middle school 50.7 24.2 27.1 28.2 17.8 17.4
Vocational high school 12.1 18.5 22.9 15.8 17.8 21.7
School Zone
ZEP 8.6 6.1 6.5 6.6 7.2 3.6
Non-ZEP 91.4 93.9 93.5 93.4 92.8 96.4
Use among peers:
None 52.1 4.6 13.8 3.7 1.7 0.7
Some, several 43.8 57.7 72.7 71.3 44.1 21.2
Most, all 4.1 37.7 13.5 25.0 54.2 78.0
Procurement location
Street, park 19.5 36.5 30.9 30.7 42.8 50.7
School 30.5 55.7 48.1 54.9 61.4 59.8
Discotheque, café 26.6 25.7 25.6 24.8 24.7 28.9
Dealer’s place 31.5 52.2 42.4 44.2 61.9 73.4
All 64.1 34.7 6.3 16.1 6.1 6.2
N 6,809 3,670 660 1,702 651 657
Source: ESPAD 99, INSERM, OFDT, MENRT.
ESPAD 99, INSERM, OFDT, MENRT.
Table I is to be read by columns; for example, 44.5% of abstainers are boys
and 55.5% girls. All variable combinations presented are significant at a
highly satisfactory statistical threshold (except stating that it’s easy to procure
cannabis in a café or discotheque). The column entitled “at least once” aggregates all the following columns and thus makes it possible to specify the results we would have obtained if we hadn’t distinguished between different
consumption levels. On the basis of the table we may state the following :
- Male preeminence strengthens as consumption level increases, but does
so by successive plateaus rather than continuously, stagnating between experimentation and occasional use and jumping up between repeated and regular
use.
- Average age is not closely linked to consumption; it increases particularly between abstinence and experimentation, then decreases, then increases
again.
- Length of time using decreases between experimentation and occasional
use, then increases regularly with consumption level.
- The higher the consumption level, the fewer middle school students
among users. This was predictable given that they are younger. On average,
there are three times more general and technical high school and mixed high
school pupils than vocational high school pupils, while these last are
overrepresented among experimenters and regular users and underrepresented
for the two intermediate levels.
- Education zone is not closely linked to consumption level. ZEPs even
tend to be underrepresented when consumption level increases.
- Use among peers is closely related to respondent’s consumption level.
There are extremely few occasional users without any user friends. The proportion of respondents stating that all or most of their friends are users increases quickly with consumption level.
- Perceived procurement ease increases with consumption, except for
cafés and discos. For the other procurement modes the relation varies : for “on
the street”, “in a park”, and “at a dealer’s”, perceived purchasing ease stagnates between experimentation and occasional use, while for middle school
and high school it stagnates starting with repeated use. School seems the place
where the drug can be most easily procured for experimentation and occasional use, while dealer’s place comes out ahead for repeated or regular use.
Overall, user characteristics do not vary regularly by consumption level :
plateaus and stagnation points appear, namely for sex, age, and supply possibilities. Becker’s hypothesis on the relation between supply mode and use
level is here supported by empirical arguments, though it should be remembered that survey questions bore on possibility of procuring cannabis rather
than actual procurement.
To measure “other-things-being-equal” relations here, structural effects
must still be controlled for. The preceding table already enables us to discard
three variables : school type (which reflects above all an age effect), school
zone, and ease of procurement in discotheque or café. But what statistical
model should be chosen for comparing different consumption levels ? Höfler
et al. (1999) chose an ordered polytomous model based on the hypothesis
known as “equal slopes” according to which the impact of an independent
variable cannot vary by mode of dependent variable. For example, if a boy is
1.5 times more likely than a girl to try cannabis, he will also be 1.5 times
more likely to move beyond occasional and repeated use stages, and 1.5 times
more likely to reach regular use. Obviously such a model would not allow us
to explore the first three hypotheses. Choquet and Ledoux (1994,1999) identify abstinence and two other consumption levels, then perform multinomial
logistic regression by comparing each of the two levels with abstinence, the
latter being the base (this is the strict equivalent of performing two distinct dichotomous regressions). Their procedure removes the equal slopes constraint,
but it would be more interesting, instead of comparing each of the two levels
to abstinence, to compare them to each other, as Kandel and Davies do
(1992), though they then compare abstainers to all consumers, thus no longer
distinguishing between different consumption levels.
I have chosen here to compare adjacent levels. Though it is entirely possible for an individual to move directly from occasional to regular use, the results of Perkonigg et al. (1999) suggest that the most frequent consumption
variations are between successive levels. For my five levels, then, I need to
approximate four models. The last question is which respondents to compare.
For the move from occasional to repeated use, should the whole sample be
kept, with an oppositional break between “occasional or lesser” use and “repeated or greater” use ? Obviously not, since then the specific characteristics
of the distinct “occasional” and “repeated” levels would not show clearly, and
in the end what would probably show up in the analysis are characteristics of
the extreme levels (particularly abstainers). Moreover, if we only compare
occasional use with “repeated or greater” use, that implicitly amounts to
thinking that a cannabis smoker’s career is irreversible, that regular users necessarily went through a “repeated use” phase, and above all that repeated use
can only evolve toward regular use. To keep in mind the flexibility of cannabis use as it comes through in Aquatias’s studies, among others, it seems more
judicious to compare occasional users to repeat users only and, more generally, only to compare adjacent levels and users in adjacent categories. I conducted four logistic regressions, each of which points up differences between
two successive consumptions levels and compares user characteristics for the
two categories.
TABLE II.
Logistic regressions comparing successive consumption levels
TABLE II. – Logistic regressions comparing successive consumption levels
Odds ratios
Abstinence Experimentation Occasional use Repeated use
→ → → →
experimentation occasional use repeated use regular use
Sex:
Boy 1.28** 1.01 ns 1.44*** 1.66***
Reference: girl-1- -1- -1- -1-Age (years) 1.39*** 0.90** 1.07 ns 0.99 ns
Length of time using — 0.81*** 1.46*** 1.39***
(years)
Use among peers:
Most, all 8.09*** 6.53*** 3.44** 4.67**
Some, several 4.83*** 3.50*** 1.07 ns 1.64 ns
Reference: none-1- -1- -1- -1-Procurement locations
Middle school, high 1.13 ns 1.23* 1.12 ns 0.83 ns
school: yes
Reference: no-1- -1- -1- -1-Street, park: yes 1.11 ns 0.96 ns 1.29* 1.11 ns
Reference: no-1- -1- -1- -1-Dealer’s: yes 1.16 ns 1.14 ns 1.55*** 1.38*
Reference: no-1- -1- -1- -1-***, **, *, ns: respectively, p <= 0.001,0.01,0.05, not significant.
Source: ESPAD 99, INSERM, OFDT, MENRT.
ESPAD 99, INSERM, OFDT, MENRT.
Table II presents the results obtained for the four models. It reads as follows : other things being equal (within the limits of the variables introduced
into the model), a boy is 1.28 times more likely than a girl to be an experimenter rather than an abstainer, and being a year older (eg 16 rather than 15)
multiplies likelihood by 1.39. It should be noted that the effect of age becomes almost or wholly insignificant when length of time using is controlled
for; that variable is obviously not taken into account in the first model since
for abstainers it is by definition zero.
[18] Interestingly, experimenters are
older and have used longer than occasional users, but that is due to the definition of the former consumption level, which implies that an experimenter has
been using for at least a year (he/she’s already used cannabis but not in the
preceding year), whereas an adolescent who has consumed cannabis for the
first time that year is categorized as an occasional user.
Overall, the results confirm the three hypotheses. First, preferred procurement locations vary by compared use levels : none in particular for experimentation; high school or middle school for occasional use; street, park, or
dealer’s for repeated use; and dealer’s for regular use (Hypothesis 3). Furthermore, use among peers remains determinant beyond the experimentation
stage, but less and less so, with lower or less significant odds ratios (Hypothesis 2). Relations observed between determinants and consumption levels do
indeed vary by levels considered (Hypothesis 1), and this is also valid for sex :
excepting comparison between experimentation and occasional use, the
higher the use level, the stronger the influence of sex (higher and higher odds
ratios). Moreover, for procurement places, it should be noted that only one
odds ratio out of six is significant for the first two models, and then only
slightly. In other words, it seems that for an adolescent to take his or her “first
steps” in cannabis use, there doesn’t need to be procurement ease, probably
because at this consumption level one smokes only with one’s peers and does
not oneself buy the product.
Opinions on drugs and self-esteem
Let us first consider stated opinions on people who take one or another of
the drugs and on how dangerous the different substances and using them are.
All the combinations presented in Table III are significant at a highly satisfactory statistical level. Table III reads thus : 28.4% abstainers say they are “not
against” people who try cannabis once or twice.
A tolerant attitude toward cannabis users is closely associated with consumption level. Starting with experimentation, a large majority of respondents
say they are “not against” people trying it. The same relation appears between, on the one hand, occasional and regular consumption levels as defined
and, on the other, opinions expressed about people who smoke occasionally or
regularly. If we assume that the majority of respondents say they are “not
against” a use level as soon as it corresponds to their own perceived level,
then the names given to the different consumption levels here seem to correspond fairly well to the ones respondents spontaneously use. Exactly the same
is true for questions about associated risks. For example, only 6.8% of occasional users think that occasionally smoking cannabis involves “high risk”,
and only 8.8% of regular users say so for regular use. The first part of hypothesis 4 has thus been confirmed. For the other substances, the tendencies are
similar for judgments of users (“against” or not) but reversed for assessment
of danger. Tolerance is positively correlated to respondent’s consumption
level : the proportion of respondents saying they are “not against” people trying
heroin or crack is twice as high among regular smokers than abstainers (21.8%
and 11.1%, 22.7% and 11.5% for the two drugs respectively). However, the
higher respondent’s consumption level, the more likely the other substance,
whether it be heroin, crack, or cocaine, is perceived as dangerous, from “trying” to “regular use”. The second part of hypothesis 4 may therefore be
amended and confirmed thus : when cannabis users’ consumption level increases, they are more likely to stress the risks of “hard drugs” but to stigmatize their users less.
TABLE III.
Cannabis consumption levels and opinions on drugs and users (% in columns)
TABLE III. – Cannabis consumption levels and opinions on drugs and users (% in columns)
Abstinence Experimentation Occasional Repeated Regular
use use use
Opinions about cannabis:
Trying it: not against 28.4 72.3 88.8 96.5 97.6
Occasional use: not against 21.7 50.5 77.6 95.0 97.5
Regular use: not against 11.2 23.4 36.5 66.6 89.5
Opinion on trying heroin:
not against 11.1 14.3 15.0 15.8 21.8
Opinion on trying crack:
not against 11.5 14.8 17.2 16.4 22.7
Risks associated with cannabis:
Trying: high risk 28.7 6.7 2.4 1.1 1.6
Occasional use: high risk 38.8 17.5 6.8 2.3 1.8
Regular use: high risk 74.4 54.9 37.6 17.1 8.8
Risks associated with heroin:
Trying: high risk 47.4 61.2 56.4 63.2 65.4
Regular use: high risk 85.9 87.6 86.2 90.7 89.7
Risks associated with cocaine
and crack:
Trying: high risk 48.8 62.5 57.5 67.4 66.4
Regular use: high risk 86.6 88.3 86.3 90.6 90.6
Source: ESPAD 99, INSERM, OFDT, MENRT.
ESPAD 99, INSERM, OFDT, MENRT.
Answers relative to self-esteem are presented in Table IV.
In general, ordinal responses to the questions are coded numerically and
added together to obtain a unidimensional synthetic index. T. J. Owens (1994)
points out, however, that it is crucial to distinguish between “positive self-worth” and “self-deprecation” and use two distinct scales. As a precaution, I
have first done factorial analysis on the items so as to explore simultaneously
all statistical relations between them two by two. A sharp “size effect” appears on the first axis and drains off half the inertia : items themselves are positively correlated.
TABLE IV.
Questions on self-esteem
TABLE IV. – Questions on self-esteem
Self-esteem Responses to choose from:
I feel that I am a person of worth, at least on an equal
plane with others.
I feel that I have a number of good qualities.
I tend to feel I’m a failure.
I am able to do things as well as most other people.
I feel I have reasons to be proud of myself. Agree strongly
I take a positive attitude toward myself. Agree slightly
I’m satisfied with myself overall. Disagree slightly
I would like to respect myself more. Disagree strongly
Sometimes I feel really useless.
Sometimes I think I am no good at all.
Source: ESPAD 99, INSERM, OFDT, MENRT.
ESPAD 99, INSERM, OFDT, MENRT.
I have therefore opted for the usual index : the responses “agree strongly”,
“agree slightly”, “disagree slightly”, “disagree strongly” were coded respectively 4,3,2, and 1. Responses to the 5 self-approving statements were added
and responses to the 5 self-deprecating ones were substracted from the sum.
The index thus obtained varied from–16 to +16.
Table V presents the average values of this index for each consumption
level and the entire sample.
TABLE V.
Cannabis consumption levels and self-esteem
TABLE V. – Cannabis consumption levels and self-esteem
Abstinence Experimentation Occasional Repeated Regular Total
use use use
Self-esteem index 4.33 4.35 4.18 4.88 5.14 4.39
Source: ESPAD 99, INSERM, OFDT, MENRT.
ESPAD 99, INSERM, OFDT, MENRT.
Self-esteem seems to increase with consumption. We should, however, be
careful in interpreting this result, since self-esteem is also closely correlated
with age and sex : it increases with age, and boys have more of it than girls. To
control for these effects, a linear regression was done, modeling the index as a
function of age, sex, and consumption level.
Table VI reads thus : with sex and age controlled for, an experimenter’s
self-esteem index is half a point lower than an abstainer’s. Likewise an occasional user has 0.29 of a point lower self-esteem than an abstainer. For the
other two consumption levels, however, the estimated parameters are not significant : a repeat or regular user does not have lower self-esteem than an abcharacterized by lower self-esteem than non-users, this relation is only valid
for the two intermediate consumption levels, beyond which it disappears.
TABLE VI.
Linear regression on self-esteem index
TABLE VI. – Linear regression on self-esteem index
Estimated parameter
Sex:
Boy 2.66***
Reference: girl-0-Age (years) 0.40***
Consumption level:
Experimenter-0.50*
Occasional user-0.29***
Repeated user-0.07 ns
Regular user-0.28 ns
Reference: abstainer-0-***, **, *, ns : respectively, p <= 0.001,0.01,0.05, not significant.
Source: ESPAD 99, INSERM, OFDT, MENRT.
stainer. Hypothesis 5 is thus partially confirmed: while cannabis users seem
ESPAD 99, INSERM, OFDT, MENRT.
Analyzing data from the ESPAD survey thus confirms the hypotheses proposed here. Characteristics of cannabis users vary by consumption level. Use
among peers is particularly determinant for consumption level but its impact
becomes less and less pronounced as consumption level increases. As for the
places where respondents think they can procure the drug easily, they vary by
consumption level, with repeat and regular users finding it easier to procure at
a dealer’s. A high level of consistency between consumption level and judgments about cannabis users and risks associated with that substance is also observed. Moreover, the higher respondent’s cannabis consumption level, the
less likely he will be to stigmatize “hard” drug users but the more likely he
will be to stress risk associated with those substances. The neutralization
mechanisms observed by Becker and by Duprez and Kokoreff thus have quantitative resonance. Lastly, cannabis use does not seem closely associated with
self-esteem. The validation of our hypotheses brings to light both the relevance of Becker’s sequential approach and the possibility of exploring it with
quantitative tools. And that approach should be kept in mind when studying
the consumption of other products, namely legal ones, such as alcohol and tobacco, and misused ones, such as inhaled glue. This would enable us to refine
interpretation of the role played by peers. If we suppose, for example, that in
contrast to what was observed for cannabis, use among peers has no impact on
high consumption levels for legal products, this could mean that for illegal
substances peers continue to play an important “supply” role as consumption
level rises.
Obviously I do not claim to disqualify studies by psychologists and
epidemiologists. Drug use is unquestionably a transversal research object and
should not be monopolized by sociology. However, the analyses developed in
Outsiders remind us that methods used often reflect an implicit conception of
individual free will. As A. Ogien has pointed out (1994, p. 9), “What is called
into play when we utter the word ‘drug’ is our idea of human nature, human
freedom and its limits.” In this case the various approaches to drug use fall
into two categories : those that follow the “disease model” and those that don’t
(Valleur, 1994). In my view, having a quantitative perspective does not necessarily mean one belongs to the first category. Above and beyond the field of
drug-related social practices, the quantitative perspective is not incompatible
with the hypothesis of an individual actor making reasoned choices and controlling his or her practices. Once statistical and ethnographic data become
complementary, the second type will enable us to greatly enrich the interpretations we propose of the first.
Translation : Amy Jacobs
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[*]
My thanks to François Beck and Stéphane
Legleye, as well as to the Revue Française de
Sociologie editorial c ommittee, fo r their
comments on this article, for whose content I
am solely responsible. Thanks also to my translator, Amy Jacobs.
[(1)]
“I am devoted to qualitative work and
think that the criticisms made of ‘simpleminded counting’ are often correct. But I also
rely, whenever I can, on data from the US and
other Censuses. […] Similarly, the hardestnosed positivists, if anyone will admit to being
such anymore, routinely take into account all
sorts of knowledge acquired with the help of
‘soft’ methods, without which they couldn’t
make sense of their data. They may not admit
it, but the interpretations they make of ‘hard
findings’ rely on their own understanding of the
le ss easily mea sured, though still ea sily
observed, aspects of social life.” (Becker, 1993,
pp. 221-222).
[(2)]
On this point see, for example, the
notion of r etrospective illusion (Goff man,
1968, pp. 198-199).
[(3)]
On the initiative of the Swedish Council
for information on alcohol and other drugs
(CAN), this survey, which is scheduled to be
conducted again in 2003, is taken in approximately thirty European countries. The project is
supported by the European Council (Pompidou
Gr oup). The 1999 Fr ench segment was
conducted by INSERM (Institut National de la
Santé et de la Recherche Médicale), Unit 472 :
Santé et l’adolescent [Health and adolescents],
in partnership with the OFDT and the MNERT
[French Ministry of Education, Research, and
Technology]. It is presented in full in Beck et
al. (2000).
[(4)]
A stereotypical conception illustrated
perfectly by the more than evocative title of an
article first published in July 1937 in American
Magazine : “Marijuana : Assassin of Youth”.
[(5)]
Becker remarks with humour that while
sociologists often develop determinist theories
to explain individuals’ “destinies”, they readily
evoke the role of chance in recounting their
own life stories.
[(6)]
These tw o notion s a re als o use d,
though with slightly different meanings, in
victim studies. Epidemiology has contributed
other useful tools to the social sciences, such as
methods for analyzing data on survival that
make it possible, for example, to model the
time needed by an unemployed person to find
work again.
[(7)]
I n their analysis of the effects of
cannabis use, Perkonigg et al. explicitly refer to
the “dose-effect” model typical of toxicity
studies of an organism’s reactions to stimuli
and, often, of a parasite’s or micro-organism’s
resistance to a toxic agent it is has been inoculated with in the aim of destroying it. For his
part, Clayton establishes an opposition between
“risk factors” and “protective factors”, the
latter understood to inhibit or at least reduce the
“risk of drug abuse” –in the manner of a
vaccine.
[(8)]
That is, bef or e they “move” from
cannabis to “harder drugs” (heroin, crack, etc.).
On the escalation thesis as perceived in public
opinion, see Beck and Peretti-Watel (2000).
The medical analogy is of course not always a
problem : when modeling length of unemployment
with tools devised to study how long cancer
patients live, getting back into work is likened to
death, but until now at any rate no one has
thought to make untoward use of that analogy.
[(9)]
“If I study marijuana, do I speak of
‘marijuana addiction’ or, as I chose to do, in a
minor linguistic variation that connoted a
serious shift in perspective, of ‘marijuana use’?
Do we speak of ‘getting high on’, of ‘being
intoxicated by’, or of ‘being under the
influence of ’ this substance ? If I choose the
terms used by the people who ‘own’ the
territory, and therefore choose the perspectives
associated with those terms, I let my analysis
be shaped by conventional social arrangements
and the distribution of power and privilege they
create […] The moral consequence of adopting
existing language and perspectives toward the
phenomena w e study is tha t w e accept,
willingly or not, all the assumptions about right
and wrong contained in those words and ideas.
We accept, in the case of drugs, the idea that
addicts are people who have lost control of
themselves and therefore cannot help doing
things which are inherently bad.” (Becker,
1999).
[(10)]
It is worth noting that we are not
limited to the analysis of variance model. Let’s
assume, for example, that in a study of cannabis
use prevalence over a lif etime among
14-19-year-olds we are interested in three
“covariables”: age, sex, and type of residence
area (rural or urban). To evaluate the impact on
use of eac h of these covariables w hile
controlling for level in the two others, all we
have to do is construct a table that simultaneously crosses age, sex, and residence area (ie,
6 × 2 × 2 = 24 cases), thus indicating
associated prevalence for each case. This is
precisely what Durkheim did in Suicide when
he studied the effect of marital status on suicide
rate by controlling for age, and vice versa. He
therefore did not need logistic regression to
control for confounds. Of course when the
number of covariables increases, the corresponding table of relations is less easy to work
with than a regression.
[(11)]
Reference is to the survey series
known as KABP ( Knowledge, A ttitudes,
Beliefs, and Practices).
[(12)]
To this might be added some of the
more far-fetched risk factors that have been
examined in French studies, eg, “sitting around
doing nothing” or “playing pinball” (Choquet
et al., 1990).
[(13)]
It should be specified that marijuana
and cannabis are synonyms. Many other terms
are used to designate the substance, though
some are more associated with a particular
variety, plant part (leaves, heads, resin) or
appearance (dried leaves, paste in the form of
small bars). I will use the term marijuana when
presenting Becker’s analysis and cannabis for
more recent studies.
[(14)]
In their replication of Becker’s study,
M. L. Hirsch et al. (1998) affirm that this
three-phase model is too simple and propose to
add supplementary stages. What counts of
course is not the number of stages identified
but the fact that the model is sequential.
[(15)]
In statistical terms, these researchers
obtained a 32+ odds ratio for impact of “being
offered”. “Being offered” thus seems a “near
necessary” condition for cannabis first use, as
for tobacco. It therefore seems more judicious
to model “being offered” separately from experimentation, limiting study of the latter to
respondents who have been offered cannabis.
[(16)]
[ZEP : Zone d’Éducation Prioritaire.
ZEP’s are school districts officially deemed
underprivileged (or situated in underprivileged
areas) which are allocated special government
funding, ther eby making possible smalle r
classes, for example.].
[(17)]
Self-esteem is highly linked to age and
sex in that it depends greatly on existing
relations between the adolescent and his or her
parents, and on parents’ “upbringing style”
(Kellerhals et al., 1992).
[(18)]
From an interpretive perspective, this
mechanical relation between abstinence and
length of time using is without interest. From a
purely statistical one, if length of time is used
to compare abstainers and experimenters, the
maximum likelihood es timator will not
converge (odds ratio associated with length of
time using will tend towards infinity).