1300 students (54.3% girls) 13–16 years old were interviewed in the urban area of Bologna during 2010. Random effect multiple logistic regression models were used. Results show a reciprocal relationship between alcohol use, tobacco, and cannabis. Most users were offered cannabis, began using at 14 years of age, and do not believe using is very dangerous. They live with only one parent, have more than 50 euros of spending money per month, and abuse alcohol, abuse that increases relative to the intensity of cigarette smoking. Legal/illegal dichotomy seems to overturn, where alcohol becomes a “drug” and the use of tobacco, similar to other drugs, is motivated as a solution to reduce anxiety, combat boredom, relax, and to ease loneliness. 1. Introduction In Italy among 15 year olds, in the last year 9% have used cannabis at least once, 69% have used alcohol, and 34% have used tobacco, and this data increases at 16 years of age (17% cannabis, 80% alcohol, and 44% tobacco), with a greater prevalence of tobacco use among girls and alcohol and cannabis among boys [1]. Many try and then quit, but higher rates of continued use are evident for alcohol and tobacco [2]. Substance use in adolescence is an important predictor of possible continued use of illegal substances in adulthood, together with other risk factors: specific lifestyles outside the home (bar, discos, avd private parties), early start of sexual activity, a greater amount of spending money, frequenting urban environments or areas with a high prevalence and availability of illegal substances, the use of substances at home, family composition, and the development of various forms of sociability [3–9]. There is additional evidence that the decision to consume various substances is not connected only to specific contexts or individual characteristics, but that beliefs and expectations predict consumption styles. More recent studies are aimed at the decision-making processes of the adolescent where the possible costs and the potential expected benefits of consumption are considered [10–12]. In fact, given a set combination of experiences, abilities, information, and initiation of use, the choice of whether to use a substance followed by which to use, seems driven both by the function that it serves, as by the specific significances attributed to them by the consumer [13–22]. While most prevention programs are aimed at helping young people stay abstinent and to resist peer group pressure, there are few studies that describe the processes which drive the choice of utilizing diverse substances, studies that
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