The survey by researchers at Middelheim Hospital in Antwerp, Belgium, included 3,380 teens aged 14 to 17 living in urban regions in Belgium, Russia, and the United States.

The researchers found a link between alcohol and other drug use and teens being either directly threatened with violence or witnessing threats or acts of violence between others. For the survey, violent acts were defined as being mugged or beaten up, attacked with a knife or gun, chased, or wounded.

According to the researchers, the more violence teens witnessed, the more likely they were to smoke cigarettes or marijuana, consume alcohol, or use hard drugs.

Dr. Robert Vermeiren, who led the study, said this trend could be a "worldwide urban phenomenon."

"Prevention and treatment initiatives that target substance use and dependence should focus on the role of community violence as part of their intervention," the authors recommended.

The research is published in the March 2003 issue of the journal Pediatrics.

Vermeiren, R., Schwab-Stone, M., Deboutte, D., Leckman, P., & Ruchkin, V. (2003) Violence Exposure and Substance Use in Adolescents: Findings From Three Countries. Pediatrics, 111: 535-540.

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