Peer-reviewed article
Tobacco and cannabis use in the young 'Not in Employment, Education or Training' population: A systematic review and meta-analysis.
Eyraud C, Collin C, Martin P, Alberti C, Minary L et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review and meta-analysis examines tobacco and cannabis use among young people aged 15-29 who are not in employment, education or training (NEET). The study analysed 25 observational studies covering over 91,000 individuals and found that NEET youth have significantly higher rates of tobacco and cannabis use compared with students and employed peers. The research highlights that NEET populations face elevated substance use as part of broader health vulnerabilities. The findings suggest that prevention strategies need to be tailored to address substance use in this vulnerable group.
Key points
- NEET youth show 1.92 times higher odds of tobacco use and 2.14 times higher odds of cannabis use compared with general population
- Current smoking was 3.05 times more prevalent among NEET than students, but not significantly different from young workers
- Cannabis use was significantly higher in NEET youth compared with both students (1.81 times) and workers (1.67 times)
- Cannabis use disorder prevalence was 31.93% among NEET youth versus 12.12% among non-NEET peers
- Meta-analysis included 25 observational studies with 91,085 total participants
Limitations
This systematic review analyses only observational studies, which cannot establish causality or determine whether NEET status causes substance use or vice versa. The review does not provide detailed information about specific countries, age-specific findings within the 15-29 range, or the effectiveness of any interventions to reduce substance use in this population.
Abstract
Background and aims NEET (Not in Employment, Education or Training) youth represent a vulnerable population from a public health perspective, facing multiple health challenges, including elevated substance use. Tobacco and cannabis are the most commonly used psychoactive substances among young people, with early initiation associated with long-term health and social consequences. While evidence suggests associations between NEET status and substance use, data remain limited regarding patterns of use and potential variations across different NEET profiles. This study aimed to characterise tobacco and cannabis use within the NEET population, taking into account the diversity of profiles, and to compare it with that of the general population, including employed youth and students, in order to inform targeted prevention strategies. Methods A systematic review and meta-analysis included observational studies examining tobacco and cannabis use among NEET youth aged 15-29 years. A search was conducted for observational studies available on PubMed, PsycINFO, Cairn and Web of Science databases and published between 1999 and 2025. Analyses studied the variations in use among NEET profiles and compared NEET against employed youth, student and general population controls. Random-effects models generated pooled crude odds ratios. Sensitivity and subgroup analyses were conducted based on study quality, gender and type of comparison population. Results Twenty-five studies were included and analysed, including a total of 91 085 individuals. A statistically significant association between NEET status and both tobacco use [odds ratio (OR) = 1.92, 95% confidence interval (CI) = 1.46-2.53] and current cannabis use (OR = 2.14, 95% CI = 1.68-2.71) was found. Current smoking was statistically significantly more prevalent among NEET than among students (OR = 3.05, 95% CI = 2.31-4.03), but not statistically significantly different compared with young workers (OR = 1.10, 95% CI = 0.91-1.34). NEET demonstrated statistically significantly higher cannabis use compared with both students (OR = 1.81, 95% CI = 1.34-2.44) and workers (OR = 1.67, 95% CI = 1.21-2.31). A higher prevalence of cannabis use disorder among young people with NEET status (31.93%) was observed compared with their non-NEET peers (12.12%), but no statistically significant association was found. Conclusions Youth Not in Employment, Education or Training (NEET) appear to show higher tobacco and cannabis use compared with their peers. Given these findings, targeted prevention strategies addressing substance use in NEET populations are essential to reduce social health inequities.