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This paper provides an overview of the context, definition, and key features of the harm reduction approach, and provides several examples of current programs in various countries. Both licit and illicit drugs are included in these illustrations. Some of the critical issues, and the strategies needed to advance harm reduction, are discussed. [Translations are provided in the International Abstracts Section of this issue.]

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We surveyed 1,684 students from Grades 7 through 12 on their use of cigarettes and the types of circumstances they perceived as stressful. Students' smoking status was classified as either none, light, medium, or heavy use while over-all stress levels were either low, medium, or high. Nonsmoking boys had significantly lower over-all mean stress scores than all others while heavy users had significantly greater perceived stress scores than all other categories. Among girls, regular and heavy users reported significantly higher over-all stress scores than either nonsmokers or occasional users. Those items reported as causing the highest level of perceived stress among smoking boys were school work, money, and parents while among smoking girls the items were appearance, parents, and money.

The purpose of this study was to gain a better understanding of the association between youth substance use patterns and mental health symptoms, and the risk and protective factors unique and common to each of these areas. A survey was administered to a random sample of 663 youth ages 12 to 18 in Victoria, British Columbia. As expected, age was a strong predictor of greater frequency and amounts of alcohol consumption. Males were at higher risk for alcohol consumption and externalizing problems while females were more susceptible to internalizing problems. Youth who scored lower on substance use and reported fewer mental health symptoms rated their parents and peers as being more protective. Youth who scored higher on substance use scored higher on the risky peer affiliations scale.Mental health surveys have shown that there is a very high prevalence of psychiatric morbidity in youth aged 15-24 years (e.g., Kessler et al., 1994). Many health authorities in Canada, for example in Ontario and British Columbia, have moved to amalgamate addiction and mental health services. The successful implementation of these integrated services for youth requires an understanding of the nature of the association between substance use and mental health in youth, and the risk and protective factors that are shared or unique to each. Research on risk and protective factors related to maladjustment in adolescence has recognized a cluster of problem behaviours, including delinquency and

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Objective: To determine the prevalence and context of alcohol use in the deaths of children and youth reviewed by the BC Children's Commission. Methods: In 489 case reviews of BC children and youth, we examined the role that alcohol may have had at the time of death or whether there was a history of alcohol use either by the deceased child or another person in the child's life. Results: Alcohol is most prevalent in the lives of 15-18 year olds. It is present at the time of death in two fifths of Motor Vehicle Incidents (MVI) and one third of suicides and drownings. Interpretation: Alcohol has a profound presence in the lives and deaths of children reviewed by the Children's Commission. Enhancing deterrence laws and alcohol control policies, and increasing public awareness are warranted. La traduction du résumé se trouve à la fin de l'article.