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Among boys, TS misuse increased significantly among those reporting medical use of TS from 21.1% to 41.4% in 2003\u20132019 (p=0.006). Medical use of TS multiplied the odds of misuse by 6.89 (95% CI 5.15 to 9.24) for boys and by 4.53 (95% CI 3.58 to 5.73) for girls. Perceived easy access to TS increased the odds of misuse by 6.57 (95% CI 4.13 to 10.46) times for boys and by 4.66 (95% CI 3.25 to 6.70) times for girls. Having many friends who misuse TS increased the odds of misuse by 3.27 (95% CI 2.16 to 4.95) times for boys and by 5.07 (95% CI 3.79 to 6.77) times for girls. Furthermore, higher odds of TS misuse were observed among adolescents who smoked cigarettes and engaged in less sports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TS misuse prevalence among Estonian adolescents increased significantly from 2003 to 2019. Misuse was strongly associated with medical use, perceived easy access and friends\u2019 TS misuse. These findings emphasise the need for targeted prevention strategies, including improving prescription practices, limiting TS access and promoting healthy behaviours and positive peer relationships among adolescents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-077899","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T13:30:24Z","timestamp":1716384624000},"page":"e077899","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Tranquilisers and sedatives misuse and associated factors among adolescents in Estonia: findings from cross-sectional ESPAD surveys, 2003\u20132019"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3023-8741","authenticated-orcid":false,"given":"Liina","family":"Veskim\u00e4e","sequence":"first","affiliation":[{"name":"Department of Risk Behaviour Studies, National Institute for Health Development, Tallinn, Estonia"},{"name":"Institute of Family Medicine and Public Health, University of Tartu Faculty of Medicine, Tartu, Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigrid","family":"Vorobjov","sequence":"additional","affiliation":[{"name":"Department of Risk Behaviour Studies, National Institute for Health Development, Tallinn, Estonia"},{"name":"Institute of Family Medicine and Public Health, University of Tartu Faculty of Medicine, Tartu, Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7677-9493","authenticated-orcid":false,"given":"Kersti","family":"P\u00e4rna","sequence":"additional","affiliation":[{"name":"Institute of Family Medicine and Public Health, University of Tartu Faculty of Medicine, Tartu, Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,5,22]]},"reference":[{"key":"2025121601294068000_14.5.e077899.1","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/j.jadohealth.2018.04.003","article-title":"Trends in the misuse of tranquilizers, Sedatives, and sleeping pills by adolescents in Spain, 2004\u20132014","volume":"63","author":"Carrasco-Garrido","year":"2018","journal-title":"J Adolesc Health"},{"key":"2025121601294068000_14.5.e077899.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp068010"},{"key":"2025121601294068000_14.5.e077899.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2008.05.001"},{"key":"2025121601294068000_14.5.e077899.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.02.033"},{"key":"2025121601294068000_14.5.e077899.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-016-0909-3","article-title":"Nonmedical use of prescription drugs in the European Union","volume":"16","author":"Novak","year":"2016","journal-title":"BMC Psychiatry"},{"key":"2025121601294068000_14.5.e077899.6","unstructured":"ESPAD Group . 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