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Swiss Research Institute for Public Health and Addiction

C-SURF Study on substance use

Summary Cohort study on the development of substance use among young male adults
Project manager(s) Gerhard Gmel, Meichun Mohler-Kuo
Duration 03.2010 - 03.2018
Client / Funding partner(s) Schweizerischer Nationalfonds SNF
Cooperating partner(s) Waadtländisches Universitätsklinikum (CHUV)


Drug use among adolescents and young adults is one of the most widespread and costly problems in Europe, despite high investments in prevention and health campaigns. The use of legal and illegal substances is the main cause of illness and mortality among young adults, especially men, and is associated with various high-risk behaviors such as violence, suicide, depressive disorders, dropping out of school and risky sexual behavior. In a study among 19-year-old men in Switzerland, almost 70% of young men showed risky behavior (cannabis use at least twice a week, daily tobacco use or binges drinking at least twice a month). Although substance use is widespread at amongst young adults, many young people return to moderate use later in life, while other continue to develop a dependence, with many social and health consequences for themselves, their families and society. 


Every time there are reports in Switzerland about the high proportion of substance-abusing adolescents and young adults, question about “why” and “what to do” remain unanswered. C-SURF aims to answer precisely these questions and identify risk and protective factors: Why do most of the young adults with risk behaviors show inconspicuous behavior later on? What are the protective factors and circumstances that prevent excessive substance use and later lead to the emergence from the problematic use of alcohol and drugs? Why do some young adults continue to show problematic addictive behavior or even intensify this behavior with increasing age? What are the risk factors and circumstance that make people susceptible to becoming heavy drug users, to maintaining heavy drug use, or even to increasing it with age?


C-SURF is a cohort study that began in 2010 and continues today thanks to the financial support of the Swiss National Science Foundation. A cohort study is a study over a longer period of time in which the same individuals are repeatedly interviewed about the same topics, thus making it possible to record developmental trajectories. To answer the main research questions, C-SURF participants must be followed at least through middle adulthood. Not only the "good boys" with rather moderate substance use patterns are participants of the study: From the beginning, the aim of C-Surf was to recruit a sample that is truly representative for Switzerland. Therefore, study participants were contacted during enlistment at the Army Recruitment Center. Army enlistment is mandatory in Switzerland and approximately 98% of all young men of a certain age go through this process. Currently, the third wave of data collection is underway.


Long-term studies of substance use are rare and expensive. Most exist in North America, with a completely different youth culture. There are very few long-term studies of substance use in Europe and C-SURF is, to our knowledge, the first in Switzerland. The long-term data from C-SURF will allow us to examine the different trajectories of substance use among Swiss men across young adulthood and identify corresponding risk and protective factors.


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