摘要Background Adolescent drug use poses significant public health challenges worldwide,with detrimental effects on mental and physical health.Most existing research focuses on Western countries,holding a gap in understanding drug use in low-and middle-income countries.Thus,we aimed to assess the prevalence of cannabis and amphetamine or methamphetamine use among school-going adolescents aged 12-15 years across 47 countries globally.Methods We used data from the Global School-based Student Health Survey from 47 countries(2009-2018)to analyze can-nabis and amphetamine/methamphetamine use and age at first drug use among adolescents(n=220,362).A meta-analysis utilizing random-effects models estimated prevalence rates and weighted linear regression analyzed trends.Student's t tests were used to compare two-subgroup categories,while one-way ANOVA was employed for analyses involving the four-subgroup category.Stratification analysis by sex,World Bank income category,region,and country-specific characteristics based on World Health Organization data were also performed.Results The study included a total of 220,362 school-going adolescents aged 12-15 years(49.96％girls)from 47 countries.The overall prevalence of cannabis use was 7.02％[95％confidence interval(CI)6.16-7.89],with higher usage among boys[9.20％(95％CI 8.05-10.36)]compared to girls[4.20％(95％CI 3.68-4.72)].Amphetamine/methamphetamine use prevalence was 4.05％(95％CI 3.51-4.60),also higher among boys[5.14％(95％CI 4.45-5.84)]than girls[2.34％(95％CI 2.00-2.69)].The region of the Americas exhibited the highest prevalence of cannabis use[11.31％(95％CI 8.44-14.17)],while the African region showed the highest prevalence of amphetamine use[4.34％(95％CI 3.14-5.53)].High-income countries reported the highest prevalence of cannabis use[9.45％(95％CI,6.06 to 12.84)],whereas low-income countries had the lowest[3.46％(95％CI 2.01-4.91)].Higher prevalence rates were associated with countries having higher homicide rates,better sanitation services,and higher health expenditures.Conclusions Cannabis use among adolescents is more prevalent than amphetamine or methamphetamine use,with signifi-cant sex differences showing higher prevalence among boys.The highest prevalence of cannabis use was observed in Latin America,while Africa exhibited the highest rates of amphetamine use.Findings from the present study indicate a need for public policies and programs targeting adolescents to effectively reduce adolescent drug use.