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© 2020 Wiley Periodicals, Inc.AIMS To characterize changes in patterns of adolescent substance use in Sweden between 1988 and 2011, and to assess whether sex and psychosomatic problems were associated with substance use and whether these associations changed over time. DESIGN Secondary analysis of repeated cross-sectional survey data. Survey data were collected eight times and analyzed as four cohorts (1988-91, 1995-98, 2002-05 and 2008-11). SETTING AND PARTICIPANTS The sample included all 15-16-year-olds in Värmland County, Sweden (n =

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