Substance Abuse is the repeated use of a substance like tobacco, alcohol and/or illicit drugs despite having personal distress and problems related to its use. The problem of substance use has to a large extent stabilized in developed countries which have been exposed to substance use for decades, in contrast to many developing countries where the problem is on the rise. Research on the causal factors is pointing towards urbanization, poverty, migration, technological change and educational deficits.
The situation will become worse as multinational alcohol manufacturers are now aggressively targeting the developing countries particularly in South-East Asia. In India, Sri Lanka, Thailand and Malaysia drinking patterns illustrate how the per capita consumption figures of a country do not necessarily give the true picture of consumption patterns of Asian countries. Parallel with the international and more expensive alcoholic beverages there exist the local, cheap, potent brews, both legal and illicit which are not computed into the national statistics.
National Sample Survey of India (1993-1994) show the rural-urban divide for males and females respectively for bidis and cigarettes and tobacco consumption in other forms such as snuff, chewing tobacco, burnt tobacco powder, and paste (graph)

Approximately 55,500 adolescents start using tobacco every day in India, joining the 7.7 million young people under the age of 15 who already regularly use tobacco. Global Youth Tobacco Survey (GYTS) showed that 10 percent had ever used tobacco in any form. The proportion of students currently using any tobacco products was 4.5% (boys: 5.5%; girls: 3.1%). Alcohol abuse in the rural communities of South East Asia Region member States is a particularly serious problem. The pattern of drinking is usually binge drinking centred around pay day or on special occasions, such as, marriages and festivals. Also given the poor socio- economic status of most rural communities, disproportionate amounts of family income (30% in Asian countries) is spent on alcohol leaving very little money for food, education, housing and health. Thus a vicious cycle of poverty is perpetuated.