Cannabis and Amphetamine Use and Associated Factors Among School-Going Adolescents in Nine African Countries

Cannabis use and its psychosocial correlates among school-going adolescents in Sierra Leone

BACKGROUND

In Sierra Leone, adolescents are increasingly engaging in risky activities, including cannabis use, which can lead to substance abuse, poor academic performance, and psychotic symptoms. This study aims to investigate the prevalence and associated factors of cannabis use among school-going adolescents in the country.

METHOD

Data for the study was sourced from the 2017 Sierra Leone Global School-based Student Health Survey (GSHS), a nationally representative survey conducted among adolescents aged 10-19 years using a multistage sampling methodology. A weighted sample of 1,467 adolescents in Sierra Leone was included in the study. The study utilised bivariate and multivariable logistic regression analysis to identify factors linked to cannabis use, presenting results using adjusted odds ratios and 95% confidence intervals.

RESULTS

The prevalence of cannabis use was 5.1% [3.0,8.6] among school-going adolescents in Sierra Leone. School-going adolescents who attempted suicide [aOR = 6.34, 95% CI = 1.71-23.45], used amphetamine [aOR = 15.84, 95% CI = 7.94-31.62] and were involved in sexual risk behaviour [aOR = 5.56, 95% CI = 2.18-14.20] were more likely to be associated with cannabis use.

CONCLUSION

In Sierra Leone, a small but non-trivial minority of students use cannabis. Ever-used amphetamines or methamphetamines, suicidal attempts, and sexual risk behaviour were the factors associated with cannabis use in Sierra Leone. The development of school-based health intervention programmes is crucial to address the risk factors associated with cannabis use among school-going adolescents.

Prevalence and predictors of lifetime amphetamine use among in-school adolescents in Sierra Leone

OBJECTIVE

This study examined the prevalence of amphetamine use and its associated factors among in-school adolescents in Sierra Leone.

DESIGN

Data for the study was sourced from the 2017 Sierra Leone Global School-based Health Survey. Percentages with confidence intervals (CIs) were used to present the prevalence of amphetamine use among in-school adolescents. A multivariable binary logistic regression analysis was employed to examine the factors associated with amphetamine use. The results were presented using adjusted odds ratios (aORs) with 95% CIs.

SETTING

Sierra Leone.

PARTICIPANTS

A weighted sample of 1,314 in-school adolescents in Sierra Leone.

OUTCOME MEASURE

Lifetime amphetamine use.

RESULTS

The prevalence of amphetamine use was 6.1% (3.9%-9.5%). In-school adolescents who planned suicide were more likely to use amphetamine compared with those who did not (aOR 2.54; 95% CI 1.02 to 6.31). Also, the odds of amphetamine use were higher among in-school adolescents who received support from their peers (aOR 3.19, 95% CI 1.71 to 5.96), consumed alcohol (aOR 4.85, 95% CI 2.61 to 9.03), and those who had previously used marijuana (aOR 13.31, 95% CI 6.61 to 28.78) compared with those who did not receive any support, never consumed alcohol, and never used marijuana, respectively.

CONCLUSION

Amphetamine use is prevalent among in-school adolescents in Sierra Leone. There is a need to implement comprehensive public health policies that extend beyond school-based psychobehavioural therapies. These policies should specifically address the considerable risk factors associated with amphetamine use among in-school adolescents in Sierra Leone.

Cannabis and amphetamine use among school-going adolescents in sub-Saharan Africa: a multi-country analysis of prevalence and associated factors

BACKGROUND

Global evidence indicates that early onset of illicit substance use among adolescents and emerging adults is associated with negative mental-health related-outcomes that can persist into adulthood. However, the lack of quality regional data on adolescent illicit substance use and its determinants remains a common barrier to evidence-based policy-making and the development of school-based interventions in Africa. The purpose of our study was to estimate the prevalence and describe the correlates of cannabis and amphetamine use among school-going adolescents in eight sub-Saharan African countries (SSA) - Benin, Ghana, Liberia, Mauritius, Mozambique, Namibia, Seychelles, and Tanzania.

METHODS

We analysed 15,553 school-going adolescents that participated in the Global School-based Student Health Survey. A two-stage sampling approach was used to generate a nationally representative sample of school children (grades 7-12) in each of these countries. Students responded to a self-administered structured questionnaire that contained information on sociodemographic factors, family involvement factors, mental health factors, school environment factors and past-month cannabis and life-time amphetamine use.

RESULTS

The overall prevalence estimates of past-month cannabis use and lifetime amphetamine use among school-going adolescents in the eight SSA countries was 4.39% (95% CI = 4.08, 4.72) and 3.05% (95% CI = 2.79, 3.34) respectively. In the multivariable logistic regression analysis, demographic characteristics (age and male gender), mental health factors (suicide ideation and attempt), lifestyle factors (cigarette smoking, past-month alcohol use, lifetime drunkenness and leisure-time sedentary behaviour) and school level factors (truancy and bullying victimisation) showed strong associations with increased odds of both past-month cannabis use and lifetime amphetamine use. Social support at school was associated with increased odds for lifetime amphetamine, while parental monitoring decreases the odds for lifetime amphetamine use. It was also observed that parental tobacco use was associated with increased odds of both past-month cannabis use and lifetime amphetamine use.

CONCLUSION

The relatively low overall prevalence estimates of past-month cannabis use and lifetime amphetamine use among school-going adolescents in not surprising. However, the identified risk and protective factors associated with cannabis and amphetamine use underscores the need for these eight countries in SSA to develop contextual and multi-sectoral intervention and school-based prevention programmes that could target school-going adolescents who may be at risk of misusing these illicit drugs.

Prevalence and correlates of substance use among school-going adolescents (11-18years) in eight Sub-Saharan Africa countries

BACKGROUND

Substance use constitutes a major public health issue especially among adolescents as it has associated adverse behavioural, health, social and economic outcomes. However, there is a paucity of comprehensive evidence on the prevalence and associated factors of substance use (alcohol, marijuana and amphetamine) among school-going adolescents in sub-Saharan Africa (SSA). This study examined the magnitude of substance use and its associated factors among school-going adolescents in eight eligible sub-Saharan Africa countries.

METHODS

Data for the study were obtained from the Global School-based Health Survey (2012-2017) of 8 countries in SSA (N = 16,318).

RESULTS

Findings showed overall prevalence rates of 11.3% (95%CI = 10.8 - 11.8%), 2% (95%CI = 1.8 - 2.2%) and 2.6% (95%CI = 2.3 - 2.9%) for current alcohol use, current marijuana use and lifetime amphetamine use, respectively between 2012 and 2017. Late adolescence (15-18 years), being male, anxiety, bullying, fighting, truancy, having close friends, current cigarette smoking and tobacco use are significant risk factors for alcohol use. Anxiety, truancy, current cigarette smoking, tobacco use and suicidal attempt are significant risk factors for marijuana use. Anxiety, bullying, truancy, current cigarette smoking, tobacco use and suicidal attempt are significant risk factors for amphetamine use. Parental knowledge of activity, supervision and respect of privacy are significant protective factors of substance use.

CONCLUSION

There is the need for comprehensive public health policies beyond school-based psycho-behavioural interventions targeting the significant risk factors of substance use among school-going adolescents in SSA.

Adolescent suicidal behaviour in Namibia: a cross-sectional study of prevalence and correlates among 3,152 school learners aged 12-17 years

BACKGROUND

While adolescent suicidal behaviour (ideation, planning, and attempt) remains a global public health concern, available county-specific evidence on the phenomenon from African countries is relatively less than enough. The present study was conducted to estimate the 12-month prevalence and describe some of the associated factors of suicide behaviour among school-going adolescents aged 12-17 years old in Namibia.

METHODS

Participants (n = 4531) answered a self-administered anonymous questionnaire developed and validated for the nationally representative Namibia World Health Organization Global School-based Student Health Survey conducted in 2013. We applied univariate, bivariable, and multivariable statistical approaches to the data.

RESULTS

Of the 3,152 analytical sample, 20.2% (95% confidence interval [CI]: 18.3-22.2%) reported suicidal ideation, 25.2% (95% CI: 22.3-28.4%) engaged in suicide planning, and 24.5% (95% CI: 20.9-28.6%) attempted suicide during the previous 12 months. Of those who attempted suicide, 14.6% (95% CI: 12.5-16.9%) reported one-time suicide attempt, and 9.9% (95% CI: 8.1-12.1%) attempted suicide at least twice in the previous 12 months. The final adjusted multivariable models showed physical attack victimisation, bullying victimisation, loneliness, and parental intrusion of privacy as key factors associated with increased likelihood of suicidal ideation, planning, one-time suicide attempt, and repeated attempted suicide. Cannabis use showed the strongest association with increased relative risk of repeated attempted suicide.

CONCLUSION

The evidence highlights the importance of paying more attention to addressing the mental health needs (including those related to psychological and social wellness) of school-going adolescents in Namibia. While the current study suggests that further research is warranted to explicate the pathways to adolescent suicide in Namibia, identifying and understanding the correlates (at the individual-level, family-level, interpersonal-level, school context and the broader community context) of adolescent suicidal ideations and non-fatal suicidal behaviours are useful for intervention and prevention programmes.

Understanding the Impact of Deviant Peer Association on Risk for Stimulant/Amphetamine Use: The Moderating Role of Exposure to Violence

Prior research has indicated that deviant peer association is associated with increased risk for stimulant/amphetamine use. However, there remain gaps in our understanding of the context under which this relationship occurs. This study examined two forms of exposure to violence (direct victimization, witnessed violence) as moderators of the relationship between deviant peer association and stimulant/amphetamine use risk. All 11 waves of the Pathways to Desistance longitudinal data were used in analyses. Mixed effects logistic regression models were used to estimate relationships of interest while accounting for repeated measures nested within individual participants across time. Findings indicated that greater deviant peer association was associated with greater odds of stimulant/amphetamine use. Experiencing direct victimization significantly moderated this relationship, but in the opposite of the hypothesized direction, with individuals reporting direct victimization also reporting less reactivity to deviant peer association as it pertained to stimulant/amphetamine use. Witnessed violence did not moderate this relationship.

Prevalence of and Factors Associated with Club Drug Use among Secondary Vocational Students in China

To understand the prevalence of and factors associated with club drug use among Chinese secondary vocational students, a nationally representative survey was conducted. The multistage cluster sampling strategy was employed to select participants. A total of 9469 students from eleven secondary vocational schools in five cities completed self-reported questionnaires, which included information on club drug use, sociodemographic variables, individual factors, as well as peer and family related factors. The data were separately analyzed with Poisson regression models for female and male students. The overall lifetime prevalence of club drug use was 2.7% (258/9469), and male students had higher prevalence than female students (3.5% vs. 1.9%, p < 0.001). Female and male students shared four risk factors (i.e., having ever smoked, perceiving social benefit expectancies, peer drug using and perceiving peer's approval of drug use) and one protective factor (i.e., having medium or high levels of refusal skills) for club drug use. Moreover, family drug using and having a part-time job were two additionally independent risk factors for club drug use among male students. These findings indicate that the problem of club drug use among Chinese secondary vocational students is worthy of attention. The prevention of club drug use should address multiple risks and protective factors on individual, peer and family levels.

Marijuana use and suicidal behaviours among school-going adolescents in Africa: assessments of prevalence and risk factors from the Global School-Based Student Health Survey

Background

Marijuana use among adolescents, including high school students, has been consistently reported to be associated with a high incidence of suicidal behaviours. Little empirical research has been conducted on the propensity impact of marijuana use on suicidal behaviours in Africa.

Aims

To assess factors associated with marijuana use and further quantify marijuana use as an associated factor of suicidal behaviours, including repeated attempted suicide, suicidal ideation and suicide planning, among high school students in Africa.

Methods

A cross-sectional study was conducted among 32 802 school-going adolescents using the Global School-Based Student Health Survey data from 10 African countries grouped into West Africa, North Africa, South-East Africa, South Africa and East Africa subregions. Marijuana use and repeated attempted suicide were the main outcome variables. We employed double selection least absolute shrinkage and selection operator poisson regression model to assess risk factors associated with marijuana use and dominance analysis to establish ranked important and common risk factors. Inverse probability weighting poisson regression adjustment was applied to assess impact.

Results

The prevalence of marijuana use and repeated attempted suicide were 3.7% (95% CI: 3.1 to 4.3) and 6.6% (95% CI: 5.9 to 7.4), respectively. The most important risk factor for marijuana use generally across the countries and specifically in three subregions was alcohol consumption, which constituted approximately 40% of the impact. The average treatment effect on the treated (ATT) indicated that marijuana use significantly increased the risk of suicidal ideation, suicide planning and repeated attempted suicide by 12% (ATT=0.12 (95% CI: 0.02 to 0.22)), 18% (ATT=0.18 (95% CI: 0.13 to 0.22)) and 31% (ATT=0.31 (95% CI: 0.20 to 0.41)), respectively.

Conclusions

Marijuana use was significantly associated with suicidal behaviours (suicidal ideation, planning and repeated attempted suicide) among the students. To achieve Sustainable Development Goal 3.5 (to strengthen prevention and treatment of substance abuse), school-based psychosocial interventions should be streamlined to adequately assess and manage marijuana use. Targeting the most dominant risk factors in this population could translate into the reduction of suicidal behaviours in countries within Africa.

Prevalence and Demographic Correlates of Substance Use among Adults with Mental Illness in Eastern Cape, South Africa: A Cross-Sectional Study

This study reports on the prevalence and demographic correlates of substance use among individuals with mental illness in the Eastern Cape, South Africa. This cross-sectional study was conducted in the Outpatient Clinic of a large hospital in the Eastern Cape, South Africa. A pre-validated tool on alcohol and psychoactive drug use was administered to 390 individuals with mental illness. Multivariable logistic regression models were fitted to explore the demographic correlates of alcohol and psychoactive drug use. Of the total participants (N = 390), 64.4% and 33.3% reported lifetime (ever used) and past-year use of alcohol, respectively, but the prevalence of risky alcohol use was 18.5%. After adjusting for relevant covariates, only male sex, younger age, and rural residence remained significantly associated with risky alcohol use. The prevalence of ever-use and past-year use of psychoactive substances was 39.7% and 17.4%, respectively. The most common substance ever used was cannabis (37.4%). Male sex, younger age, owning a business, and being unemployed were significantly associated with higher odds of lifetime and past-year use of psychoactive substances. Findings highlight the need for dedicated infrastructure and staff training in the management of these dual diagnoses in the region.

Cannabis and amphetamine use and its psychosocial correlates among school-going adolescents in Ghana

BACKGROUND

The aim of this study was to examine the prevalence of cannabis and amphetamine use and to determine its associated factors among school-going adolescents in Ghana.

METHOD

The 2012 Ghanaian Global School-based Student Health Survey on 3632 adolescents aged 11-19 years (mean = 15.1 years; SD = 1.4) was used. Participants for this study were sampled from selected junior (JHS) and senior high schools (SHS) in all the 10 administrative regions of Ghana. A two-stage cluster sampling design was used to select 25 senior high schools to represent all the 10 regions of Ghana. Information was collected with a self-administered structured questionnaire that contained information on demographics, alcohol, tobacco and other drug use, violence, and a range of other health-related behaviours.

RESULTS

The result showed that past-month cannabis use was 5.3% and lifetime amphetamine use was 7.1% among students. In multivariate model, after controlling for other variables, school truancy and current cigarette smoking were associated with both past-month cannabis and lifetime amphetamine use. The number of close friends was associated with only past-month cannabis use. School environment factors (bullying victimisation and having been attacked) and parental substance use were associated with lifetime amphetamine use.

CONCLUSION

This study identified a number of risk factors, including parental substance use and various risk behaviours, for both past-month cannabis and lifetime amphetamine use. School-based health intervention programmes should be developed taking into consideration the risk factors associated with cannabis and amphetamine use among school-going adolescents.

Cannabis and amphetamine use and socio-ecological (proximal and distal) factors among school-going adolescents in four countries in the Caribbean and four countries in South America

The study aimed to assess the prevalence of cannabis and amphetamine use and socio-ecological (proximal and distal) factors among adolescents in eight countries of the Americas. We analysed cross-sectional survey data from 44,904 adolescents [mean age 14.6 years, standard deviation (SD) = 1.4] from Argentina, The Bahamas, Barbados, Belize, Bolivia, Chile, Peru and Trinidad and Tobago that participated in the Global School-Based Student Health Survey (GSHS) in 2011-2013. The prevalence of the past month's cannabis use was 8.3% and lifetime amphetamine use was 3.0%. In adjusted mixed-effects logistic regression analysis older age, male gender, personal attributes (anxiety, suicidal ideation, current tobacco use, current alcohol use, school truancy and sexual risk behaviour) and environmental stressors (having been in a physical fight, hunger, being bullied) were positively and parental support and peer support were negatively associated with the past month's cannabis and/or lifetime amphetamine use. Measures to prevent and control cannabis and amphetamine use in this adolescent population should include personal attributes (mental health, substance use, school truancy and sexual risk behaviour), environmental stressors and parental and peer support.