Prevalence of substance use and psychosocial influencing factors among secondary school students in Dodoma municipality

Abstract

Background: Substance abuse among adolescents continues to be a growing concern globally and in this setting. Available information in Tanzania suggests that the drug abuse problem among youth both in school and out of school is on the increase. Adolescence is a developmental period of peak risk for onset of substance use and substance-related problems. Although many adolescents who engage in experimental use of alcohol and tobacco do not progress to regular use, some do progress and experience more chronic and severe substance-related problems that persist into adulthood. There is, however, some evidence that those adolescents who receive support from their families, schools, and the community at large are: less likely to involve themselves in substance use behavior; perform well in school; develop positive identities and grow up to be responsible adults in their families, society and at work. This study aimed at determining the prevalence of substance use and psychosocial factors influencing drug use behavior among adolescents in secondary schools in an urban setting in the Tanzanian context so that more targeted preventive measures can be developed. Materials and methods: A descriptive cross-sectional study design; community based, using quantitative data collection methods. The study was conducted from August through November 2011 in Dodoma Municipality. The self-administered structured Student Based Health Promotion Questionnaire was modified and used to collect data.The study population comprised of 1501 ordinary level secondary school students from 12 schools who were selected using a multistage cluster sampling. A computer program SPSS windows version 18 was used to analyze the data. Both univariate and multivariate statistical analyses were done using significance level set at P< 0.05Results: A total of 1496 respondents completed the study which constituted a response rate of 98.1%. Majority (44.3%) were aged between 18 and 19 years with an age range between 12 to 25 years and mean age 17.22 ± 1.87(2SD). Female respondents were 51.5%. The overall prevalence of substance use was 14.6% of whom 78.4% (n=171) of them were using a single substance and 21.6% (n=47) were using multiple substances. The commonest substances used were inhalants (7.6%) followed by alcohol (6.8%), tobacco (3.7%), cannabis (2.0%) and other substances (0.9%). The peak age of onset is 14-16 years except for tobacco which had a peak age of onset at 20 years and above. Age, gender, religiosity, parental marital status, quality of parent-youth relationship, parental monitoring and values, substance use of significant others, the person the youth spends most time with generally, and when he/she goes out; their involvement in extracurricular activities, academic performance and post secondary career goals were significantly associated with substance use. On multivariate analysis, it was found that only youths’academic performance (OR=1.20, p>0.005, 95% CI =1.05-1.37), post secondary career goals (0R=1.74, p>0.004, 95% CI=1.05-1.31); feeling understood by parents (OR=3.79, p>0.024, 95% CI=1.18-12.14) and quality of relationship with parents (OR=1.60, p>0.006, 95% CI=1.14 - 2.24) were independently associated with substance use. Conclusion and recommendations: Substance use among Tanzanian school youths is highly prevalent. In addition, the findings confirm the importance of the quality of adolescent parent relationship and school motivation and performance as factors that positively influence substance use among youth. This calls for culturally creative intervention strategies that reaffirm the crucial monitoring role of parents and motivating role of educators. Laws and policies that facilitate and reinforce parental and educatorsroles in controlling substance abuse among adolescents should should be put in place.