Patterns of adolescents' substance use in Serbia: A latent class analysis

Abstract

Background: While data on prevalence of psychoactive substance use and trends among adolescents are available in Serbia, less is known about patterns of use, including concurrent use of illicit and licit psychoactive substances. Methods and Objectives: The purpose of this study is to explore patterns of substance use among students in Serbia and correlation with sociodemographic and other factors using latent class and chi square test to examine demographic factors and other correlates of the defined groups. Data were obtained from ESPAD survey conducted in Serbia in 2019 on representative sample of 3529 16 years old students. Results: Six latent class solution with the lowest BIC value was selected: Class1 (38.4%) characterized by low probability of any psychoactive substance use; Class 2 (3.8%) high probability of only cigarette use; Class 3 (47.8%) high probability of alcohol use and low probability of any other substance; Class 4 (4.4%) high probability of alcohol and sedatives use; Class 5 ( 4.1%) high probabilities of concurrent use of alcohol, cigarettes and cannabis and Class 6 ( 3.8%) high probability of concurrent use of all explored substances. Results show alcohol, the most popular psychoactive substances is used either as only substance or concurrently, with girls having higher probability using it concurrently with sedatives. Class 6 students are more likely to be from more affluent families and those in classes with high probability of concurrent substance use (Classes 4, 5 and 6) were more likely to skip school five or more days in the last 30 days (6.5%; 13.7% and 10.8% respectively) compared to Classes 1, 2 and 3 (0.5%;1.4% and 2.2%) Conclusion: Concurrent substance use is associated with skipping school, not being engaged in sports activities and lower grades. Variations in substance use patterns have implications for monitoring, prevention and treatment.