Abstract

Abstract Background During adolescence, alcohol consumption represents a new experience with the advantage of facilitating the integration of a peer group. The global overall prevalence of this risk behavior among the 15-19 years old was over 25% in 2018. However, this prevalence varies between countries. Objectives To determine the incidence and the predictors of alcohol consumption among high school students in Sousse, Tunisia between 2017/2018 and 2018/2019. Methods A prospective longitudinal study was conducted in four high schools in the governorate of Sousse during the 2018-2019 school year. Pre-trained medical doctors used an anonymous self-administered questionnaire to collect data about socio-demographic and educational features, alcohol consumption, tobacco use, illicit substances use and emotional disorders. Results Participants accounted for 404. Their average age was 16.4 (±1.1) years. Females represented 68%. The prevalence of alcohol consumption in 2017/2018 was 5.9% while the cumulative incidence during the 2018/2019 school year was 3.5%. Among males, this incidence was of 11.9%. Among females, it was of 3% (p = 0.020). Illicit substance use among friends was the main predictor of becoming alcohol consumer with an adjusted odds ratio of 6.4 (95% CI: 1.9-21.3) on the other hand, having an anxiety trouble predicted less this risk behavior (adjusted odds ratio =0.2 95% CI: 0.1-0.8). Conclusions Alcohol consumption is becoming more and more common among the adolescents of Sousse especially among males. The current national strategy against substances use in schools should be reinforced. Implementation of a social skills training among adolescents to improve assertiveness is essential. Key messages • Alcohol consumption has an upword trend among the adolescents of Sousse. • The current prevention programs targetting adolescents in Tunisia should be revised and integrate a comprehensive and multisectoral program.

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