Psychoactive substances use among Tunisian adolescents: Trend analysis 2013-2021

Abstract

Abstract Introduction Psychoactive substances (PAS) use among adolescents has been a growing concern in Tunisia in recent years. Their use can have a serious impact on the physical and mental health of young people, leading to addiction, academic difficulties and a range of social problems. We aimed to study the prevalence of PAS use among Tunisian high school adolescents and assess significant trends from 2013 to 2021. Methods Pooled data from Mediterranean school surveys on PAS conducted in 2013, 2017, and 2021 were used. Based on three-stage stratification sampling method, first and second grade secondary education students were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Self-administered standardized questionnaire was used in data collection. We studied weighted lifetime prevalence of PAS use (cigarettes, alcohol, cannabis, cocaine and ecstasy) and performed global trend analysis. STATA software was used for statistical analysis. Results A total of 14,723 students were enrolled with sex ratio (M/F) equal to 0.61 and mean age of 16.2±0.8 years. The prevalence of cigarettes use increased from 22.6%, to 25.1% then to 30.7% for 2013, 2017 and 2021 respectively (p < 10-3). Trend analysis concluded to significant increase in alcohol use (5.8%, 6,3% and 8% respectively in the three years) (p < 10-3). The greatest increase was in cannabis use (1.5% in 2013, 3.0% in 2017 and 7.9% in 2021) (p < 10-3). However, there was no significant change in cocaine and ecstasy use (p < 0.05). Conclusions Although restrictive legislative measures have been reinforced, there has been a significant increase in the use of PAS among high school adolescents in Tunisia. Thus, it is crucial to delve deeper into this issue and its potential risk factors. The findings can help shed light on the scope of the problem and guide targeted efforts to mitigate the harm caused by these substances. Key messages • Trend analysis confirmed the significant increase in psychoactive substances use in high school adolescents in Tunisia. • This alarming public health issue requires urgent legislation review and close multisectoral collaboration to reduce the impact of this phenomenon.