Abstract
Background: Substance use is a significant public health problem worldwide, with consequences including violence, risky behaviours, and even death. Substance use amongst adolescents is increasing in South Africa, and limited research on frequency, risk and protective factors means that prevention interventions are difficult to design. This paper aims to describe and discuss factors associated with substance use among school-going adolescents in three peri-urban South African settings. Methods: A cross-sectional analysis was conducted using baseline data from participants in the Girls Achieve Power (GAP Year) trial. Grade 8 learners (N=2383), aged 11-18, were recruited from 26 lowest quintile public high schools in three townships: Soweto and Thembisa in Gauteng Province, and Khayelitsha in Western Cape Province. A baseline survey gathered demographic and behavioural data. Questions relevant to substance use and social support were used for this analysis. Multivariate logistic regression analyses were conducted to identify factors associated with substance use. The final variables were included in an unadjusted and adjusted logistic regression for current substance use, and a multinomial logistic regression for frequency of substance use. Results: A total of 22.5% (534) of participants indicated they had ever used substances. Being male was strongly associated with substance use (P<0.001), and less strongly with frequency of substance use. Age significantly predicted substance use, with older adolescents being more likely to engage in substance use (P<0.001); having a parent/guardian employed was negatively associated with substance use (P=0.021). Family-related social support variables were predictive of substance use. Being able to count on friends when things went wrong was predictive of lower frequency of substance use (P=0.019). Conclusions: These results can inform the targeting of prevention interventions to males and younger learners, as well as ensuring youth interventions build family and peer support to make substance use less likely and less frequent.
Highlights
Substance use is defined as taking a substance into the body for an intended purpose, such as behavioural or emotional change (Marshall & Spencer, 2018)
Socio-Demographic and Substance Use Variables Overall, 3432 eligible learners participated in the baseline survey
The results give an overview of substance use activities amongst GAP Year participants, highlighting that 22.5% have ever used substances
Summary
Substance use is defined as taking a substance into the body for an intended purpose, such as behavioural or emotional change (Marshall & Spencer, 2018). Substance use is a public health concern, as it has been found to be a predictor of injury, violence, risky sexual behaviour, and a risk factor for HIV and TB acquisition (Flisher et al, 2012; Morojele & Ramsoomar, 2016). Substance use disorders are characterised by a growing addiction or dependence on the substance, and an inability to curb one’s use (American Psychiatric Association (APA), 2013). These disorders are associated with various mental health and psychosocial problems and have the potential to reinforce broader socio-economic inequalities (World Health Organisation (WHO), 2018). Substance use is a significant public health problem worldwide, with consequences including violence, risky behaviours, and even death.
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