Introduction: Forced displacement leading to internal displacement, especially in developing countries, is a growing global public health problem. The additional presence of substance use and abuse among forcefully displaced young people worsens the challenge by posing long-term health, social and legal consequences for both substance users and the general public. A better understanding of the pattern and drivers of substance use will be useful for the prevention and control of the menace among this vulnerable population. This study, therefore, aims to assess and compare the prevalence and willingness to stop substance use among youths in Internally Displaced Persons (IDP) camps and their host communities in Borno State, Nigeria. Methods: A comparative cross-sectional study was conducted among youths (15-29 years old) in IDP camps and the host communities in Maiduguri, North-East Nigeria. A multistage sampling technique was used to recruit respondents from their households into the two study groups. Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), and Stages of Changes Readiness and Treatment Eagerness Scale (SOCRATES) instruments, were pretested and used to assess the prevalence, types and pattern of substance use, as well as willingness to stop substance abuse, via interviewer-administration Results: Three hundred (300) respondents were surveyed, comprising one hundred and fifty (150) each, from IDP camp and their host communities. Male-to-female ratios were 1:0.85 for the host and 1:0.67 for IDP study groups. The mean age was 21.9 ± 4.58 years (15-29 years), with significantly younger respondents in IDP compared with host communities. Overall 138 respondents were involved in substance abuse, yielding a prevalence rate of 46.0%. The prevalence of substance use among host and IDP study groups was 59.3% and 32.7%, respectively (p<0.05). Among substance users, the mean age at onset of substance use was 17.9 ± 3.6 years, with significantly earlier onset among IDP compared with host groups (p<0.05). Also, the mean duration of substance use was 5.39 ± 3.3 years, but with a significantly longer duration of use among IDP compared with host groups (p<0.05). Tobacco was the most commonly abused substance with high (15.2%) and moderate (33.3%) degrees of dependence, and a significantly higher proportion among IDP compared with host groups (p<0.05). In both groups, the commonest social means of taking substances was with friends, who were also the most common introducers of substances to respondents in both study groups. Most subjects had low levels of recognition (94.9%), ambivalence (62.0%) and taking steps (72.3%). Compared with respondents in the host group, those in the IDP group had a significantly higher proportion of high degree for taking steps (20.4% vs. 4.5%, p<0.05). Multinomial regression analysis identified age and male gender as the significant predictors of substance use (p<0.00). For every unit increase in age by one year, there was a 15% increased likelihood of substance use. More so, compared with females, males had a 12.28 times increased likelihood of substance use (p<0.05). Conclusion: There is a high prevalence of substance abuse among youths forcefully displaced due to Boko Haram insurgency in Northern Nigeria. Youths should be gainfully employed and/or engaged in diverse forms of capacity-building activities. Rehabilitation services should be made available in host communities and IDP camps, to provide health education and counselling, towards prevention, treatment and control of substance use and its consequences.
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