Prevalence and psychosocial drivers of substance use among school-going adolescents in addis ababa, Ethiopia: A cross-sectional study

Background: The initiation of substance use often occurs during adolescence, a formative period with long-term consequences for physical, mental, and social well-being. While studies exist on university students, there is a critical gap in data concerning the prevalence and underlying drivers among younger, school-going adolescents in Ethiopia. This study aimed to determine the prevalence of substance use and identify key psychosocial predictors among adolescents in Addis Ababa.

Methods: A school-based cross-sectional study was conducted among 360 students aged 13-18 years, selected via stratified random sampling from six secondary schools. Data were collected using a pre-tested, structured, and anonymous questionnaire that assessed socio-demographic factors, substance use (alcohol, khat, tobacco), academic performance, family dynamics, peer influence, and mental well-being. Data analysis was performed using SPSS version 26, employing binary logistic regression to identify factors associated with substance use.

Results: The lifetime prevalence of any substance use was 24.7% (89/360). The most commonly used substances were alcohol (18.9%), khat (13.6%), and cigarettes (6.4%). Peer pressure was the strongest predictor, with users being 5.2 times more likely to have friends who use substances (AOR=5.2, 95% CI: 2.8-9.6). Other significant factors included poor parental monitoring (AOR=3.1, 95% CI: 1.6-5.9) and self-reported academic stress (AOR=2.5, 95% CI: 1.3-4.7). Substance use was significantly associated with lower self-reported academic achievement and higher rates of school absenteeism.

Conclusions: Substance use is a significant public health issue among school-going adolescents in Addis Ababa, heavily influenced by peer pressure and family environment. These findings underscore the urgent need for the early implementation of evidence-based, school-integrated preventive interventions. Such programs should focus on building resilience, strengthening family oversight, and educating youth on the detrimental effects of substance use to safeguard their health and future potential.

Dr. Takele Achalu Dengela is a dedicated public health researcher and lecturer with a PhD and a Master of Public Health in Epidemiology. With over 50 research publications in public health and pharmacy, his work focuses on behavioral health, substance abuse, and improving healthcare outcomes in young populations. He is a life member of the Ethiopian Pharmacy Association and currently serves as a lead researcher and faculty member at Africa Medical College, where he is actively involved in mentoring the next generation of health professionals.