Research Article | | Peer-Reviewed

Factors Associated with Drug Use Among Secondary and High School Adolescents

Received: 15 March 2024     Accepted: 27 March 2024     Published: 11 April 2024
Views:       Downloads:
Abstract

Introduction: Drug abuse is a significant public health concern among adolescents, who are a very susceptible group. This study aimed to identify the various factors associated with drug use among adolescents in secondary school. Methodology: Between October 2022 and April 2023, a cross-sectional and analytical study was carried out among adolescents in fourteen secondary schools in the city of Yaoundé, the administrative capital of Cameroon. The sampling was consecutive and non-exhaustive. The SPSS software version 23.0 was used for data analysis. Multivariate analysis was achieved using the logistic regression model. An Odd Ratio with a 95% confidence interval was used to establish associated factors. The association between categorical variables was measured using Chi-square and Fisher's exact tests (p < 0.05). Results: Of the 1987 adolescents included, the prevalence of drug use was 27.5%, i.e. 546 pupils with an average age of 16.9 ± 1.4 years. The prevalence of drug use in the study was 27.5%. The risk factors identified were students aged 15 to 18, being in the first and final year of secondary school, being raised by either their father or grandparents only and having a bar at home. The protective factor was the absence of drug use by a household member. Conclusion: The high prevalence of drug use among teenagers at school means that preventive measures need to be instilled for school health and the community.

Published in American Journal of Pediatrics (Volume 10, Issue 2)
DOI 10.11648/j.ajp.20241002.13
Page(s) 63-68
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Drugs, Teenagers, Risk Factors

1. Introduction
The World Health Organization (WHO) defines a drug as any substance with the capacity to modify its user’s consciousness and behaviour . Drug use is a genuine public health concern, which is growing and widespread in all regions of the world. Approximately 275 million people used drugs in 2020, a figure that is expected to increase by 11% worldwide and by 40% in Africa alone by 2030 . In Cameroon, the National Committee for the Fight against Drugs (CNLD) reported in 2018 that 21% of Cameroon's school-age population had already used drugs . Adolescence, defined as the period between the ages of 10 and 19, is a time of transition and vulnerability, and initiation into drug use during this period increases the risk of facing social, legal and health-related repercussions . Schools, which are teeming with teenagers, are therefore the ideal settings for understanding this phenomenon and preventing its spread. The general objective of this study was to identify the factors associated with drug use among adolescents attending school in the city of Yaoundé, to generate data that would enable us to gain a better understanding of drug use among adolescents and contribute to better management of the latter.
2. Materials and Methods
This was a cross-sectional and analytical observational study carried out in classes from “6ème” (first year) through “Terminale” (final year) in fourteen secondary schools in the city of Yaoundé, between October 2022 and April 2023, otherwise, seven months. This period was chosen because it falls within the students' calendar year. The study population consisted of pupils in the selected public and public schools, aged between ten and eighteen years, whose consent had been obtained including that of their parents. The visually and hearing impaired were not included. The sample was non-exhaustive and consecutive. The choice of schools, private or public, was made randomly, covering the seven districts of Yaoundé, and two schools were selected per district randomly, using the software package "RESEARCH RANDOMIZER" . The sample size was calculated using the WINPEPI software according to the formula: N=10% n +n, n= δ [Z² P (1-P)] ί ² obtaining a minimum required sample size of 338 pupils . 1,987 pupils were selected for this study. After securing the various administrative authorisations and ethical clearance from the Institutional Ethics and Research Committee of the FMSB of the UYI (Ref.: N° 0107/UY1/FMSB/VDRC/DAARC/CSD of 12 May 2023), data was collected using an anonymous and detailed pre-tested questionnaire in compliance with ethics and confidentiality. The pre-tested questionnaire was shared with the adolescents after a brief interview. The data collected were analysed using SPSS version 23.0 software. Multivariate analysis was done using logistic regression to identify the independent factors associated with drug use among adolescents attending school, with an Odd Ratio with a 95% confidence interval. The significance threshold was 5%. The Chi-square and Fisher's exact tests calculated associative measures between qualitative variables.
3. Results
Of the 1,987 teenage students selected, 546 were drug users, representing a prevalence of drug use of 27.5%. The average age of the drug-using pupils was 16.9 ± 1.4 years, with extremes of 11 and 18 years. Girls were in the majority (50.4%), with a sex ratio of 0.99 (Table 1).
Table 1. Breakdown of the population by age and gender.

Variables

Frequency

Percentage (%)

Age groups (years)

[10-13]

3

0,5

[13-16]

89

16,3

[16-19]

454

83,2

Gender

Male

271

49,6

Female

275

50,4

The average age of drug use initiation was 13.9 ± 2.5 years, with 33.2% of students aged between 14 and 15, as shown in Table 2.
Table 2. Breakdown of the sample population by age of onset of drug use.

Age of onset of consumption

Frequency

Percentage (%)

< 10 years

31

5,7

10-11 years

63

11,5

12-13 years

115

21,1

14-15 years

181

33,2

16-17 years

124

22,7

18 years old

32

5,9

Figure 1. Distribution of the population according to drug use.
Figure 1 shows that the most widely used licit substances were alcohol and tobacco, with 91.6% and 14.1% respectively. Illicit drugs were hookah shisha (49.1%), organic solvents (9.1%) and cannabis (7.7%). Multiple drug use was found in half of the cases (51.5%), with a median of 2 drugs.
There were 16 factors associated with drug use at the 5% threshold in the univariate analysis. After binary logistic regression, the independent risk factors for drug use by pupils were: being aged between 15 and 18 years and over (ORa=1.62; adjusted p=0.015), being enrolled in the first or final year (ORa=2.04; adjusted p < 0.001), having attended a boarding school (ORa=2.02; p=0.001), having been brought up solely by the father (ORa=1.78; adjusted p=0.007) or grandparents (ORa=1.53; adjusted p=0.048) and having a bar at home (ORa=1.62; adjusted p < 0.001). The only protective factor was the absence of drug use by a household member (ORa=0.40; adjusted p < 0.001). (Table 3)
Table 3. Independent factors associated with drug use.

Variables

Drug users

Adjusted OR [95% CI]

p adjusted

N=546; n (%)

[15-19[ age group

501 (29,9)

1,62 [1,10-2,40]

0,015*

Male sex

271 (30,5)

1,21 [0,97-1,51]

0,084

Of Southern Cameroonian descent

58 (36,0)

1,37 [0,96-1,97]

0,084

Of Northern Cameroonian descent

26 (19,4)

0,70 [0,41-1,18]

0,176

Christian religion

511 (28,3)

0,82 [0,34-2,01]

0,668

Islam religion

26 (17,2)

0,52 [0,20-1,36]

0,184

Enrolled in final years (junior and senior high)

421 (32,8)

2,04 [1,56-2,67]

< 0,001*

Pocket money

453 (26,6)

0,82 [0,62-1,10]

0,182

Member of a school handball team

318 (25,2)

2,97 [0,64-13,87]

0,166

Member of a school football team

226 (31,8)

3,84 [0,82-17,97]

0,087

Previous boarding experience

49 (44,1)

2,02 [1,33-3,09]

0,001*

Being raised by both parents

248 (24,2)

0,88 [0,70-1,11]

0,277

Being raised by your father alone

50 (40,0)

1,78 [1,17-2,72]

0,007*

Being brought up by your grandparents

46 (36,5)

1,53 [1,01-2,34]

0,048*

No drug users in the household

109 (16,5)

0,40 [0,31-0,51]

< 0,001*

Home bar available

197 (36,4)

1,62 [1,30-2,03]

< 0,001*

4. Discussion
This study was performed in 14 secondary schools in Yaoundé. It sought to determine the prevalence of drug use and to identify the factors associated with it. A possible non-response bias due to the lack of participation of drug-using students was a limitation of the study. However, the methodology and sample size gave room for conclusion-making. The prevalence of drug use was 27.5%. Studies carried out in Ethiopia in 2013 and in Nigeria in 2020 found respective prevalences of drug use of 14.1% and 24.5 . The results of various studies carried out between 2013 and 2023 show an increase in the number of drug users among school children. The predominance of female drug use (50.4%) in this study was also observed in 2014 in the United States. Cameroon currently has slightly more women than men, with higher school enrolment rates in urban areas which could explain this predominance. The average age of onset of drug use was 13.9 ± 2.5 years, with most (33.2%) between 14 and 15 years. These figures are similar to those found in 2021 in the United States, where the average age of drug initiation is 15 years. The 13-15 age group is the age when young people are most influenced by their peers; they believe themselves to be mature and often overestimate their abilities, hence their desire for what is forbidden. The concomitant rise in consumption alongside age may be linked to the psychological development of adolescents, who become increasingly independent, developing relationships with peers and forming circles of friends who become role models. The whole group is thus exposed to bad habits and when adopted, they can be linked to a single person. This study also found that attending boarding school (ORa=2.02; p=0.001) was an independent risk factor, supporting this group theory. The most widely used legal substance was alcohol (91.6%), followed by tobacco (14.1%). Multiple drug use was common (51.5%), with the majority of users taking at least two drugs. Alcohol and tobacco consumption are characteristically seen in Cameroonian television shows. These results could be explained by the fact that the use of drugs such as alcohol and tobacco is culturally, socially and legally acceptable in Cameroon. They are also easily accessible, additionally having authorised advertisements in the media. Illicit drugs used hookah-shisha (49.1%), solvents (9.1%) and cannabis (7.7%). These results are contrary to those observed in South Africa in 2017, which reported higher consumption of illicit drugs such as cannabis (81.3%), nyaope- a form of black tar heroin (52.3%) and organic solvents (20.2%) . In recent years in Cameroon, hookah has become more widely available among young people; it is heavily coveted in bars and restaurants patronised by adolescents, given it is perceived as fashionable. On top of this, it is falsely described as harmless because of its pleasant aroma. The 15-18 age group was a risk factor for drug use. Adolescents, who are closer to adulthood than childhood, are constantly searching for an identity. Self-esteem and considerable risk-taking, including drug use, are seen as means of asserting their autonomy, their position, and their uniqueness within the group. Similarly, students in the final years (junior and senior high school) have a 2.3 times greater risk of using drugs than students in other classes (p < 0.001), probably because these classes have adolescents who are closer to adults, as described above. The presence of a home bar increased the risk of drug use by 1.8 times (p < 0.001). In addition to the habits of parents, which can influence those of young people, the adolescent's exposure to these substances also comes into play. Students living solely with their father or grandparents were more likely to use drugs (p < 0.001). In South Africa, in 2017, it was seen that the tendency to use drugs was lower among respondents who stayed with both parents than among those from single-parent families or living with guardians other than their parents . One explanation for this finding is that young adults who did not live with their mothers, whether as a result of death or divorce, may experience behavioural problems. Mothers are essential for exercising control over the behaviour of young adults, particularly in Cameroon, where the burden of parental responsibilities falls mainly on mothers . The relationship between young people and their parents is crucial in terms of development, and the family structure is an important variable. When no member of a household used drugs, students were less likely to use drugs (OR: 0.40; p < 0.001). Another study carried out earlier in Cameroon showed that the presence of an alcohol consumer in the student's entourage did not influence their alcohol consumption . This difference could be because the adolescents in their study lived on campus, unlike those in this study who still lived with their parents and were under their parents' influence.
5. Conclusion
The prevalence of drug use among adolescents attending secondary schools in Yaoundé was 27.5%. Being aged between 15 and 18, enrolled in the first or final year of secondary school, having attended boarding school, having been raised solely by their father or grandparents, and having a bar at home were risk factors for drug use. The absence of drug use by a household member was a protective factor. Through this study, targeted preventive measures can be implemented among adolescents in these schools.
Abbreviations
Ref: Reference
FMSB: Faculty of Medicine and Biomedical Sciences
UYI: University of Yaoundé 1
VDRC: Vice Dean for Research and Cooperation
DAARC: Division of Academic Affairs, Research and Cooperation
CSD: Head of Diplomas Department
ORa: Odd Ratio Ajusted
SPSS: Statistical Package for the Social Sciences
Author Contributions
Isabelle Mekone Nkwele: Conceptualization, Data curation, Project administration, Writing – original draft, Writing – review & editing
Hélène Kamo Selangain: Data curation, Writing – original draft
Abada Siméone Carelle: Methodology, Investigation
Menguene Laure: Writing – review & editing
Elong Jules Thierry: Data curation, Formal Analysis
Jeannette Epee Ngoué: Writing – review & editing
Meguieze Claude Audrey: Writing – review & editing
Nsoh Ndeh-Fofang: Writing – review & editing
Nguefack Séraphin: Supervision, Validation
Conflicts of Interest
The authors declare no conflicts of interest.
References
[1] World Health Organization (WHO). Neuroscience of Psychoactive Substance Use and Dependence. Available at:
[2] World Health Organization (WHO). The public health dimension of the world drug problem: how WHO works to prevent drug misuse, reduce harm and improve safe access to medicine available at
[3] Cameroon Human Rights Commission. Declaration of the Human Rights Commission of Cameroon on the celebration of the International Day against Drug Abuse and Illicit Trafficking. CDHC, 2022. Available at:
[4] François Beck, Alain Dervaux, Enguerrand Du Roscoät, Karine Gallopel-Morvan, Marie GrallBronnec, et al.. Conduites addictives chez les adolescents: Usages, prévention et accompagnement. [Rapport de recherche] Institut national de la santé et de la recherche médicale (INSERM). [Addictive behaviour among adolescents: Use, prevention and support. (Research report)] French National Institute for Health and Medical Research 2014, Paris: Inserm: Editions EDP Sciences (ISSN: 1264-1782) / 500 p. ffinserm-02102920f.
[5] Abramson JH. WINPEPI updated: computer programs for epidemiologists and their teaching potential. Epidemiologic Perspectives & Innovations 2011, 8: 1. available at
[6] Urbaniak GC, Plous S. Research randomizer (version 4.0) [computer software]. Retrieved on June 22, 2013. Available at:
[7] Aklog T, Tiruneh G, Tsegay G. Assessment of Substance Abuse and Associated Factors among Students of Debre Markos Poly Technique College inDebre Markos Town, East Gojjam Zone, Amhara regional state, Ethiopia, 2013. 2013.
[8] Ajayi AI, Somefun OD. Recreational drug use among Nigerian university students: Prevalence, correlates and frequency of use. Das A, éditeur. PLoS ONE. 18 mai 2020; 15(5): e0232964.
[9] Suerken CK, Reboussin BA, Sutfin EL, Wagoner KG, Spangler J, Wolfson M. Prevalence of marijuana use at college entry and risk factors for initiation during freshman year. Addictive Behaviors. janv 2014; 39(1): 302-7.
[10] The 2011 Cameroon Demographic health Survey. Calverton, Maryland, USA: INS/Cameroun and ICF International. Available at
[11] Clemans-Cope L, Lynch V, Winiski E, Epstein M, Taylor KJ, Eggleston A. Substance Use and Age of Substance Use Initiation during Adolescence: Self-Reported Patterns by Race and Ethnicity in the United States, 2015–19.
[12] Kamenderi M, Muteti J, Okioma V, Nyamongo I, Kimani S, Kanana F, et al. Status of Drugs and Substance Use, Kenya, 2019. African J Alcohol Drug Abus 1, 54-9.
[13] Nikiéma L, Kouanda S, Seck I, Tiendrebéogo S, Ouédraogo HG, Yaméogo M, et al. Consumption of psychotropic drugs in schools in Burkina Faso: Prevalence and risk factors. African journal Online (AJOL) 2011; 34: 1-2.
[14] Metuge CE, Dzudie A, Ebasone PV, Assob JCN, Ngowe MN, Njang E, et al. Prevalence and factors associated with substance use among students in tertiary institutions in Buea, Cameroon. Pan Afr Med J 2022; 41.
[15] Ololade S, Mndzebele S. Factors influencing use of illicit drugs among high school learners in an informal township of Gauteng Province, South Africa. 2017; 31(1).
[16] Ajayi AI, Somefun OD. Recreational drug use among Nigerian university students: Prevalence, correlates and frequency of use. PLoS One. 2020; 15(5): e0232964.
[17] Félicien NE, Estelle WK, Firmin A, Christian T. Factors favoring the consumption of liquor among Cameroonian students. Health Sci. Dis: Vol 18 (3) July–August–September 2017 Available at
Cite This Article
  • APA Style

    Isabelle, M. N., Laure, M. J., Carelle, A. S., Selangai, K. H., Thierry, E. J., et al. (2024). Factors Associated with Drug Use Among Secondary and High School Adolescents. American Journal of Pediatrics, 10(2), 63-68. https://doi.org/10.11648/j.ajp.20241002.13

    Copy | Download

    ACS Style

    Isabelle, M. N.; Laure, M. J.; Carelle, A. S.; Selangai, K. H.; Thierry, E. J., et al. Factors Associated with Drug Use Among Secondary and High School Adolescents. Am. J. Pediatr. 2024, 10(2), 63-68. doi: 10.11648/j.ajp.20241002.13

    Copy | Download

    AMA Style

    Isabelle MN, Laure MJ, Carelle AS, Selangai KH, Thierry EJ, et al. Factors Associated with Drug Use Among Secondary and High School Adolescents. Am J Pediatr. 2024;10(2):63-68. doi: 10.11648/j.ajp.20241002.13

    Copy | Download

  • @article{10.11648/j.ajp.20241002.13,
      author = {Mekone Nkwele Isabelle and Menguene Justine Laure and Abada Siméone Carelle and Kamo Hélène Selangai and Elong Jules Thierry and Meguieze Claude Audrey and Epee Ngoué Jeannette and Nsoh Ndeh-Fofang and Nguefack Séraphin},
      title = {Factors Associated with Drug Use Among Secondary and High School Adolescents
    },
      journal = {American Journal of Pediatrics},
      volume = {10},
      number = {2},
      pages = {63-68},
      doi = {10.11648/j.ajp.20241002.13},
      url = {https://doi.org/10.11648/j.ajp.20241002.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20241002.13},
      abstract = {Introduction: Drug abuse is a significant public health concern among adolescents, who are a very susceptible group. This study aimed to identify the various factors associated with drug use among adolescents in secondary school. Methodology: Between October 2022 and April 2023, a cross-sectional and analytical study was carried out among adolescents in fourteen secondary schools in the city of Yaoundé, the administrative capital of Cameroon. The sampling was consecutive and non-exhaustive. The SPSS software version 23.0 was used for data analysis. Multivariate analysis was achieved using the logistic regression model. An Odd Ratio with a 95% confidence interval was used to establish associated factors. The association between categorical variables was measured using Chi-square and Fisher's exact tests (p < 0.05). Results: Of the 1987 adolescents included, the prevalence of drug use was 27.5%, i.e. 546 pupils with an average age of 16.9 ± 1.4 years. The prevalence of drug use in the study was 27.5%. The risk factors identified were students aged 15 to 18, being in the first and final year of secondary school, being raised by either their father or grandparents only and having a bar at home. The protective factor was the absence of drug use by a household member. Conclusion: The high prevalence of drug use among teenagers at school means that preventive measures need to be instilled for school health and the community.
    },
     year = {2024}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Factors Associated with Drug Use Among Secondary and High School Adolescents
    
    AU  - Mekone Nkwele Isabelle
    AU  - Menguene Justine Laure
    AU  - Abada Siméone Carelle
    AU  - Kamo Hélène Selangai
    AU  - Elong Jules Thierry
    AU  - Meguieze Claude Audrey
    AU  - Epee Ngoué Jeannette
    AU  - Nsoh Ndeh-Fofang
    AU  - Nguefack Séraphin
    Y1  - 2024/04/11
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ajp.20241002.13
    DO  - 10.11648/j.ajp.20241002.13
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 63
    EP  - 68
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20241002.13
    AB  - Introduction: Drug abuse is a significant public health concern among adolescents, who are a very susceptible group. This study aimed to identify the various factors associated with drug use among adolescents in secondary school. Methodology: Between October 2022 and April 2023, a cross-sectional and analytical study was carried out among adolescents in fourteen secondary schools in the city of Yaoundé, the administrative capital of Cameroon. The sampling was consecutive and non-exhaustive. The SPSS software version 23.0 was used for data analysis. Multivariate analysis was achieved using the logistic regression model. An Odd Ratio with a 95% confidence interval was used to establish associated factors. The association between categorical variables was measured using Chi-square and Fisher's exact tests (p < 0.05). Results: Of the 1987 adolescents included, the prevalence of drug use was 27.5%, i.e. 546 pupils with an average age of 16.9 ± 1.4 years. The prevalence of drug use in the study was 27.5%. The risk factors identified were students aged 15 to 18, being in the first and final year of secondary school, being raised by either their father or grandparents only and having a bar at home. The protective factor was the absence of drug use by a household member. Conclusion: The high prevalence of drug use among teenagers at school means that preventive measures need to be instilled for school health and the community.
    
    VL  - 10
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Yaounde, Cameroon

  • Higher Institute of Medical Technology, Yaounde, Cameroon

  • Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Yaounde, Cameroon

  • Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon

  • Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Yaounde, Cameroon

  • Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Yaounde, Cameroon

  • Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Yaounde, Cameroon

  • Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Yaounde, Cameroon

  • Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1 Yaounde, Cameroon