Abstract
Background
Globally, substance abuse has been identified as a major public health issue. The aim of the study was to determine and compare the prevalence, pattern, and predictors of substance abuse among adolescents in public and private day secondary schools in Katsina State.
Methods
A cross-sectional comparative study was employed to investigate 1126 adolescents obtained through multistage sampling technique in selected public and private day secondary schools across geopolitical zones spanning both rural and urban LGAs in Katsina State. Data was collected over eight weeks with the aid of pretested interviewer-administered questionnaire and was analysed using IBM SPSS version 25. Ethical approval was obtained from Katsina State Ministry of Health.
Results
Overall, majority (25.1%) of respondents were 18 years of age (majority, 28% in public and 25.2% in private schools were 17 and 18 years of age respectively. Overall mean age of the study population was 16.98 ± 1.27 years (Public; 16.97 ± 1.237 years and Private;16.99 ± 1.309 years). Overall, most of the respondents were in SS3 (44.1%), (Public; 47.4% and Private; 40.8%). Proportion of adolescents who ever used any substance at least once was 22.02% (7.99% public, 14.03% private). Factors independently associated with substance abuse were being in SS3 class (p = 0.022), coming from monogamous family (p = 0.014) and peer substance abuse (p = 0.017). The logistic regression model reveals that current users in SS3 class, from monogamous setting and whose peers abuse substances are 7 times more likely (aOR = 7.12), 5 times more likely (aOR = 5.4) and 20% more likely (aOR = 0.209) to be in private than in public schools, respectively.
Conclusion
Prevalence of substance abuse was high. Major predictor was peer substance abuse. Consequently, the state Ministry of Education in collaboration with Ministry of Health and NDLEA should design a substance abuse prevention programme with a view to reducing the menace of substance abuse in the state.
Keywords: Abuse, Adolescents, Nigeria, Prevalence, Private, Public
Introduction
Globally, there are 1.2 billion adolescents aged 10–19 years making up 16% of the world’s population [1], [2]. The global proportion of adolescents peaked in 1980 and since then has been on the decline although the absolute number is expected to rise [3]. More than half of global adolescents live in Asia, while in sub-Saharan Africa about 23 per cent of the region’s population is constituted by adolescents and in Nigeria there are estimated 30 million adolescents making up about 22.5% of the population. [4] Adolescence is a period of transition between childhood and adulthood and it is typically characterized by bodily, psychological and cognitive changes [5]. These individuals face numerous health challenges including illnesses, injuries and premature death which ultimately hinder them from achieving their full potential. For instance, risky behaviours such as substance abuse, unprotected sex among others have been shown to affect not only their present state of health, but also their overall health along the various stages of their lifecycle and cascade down to their future generations [2].
Drug use among 15–19 year olds is also an important global public health concern and its control needs to focus on reducing demand, supply or both [6]. According to the World Health Organizations (WHO), ‘Adolescents’ are individuals in the age range of 10–19 years [2]. Generally, adolescents are considered as valuable resources to be harnessed for national development and progress [7]. Despite the importance of adolescents to national building, this category of individuals often engage in substance abuse, a phenomenon that has far reaching consequences [7].
Globally, substance abuse has been identified as a major public health issue that undermines development on a socioeconomic compact scale [8]. [9] It has, for long attracted public concern and serious political undertone [10]. This concern is attributable to the potential health consequences associated with the use of substances such as cigarettes, alcohol and cannabis. This phenomenon is associated with major Non-Communicable Diseases as well as social issues including high rate of school drop-out, unemployment, crimes and impoverishment [10]. Studies have documented relationship between substance abuse and Non-communicable Diseases (NCDs). For instance, alcohol has been shown to contribute to the development of hypertension, stroke and cancers while tobacco smoking which has been identified as the single largest preventable risk factor for NCDs has been shown to increase the risk of hypertension in adolescents [11]. Tobacco consumption, which has been on the increase in Nigeria might have connection with some of the poor health indices recorded in the country [12]. From economic point of view, in the year 2010, close to ₦1.79 billion was spent on tobacco consumption in Nigeria [13]. Substance abuse is a major problem among school-going adolescents as significant number of these individuals begin to experiment with alcohol and cigarettes (popularly described as gateway substances) and eventually indulge in more dangerous substances such as cannabis and cocaine [14]. Data from school surveys reveal a rising prevalence of substance abuse among adolescents in Nigeria [14]. This is not unconnected with the fact that adolescence period is full of high-risk undertakings and may be a reason why use of psychoactive substances is prevalent in this period [15]. [16] This explains why 10–19 year olds are extremely prone to various mental health problems which start at this period and continue up till adulthood [17].
According to WHO “substance abuse refers to harmful use of psychoactive substances including alcohol and illicit drugs” [9]. It has also been defined as harmful or hazardous use of psychoactive substances including alcohol, opioids, cannabinoids, hypnotics, cocaine, hallucinogens, tobacco, caffeine and nicotine. A psychoactive (psychotropic) substance is any substance which after absorption has influence on both cognitive and affective mental processes. These influences could be stimulative, suppressive, or hallucinogenic. Young people begin to use substances singly or in combination at an early age and they report varied reasons for using them [18, 19].
Globally, close to 5% of the world’s population in the productive age group (15–64) years are involved with illegal drugs according to The United Nations Office on Drug and Crime (UNODC) and World Drug Report [20]. [7] The Global Youth Tobacco Survey revealed the proportion of adolescents smokers as 15% in 4 of 29 regions of Africa and 13 of 38 sub-regions of America [21]. In the year 2016, Nigeria recorded a 14.4% national prevalence of substance abuse with variations in the various geopolitical zones; (south-east 13.8%, south-south 16.6% south-west 22.4%, north-east 13.6%, north-central 10%, and north-west 12%) [22]. Common substances of abuse globally include cannabis, alcohol, tobacco, amphetamine, inhalants and opiates [23]. In Nigeria, cannabis is the most widely abused substance after alcohol and tobacco followed by opioids, cough syrups, tranquilizers, ecstasy, inhalants, amphetamine and cocaine [22] while in Katsina State, the commonest substances abused by adolescents include tobacco, codeine-containing cough syrup, marijuana and tramadol [24]. In an ideal situation, access to substances of addiction such as cigarette should be restricted especially to adolescents. On the contrary, however, studies have shown that up to 49.6% of adolescent smokers were never refused cigarettes by vendors on account of their age [21]. The prevalence of cigarette smoking was higher among the older adolescents (15–19) year olds compared to the early and mid-adolescents [21]. Other studies also suggest that more than 80% of adolescents experiment with drugs or alcohol before adulthood [25].
Globally, smoking alone has been shown to account for more than six million deaths every year [26], while alcohol use accounts for 320 deaths on an hourly basis (an estimated 2.3 million deaths) [27]. In spite of this unwelcome effect associated with alcohol use, it remains the most widely used and abused psychoactive substance among young adults [27]. In Asian countries, for example, studies have shown that heavy drinking was found to be significantly associated with suicidal ideation, suicidal attempts and self-distress [28].
Studies have shown that in Nigeria, 13% of school going adolescents use alcohol and up to 26% have ever used alcohol [17]. Evidence indicates that Nigeria is currently the highest consumer of cannabis and amphetamine in Africa.
A number of studies in Asia, USA and the United Kingdom have shown widespread drug use among adolescents and young adults and this has been on the centre-stage in drawing global attention to this effect [29].
There is evidence to suggest that the phenomenon of substance abuse is on the increase in Nigeria [30]. Therefore, understanding the prevalence, pattern and predisposing factors will enable the design of cost-effective interventions to curb out this menace [30]. Additionally, since the problem of substance abuse among youth starts in school, it is therefore the best place for early detection and prevention of substance abuse in the adolescent population [14]. Despite the documented literature on substance abuse among school-going adolescents, there is a need for additional school surveys in the country. This will allow for comparison of data bearing in mind possible prevailing social differences from various cities in Nigeria.
In Katsina state, to the best of the researcher’s knowledge, no study was conducted to compare the prevalence, pattern, and predictors of substance abuse among adolescents in public and private secondary schools. It is hoped that findings of the study will help policy makers and the authorities of Ministry of Education to design substance abuse prevention strategies as part of overall school health programme. Therefore, this study aimed to determine and compare the prevalence, and associated factors of substance abuse among adolescents in selected public and private secondary schools in Katsina State.
Methods
The study was conducted in Katsina State, one of the 36 states of the Federal Republic of Nigeria located in the Northwest geopolitical zone and lies between latitude 11°08’N and 13°22’N and longitude 6°52’E and 9°20’E. Katsina State is a centre of both formal and informal education [31]. [32] As at 2019 there were 257 public junior secondary schools, 90 public senior secondary schools and 67 private secondary schools with total enrolment of 186,658 (112,995 males and 73663 females) for public senior secondary schools, 276,332 (152,650 males, 123,672 females) for public junior secondary schools and 8,549 (4510 males, 4039 females) for private schools.
A cross-sectional comparative study design was used for the study. The study population comprised of 1126 older adolescents aged 15–19 years who were enrolled in public or private secondary schools in Katsina state duly registered by the State Ministry of Education. Sample size was calculated using the formula for sample size calculation for comparing proportions obtained from similar research.
 |
Where;
n = minimum sample size to be estimated.
Zα = Critical value of the normal distribution at significance level of 95% = 1.96.
Zβ = Statistical power at 80% = 0.84.
P1 = Prevalence of substance abuse among adolescents of public school = 15.3% respectively.
P2 = Prevalence of substance abuse among adolescents of private school = 22.1% respectively.
Using, the above values, it implies that:
P1 = 15.3% = 0.153
(1-P1) = 1-0.153 = 0.847
P2 = 22.1%=0.221
(1-P2) = 1-0.221 = 0.779
Substituting,
n = (1.96 + 0.84)2 * 0.153(1-0.153) + 0.221(1-0.221)/ (0.221–0.153)2.
n = 7.84 * (0.129591 + 0.172159)/ (0.068)2.
n = 7.84*(0.30175)/0.004624.
n = 511.6.
Making allowance for non- response, a 10% non-response insurance was obtained from a similar study [9]. Hence (51.6) was added to the minimum sample size calculation, giving a total sample size of 562.7. So, a final sample size of 563 was used for each arm of the study, making overall sample size to 1126. A multistage sampling technique was used to select participants. In the first stage, two LGAs (one rural and one urban) from each of the three senatorial zones were selected using simple random sampling by balloting to make a total of 6 LGAs. In the second stage, six public and three private (based on ratio of 2:1 as the number of public schools is twice the number of private schools in the state) schools were selected using simple random sampling by balloting. In the third stage, from each of the schools that were selected in second stage one class (a cluster) each from SS1, SS2 and SS3 were selected using simple random sampling by balloting. In the fourth stage, 94 participants from each of the 6 selected public schools and 188 participants from each 3 selected private school were selected by proportionate allocation and interviewed. In each of the schools a cluster was selected using simple random sampling by balloting, and in each cluster, all eligible respondents were administered the questionnaire and where the required number could not be reached, a second cluster was selected to obtain the required participants.
Data was collected with the aid of a pretested, semi-structured, interviewer-administered questionnaire adapted from (a) Tobacco Questions for Survey of youth (TQS-youth) based on tobacco surveillance system, a subset of global youth tobacco survey GYTS [33]. (b) The European School Survey Project on Alcohol and Other Drugs [34]. (c) Youth Risk Behaviour Survey (YRBS) [35] and Alcohol Use Disorder Identification Test (AUDIT) [36]. This tool was entered into Open Data Kit (ODK) [37] software version 1.16.1 using android hand-held smart devices which was scripted to minimize data entry error, ease timely data collection, ensure completeness of information and subsequent processing and analysis. Adjustments were made to the questionnaire based on observations during the pretest. Data collection was done over a period of eight weeks in the months of March and April 2021 by a team of trained research assistants. Ethical approval was sought and obtained from Katsina State Ministry of Health. Permission to conduct the study was sought and obtained from Katsina State Ministry of Education, Katsina Zonal Education Quality Assurance Offices (Formerly, Zonal Inspectorate) as well as from the principals of the respective secondary schools. Prior to administration of questionnaires, nature and objectives of the study were explained to the respondents and assurance of confidentiality was given to obtain voluntary informed consent and assent where applicable for participation in the study. Data was cleaned and analysed using IBM Statistical Product and Service Solution (SPSS) version 25. Recoding, categorization, and computation were performed for some of the variables before the data analysis.
Results
A total of 1126 (563 each from public and private schools) adolescents responded to the questionnaire giving a response rate of 100%. On the overall, majority 25.1% of respondents were 18 years of age (Public; 28% and Private; 25.2% were 17 and 18 years of age respectively (Table 1a). Overall mean age of the study population was 16.98 ± 1.27 years (Public; 16.97 ± 1.237 years and Private;16.99 ± 1.309 years). Overall, most of the respondents were in SS3 (44.1%), (Public; 47.4% and Private; 40.8%), Hausa by tribe (91.7%) (Public; 96.9% and Private; 86.3%), and belong to the Islamic religion (94.2%) (Public; 97.5% and Private; 90.9%), Most of the respondents (63.1%) (Public; 71.2% and Private; 54.8%), came from polygamous family setting with members of the family greater than five in number and their parents are currently married (82.9%) (Public; 84.3% and Private; 81.5%). Most of the respondents’ mothers had secondary education (43.6%) (Public; 40.6% and Private; 46.5%) and their major occupation was petty trading (57.4%) (Public; 64.8% and Private; 49.9%) (Table 1b). Proportion of adolescents who ever used any substance at least once was 22.02% (Public; 7.99% and Private;14.03%) as depicted in (Table 2). Factors associated with substance abuse, in both public and private schools were class (P = 0.034) (Table 3a), family type (P = 0.003), household size (P = 0.032), (Table 3b), teacher substance abuse (P = 0.01), peer substance abuse (P = 0.004), engaging in paid work after school (p = 0.023), parental strict monitoring (p = 0.032), parental non-restriction of friends (p = 0.012) and parental trust (p = 0.001) (Table 4). After controlling for confounding, factors independently associated with substance abuse were being in SS3 class (p = 0.022), coming from monogamous family (p = 0.014) and peer substance abuse (p = 0.017) (Table 5). The logistic regression model reveals that current users in SS3 class, from monogamous setting and whose peers abuse substances are 7 times more likely (aOR = 7.12), 5 times more likely (aOR = 5.4) and 20% more likely (aOR = 0.209) to be in private than in public schools, respectively. (Table 5).
Table 1.
a. socio-demographic characteristics of adolescents in Public and private secondary schools in Katsina State, May 2021. b. Socio-demographic characteristics of adolescents in Public and private secondary schools in Katsina State, May 2021
| a | ||||
|---|---|---|---|---|
| Variables | Description | Public School (n = 563) | Private School (n = 563) | Test statistic |
| Age (years) | 15 years | 87(15.4) | 92(16.3) | χ2 = 7.27 |
| 16 years | 114(20.2) | 125(22.2) | p = 0.122 | |
| 17 years | 158(28) | 122(21.6) | V = 0.08 | |
| 18 years | 139(24.6) | 142(25.2) | ||
| 19 years | 65(11.5) | 82(14.5) | ||
| Total | 563(100) | 563(100) | ||
| Mean age (years) | 16.97 ± 1.237 | 16.99 ± 1.309 | t=-0.26 | |
| P = 0.7922 | ||||
| Sex | Male | 252(44.7) | 311(55.2) | |
| Female | 311(55.2) | 252(44.7) | P < 0.001* | |
| Total | 563(100) | 563(100) | ϕ=-0.105 | |
| Class | SS1 | 52(9.2) | 135(23.9) | χ2 = 44.3 |
| SS2 | 244(43.3) | 198(35.1) | P < 0.001* | |
| SS3 | 267(47.4) | 230(40.8) | ϕ = 0.199 | |
| Total | 563(100) | 563(100) | ||
| Tribe | Hausa | 546(96.9) | 486(86.3) | |
| Igbo | 4(0.7) | 23(4) | χ2 = 42.57 | |
| Yoruba | 7(1.2) | 37(6.5) | P < 0.001* | |
| Others | 6(1) | 17(3) | V = 0.194 | |
| Total | 563(100) | 563(100) | ||
| Religion | Islam | 549(97.5) | 512(90.9) | χ2 = 22.35 |
| Christianity | 14(2.4) | 51(9.1) | p = 0.001* | |
| Total | 563(100) | 563(100) | ϕ = 0.14 | |
| Marital status of parents | Currently married | 475(84.3) | 459(81.5) | χ2 = 2.63 |
| Separated | 16(2.8) | 25(4.4) | P = 0.452 | |
| Divorced | 17(3) | 20(3.5) | V = 0.048 | |
| Widowed | 55(9.7) | 59(10.4) | ||
| Total | 563(100) | 563(100) | ||
| b | ||||
|---|---|---|---|---|
| Variables | Description | Public School (n = 563) | Private School (n = 563) | Test statistic |
| Mother’s highest level of education completed | No formal | 172(30.5) | 87(15.4) | χ2 = 86.2 |
| Primary | 120(21.3) | 80(14.2) | P < 0.001* | |
| Secondary | 229(40.6) | 262(46.5) | V = 0.277 | |
| Tertiary | 42(7.4) | 134(23.8) | ||
| Total | 563(100) | 563(100) | ||
| Father’s highest level of education completed | No formal | 70(12.4) | 42(7.4) | χ2 = 46.9 |
| Primary | 39(6.9) | 11(1.9) | P < 0.0001* | |
| Secondary | 201(35.7) | 153(27.1) | V = 0.27 | |
| Tertiary | 253(44.9) | 357(63.4) | ||
| Total | 563(100) | 563(100) | ||
| Father’s occupation | Unemployed | 7(1.2) | 5(0.8) | χ2 = 37.4 |
| Farming | 83(14.7) | 41(7.2) | P < 0.0001* | |
| Business | 198(35.1) | 205(36.4) | V = 0.18 | |
| Civil Service | 194(34.4) | 265(47) | ||
| Artisan | 54(9.5) | 38(6.7) | ||
| Others | 27(4.7) | 9(1.5) | ||
| Total | 563(100) | 563(100) | ||
| Mother’s occupation | Full housewife | 148(26.2) | 149(26.4) | χ2 = 72.2 |
| Petty trading | 365(64.8) | 281(49.9) | P < 0.0001* | |
| Civil Service | 38(6.7) | 132(23.4) | V = 0.25 | |
| Others | 12(2.1) | 1(0.1) | ||
| Total | 563(100) | 563(100) | ||
| Family Type | Monogamous | 162(28.7) | 254(45.1) | χ2 = 32.2 |
| Polygamous | 401(71.2) | 309(54.8) | P < 0.0001* | |
| Total | 563(100) | 563(100) | ϕ = 0.16 | |
| Full Siblings | ≤ 5 siblings | 141(25) | 238(42.2) | χ2 = 37.4 |
| > 5 siblings | 422(74.9) | 325(57.7) | P = 0.001 | |
| Total | 563(100) | 563(100) | ϕ = 0.18 | |
| Household Size | ≤ National average | 39(6.9) | 130(23) | χ2 = 57.6 |
| > National average | 524(93) | 433(76.9) | P < 0.0001 | |
| Total | 563(100) | 563(100) | ϕ = 0.22 | |
χ2 = Chi-squared Test,
ϕ = Crammer’s phi
V = Crammer’s V
Table 2.
Prevalence of substance abuse among adolescents in public and private schools in Katsina State, May, 2021
| School | Relative proportion | |||||||
|---|---|---|---|---|---|---|---|---|
| Variable | Public School (n = 563) | Private school (n = 563) | Pooled Frequency (n = 1126) | Pooled proportion | Public | Private | Test statistic | |
| Ever Use (n = 1126) | Yes | 90(15.9) | 158(28) | 248 | 22.02 | 7.99% | 14.03% | χ2=23.91 |
| No | 473(84) | 405(71.9) | 878 | 77.98 | P < 0.001* | |||
| Total | 563(100) | 563(100) | 1126 | 100.00 | ϕ=-0.14 | |||
| Past Use (n = 1126) | Yes | 21(3.73) | 36(45.5) | 57 | 5.06 | 1.87% | 3.19% | χ2=11.2 |
| No | 542(96.27) | 527 | 1069 | 94.94 | P = 0.004* | |||
| Total | 563(100) | 563(100) | 1126 | 100 | ϕ = 0.1 | |||
| χ2=23.93 | ||||||||
| Current Use (n = 1126) | Yes | 46(8.17) | 79(14.04 | 125 | 11.1 | 4.09% | 7.02% | |
| No | 517(91.83) | 484(85.97) | 1001 | 88.9 | ||||
| Total | 563(100) | 563(100) | 1126 | 100 | P < 0.001* | |||
| ϕ = 0.14 | ||||||||
Overall, 22.02% of adolescents (public: 7.99% and private 14.04%) schools have ever used substances. 5.06% (public; 1.87% and private; 3.19%) have used any substance in the past, but not anymore, and currently 11.1% (public; 4.09% and private;7.02%) use substances
Table 3.
Relationship between sociodemographic characteristics and prevalence of substance abuse (current use) in Public and Private Day secondary schools in Katsina State, May 2021 (n = 125). B: relationship between sociodemographic characteristics and prevalence of substance abuse (current use) in Public and Private Day secondary schools in Katsina State, May 2021 (n = 125)
| A | ||||
|---|---|---|---|---|
| Variable | School | Test statistic | ||
| Public (n = 46) | Private (n = 79) | |||
| Age | 15 years | 4(8.6) | 3(3.7) | FE = 7.19 |
| 16 years | 7(15.2) | 14(17.7) | P = 0.121 | |
| 17 years | 15(32.6) | 13(16.4) | V = 0.2 | |
| 18 years | 15(32.6) | 31(39.2) | ||
| 19 years | 5(10.8) | 18(22.7) | ||
| Total | 46(100) | 79(100) | ||
| Sex | Male | 31(67.3) | 56(70.8) | χ2 = 0.168 |
| Female | 15(32.6) | 23(29.1) | P = 0.682 | |
| Total | 46(100) | 79(100) | f=-0.037 | |
| Class | SS1 | 2(4.3) | 14(17.7) | χ2 = 6.778 |
| SS2 | 13(28.2) | 28(35.4) | P = 0.034* | |
| SS3 | 31(67.3) | 37(46.8) | f = 0.233 | |
| Total | 46(100) | 79(100) | ||
| Tribe | Hausa | 37(80.4) | 62(78.4) | LR = 1.062 |
| Igbo | 3(6.5) | 8(10.1) | P = 0.786 | |
| Yoruba | 5(10.8) | 6(7.5) | V = 0.09 | |
| Others | 1(2.1) | 3(3.7) | ||
| Total | 46(100) | 79(100) | ||
| Religion | Islam | 39(84.7) | 64(81) | χ2 = 0.285 |
| Christianity | 7(15.2) | 15(18.9) | P = 0.594 | |
| Total | 46(100) | 79(100) | f = 0.04 | |
| Marital status of parents | Currently married | 40(86.9) | 62(78.4) | LR = 6.753 |
| Separated | 4(8.6) | 4(5) | P = 0.08 | |
| Divorced | 2(4.3) | 8(10.1) | V = 0.2 | |
| Widowed | 0(0) | 5(6.3) | ||
| Total | 46(100) | 79(100) | ||
| B | ||||
|---|---|---|---|---|
| Variable | School | Test statistic | ||
| Public (n = 46) | Private (n = 79) | |||
| Mother’s highest level of education completed | No formal | 11(23.9) | 12(15.1) | χ2 = 1.64 |
| Primary | 8(17.3) | 15(18.9) | P = 0.65 | |
| Secondary | 18(39.1) | 37(46.8) | V = 0.115 | |
| Tertiary | 9(19.5) | 15(18.9) | ||
| Total | 46(100) | 79(100) | ||
| Father’s highest level of education completed | No formal | 3(6.5) | 4(5) | LR = 2.19 |
| Primary | 1(2.1) | 0(0) | P = 0.534 | |
| Secondary | 16(34.7) | 30(37.9) | V = 0.124 | |
| Tertiary | 26(56.5) | 45(56.9) | ||
| Total | 46(100) | 79(100) | ||
| Father’s occupation | Farming | 7(15.2) | 7(8.8) | LR = 5.683 |
| Business | 14(30.4) | 35(44.3) | P = 0.224 | |
| Civil Service | 20(43.4) | 34(43) | V = 0.209 | |
| Artisan | 4(8.6) | 3(3.7) | ||
| Others | 1(2.1) | 0(0) | ||
| Total | 46(100) | 79(100) | ||
| Mother’s occupation | Full housewife | 6(13) | 23(29.1) | LR = 7.293 |
| Petty trading | 32(69.5) | 41(51.8) | P = 0.063 | |
| Civil Service | 7(15.2) | 15(18.9) | V = 0.232 | |
| Others | 1(2.1) | 0(0) | ||
| Total | 46(100) | 79(100) | ||
| Family Type | Monogamous | 11(23.9) | 40(50.6) | χ2 = 8.593 |
| Polygamous | 35(76) | 39(49.3) | P = 0.003* | |
| Total | 46(100) | 79(100) | f = 0.262 | |
| Household Size | ≤National Average | 9(19.5) | 30(37.9) | χ2 = 4.59 |
| > National Average | 37(80.4) | 49(62) | P = 0.032* | |
| Full Siblings | Total | 46(100) | 79(100) | f = 0.192 |
| ≤ 5 siblings | 20(43.4) | 47(59.4) | χ2 = 2.998 | |
| > 5 siblings | 26(56.5) | 32(40.5) | P = 0.083 | |
| Total | 46(100) | 79(100) | f = 0.155 | |
A. Only 125 (11.1%) of adolescents (Public;46(4.09%) and Private; 79(7.02%)) currently abuse substances. Factors significantly associated with substance abuse are class (P = 0.034) and religion (P = 0.04)
B. Factors significantly associated with substance abuse are household size (P = 0.032), teacher substance abuse (P = 0.01), peer substance abuse (P = 0.004), engaging in paid work after school (P = 0.023), parental strict monitoring (P = 0.032), parental non-restriction of friends (P = 0.012) and parental trust (P = 0.001)
Table 4.
Relationship between other independent variables and prevalence of substance abuse (current use) in Public and Private Day secondary schools in Katsina State, May 2021 (n = 125)
| Variable | School | Test statistic | ||
|---|---|---|---|---|
| Public (n = 46) | Private (n = 79) | |||
| Parental substance abuse | Yes | 19(41.3) | 31(39.2) | χ2 = 0.052 |
| No | 27(58.6) | 48(60.7) | P = 0.82 | |
| Total | 46(100) | 79(100) | f = 0.02 | |
| Teacher substance abuse | Yes | 26(56.5) | 26(32.9) | χ2 = 6.671 |
| No | 20(43.4) | 53(67) | P = 0.01* | |
| Total | 46(100) | 79(100) | f = 0.231 | |
| Peer Substance abuse | Yes | 33(71.7) | 72(91.1) | χ2 = 8.141 |
| No | 13(28.2) | 7(8.8) | P = 0.004* | |
| Total | 46(100) | 79(100) | f=-0.255 | |
| Engaging in paid “work” after school | Yes | 37(80.4) | 48(60.7) | χ2 = 5.172 |
| No | 9(19.5) | 31(39.2) | P = 0.023* | |
| Total | 46(100) | 79(100) | f = 0.203 | |
| Having a boy/girl friend | Yes | 42(91.3) | 67(84.8) | χ2 = 1.099 |
| No | 4(8.6) | 12(15.1) | P = 0.295 | |
| Total | 46(100) | 79(100) | f = 0.094 | |
| Ever had sex before | Yes | 15(32.6) | 19(24) | χ2 = 0.735 |
| No | 31(67.3) | 60(75.9) | P = 0.391 | |
| Total | 46(100) | 79(100) | f=-0.082 | |
| Parental strict monitoring | Yes | 35(76) | 45(56.9) | χ2 = 4.615 |
| No | 11(23.9) | 34(43) | P = 0.032* | |
| Total | 46(100) | 79(100) | f = 0.192 | |
| Parental non-restriction of friends | Yes | 27(58.6) | 28(35.4) | χ2 = 6.379 |
| No | 19(41.3) | 51(64.5) | P = 0.012* | |
| Total | 46(100) | 79(100) | f = 0.226 | |
| Parental trust | Yes | 7(15.2) | 35(44.3) | χ2 = 11.024 |
| No | 39(84.7) | 44(55.6) | P = 0.001* | |
| Total | 46(100) | 79(100) | f=-0,297 | |
| Ever received help to quit | Yes | 33(71.7) | 46(58.2) | χ2 = 2.28 |
| No | 13(28.2) | 33(41.7) | P = 0.13 | |
| Total | 46(100) | 79(100) | f = 0.213 | |
| School location | Rural | 22(47.8) | 48(60.7) | χ2 = 1.974 |
| Urban | 24(52.2) | 31(39.2) | P = 0.16 | |
| Total | 46(100) | 79(100) | f = 0.126 | |
Statistically significant relationship exists between teacher substance abuse (P = 0.01), peer substance abuse (P = 0.004), engaging in “paid work” after school (P = 0.023), parental strict monitoring (0.032), parental non-restriction of friends (P = 0.012) and parental trust (P = 0.001)
Table 5.
Factors independently associated with substance abuse among adolescents in private and private day secondary schools in Katsina State, May 2021
| Variable | Current Use | Test statistic | aOR | 95% CI | P value | |||
|---|---|---|---|---|---|---|---|---|
| Private (n = 79) | Public (n = 46) | Lower | Upper | |||||
| Class | SS1 | 14(17.7) | 2(4.3) | χ2 = 6.778 | 1 | |||
| SS2 | 28(35.4) | 13(28.2) | P = 0.034* | 3.842 | 0.646 | 22.847 | 0.139 | |
| SS3 | 37(46.8) | 31(67.3) | f = 0.233 | 7.216 | 1.325 | 39.284 | 0.022 | |
| Total | 79(100) | 46(100) | ||||||
| Family Type | Monogamous | 40(50.6) | 11(23.9) | χ2 = 8.593 | 5.486 | 1.405 | 21.411 | 0.014 |
| Polygamous | 39(49.3) | 35(76) | P = 0.003* | 1 | ||||
| Total | 79(100) | 46(100) | f = 0.262 | |||||
| Household Size | ≤National Average | 30(37.9) | 9(19.5) | χ2 = 4.59 | 0.381 | 0.089 | 1.628 | 0.193 |
| > National Average | 49(62) | 37(80.4) | P = 0.032* | 1 | ||||
| Total | 79(100) | 46(100) | f = 0.192 | |||||
| Teacher substance abuse | Yes | 26(32.9) | 26(56.5) | χ2 = 6.671 | 2.11 | 0.823 | 5.414 | 0.12 |
| No | 53(67) | 20(43.4) | P = 0.01* | 1 | ||||
| Total | 79(100) | 46(100) | f = 0.231 | |||||
| Peer Substance abuse | Yes | 72(91.1) | 33(71.7) | χ2 = 8.141 | 0.209 | 0.058 | 0.752 | 0.017 |
| No | 7(8.8) | 13(28.2) | P = 0.004* | 1 | ||||
| Total | 79(100) | 46(100) | f=-0.255 | |||||
| Engaging in paid “work” after school | Yes | 48(60.7) | 37(80.4) | χ2 = 5.172 | 1.547 | 0.531 | 4.504 | 0.424 |
| No | 31(39.2) | 9(19.5) | P = 0.023* | 1 | ||||
| Total | 79(100) | 46(100) | f = 0.203 | |||||
| Parental strict monitoring | Yes | 45(56.9) | 35(76) | χ2 = 4.615 | 0.857 | 0.274 | 2.68 | 0.791 |
| No | 34(43) | 11(23.9) | P = 0.032* | 1 | ||||
| Total | 79(100) | 46(100) | f = 0.192 | |||||
| Parental non-restriction of friends | Yes | 28(35.4) | 27(58.6) | χ2 = 6.379 | 2.023 | 0.768 | 5.326 | 0.154 |
| No | 51(64.5) | 19(41.3) | P = 0.012* | 1 | ||||
| Total | 79(100) | 46(100) | f = 0.226 | |||||
| Parental trust | Yes | 35(44.3) | 7(15.2) | χ2 = 11.024 | 0.355 | 0.105 | 1.201 | 0.096 |
| No | 44(55.6) | 39(84.7) | P = 0.001* | 1 | ||||
| Total | 79(100) | 46(100) | f=-0,297 | |||||
*Significant aOR = adjusted Odds ratio
Sociodemographic characteristics of respondents
Prevalence of substance abuse
Common substances abused by adolescents in public and private schools
We found that common substances abused by adolescents include “Shisha” (Hookah), cigarette, codeine-containing cough syrups, tramadol and other prescription medicines, cannabis and alcohol (Fig. 1). In both public and private schools, the commonest substance abused was “Shisha” (Hookah) followed cigarette while alcohol was the least abused substance.
Fig. 1.
Common substances abused by adolescents in public and private Schools in Katsina State, May 2021
Factors associated with substance abuse
Factors independently associated with substance abuse were being in SS3 class (p = 0.022), coming from monogamous family (p = 0.014) and peer substance abuse (p = 0.017).
Discussion
Substance abuse is a global phenomenon. A critical segment of the population (school-going adolescents) is at increased risk of substance abuse and its associated problems. In this study we determined the prevalence and associated factors of substance abuse among adolescents in Katsina State.
In our study, one in every five adolescents has ever used any substance (either cigarette, marijuana, alcohol, cough syrup, “shisha”, or tramadol) in both public and private schools (ever use of any substance/Lifetime use). This is similar to what was reported in a study conducted in two secondary schools in Mushin Local Government Area of Lagos [16], but much lower than what was reported in another study in Ibadan, Southwest, Nigeria [38]. The differences could be due to variation in sociodemographic characteristics, availability and accessibility of these substances to the respondents. The higher value obtained in the study on pattern of substance use among male in-school adolescents in Ibadan, Southwest (quoted above) could be because of differential in ease of access between Southwest and Northwest. One in every twenty adolescents studied had used substance in the past but not anymore. This could be as a result of exposure to health education messages, rehabilitation services or mere lack of access to the substances. One in ten adolescents studied were using substances at the time of the study (pooled current prevalence). This is lower than the figure reported in a cross-sectional study conducted among secondary schools in Ethiopia where one in every six adolescents were using substances at the time of the study [6], and much lower than the value obtained in another study among senior secondary students in Igboora [29], Abakaliki [39], and in Enugu [14]. This difference could be accounted for by the prevailing circumstance of financial access that will enable the students to be able to purchase these substances because in Enugu and Abakaliki, most adolescents are often engaged in “paid work” after school which will enable them purchase these substances with relative ease compared with their Northern counterpart who are almost always dependent on their parents. The significance of this is that while older adolescents can engage in menial jobs after school to improve their economic standing, they need more parental guidance and health education so as to avoid engaging in substance abuse behaviour simply because they can afford to buy illicit drugs and other substances.
We found a statistically significant association between prevalence of substance abuse (current use) and peer substance abuse, household size, family type, teacher substance abuse, parental strict monitoring, parental non-restriction of friends, parental trust and engaging in paid work after school. This finding is similar to what was reported in a cross-sectional study conducted in Harare, Zimbabwe where substance abuse was shown to be associated with having friends that smoke [40]. The similarity could be due to similar behavioural patterns between Nigeria and Zimbabwe as both are on the African sub-region. Parental strict monitoring, Parental permissiveness (non-restriction of friends) and Parental trust have been shown to be significantly associated with substance abuse behaviour. This finding is in contrast with that of a cross-sectional study on the effect of parental monitoring, permissiveness and injunctive norms on substance use among Mexican and Mexican-American adolescents conducted in Vietnam which found no association between parental monitoring and substance abuse behaviour [41]. This difference could be accounted for by the difference in parenting practices between the two countries. In this study, parental substance use showed no association with adolescent substance abuse. This is in agreement with the result of a cross-sectional comparative study done in Jos, Nigeria, where no relationship was found between parental substance abuse and adolescent substance abuse [42]. This is, however, in contrast with that of a cross-sectional study on the influence of perceived parenting on substance initiation among Mexican children, carried out in Mexico which showed that parental illicit substance use was associated with increased risk of substance abuse among study participants [43]. This is could be because parenting is a serious mentoring process where children tend to copy whatever their parents do especially at their formative stage of life regardless of whether it is good or bad as their mental capacity will not allow them to fully appreciate what is good from what is bad at early stage of life. At a later stage during adolescence stage, they may also experiment what they see their parents do. Factors independently associated with substance abuse were peer substance abuse, family type, and class. Those whose peers abuse substances were more likely to abuse substances as well due to copy-cat syndrome, need for acceptance by peers and desire to feel accepted by peers. In addition, those in the higher classes especially SS3 were more likely to be involved with substance abuse because of the feeling that they are the most senior students, who often command other students to do things, usually establish circle of friends that have more independence and possibly better economic standing compared with the rest of the students. As this study is limited to school-going adolescents and specifically older adolescents, its findings could not be generalized to all adolescents. Further studies should consider all adolescents including out-of-school adolescents.
Conclusion
This study was conducted among school-going and as such findings cannot be generalized to all adolescents in Nigeria, hence future studies should focus on all adolescents. Prevalence of substance abuse among adolescents in both public and private day secondary schools in Katsina State was high the value of which was higher in the private than the public. Stakeholders such a NDLEA should organize and sustain sensitization campaign on dangers of substance abuse among adolescents. Principals should identify students who have used substances in the past but have completely stopped for health reasons. These can be used as agents of change in encouraging those who actively use substances to desist from the problem. The State Government through Ministry of education should engage all relevant stakeholders such as parents, religious leaders, media, youth groups and sensitize all stakeholders on their roles in addressing adolescents’ substance abuse in the society.
Acknowledgements
The authors acknowledged the support of the following organizations and distinguished personalities for their kind support and guidance towards this work: Department of Community Medicine, Ahmadu Bello University Zaria; Ahmadu Bello University Teaching Hospital Zaria (ABUTH) Zaria; Katsina State Ministry of Education; Katsina State Primary Healthcare Agency; NDLEA Katsina Office; Professor M. B. Sufiyan; Professor A. A. Abubakar; All the entire staff of the department of Community Medicine; All the Principals of the schools sampled and all the Co-authors.
Author contributions
AL (Principal investigator): Proposed, designed and implemented the study, did the analysis and write-up. SBA, AAO, KLH, BU, AA, SKA, SY, and NSN: Contributed in the conception and design of the proposal, analysis and interpretation of data. LA, ZBS, SB, HI, and UMU, critically edit and approved the draft manuscript. BMJ, SSB, and AA,: Made significant contributions in design, interpretation of data, involved in revising and approved the final manuscript. FAS, MBS and AA: Participated sufficiently in analysis and interpretation of data, critically edit and approved the final manuscript. All authors read and approved the final manuscript.
Funding
The research was self-funded by the authors, with no form of funding by any organization.
Data availability
All components of data related to the research are available with the primary author Lawal Aminu, danmusaone60@gmail.com.
Declarations
Ethics approval and consent to participate
In accordance with the Declaration of “Helsinki” all research protocols were approved by the Health and Research Ethics Committee of Katsina State Ministry of Health bearing HREC number MOH/ADM/SUB/1152/1/357. Participants’ autonomy to make informed choice on whether to participate in the research or not was fully respected. Participants were assured of confidentiality of information provided while adequate explanation on possible risks and benefits were fully explained to the participants. Although there was no risk posed by participating in the research, the benefit of participating in the research which involves making use of the findings to drive policy change was fully explained to the participants. Participants were made to understand that no compensation would be provided for the time spent responding to the questions. Furthermore, this research was conducted by a team of researchers with ethical and scientific knowledge, training and qualification in the subject area.
Informed consent
was obtained from all subjects and/or their legal guardian(s) in accordance with the Nuremberg Code.
Consent for publication
Not Applicable.
Competing interests
The authors declare no competing interests.
Footnotes
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
All components of data related to the research are available with the primary author Lawal Aminu, danmusaone60@gmail.com.