Psychosocial correlates of substance use among adolescents in Mersin, Turkey

Substance Use, Alcohol Consumption, and Smoking Prevalence Amongst Medical Students in Erbil, Iraq

BACKGROUND

A significant proportion of medical students engage in the illicit use of drugs and indulge in heavy alcohol consumption. The utilization of substances during medical school frequently has repercussions on both the personal and professional lives of students. Therefore, we aimed to investigate the extent of substance use, alcohol consumption, and smoking among medical students in Erbil City.

METHODS

An observational cross-sectional study was conducted at Hawler Medical University (HMU) for this purpose. The study involved 368 students from stages one to six. The questionnaire covered sociodemographic information, Drug Use Disorders Identification Test (DUDIT), Alcohol Use Disorders Identification Test (AUDIT), and Fagerstrom Test for Nicotine Dependence (FTND) scales. The data was analyzed using Microsoft Excel 2016 and IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States).

RESULTS

A total of 368 students were involved in the study. The mean age (SD) of the respondents was 20.92 (2.01) years; 191 (51.9%) participants were males. Thirty-two (8.7%) students have used substance in the last 12 months; 10 (31.2%) of them were non-problematic drug users, 20 (62.5%) were problematic drug users, and 2 (6.3%) were dependent users. Twenty-nine (7.9%) students were alcohol users; 17 (58.7%) were categorized as low-risk users, 5 (17.2%) as hazardous users, and 7 (24.1%) as dependent users. Regarding smoking, 45 (12.2%) students were smokers, among this group, 27 (60%) were categorized as having low dependence, and 18 (40%) had high dependence.

CONCLUSION

The findings suggest a worrying trend of substance misuse among university students. There is a critical need for targeted preventive interventions that address these issues to enhance student health and educational outcomes.

Prevalence of Cigarette Smoking and Influence of Associated Factors among Students of the University of Banja Luka: A Cross-Sectional Study

Background and Objectives: Cigarette smoking among the youth population has increased significantly in developing countries, including Bosnia and Herzegovina. However, no extant literature assesses the prevalence of tobacco use, nor identifies factors associated with smoking. This study determined the prevalence of cigarette smoking among a specific cohort of students and assessed factors related to tobacco use in this population. Materials and Methods: This cross-sectional study included 1200 students at all faculties of Banja Luka University. Data were collected from questionnaires adapted from the Global Youth Tobacco Survey (GYTS) and the Global Health Professional Student Survey (GHPSS) standardized questionnaires and were analyzed using descriptive statistics, Pearson's χ2 test, and logistic regression. Results: When the prevalence of cigarette smoking within the last thirty days was recorded, we found that 34.1% of students smoked within this period. Nearly three-quarters (74.9%) of the student population had smoked or experimented with cigarette smoking. However, medical students were 27.2% less likely to smoke than their counterparts from other faculties. Overall, 87% of all students were aware of the harmful effects of cigarette smoking, 79% were aware of the harmful effects of secondhand smoke, and 65% reported that it was difficult to quit. Increased spending of personal money was associated with a higher probability of smoking, while exposure to secondhand smoke increased the odds of smoking by 62%. Conclusion: Policies, strategies, and action plans should be introduced in order to reduce the prevalence of smoking among university students and to create a smoke-free environment at the various universities involved.

Stigmatization of people with alcohol and drug addiction among Turkish undergraduate students

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Females were more fearful of people with alcohol, marijuana and heroin addiction than males.

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Younger compared to older participants perceived those with substance addiction as more dangerous.

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Younger participants were more fearful of people with substance addiction than older participants.

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Younger than older participants had higher social distance towards people who are addicted to alcohol and marijuana.

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Perceived dangerousness and fearfulness partially mediated the relationship between stigma and social distance.

Introduction

Stigmatization of people with substance use problems have been reported to be high among young adults in Western countries. It is not clear if this finding could be replicated among emerging adults in non-Western countries. Thus, the aim of this study was to firstly explore stigmatizing attitudes of undergraduate students in Turkey towards people with alcohol, marijuana and heroin addiction, and then test a mediation model to explain stigmatizing attitudes among college students.

Method

A total of 513 undergraduate students participated in the study. They completed a set of questionnaires to measure perceived stigma towards substance use, perceived danger and feeling fearful towards people with substance addiction (i.e., alcohol, heroin, marijuana), and a willingness to engage in relationships with people who are addicted to these three substances.

Results

Females, compared to males, reported being more fearful of people who are addicted to alcohol, marijuana and heroin. Younger compared to older participants perceived people who are addicted to these substances as more dangerous. Younger participants also had higher social distance towards people who are addicted to alcohol and marijuana than older participants. Perceived dangerousness and fearfulness partially mediated the relationship between perceived stigma and social distance in alcohol, marijuana and heroin.

Conclusion

Research findings may help determine potential correlates of stigmatizing attitudes as well as developing models to explain stigmatizing attitudes among Turkish college students.

A Systematic Review of Household and Family Alcohol Use and Adolescent Behavioural Outcomes in Low- and Middle-Income Countries

Exposure to alcohol misuse is considered an adverse childhood experience impacting on neurodevelopmental and behavioural outcomes in adolescents including substance use, mental illness, problem behaviours, suicidality, and teenage pregnancy. Most research on this issue has focussed on higher income countries, whereas patterns of alcohol use and related factors may be different in low- and middle-income countries (LMICs). This systematic review therefore seeks to collate all published studies from 1990-2020 on the topic set in LMICs. 43 studies were included, totalling 70,609 participants from 18 LMICs. Outcomes assessed included: substance use; depression/anxiety; suicidal ideation; problem behaviour; emotional dysfunction; teenage pregnancy; and self-harm. Despite heterogeneity in the studies identified, this review documented some association between exposure to household alcohol misuse and adverse adolescent outcomes in LMICs, including mental health problems, problem behaviours, and suicidality. The mechanisms leading to these outcomes are likely varied, and further research in different socio-economic and cultural contexts, particularly in the form of longitudinal studies, is called for.

Tobacco use: the main predictor of illicit substances use among young adolescents in Sousse, Tunisia

Introduction Early adolescence is a critical period usually associated with experimentation with illicit substances. In Tunisia few studies explored these risk behaviors among young adolescents. Aims To evaluate the prevalence and the predictors of the use of illicit substances among the young adolescents of Sousse. Methods A cross-sectional study was conducted in the region of Sousse, Tunisia during the 2013/2014 school year among 4272 schoolchildren in 16 public middle schools. Data about psychosocial characteristics and risk behaviors among the schoolchildren, their parents, their siblings and their friends were collected anonymously using a self-administrated questionnaire. Results Females represented 50.5% of participants. The mean age of schoolchildren was 13.3 (±1.2) years. Lifetime illicit substances use prevalence was 2.9% [confidence interval (CI) 95%: (2.4%-3.4%)] and lifetime use of tobacco prevalence was 12.9% [CI 95%: (11.9%-13.9%)]. The age of tobacco onset was significantly younger to the age of experimentation with illicit substances. Insomnia, sadness and illicit substances use among peers were associated with illicit substances use among participants. While the most influential risk factor on illicit substances use was current cigarette smoking with an adjusted odds ratio (OR) of 7.2 [CI 95%: (4.5-11.2)]. Conclusion A national substances use prevention program should be implemented in the schools of Tunisia with an emphasis on tobacco use prevention.

Evaluation of Risk Factors Affecting Substance Use among Tenth-Grade Students

Aim

The aim of this study is to detect the prevalence of substance use among tenth-grade students; their thoughts, attitudes, behaviors, and tendencies towards substance use; and risk factors of substance use in tenth-grade students in general.

Methods

This study is descriptive and cross-sectional conducted between April and May 2016. Research population consists of tenth-grade students in 2015-2016 school year in the city of Ordu. Since the study involved all tenth-grade students, no sampling was done. Questions on substance use were prepared by Ordu Public Health Directorate and the authors by making use of European School Survey Project on Alcohol and Other Drugs (ESPAD) study questions, AMATEM's “Drugs and Addiction Youth Survey” study conducted on May 1996, and scientific studies conducted previously on similar subjects.

Results

9825 tenth-grade students in 88 schools from 19 counties in the city of Ordu were included in the study. 8714 of the students participated in the survey. Being male, being over the age of 15, mother and father being separated, living with relatives, being in low income, negative feelings about school, perception of being unsuccessful in school, failing a year, absenteeism, and not being content with life are the risk factors for substance use.

Conclusions

The tendency of illegal substance use becoming more and more prevalent especially among youth requires the development of new treatment strategies.

Illicit substance use among Tunisian college students: prevalence and risk factors

Background Illicit substance use among college students represents one of the most complicated social problems. Studying its predictors could help deal with this problem more efficiently. Aims To determine the prevalence of life time illicit substance use and its predictors among Tunisian college students. Methods A cross-sectional study was conducted in five colleges in the region of Sousse, Tunisia in the 2012-2013 school year. A sample of 556 college students responded to an anonymous self-administrated questionnaire. Collected data concerned socio-demographic characteristics and substances use. Results The mean age of students was 21.8 ± 2.2 years. Females represented 51.8% of participants. Among respondents: 31 (5.6%) had used illicit substance at least once. Cannabis was the main substance used by 26 (4.7%) students. The average age of the illicit substance use initiation was 19 (±2.5) years while it was almost 17 (±3) years for both tobacco and alcohol use initiations. Proportions of male students and academic failure were significantly more important among illicit substance users than among non users. While the most influential factors on illicit substance use were: alcohol use, tobacco use and low socioeconomic level. Conclusion This study highlights the strong association between the other risk behaviors and illicit drug use. Future interventions should focus on the whole risk behaviors simultaneously at late adolescence with regard to the environmental context.

Smoking, alcohol, and substance use and rates of quitting during pregnancy: is it hard to quit?

Background

Alcohol and substance use is a major health challenge in Turkey, as it is worldwide. Recently, there has been a rapid increase in the number of females using substances and although usage tends to reduce during pregnancy, it is of critical importance to determine its exact level as substance use negatively impacts on the health of both the mother and infant.

Aim

The aim of the present study was to investigate the frequency of smoking, alcohol, and substance use, and quitting rates during pregnancy.

Method

This study was conducted on pregnant females in Sakarya, Turkey. A total of 1,082 consecutively presenting females who agreed to participate in the study were evaluated. The study team prepared a sociodemographic data form and adapted the “Introduction” section, derived from the Addiction Profile Index, to cover substance use during pregnancy.

Results

The substances most frequently used by pregnant females in their previous pregnancies and current pregnancies were cigarettes/tobacco products (11% and 11.8%, respectively), alcohol (0.6% and 0.4%, respectively), and rarely, synthetic cannabinoids (0.3% and 0.2%, respectively). Daily tobacco smokers continued to smoke during pregnancy, with a rate of 42.5%. Based on research into predictors of smoking (cigarettes) in pregnancy, a correlation was found between lifetime smoking and smoking during a previous pregnancy. A similar link was found with respect to alcohol.

Conclusion

Cigarettes are the most frequently used substance in pregnancy, and to a lesser extent, alcohol and synthetic cannabinoids, also considered to be risky substances. A high incidence of smoking regularly during pregnancy was found in daily smokers. It is recommended that physicians should sensitively ask pregnant females presenting at clinics about all forms of substance use, including alcohol and synthetic cannabinoids, and to include such questions in their routine enquiries.

Alcohol and Psychoactive Substance Use among University Students in Edirne and Related Parameters

INTRODUCTION

Alcohol and psychoactive substance use and their effects are an important issue among adolescents and young adults. Different results have been reported about the frequency of alcohol and psychoactive substance use among university students in studies conducted both in Turkey and in different places worldwide.

METHODS

The frequency of alcohol and psychoactive substance use among Trakya University students (n=1385) and the related parameters were studied cross-sectionally using a self-reporting questionnaire.

RESULTS

Alcohol was the most common substance used (30%), followed by tobacco (29.9%) and marijuana (3.1%). The frequency of alcohol and psychoactive substance use was found to be higher among males with higher amounts of pocket money, whose parents experienced more conflict in their relationship, and who belong to families with a higher education and income level.

CONCLUSION

The frequency of alcohol and psychoactive substance use among Trakya University students was found to be lower than other regions in Turkey and particularly lower than the levels reported in studies conducted in other countries.

Prevalence of substance use among moroccan adolescents and association with academic achievement

AIM: To investigate rates of drug and alcohol use and their association with academic performance in Moroccan youth.

METHODS: An adapted version of the European School Project on Alcohol and Other Drugs survey was administered to 2139 10^th-12^th graders in 36 Moroccan public high schools. Two multiple logistic regressions were completed, one for male and one for female subjects. Grade average was used as a two-part outcome variable, and drug use was used as a four-level categorical independent variable. Parents’ education levels and socioeconomic status were included as covariates.

RESULTS: Of the subjects, 181 girls (16%) and 390 boys (40%) reported ever having used alcohol, hashish, or psychotropic drugs. Girls who had used any of those substances in the past 30 d demonstrated an adjusted odds ratio (AOR) of 2.62 (95%CI: 1.31-5.22) of having average or below-average grades, and those with any lifetime use showed an AOR of 1.72 (95%CI: 1.07-2.77). Among the boys, use in the past 30 d was associated with an AOR of 2.08 (95%CI: 1.33-3.24) of average or below average grades, and use in the last 12 mo with an AOR of 1.74 (95%CI: 1.00-3.05). Any lifetime use among male and previous 12 mo use among female subjects were not significantly associated with academic achievement.

CONCLUSION: Among Moroccan adolescents, drug use is substantially different between boys and girls. In both genders, lower academic achievement was associated with alcohol, hashish, or psychotropic drug use in the last 30 d.

The role of cultural interaction in Tianeptine Abuse and Different Tianeptine Application Methods

Tianeptine is a selective serotonin reuptake enhancer, possessing strong antidepressant and anxiolytic properties. Its relative lack of sedative, anticholinergic and cardiovascular side effects makes it a highly tolerable substance of abuse. However, physical dependence quickly develops and withdrawal symptoms are common. Abusers in Georgia and Armenia use tianeptine by intravenous injection. Drug abusing behaviour usually starts during puberty, since it stems from psychological, social and cultural circumstances. Sociodemographic studies show that drug abusing behaviour in Turkey varies according to region and substance. This paper investigates differences between Georgian foreigners and the local population in the eastern Black Sea region in terms of tianeptine abuse and discusses complications resulting from intravenous injection of tiapentine.

Beyond primary prevention of alcohol use: a culturally specific secondary prevention program for Mexican heritage adolescents

Classroom-based primary prevention programs with adolescents are effective in inhibiting the onset of drug use, but these programs are not designed to directly address the unique needs of adolescents at higher risk of use or already using alcohol and other drugs. This article describes the initial efficacy evaluation of a companion psychosocial small group program which aims at addressing the needs of Mexican heritage students identified by their teachers as being at higher risk for substance use or already experimenting with alcohol and other drugs. The adolescent (7th grade) small group curricula, REAL Groups, is a secondary prevention program which supplements the primary classroom-based substance use prevention program, keepin' it REAL. Following a mutual aid approach, a total of 109 7th grade students were referred by their teachers and participated in the REAL Groups. The remaining 252 7th grade students who did not participate served as the control group. To account for biased selection into REAL Groups, propensity score matching (PSM) was employed. The estimated average treatment effect for participants' use of alcohol was calculated at the end of the 8th grade. Results indicate that alcohol use decreased among students who participated in the REAL Groups relative to matched students who did not participate. These findings suggest that REAL Groups may be an effective secondary prevention program for higher-risk Mexican heritage adolescents.

Smoking determinants in Turkish university students

The aim was to explore the prevalence and the correlates of smoking in a group of Turkish university students. A sample of 1,870 students (21.2 ± 2.0 years old) completed the Beck Depression Inventory, Beck Hopelessness Scale, Anxiety Sensitivity Index, 20-item Toronto Alexithymia Scale. Smoking was highly prevalent (35.9%) in this sample. Male gender (OR = 2.72, CI 2.15–3.44), and parental smoking (OR = 1.41, CI 1.13–1.78) were factors associated with increased likelihood of smoking. Higher depressive symptoms and hopelessness levels were significantly related to smoking behavior. Smoking behavior might initiate as a mild and transient habit and unfortunately could become more serious and lead to an actual dependence. The results of this study show that it is necessary to pay attention to levels of depression and hopelessness, as well as parental influence.

Correlates of family, school, and peer variables with adolescent substance use in Taiwan

This study examines adolescent substance use in relation to family, peer and school factors in the context of Taiwan. Information on family characteristics, satisfaction with performance at school, and peer influence was collected using a case-control study in which a two-stage method was applied to ascertain substance use. A set of hypotheses on interrelationships of substance use (tobacco, alcohol, betel, illicit drugs) and influences were tested with a structural equation model. There was a strong negative relation between family factors and peer relationships (p=0.005). Family variables played an important role in motivation and effort to study (p=0.004). High motivation and effort to study (p=0.0012) and good school adjustment (p=0.078) led to higher satisfaction with performance at school. A significant positive association between peer relationships and deviant peer behaviour was observed (p<0.001). Satisfaction with performance at school was negatively related to deviant peer behaviour (p=0.052). The direct effect of deviant peer behaviour was marginally statistically significant (p=0.011) and an indirect effect of family factors on substance use was statistically significant (p=0.041). In conclusion, the study found that a strong family-peer relationship and family influence has a significant effect on substance use.

Psychiatric and psychosocial predictors of substance use disorders among adolescents: longitudinal study

BACKGROUND

Few studies have prospectively examined psychosocial and psychiatric predictors of adolescent substance use disorders simultaneously.

AIMS

To identify psychosocial and psychiatric predictors of substance use disorders in adolescence.

METHOD

School children aged 12 years (s.d.=0.3) free from any substance use disorder at grade 7 (n=428) were assessed in three consecutive years, using a standardised psychiatric interview. Their baseline psychosocial information was also collected. The outcome was the onset age of a substance use disorder. The Cox regression model was used for data analysis.

RESULTS

The most significant predictive factors for adolescent substance use disorder included male gender, attention-deficit hyperactivity disorder, conduct disorder and sibling use of tobacco. Three protective factors against such morbidity included living in a household with two parents, a good academic grade at grade 7 and objection to the use of substances.

CONCLUSIONS

Early intervention for disruptive behaviour disorders and specific psychosocial risk factors might prevent substance use disorders in early adolescence.

Which sociodemographic factors are important on smoking behaviour of high school students? The contribution of classification and regression tree methodology in a broad epidemiological survey

BACKGROUND

The purpose of this study is to evaluate the most important sociodemographic factors on smoking status of high school students using a broad randomised epidemiological survey.

METHODS

Using in-class, self administered questionnaire about their sociodemographic variables and smoking behaviour, a representative sample of total 3304 students of preparatory, 9th, 10th, and 11th grades, from 22 randomly selected schools of Mersin, were evaluated and discriminative factors have been determined using appropriate statistics. In addition to binary logistic regression analysis, the study evaluated combined effects of these factors using classification and regression tree methodology, as a new statistical method.

RESULTS

The data showed that 38% of the students reported lifetime smoking and 16.9% of them reported current smoking with a male predominancy and increasing prevalence by age. Second hand smoking was reported at a 74.3% frequency with father predominance (56.6%). The significantly important factors that affect current smoking in these age groups were increased by household size, late birth rank, certain school types, low academic performance, increased second hand smoking, and stress (especially reported as separation from a close friend or because of violence at home). Classification and regression tree methodology showed the importance of some neglected sociodemographic factors with a good classification capacity.

CONCLUSIONS

It was concluded that, as closely related with sociocultural factors, smoking was a common problem in this young population, generating important academic and social burden in youth life and with increasing data about this behaviour and using new statistical methods, effective coping strategies could be composed.