Prevalence and Correlates of Substance Use Among High School Students in South Africa and the United States

Medical Research Council, Cape Town, South Africa.
American Journal of Public Health (Impact Factor: 4.55). 11/2007; 97(10):1859-64. DOI: 10.2105/AJPH.2006.086330
Source: PubMed


We compared prevalence rates and correlates of substance use among high school students in South Africa and the United States.
We used weighted data from 2 nationally representative surveys of high school students. We conducted bivariate and multivariate analyses and examined between-country differences in rates and correlates of substance use were examined.
Rates of past-month alcohol and marijuana use were lower among South African students than among US students, but rates of illicit hard drug use were higher. Correlates of use in the 2 countries differed. For example, female gender was protective against tobacco, alcohol, and marijuana use in South Africa, whereas in the United States it was protective only against marijuana use. Black race/ethnicity was associated with lower rates of past-month cigarette and alcohol use in both countries, but the protective effect for alcohol use was stronger in South Africa.
Crosscultural studies can elucidate common and culturally unique pathways to drug use. Our results can inform future research, policies, and behavioral interventions in South Africa.

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Available from: Riyadh Omardien, Mar 28, 2014
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    • "Acuda and Eide [5] also reported in Zimbabwe that cannabis use prevalence increased with age in urban and rural secondary schools. In South Africa, Reddy et al. [9] observed that cannabis use was positively related to age. "
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    ABSTRACT: Cannabis dependence in adolescents predicts increased risks of using other illicit drugs, poor academic performance and reporting psychotic symptoms. The prevalence of cannabis use was estimated two decades ago in Zambia among secondary school students. There are no recent estimates of the extent of the problem; further, correlates for its use have not been documented in Zambia. The objective of study was to estimate the current prevalence of cannabis use and its socio-demographic correlates among in-school adolescents. We conducted secondary analysis of data that was obtained from the 2004 Zambia Global School-Based Health Survey. Logistic regression analysis was conducted to identify the socio-demographic factors associated with cannabis use. A total of 2,257 adolescents participated in the survey of which 53.9% were females. The overall prevalence of self reported ever-used cannabis was 37.2% (34.5% among males and 39.5% among females). In multivariate analysis, males were 8% (AOR = 0.92; 95% CI [0.89, 0.95]) less likely to have ever smoked cannabis. Compared to adolescents aged 16 years or older, adolescents aged 14 years were 45% (AOR = 1.45; 95% CI [1.37, 1.55]) more likely, and those aged 15 years were 44% (AOR = 0.56; 95% CI [0.53, 0.60]) less likely to report to have ever smoked cannabis. Other factors that were significantly associated with cannabis use were history of having engaged in sexual intercourse (AOR = 2.55; 95% CI [2.46, 2.64]), alcohol use (AOR = 4.38; 95% CI [4.24, 4.53]), and having been bullied (AOR = 1.77; 95% CI [1.71, 1.83]). Adolescents who reported being supervised by parents during free time were less likely to have smoked cannabis (AOR = 0.92; 95% CI [0.88, 0.95]). The use of cannabis is prevalent among Zambian in-school adolescents. Efforts to prevent adolescents’ psychoactive drug use in Zambia should be designed considering the significant factors associated with drug use in the current study.
    Italian Journal of Pediatrics 02/2013; 39(1):13. DOI:10.1186/1824-7288-39-13 · 1.52 Impact Factor
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    • "Consistent with previous reports, the prevalence of the substance use was higher among boys than girls [19,20,23,26,36] and increased with age [19,23]. The gender difference may be partly attributed to socio-cultural norms that tend to stigmatize girls who engage in substance use [19] and/or to larger innate risk taking by males than females [37]. "
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    ABSTRACT: We examined the associations between substance use (cigarette smoking, alcohol drinking, and cannabis use) and psychosocial characteristics at the individual and family levels among adolescents of the Seychelles, a rapidly developing small island state in the African region. A school survey was conducted in a representative sample of 1432 students aged 11-17 years from all secondary schools. Data came from a self-administered anonymous questionnaire conducted along a standard methodology (Global School-based Health Survey, GSHS). Risk behaviors and psychosocial characteristics were dichotomized. Association analyses were adjusted for a possible classroom effect. The prevalence of cigarette smoking, alcohol drinking and cannabis use was higher in boys than in girls and increased with age. Age-adjusted and multivariate analyses showed that several individual level characteristics (e.g. suicidal ideation and truancy) and family level characteristics (e.g. poor parental monitoring) were associated with substance use among students. Our results suggest that health promotion programs should simultaneously address multiple risk behaviors and take into account a wide range of psychosocial characteristics of the students at the individual and family levels.
    BMC Pediatrics 10/2011; 11(1):85. DOI:10.1186/1471-2431-11-85 · 1.93 Impact Factor
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    • "Not surprisingly, substance use increased significantly with each measurement time point from the beginning of the eighth grade to the beginning of the eleventh grade. By eleventh grade, 64% of males and 58% of females reported having drunk alcohol in the previous 4 weeks, which is a higher percentage than reported in previous research in South Africa (Flisher et al., 2006; Flisher, Parry, Evans, Muller, & Lombard, 2003; Reddy et al., 2007). The higher prevalence of alcohol use in our study is likely due to our focus on Mitchell's Plain, a low-resource, high-risk community in South Africa. "
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    ABSTRACT: Using seven waves of data, collected twice a year from the 8th through the 11th grades in a low-resource community in Cape Town, South Africa, we aimed to describe the developmental trends in three specific leisure experiences (leisure boredom, new leisure interests, and healthy leisure) and substance use (cigarettes, alcohol, and marijuana) behaviors and to investigate the ways in which changes in leisure experiences predict changes in substance use behaviors over time. Results indicated that adolescents' substance use increased significantly across adolescence, but that leisure experiences remained fairly stable over time. We also found that adolescent leisure experiences predicted baseline substance use and that changes in leisure experiences predicted changes in substance use behaviors over time, with leisure boredom emerging as the most consistent and strongest predictor of alcohol, cigarette, and marijuana use. Implications for interventions that target time use and leisure experiences are discussed.
    International Journal of Behavioral Development 07/2011; 35(4):343-351. DOI:10.1177/0165025411404494 · 1.58 Impact Factor
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