Substance use amongst high school learners in Atteridgeville, Pretoria : prevalence and associated factors

Abstract

Introduction. Anecdotal evidence suggested the existence of a serious substance use problem amongst learners in Atteridgeville. As substance use amongst this age group may have serious short and long term biological, psychological and social consequences, it was important that the extent of the problem in Atteridgeville be formally established and understood in order for it to be addressed. The primary objectives of this study were to determine the prevalence of substance use and the factors associated with alcohol and cannabis use amongst high school learners in Atteridgeville. Methods: This was a cross-sectional study of learners and life-orientation teachers at the 9 secondary schools in Atteridgeville. A cluster sampling technique was employed. Twenty two (22) of the total of 191 grade 8 to grade 11 classes in Atteridgeville were randomly selected to participate. All of the 895 learners in the selected 22 classes were invited to participate in the learner survey and the life orientation teachers of the selected classes were invited to participate in the educator survey. Data was collected in August 2009 using self-administered questionnaires. Data collected from learners included their sociodemographic characteristics, socio-economic characteristics, scholastic characteristics, substance use, substance related knowledge, substance related attitudes and perceptions, life skills, and drug and alcohol use among family and friends. Data collected from teachers included their perceptions of substance use at their school, the resources currently available at their school to address the problem and the interventions they thought were needed to deal with substance use at their respective schools. Survey estimation commands in STATA 10.0 were used to obtain substance use prevalence rates. Pearson’s chi squared test statistic and binary logistic regression were used to determine factors associated alcohol and cannabis use amongst the learners. Results. Alcohol was found to be the most commonly used substance amongst learners in Atteridgeville. For alcohol use, a lifetime prevalence rate of 51.4% (95% confidence interval (CI) 41.5 – 61.5) and a past month prevalence rate of 18.1% (CI 10.8 – 25.4) were reported. Cigarette smoking was the second most prevalent form of substance use with a lifetime prevalence rate of cigarette smoking in this study of 25.2% (CI 17.1 - 33.3) and past month prevalence of cigarette use of 12.4% (CI 6.8 – 17.9). Cannabis was found to be the most commonly used illicit drug amongst the learners, with a prevalence rate of lifetime use of cannabis of 13.2% (CI 8.3 – 18.2) and of past month use of cannabis of 5.3% (CI 2.2 – 8.4). Glue and nyaope had lifetime prevalence rates of 6.4% (CI 4.0 – 8.8) and 2.9% (CI 1.1 – 4.8) respectively. Alcohol was found to have the lowest mean age of initiation at 14.6 years (standard deviation (SD) = 2.0), followed by cigarette smoking at 14.8 years (SD = 2.3) and cannabis at 15.1 years (SD = 2.2). Following multivariate analysis, the factors found to be associated with significantly higher odds of lifetime alcohol use amongst learners were lifetime cigarette use (OR 6.64; CI 2.15 - 20.51), lifetime cannabis use (OR 11.16; CI 2.33 – 53.55), a history of one or both parents who consume alcohol regularly (OR 2.04; CI 1.07 - 3.91) and the number of alcohol users amongst the learners’ five closest friends (OR 1.70; CI 1.49 -1.94). The factors found to be associated with significantly lower odds of lifetime alcohol use amongst learners were being absent from school for less than 3 days in the first 2 terms (OR 0.37; CI 0.20 – 0.69) and being in grade 8 (OR 0.29; CI 0.14 - 0.60). The factors found to be associated with lifetime use of cannabis following multivariate analysis were age category of 17 and older (OR 4.29; CI 1.83 – 10.04), male gender (OR 22.60; CI 7.17 – 71.27), history of drug use by an older sibling (OR 4.21; CI 1.55 – 11.43), number of illicit drug users amongst learners’ 5 closest friends (OR 1.63; CI 1.17 – 2.27), lifetime alcohol use (OR 19.98; CI 6.64 – 60.06) and lifetime cigarette use (OR 6.80; CI 2.72 – 17.01). Conclusion: The results of this study have confirmed that the concerns regarding substance use amongst learners in Atteridgeville are not unfounded. The clustering of alcohol, cannabis and cigarette use in the same individuals was found to be significant i.e. learners who use one of these substances are more likely to report use of the other substances. The study findings also confirm the important role peers play in substance use. The findings of the study suggest that preventative and therapeutic interventions are required to address the problem of substance use amongst learners in Atteridgeville. Copyright