Health Education and Behavioral Science Unit, School of Public Health, Mekelle University, Mekelle 1871, Ethiopia.
Psychiatry Department, School of Medicine, Mekelle University, Mekelle 1871, Ethiopia.
Int J Environ Res Public Health. 2020 Jan 29;17(3):847. doi: 10.3390/ijerph17030847.
Psychoactive substance use is a major public health concern globally. Though youth attending higher education institutions are considered particularly vulnerable to psychoactive substances, there is a paucity of evidence in Ethiopia. We aimed to determine the prevalence of psychoactive substance use, factors associated with psychoactive substance use and level of dependence among Mekelle University undergraduate students in Ethiopia.
An institution-based quantitative cross-sectional survey was used to randomly (using multistage sampling) invite 1220 undergraduate students in April and May 2017 to participate. Multinomial logistic regression was used to identify factors associated with psychoactive substance use. Level of dependence was determined using the WHO's Alcohol, Smoking and Substance Involvement Screening Test classification.
Among the eligible students approached, 1214 participants completed the survey, which yields a 99.5% response rate. The lifetime prevalence of psychoactive substance use was 66.5% (95% Confidence Interval (CI) = 64% to 69%) while the current prevalence was 49% (95% CI = 46% to 52%). A history of, but not current, psychoactive substance use was reported by 18%, while 33.5% reported never having used psychoactive substances. The current prevalence of alcohol use was 35.5%, tobacco 7.8% and khat 5.7%. Of the current users, 17% (95% CI = 14% to 20%) were at a moderate to high risk of dependency. Being over 21 years of age (adjusted odds ratio (AOR) = 1.6, 95% CI = 1.37 to 2.25), male (AOR = 3.13; 95% CI = 2.26 to 4.34), living in urban areas (AOR = 2.39, 95% CI = 1.77 to 3.23), an Orthodox Christian (AOR = 7.55, 95% CI = 4.56 to 12.48), and being in their 3rd year (AOR = 2.3, 95% CI = 1.49 to 3.55), 4th year (AOR = 2.0, 95% CI = 1.2 to 3.51) and 5th year (AOR = 4.0, 95% CI = 2.81 to 7.67) at university were associated with currently using psychoactive substances. Being male and Orthodox Christian was associated with being an ex-smoker.
Approximately half of Mekelle University undergraduate students were using psychoactive substances with almost one in five at risk of dependency. The likelihood of use increased with seniority. Evidence-based strategies are needed to prevent school-aged children from using psychoactive substances and university students becoming dependent on substances. Interventions designed to stop current psychoactive substance use may also have promise for reducing dependency.
精神活性物质的使用是一个全球性的主要公共卫生问题。尽管在全球范围内，接受高等教育机构教育的年轻人被认为特别容易受到精神活性物质的影响，但在埃塞俄比亚，这方面的证据仍然很少。我们旨在确定梅克莱大学本科生精神活性物质使用的流行率、与精神活性物质使用相关的因素以及依赖程度。
采用基于机构的定量横断面调查，于 2017 年 4 月至 5 月间使用多阶段抽样方法随机邀请 1220 名本科生参加。使用多项逻辑回归来确定与精神活性物质使用相关的因素。使用世界卫生组织的酒精、吸烟和物质使用筛查测试分类来确定依赖程度。
在合格的被调查学生中，有 1214 名学生完成了调查，应答率为 99.5%。精神活性物质使用的终生患病率为 66.5%（95%置信区间（CI）=64%至 69%），而目前的患病率为 49%（95%CI=46%至 52%）。18%的人报告有过但没有目前有精神活性物质使用史，而 33.5%的人报告从未使用过精神活性物质。目前的酒精使用率为 35.5%，烟草使用率为 7.8%，卡特使用率为 5.7%。在目前的使用者中，17%（95%CI=14%至 20%）处于中等到高度依赖的风险中。年龄在 21 岁以上（调整后的优势比（AOR）=1.6，95%CI=1.37 至 2.25）、男性（AOR=3.13；95%CI=2.26 至 4.34）、居住在城市地区（AOR=2.39，95%CI=1.77 至 3.23）、东正教信徒（AOR=7.55，95%CI=4.56 至 12.48）、大三（AOR=2.3，95%CI=1.49 至 3.55）、大四（AOR=2.0，95%CI=1.2 至 3.51）和大五（AOR=4.0，95%CI=2.81 至 7.67）与目前使用精神活性物质有关。男性和东正教信仰与曾吸烟有关。
大约一半的梅克莱大学本科生正在使用精神活性物质，其中近五分之一的人有依赖的风险。使用的可能性随着年龄的增长而增加。需要制定基于证据的策略，防止学龄儿童使用精神活性物质，防止大学生对物质产生依赖。旨在停止目前精神活性物质使用的干预措施也可能有望减少依赖。
