|Year : 2022 | Volume
| Issue : 1 | Page : 23-30
Knowledge, Attitude, and Practice of Substance Use in Nigeria among Secondary School Students
Adibe Maxwell Ogochukwu, Anene-Okeke Chigozie Gloria, Igboeli Nneka Uchenna, Anosike Chibueze
Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
|Date of Submission||28-Dec-2020|
|Date of Decision||05-May-2021|
|Date of Acceptance||29-Jul-2021|
|Date of Web Publication||18-Oct-2022|
Anene-Okeke Chigozie Gloria
Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Enugu State
Source of Support: None, Conflict of Interest: None
Background: The use of drugs by teenagers is a major health concern globally. At this transitional point, secondary school students are the most vulnerable and are susceptible to risks associated with lack of knowledge of substance use. Objective: The objective of this study was to evaluate the knowledge, attitude, and practice of substance use among Nsukka secondary school students. Methods: This was a cross-sectional study using a validated, self-administered questionnaire, comprising seven sections: demographic characteristics, knowledge of substance use, attitude toward substance use, practice of substance use, contributing factors, effects of substance use, and commonly used substance. Using IBM SPSS Statistics 20, the data were analyzed. To summarize the data, descriptive analysis (frequency, percentage, mean, and standard deviations) was used. Results: Over half of the respondents were female (57.5%) and were junior secondary school students (62.2%). Most of the respondents (80%) were conscious of substance abuse. More than half (52.5%) of the respondents had good knowledge of substance usage and only 9.6% of the respondents had a negative attitude toward drug use. It was deduced from the collected data that most students never carried out substance use activities. The respondents agreed that alcohol was the commonly used substance (52.4%) and curiosity (51.7%) was the major contributing factor among school students to substance use. Conclusion: The study found that students in secondary schools had sufficient awareness and a constructive outlook toward drug use, and that the majority did not use substance. Among high school students, alcohol was the most commonly used substance.
Keywords: Attitude, knowledge, Nsukka, practices, secondary school students, substance use
|How to cite this article:|
Ogochukwu AM, Gloria AOC, Uchenna IN, Chibueze A. Knowledge, Attitude, and Practice of Substance Use in Nigeria among Secondary School Students. CHRISMED J Health Res 2022;9:23-30
|How to cite this URL:|
Ogochukwu AM, Gloria AOC, Uchenna IN, Chibueze A. Knowledge, Attitude, and Practice of Substance Use in Nigeria among Secondary School Students. CHRISMED J Health Res [serial online] 2022 [cited 2022 Dec 8];9:23-30. Available from: https://www.cjhr.org/text.asp?2022/9/1/23/358820
| Introduction|| |
Substance use refers to consumption of alcohol, tobacco, and drugs (prescription drugs or illicit drugs) that could change perception, mood, cognition, and behavior., A significant public health concern is the use of substance by children and adolescents worldwide. Adolescence is a vital stage of life and the most transformative time in the life of the person. At this transformative point, secondary school students are the most vulnerable and are susceptible to danger associated with a lack of knowledge of substance use. The markers for substance use among adolescents have been described as interest, social pressure, peer group, family control, lack of parental supervision, and personality issues. In 2018, an estimated 5.6% of the world population use one type of illegal substance, and 0.62% suffer from a substance use disorder. The United Nations Office on Drugs and Crime stated in 2011 that Nigeria actually has the highest number of cannabis and amphetamine users in Africa. The WHO estimated that 18% of boys and <14% of girls in low-to-middle-income countries consume alcoholic beverages between the ages of 13 and 15 years. With frequent mental health referrals, adolescents who use psychoactive substances are at higher risk of increased crime before the age of 20.,, Alarming rates of substance use among student populations have been reported in several studies. Ogunsola and Fatusi reported that 65.7% of school students in the rural and 66.0% of school students in the urban of Osun State had used a substance. A secondary school student study conducted by Lawoyin et al. in 2005 in Igboora, South-West Nigeria, reported that 69.3% of students were current users of one or more illicit drugs. The prevalence of substance use observed in two senior secondary schools in Kagoro district of Kaduna state in adolescence was 21% and alcohol was the widely used substance. A recent study conducted by Manyike et al. among adolescents in boarding secondary schools in Enugu, South-East Nigeria, recorded that drug use ranges from 0.8% to 63.5% for life users and that kola nut is the most widely used substance and cannabis is the least. There is no study that has evaluated the knowledge, attitude, and practice of substance use among secondary school students in Nsukka, Enugu State, to the best of our knowledge, hence the need for the study. Therefore, the study aims to evaluate the knowledge, attitude, and practice of substance use, factors that contribute to substance use, and the effects of substance use among adolescents attending secondary schools in Nsukka.
| Methods|| |
The research was a cross-sectional descriptive survey conducted in Nsukka, Enugu State, among students in secondary schools.
Nsukka is a city and local government area in the state of Enugu in South-East Nigeria, and it is located about 72.8 km from Enugu city, which is the capital of the state of Enugu. Udenu, Igboeze South, Igboeze North, Igbo Etiti, and Uzo Uwani are local government areas in Enugu states, and these local government regions have a shared boundary with Nsukka Local Government. Enugu Ezike, Obollo-Afor (formerly the center of the palm oil trade), Nimbo, Adani, Uzo Uwani, and Mkpologwu are also nearby towns. Because they all collectively fall into the political zoning system in Nigeria, known as the Senate zone, they are all called Nsukka. Nsukka town is the home of the first indigenous Nigerian university, the University of Nigeria. Nsukka, based on the 2006 census, had a population of 309,633.
The principals of each school were approached and informed about the survey. The schools whose principals were willing and granted permission for the study were surveyed. A total of 10 secondary schools were purposively sampled: St. Teresa's College Nsukka, Urban Boys' Secondary School, and Anglican Grammar School were all boys' secondary schools. St. Cyprian's Girls' Secondary School, St. Cyprian's Special Science School, and St. Catherine's Secondary School were all girls' secondary schools. Mixed schools were Model Secondary School, Unity Secondary School, Deo-Gratias Secondary School, and University of Nigeria Secondary School.
The survey instrument was given to all students in Junior Secondary School (1–3) and Senior Secondary School (1–3) who were present at the time of the study. Immediately after about 5–7 min, the self-completed instruments were retrieved from them.
The study instrument consisted of 7 sections: demographics of the respondents, knowledge of substance use (23 items), assessment of factors contributing to substance use (17 items), assessment of the effects of substance use (20 items), assessment of perceived potential substances commonly used by the students (22 items), assessment of students' attitude to substance abuse (17 items), and assessment of perceived concealing practices taken by substance users (16 items).
One thousand one hundred and fifty consenting students were issued with the self-administered questionnaires. When presented, the students were asked to fill out the questionnaire and it was retrieved immediately after completion to avoid online sourcing, misplacing, or discarding data. The information collected was reviewed for completeness, and 1134 questionnaires were correct. The data collection lasted from July to September 2018.
Collected data were coded and entered into Microsoft Excel and then exported to SPSS (IBM SPSS Statistics for Windows, Version 20.0. (IBM Corp, Armonk, NY)). Descriptive statistics such as frequencies, percentages, and means and standard deviation were used to summarize the data.
The ethical approval was received from the Enugu State Ministry of Health's Study and Ethics Committee. All participants gave informed consent; they were made to understand that participation was voluntary and that nonparticipation had no repercussions. All details were kept confidential.
| Results|| |
Of the 1150 secondary students surveyed, 1134 (98.6% response rate) students participated in the study. More than half of the participants were female (57.5%) and single (94.6%). The majority of the respondents were junior high school students (62.2%), and the mean age of the respondents was 14.11 ± 2.13 years. The information of the sociodemographics is shown in [Table 1].
|Table 1: Demographics characteristics of secondary school students in Nsukka|
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Regarding knowledge of substance use, majority of the students were aware (80.5%) and knowledgeable (83.2%) that substance use and misuse endanger the quality of health. Most of the students agreed that the most commonly used substance were tramadol (56.5%), alcohol (77.7%), and marijuana (73.8%). More than two-third of the students (78.3%) knew that substance misuse can cause liver damage while 76.0% of the students responded that engaging in substance use causes cardiovascular disease. About 75.9% of the respondents were aware of the rise in the use of substances. The majority of the students (78.1%) are conscious that medications are also misused by health practitioners (doctors and pharmacists). The total knowledge of substance use and violence among secondary school students was 52.5%, and the details are shown in [Table 2].
Curiosity (51.7%), lack of knowledge of complications of substance misuse (42.2%), peer pressure from friends (40.8%), low self-confident (40.1%), and access to drugs (35.6%) were the reported factors contributing to substance use among secondary school students [Table 3].
|Table 3: Factors contributing to substance use among secondary school students|
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[Table 4] shows the effect of substance use among secondary school students; about 37.1% of the respondents indicate that substance use causes depression and excessive anger (44.7%). Less than half of the respondents (43.3%) stated that substance use can lead to decreased learning and memory ability, fatigue and pain (37.1%), eating disorder (35.4%), sleeping disorder (35.4%), and mental illness (33.0%).
The substance perceived to be the most commonly used among secondary school students were alcohol (52.4%), cocaine (46.7%), cigarette (44.5%), marijuana (42.6%), tramadol (42.3%), and codeine (41.1%) [Table 5].
|Table 5: Assessment of perceived potential substances commonly used by the students|
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More than two-third (76.1%) of the students responded that they have never used one or more substances without medical need while about 1.6% have always used one or more substances without medical need. About 12.5% sometimes used alcohol without medical need while 13.6% have used marijuana and 3.0% tramadol without medical need [Table 6].
|Table 6: Assessment of actual substances commonly used by the students (n=1134)|
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Regarding attitude to substance use, about two-third (68.8%) of the students considered that substance abuse is a crime while 64.3% suggested that substance users should be punished by law. About 53.3% thought that substance misuse should be discussed at all levels of education, and 42.9% felt that teaching substance abuse would minimize the incidence of drug use among students in secondary schools. The majority (90.6%) of the respondents had a positive attitude toward education on substance use [Table 7].
The perceived concealing practice of substance use shows that about 12.3% of secondary school students uses substances in secret places while 11.7% consults the pharmacist or medical practitioner each time they misuse a substance. About 39.3% opined avoidance of substance use during school days [Table 8].
|Table 8: Assessment of perceived concealing practices taken by substance users|
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| Discussion|| |
The findings of this study show that secondary school students were knowledgeable and had positive attitude to substance use. Most of them did not practice the use of substances. The distribution of gender among the higher number of females identified in the study was close to that reported in other studies.,,,, The average age (14.1 years) in this study was close to that recorded in previous studies.,,, This is an indication of the high risk of increased experimentation and use of alcohol, tobacco, and other drugs by students in this age bracket.
The students in this study were sufficiently knowledgeable about the use of substances. The students were knowledgeable about the health and social effects of substance use. This finding corroborates that reported among high school students in Jordan and Dodoma in Tanzania., The reason for the adequate knowledge reported in this current study, may be that the students received information about substance use from their parents, siblings, teachers, medical outreach carried out by the National Youth Service Corps (NYSC) and media such as the advertisement shown on television that usually warns that smokers are prone to die young and radio talk shows that discuss about the consequences and dangers associated with the use of psychoactive substances.
A study conducted among university students in Ethiopia stated that improved academic success, personal satisfaction, relief stress, and staying awake to study were the reasons for substance use. Other reasons have been reported in the literature for the initiation of substance use including family disputes, peer pressure, drug availability and accessibility, lack of religiosity, low-grade point average, ability to experiment, appeal of success, high social class, poor mental health, enhancing the mind's thought and sharpness, reducing boredom and tiredness, parental conflict, emotional distress, low sense of social responsibility, and negative media influences.,,,, Students in this study claimed that the key reasons for initiation of drug use among secondary school students were curiosity, joy seeking, lack of awareness of the complication of drug addiction, and low self-confidence. This possibly reflects the respondents' high knowledge of substance use and also offers a clear way to educate students about the risks and dangerous effects of substance use.
Most students found the adverse effect of substance use among secondary school students to be excessive rage (violence), diminished capacity to learn and memory, absenteeism, low self-esteem, and depression. In Dagoretti, Nairobi West District, Kenya, Njeri and Ngesu recorded that secondary school students claimed that the impact of substance use was violent action, abuse, and withdrawal. Awosusi and Adegboyega stated that substance use affects the physical, psychological, and social health of the users among tertiary students in southwestern Nigeria., Adverse effects of substance use have been identified in other studies: poor performance of the examination, frequent class absences, poor focus, low-grade point, aggressive behavior, lethargy, hopelessness, insomnia, health issues, loss of money, and valuables.,, Students with sufficient awareness of the adverse effects of substance use in this study may have prevented students from using psychoactive drugs, alcohol, and tobacco.
Alcohol is the most widely used substance in this study by secondary school students. In Lagos State, a study conducted by Ani among senior secondary school students in the mainland local government, 77.2% of students consumed alcohol once or more in their lifetime. Similar results were reported from other studies.,,,, Alcohol was the second most consumed psychoactive substance in Enugu among boarding secondary school students. Most young people believe that alcohol consumption shows signs of maturity and that the consumption of alcohol by many Nigerian societies is socially acceptable.
Apart from alcohol use, cocaine, cigarette, tramadol, and codeine are perceived to be commonly used by secondary school students. The perceived use of cocaine in this study is high. Other studies have shown similar cocaine use among secondary school students., This is not a surprise since reports has shown increase in the use of cocaine in the Nigeria population.
About half of the students had a good outlook about the use of substances. A study conducted in Dodoma, Tanzania, among secondary school students reported a good approach to substance use.,,,, Haddad et al. recorded an attitude toward substance use. Approximately 65% of Jordanian high school students view substance misuse as a problem among teenagers and grade 11 students are more conscious of substance use as a problem compared to grade 10 students. In this study, good attitude to substance use may probably be from adequate knowledge of substance use among the students.
In this study, students in secondary schools do not practice or participate in substance use, which may result from students in secondary schools who have sufficient awareness and a positive approach to drug use.
There is little information to compare and/or support the practice of substance use among secondary school students, as most research focuses on the prevalence, pattern, and knowledge of substance use among secondary school students. The strength of this research lies in the use of a standardized questionnaire validated in the study environment by a large number of study participants. Nevertheless, recall bias and social desirability bias are potential limitations to the results of the study.
| Conclusion|| |
The study showed that students in secondary schools had adequate knowledge and a positive attitude toward the use of drugs. The learners did not practice or indulge in the use of substances. The most widely known substance used was alcohol. The primary variables contributing to substance use were curiosity and joy seeking. Excessive anger, decreased learning and memory skills, and regular absenteeism from school activities were the major effects of drug use among secondary school students.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]