Prevalence and predictors of tobacco, alcohol and illicit drug experimentation among Tunisian middle and high school-adolescents.
adolescent
experimentation
initiation
prevalence
psychoactive substance
risk factors
Journal
International journal of adolescent medicine and health
ISSN: 2191-0278
Titre abrégé: Int J Adolesc Med Health
Pays: Germany
ID NLM: 8506960
Informations de publication
Date de publication:
01 Aug 2023
01 Aug 2023
Historique:
received:
14
12
2022
accepted:
31
07
2023
medline:
7
9
2023
pubmed:
10
8
2023
entrez:
10
8
2023
Statut:
epublish
Résumé
Psychoactive substance experimentation among Tunisian adolescents remains one of the most threatening public health concerns. In spite of this, little is known about the prevalence and predictors of these behaviors in the Tunisian context. This study aims to assess the prevalence of tobacco, alcohol and illicit drug experimentation and its predictive factors among adolescents in the delegation of Nfidha, Sousse governorate, Tunisia. We conducted a cross sectional study in middle and high schools in the delegation of Nfidha, Sousse governorate, Tunisia, during the first trimester of the 2019-2020 school year using an anonymous questionnaire self-administered to a randomly drawn representative sample of 1,352 pupils. Data collected included socio-demographic characteristics, substance experimentation among school-adolescents, academic performance as well as family and peer' factors. Tobacco was the most commonly experimented substance with a prevalence rate of 17.5 % (CI 95 %: 14.8-18.8 %). The prevalence of alcohol and illicit drugs use were 3.3 % [CI 95 %: (2.1-3.9 %)] and 2 % [CI 95 %: (1.1-2.6 %)] respectively. Being male (Adjusted (AOR)=4.09, p<0.001), being a high school pupil (AOR=2.81, p<0.001), having experiencing academic failure (AOR=1.60, p=0.007) and having a father and siblings who use tobacco (AOR=1.72, p=0.002; AOR=2.03, p=0.001 respectively) were the predictors of tobacco experimentation in the multivariate logistic regression analysis. Additionally, being male (AOR=8.40, p<0.001), having experienced academic failure (AOR=2.76, p=0.017) as well as having a father and siblings who use alcohol (AOR=5.90, p<0.001; AOR=3.03, p=0.045 respectively) and having experienced tobacco (AOR=4.28, p<0.001) were the determinants of alcohol experimentation. Similarly, having a history of academic failure (AOR=3.44, p=0.041), having peers who use illicit drugs (AOR=3.22, p=0.028), having a history of tobacco and alcohol experimentation (AOR=6.52, p<0.001; AOR=3.49, p=0.046 respectively) were the predictors of illicit drug experimentation among adolescents. A substantial number of socio-demographic and environmental factors have been identified as being involved in experimentation with psychoactive substance during adolescence. Therefore, further prevention programs targeting not only adolescents, but also all risk factors are needed.
Identifiants
pubmed: 37561158
pii: ijamh-2022-0117
doi: 10.1515/ijamh-2022-0117
doi:
Substances chimiques
Illicit Drugs
0
Ethanol
3K9958V90M
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
363-373Informations de copyright
© 2023 Walter de Gruyter GmbH, Berlin/Boston.
Références
El Kazdouh, H, El-Ammari, A, Bouftini, S, El Fakir, S, El Achhab, Y. Potential risk and protective factors of substance use among school adolescents in Morocco: a cross-sectional study. J Subst Use 2019;24:176–83. https://doi.org/10.1080/14659891.2018.1535003 .
doi: 10.1080/14659891.2018.1535003
Charfi, N, Turki, M, Smaoui, N, Maâlej Bouali, M, Omri, S, Zouari, L, et al.. Alcohol use and associated environmental factors among middle and high school students in Sfax (Tunisia). Int J Ment Health Addict 2020;18:658–73. https://doi.org/10.1007/s11469-018-9969-6 .
doi: 10.1007/s11469-018-9969-6
Shifflet-Chila, ED, Harold, RD, Fitton, VA, Ahmedani, BK. Adolescent and family development: autonomy and identity in the digital age. Child Youth Serv Rev 2016;70:364–8. https://doi.org/10.1016/j.childyouth.2016.10.005 .
doi: 10.1016/j.childyouth.2016.10.005
Zammit, N, Maatoug, J, Ghammam, R, Bhiri, S, Ghannem, H. Tobacco use: the main predictor of illicit substances use among young adolescents in Sousse, Tunisia. Int J Adolesc Med Health 2020;32:20170213. https://doi.org/10.1515/ijamh-2017-0213 .
doi: 10.1515/ijamh-2017-0213
Mlouki, I, Bouanene, I, Sioud, I, Bchir, A, al’Absi, M, El Mhamdi, S. Impulsivity mediates the impact of early life adversity on high risk behaviors among Tunisian adolescents. Prevent Med Rep 2021;23:101424. https://doi.org/10.1016/j.pmedr.2021.101424 .
doi: 10.1016/j.pmedr.2021.101424
WHO Report: Smoking and drinking cause millions of deaths worldwide [Internet] . Partnership to end addiction. Available on: https://drugfree.org/drug-and-alcohol-news/who-report-smoking-and-drinking-cause-millions-of-deaths-worldwide/ .
Tobacco [Internet] . Available on: https://www.who.int/news-room/fact-sheets/detail/tobacco .
Alcohol [Internet] . Available on: https://www.who.int/health-topics/alcohol .
Drug Use – Our world in data [Internet] . Available on: https://ourworldindata.org/drug-use .
Ansari-Moghaddam, A, Rakhshani, F, Shahraki-Sanavi, F, Mohammadi, M, Miri-Bonjar, M, Bakhshani, NM. Prevalence and patterns of tobacco, alcohol, and drug use among Iranian adolescents: a meta-analysis of 58 studies. Child Youth Serv Rev 2016;60:68–79. https://doi.org/10.1016/j.childyouth.2015.11.018 .
doi: 10.1016/j.childyouth.2015.11.018
Göbel, K, Scheithauer, H, Bräker, AB, Jonkman, H, Soellner, R. Substance use patterns among adolescents in Europe: a latent class analysis. Subst Use Misuse 2016;51:1130–8. https://doi.org/10.3109/10826084.2016.1160120 .
doi: 10.3109/10826084.2016.1160120
Castellanos-Ryan, N, O’Leary-Barrett, M, Conrod, PJ. Substance-use in childhood and adolescence: a brief overview of developmental processes and their clinical implications. J Can Acad Child Adolesc Psychiatry févr 2013;22:41–6.
Jackson, C. Initial and experimental stages of tobacco and alcohol use during late childhood: relation to peer, parent, and personal risk factors. Addict Behav 1997;22:685–98. https://doi.org/10.1016/s0306-4603(97)00005-1 .
doi: 10.1016/s0306-4603(97)00005-1
Cavazos-Rehg, PA, Krauss, MJ, Spitznagel, EL, Grucza, RA, Bierut, LJ. Youth tobacco use type and associations with substance use disorders. Addiction 2014;109:1371–80. https://doi.org/10.1111/add.12567 .
doi: 10.1111/add.12567
Gau, SSF, Chong, MY, Yang, P, Yen, CF, Liang, KY, Cheng, ATA. Psychiatric and psychosocial predictors of substance use disorders among adolescents: longitudinal study. Br J Psychiatry 2007;190:42–8. https://doi.org/10.1192/bjp.bp.106.022871 .
doi: 10.1192/bjp.bp.106.022871
Beal, AC, Ausiello, J, Perrin, JM. Social influences on health-risk behaviors among minority middle school students. J Adolesc Health juin 2001;28:474–80. https://doi.org/10.1016/s1054-139x(01)00194-x .
doi: 10.1016/s1054-139x(01)00194-x
El Achhab, Y, El Ammari, A, El Kazdouh, H, Najdi, A, Berraho, M, Tachfouti, N, et al.. Health risk behaviours amongst school adolescents: protocol for a mixed methods study. BMC Publ Health 2016;16:1209. https://doi.org/10.1186/s12889-016-3873-4 .
doi: 10.1186/s12889-016-3873-4
Glanz, K, Rimer, BK, Viswanath, K. Health behavior and health education: theory, research, and practice . New Jersey: John Wiley & Sons; 2008.
Arora, A, Kannan, S, , S, Choudhary, S, Sudarasanan, S, Khosla, PP. Substance abuse amongst the medical graduate students in a developing country. Indian J Med Res. 2016. 143:101–3. https://doi.org/10.4103/0971-5916.178617 .
doi: 10.4103/0971-5916.178617
Silini, A, Rejaibi, S, Zid, M, Zoghlami, N, Mallekh, R, Ben Slema, I, et al.. Alarming trends in Tobacco use in high school Tunisian adolescents: MedSPAD2013-2021. Eur J Publ Health 2022;32:216. https://doi.org/10.1093/eurpub/ckac131.216 .
doi: 10.1093/eurpub/ckac131.216
Silini, A, Rejaibi, S, Zid, M, Youssef, SB, Zoghlami, N, Mallekh, R, et al.. Prevalence and associated factors to cigarette smoking among school adolescents in Tunisia, 2021. Popul Med 2023;5. https://doi.org/10.18332/popmed/164506 .
doi: 10.18332/popmed/164506
Zammit, N, Amara, A, Ghammam, R, Ben Fredj, S, Boujebha, S, Maatouk, A, et al.. Monitoring tobacco use among a sample of Tunisian high school pupils. Eur J Publ Health 2022;32. https://doi.org/10.1093/eurpub/ckac131.570 .
doi: 10.1093/eurpub/ckac131.570
Zammit, N, Maatoug, J, Ghammam, R, Fredj, SB, Dhouib, W, Ayouni, I, et al.. Surveillance of tobacco use among young adolescents: trends and predictors across three years in Sousse, Tunisia. BMC Publ Health 2022;22:2022. https://doi.org/10.1186/s12889-022-14416-x .
doi: 10.1186/s12889-022-14416-x
Odejide, AO. Status of drug use/abuse in Africa: a review. Int J Ment Health Addiction 2006;4:87–102. https://doi.org/10.1007/s11469-006-9015-y .
doi: 10.1007/s11469-006-9015-y
Chekib, Z, Zammit, N, Manel, L, Menel, M, Elghardallou, M, Jihen, S, et al.. Illicit substance use among Tunisian college students: prevalence and risk factors. Int J Adolesc Med Health 2018;30:20160108. https://doi.org/10.1515/ijamh-2016-0108 .
doi: 10.1515/ijamh-2016-0108
Enquête MedSPAD: lignes directrices 2021–2022. pdf [Internet]. Available on: https://rm.coe.int/p-pg-mednet-2021-8-medspad-guidelines-2020-2021-fr/1680a2c810 .
MedSPAD II 2017 Tunisie: résultats de l’enquête nationale MedSPAD II. pdf [Internet]. Available on: https://rm.coe.int/2017-ppg-med-41-medspad-tunisia-report-fra/16808cbf44 .
Dadoorian, D. 2. Adolescence. In: Grossesses adolescentes [Internet] . Toulouse: Érès; 2007. pp. 25–41. Available on: https://www.cairn.info/grossesses-adolescentes--9782749205267-p-25.htm .
MedSPAD I 2014 Tunisie: résultats de l’enquête nationale MedSPAD I. pdf. Available on: https://docplayer.fr/24795864-Enquete-medspad-en-tunisie.html .
Ayedi, Y, Harizi, C, Skhiri, A, Fakhfakh, R. Linking global youth tobacco survey (GYTS) data to the WHO framework convention on tobacco control (FCTC): the case for Tunisia. Tob Induc Dis 2022;20:7. https://doi.org/10.18332/tid/143994 .
doi: 10.18332/tid/143994
Fakhfakh, R, Jaidane, I, Hsairi, M, Ben Hamida, AM. Les facteurs de risque et de protection de l’initiation à la cigarette chez les adolescents tunisiens [Risk and protection factors of smoking initiation among Tunisian adolescents]. Rev DÉpidémiologie Santé Publique 2015;63:369–79. https://doi.org/10.1016/j.respe.2015.09.005 .
doi: 10.1016/j.respe.2015.09.005
Abdelkafi Koubaa, A, Chibani, M, Bel Abed, N, Dahmen, H, Ouerfelli, N, Taher Maabouj, M, et al.. Smoker teenagers in colleges of Zaghouan. La Tunisie médicale- 2009;87:527–31.
Zarrouq, B, Bendaou, B, El Asri, A, Achour, S, Rammouz, I, Aalouane, R, et al.. Psychoactive substances use and associated factors among middle and high school students in the North Center of Morocco: a cross-sectional questionnaire survey. BMC Publ Health 2016;16:468. https://doi.org/10.1186/s12889-016-3143-5 .
doi: 10.1186/s12889-016-3143-5
Ayed, HB, Yaich, S, Hmida, MB, Jemaa, MB, Trigui, M, Karray, R, et al.. Prevalence and factors associated with smoking among Tunisian secondary school-adolescents. Int J Adolesc Med Health 2021;33:379–87. https://doi.org/10.1515/ijamh-2019-0088 .
doi: 10.1515/ijamh-2019-0088
Les drogues Durant les années lycée: Résultats de l’enquête ESPAD 2015 en France. pdf. Available on: https://www.ofdt.fr/BDD/publications/docs/eftxssw9.pdf .
Jesus, M, Braga, V, Lins, E, Jesus, R, Freitas, F, Silva, M, et al.. Factors associated with tobacco experimentation among adolescents students. UFPE 2020;14:e244043.
Bonilha, AG, Ruffino-Netto, A, Sicchieri, MP, Achcar, JA, Rodrigues-Júnior, AL, Baddini- Martinez, J. Correlates of experimentation with smoking and current cigarette consumption among adolescents. J Bras Pneumol 2014;40:634–42. https://doi.org/10.1590/s1806-37132014000600007 .
doi: 10.1590/s1806-37132014000600007
Freitas, EAde O, Martins, MSAS, Espinosa, MM. Alcohol and tobacco experimentation among adolescents of the Midwest Region/Brazil. Ciênc saúde coletiva 2019;24:1347–57. https://doi.org/10.1590/1413-81232018244.15582017 .
doi: 10.1590/1413-81232018244.15582017
El Omari, F, Salomonsen-Sautel, S, Hoffenberg, A, Anderson, T, Hopfer, C, Toufiq, J. Prevalence of substance use among moroccan adolescents and association with academic achievement. World J Psychiatr 2015;5:425–31. https://doi.org/10.5498/wjp.v5.i4.425 .
doi: 10.5498/wjp.v5.i4.425
Loffredo, CA, Shaker, YE, Jillson, IA, Boulos, DNK, Saleh, DA, Garas, M, et al.. Prevalence and correlates of substance use by Egyptian school youth. Int J Alcohol Drug Res 2017;6:37–51. https://doi.org/10.7895/ijadr.v6i1.242 .
doi: 10.7895/ijadr.v6i1.242
Ghali, H, Bhiri, S, Cheikh, A, Aissa, S, Dhidah, M, Dhidah, L, et al.. Risk factors of illicit substance use among Tunisian adolescents of Sousse. Eur J Publ Health 2020;30:v852.
Consommation de drogues chez les jeunes: faits et statistiques [2022]: centre national de statistiques sur l’abus de drogues (NCDAS) [Internet]. Available on: https://drugabusestatistics.org/teen-drug-use/ .
MedSPAD regional report: prevalence of alcohol, tobacco and drug use among adolescents in the mediterranen region. Available on: https://rm.coe.int/2017-ppg-med-15-medspad-regional-report-eng/16808cbcc1 .
Harrabi, I, Chahed, H, Maatoug, J, Gaha, J, Essoussi, S, Ghannem, H. Predictors of smoking initiation among schoolchildren in Tunisia: a 4 years cohort study. Afr Health Sci 2009;9:147–52.
Nouira, A, Maatoug, J, Harrabi, I, Hmad, S, Belkacem, M, Slama, S, et al.. Clustering of risk factors in the smoking habits of schoolchildren in Sousse, Tunisia. Int J Adolesc Med Health 2014;26:267–73. https://doi.org/10.1515/ijamh-2013-0511 .
doi: 10.1515/ijamh-2013-0511
El Kazdouh, H, El-Ammari, A, Bouftini, S, El Fakir, S, El Achhab, Y. Adolescents, parents and teachers’ perceptions of risk and protective factors of substance use in Moroccan adolescents: a qualitative study. Subst Abuse Treat Prev Pol 2018;13:31. https://doi.org/10.1186/s13011-018-0169-y .
doi: 10.1186/s13011-018-0169-y
Lowry, R, Eaton, DK, Brener, ND, Kann, L. Prevalence of health-risk behaviors among Asian American and Pacific Islander high school students in the U.S., 2001–2007. Public Health Rep 2011;126:39–49.
Huang, C, Koplan, J, Yu, S, Li, C, Guo, C, Liu, J, et al.. Smoking experimentation among elementary school students in China: influences from peers, families, and the school environment. PLoS One 2013;8:e73048. https://doi.org/10.1371/journal.pone.0073048 .
doi: 10.1371/journal.pone.0073048
Mak, YW, Leung, D, Loke, AY. The vulnerability to alcohol, tobacco, and drug use of adolescents in Hong Kong: a phenomenological study. BMC Pediatr 2019;19:303. https://doi.org/10.1186/s12887-019-1678-1 .
doi: 10.1186/s12887-019-1678-1
Kenya Medical Training College , Wangui, S, Barasa, L. University of nairobi. Predictors of smoking initiation among the youth in Kiambaa Sub county, Kiambu county. JMNPH 2022;5:85–108. https://doi.org/10.53819/81018102t6013 .
doi: 10.53819/81018102t6013
Black, DR, Tobler, NS, Sciacca, JP. Peer helping/involvement: an efficacious way to meet the challenge of reducing alcohol, tobacco, and other drug use among youth. J Sch Health 1998;68:87–93. https://doi.org/10.1111/j.1746-1561.1998.tb03488.x .
doi: 10.1111/j.1746-1561.1998.tb03488.x
Nkansah-Amankra, S, Minelli, M. “Gateway hypothesis” and early drug use: additional findings from tracking a population-based sample of adolescents to adulthood. Prev Med Rep 2016;4:134–41. https://doi.org/10.1016/j.pmedr.2016.05.003 .
doi: 10.1016/j.pmedr.2016.05.003
Kandel, DB. Stages and pathways of drug involvement: examining the gateway hypothesis . Cambridge: Cambridge University Press; 2002.