Prevalence and Psychosocial Factors Influencing Substance Use Among Students of Abia State Polytechnic: Implication for Policy Makers

doi:10.21203/rs.3.rs-5329152/v1

The issue of drug use has escalated into a critical global concern, demanding immediate attention from researchers, policymakers, and stakeholders. The widespread misuse of drugs among students is becoming increasingly problematic and a health concern in many countries, including Nigeria. This study's objective is to assess the prevalence and psychosocial factors responsible for substance use among undergraduate students of Abia State Polytechnic. The findings of this study have significant implications for the broader public health and education systems, as they highlight the urgent need for intervention programs to address the high prevalence of drug use among students.

Method: The study adopted a snowball sampling design to recruit four hundred and seventy-two (472) students from the five (5) schools that comprise all the Abia State Polytechnic Departments. A study-developed questionnaire called Substance Use and Psychosocial Factors Checklist (SUPSF) was adopted from DUDIT and AUDIT and validated. Three hypotheses were advanced, and data was analyzed via IBM SPSS-23.

Results: Descriptive results showed a high prevalence of psychoactive substance use among undergraduate students, with the highest substance being Marijuana, with a prevalence of 71.61%. Multi-linear regression revealed that psychosocial factors significantly predicted the criterion variable (β= -.66; t = -19.02; p<0.05). Also, among the demographic variables, age was the best predictor of psychoactive substance use, with 17.1% out of the 19.6% combined variance, F(1,471) = 97.03, p<0.05.

Conclusion: In line with the findings, we concluded that the school's management should, as a matter of urgency, introduce drug test programs. These programs can help identify students at risk of substance use early, allowing for timely intervention. We stress the need for the establishment of a functional counseling unit and course advisers to address possible psychosocial factors that may pressure a student into using psychoactive substances. The need for these intervention programs is crucial, and their successful implementation could significantly reduce the high prevalence of drug use among students, offering hope for a healthier future.

Psychology

Substance use prevalence

Psychosocial factors

Psychoactive drugs

Undergraduates

University or tertiary institutions prepare individuals and train their minds, behavior, and intellect through studies and research for the development of their nation and to compete favorably with their peers worldwide (Modebelu & Adeniyi, 2020). Any behavior that could affect the mental stability of the students and their ability to achieve this goal should be considered a serious matter. In recent times, Substance use among undergraduate students has become a growing concern that brings about severe health, social, psychological, and economic challenges in many countries, including Nigeria. The United Nations Office on Drugs and Crime (UNODC), in 2022, reported that drug abuse has become a global problem that affects 284 million people between the ages of 15 and 64. The cumulative age of most Africans undergoing treatment for drug use problems is under the age of 35. Institutions of higher learning seem to have become a fertile ground for substance use. Thus, many Nigerian scholars have reported the high prevalence of substance use in Nigerian higher institutions as a serious public health issue (Adeyemo et al., 2016; Chinyere & Emeka, 2021; Adesida et al., 2022)

Substance use among Nigerian youth in higher institutions of learning is not just a public health issue but a crisis that is taking a toll on their mental well-being. The reported symptoms of depression, anxiety, suicidal ideation, and violent behaviors (Adeboye et al., 2017; Wada et al., 2021) paint a grim picture of the situation. The increase in risky behaviors, such as stealing, violence, unprotected sexual behaviors, assaults of different forms, cultism, and robbery (Enang, 2007; Ekpenyong & Aakpege, 2014; Wada et al., 2021), further underscores the severity of the issue.

Substance use among Nigerian undergraduate students does not occur in a vacuum. In other words, studies have suggested some reasons for the high prevalence of substance use among undergraduate students. Some of these reasons include but are not limited to the need to belong, peer pressure, unrealistic expectations from parents, curiosity, lack of healthy role models, financial struggles, and masking some mental health struggles. (Muhammad, 2023; Fareo, 2012). Other studies have suggested that most undergraduate students use substances for recreational and social purposes (Ajayi & Somefun, 2020; Watt et al., 2014; Hall et al., 2016). Often, individuals who had prior exposure to substance use at home seem to increase their frequency once exposed to the university environment (Sani et al.,2024). This could suggest that there could exist some factors within the school environment that make students more susceptible to the use of substances. Some researchers have identified commonly used psychoactive substances among students, including alcohol, cigarettes, marijuana, cocaine, heroin, amphetamine, and prescription drugs (Patrick et al., 2024; Adesida et al., 2022).

Given the severity of the issue, it is not just important but imperative to establish a school policy that will effectively address the issue of drug abuse among undergraduate students. This policy should include launching an operational counseling unit to manage the issue and help students achieve their primary goal of becoming university graduates and productive citizens. Therefore, this research, which aims to gain a deeper understanding of the prevalence and the psychosocial factors undergraduate students at Abia State Polytechnic in Aba, Nigeria, give for engaging in psychoactive substance use, is not just a scholarly pursuit but a crucial step towards informing and proposing effective policy changes.

The study's purpose is to ascertain the prevalence of drug use among undergraduate students at Abia State Polytechnic Aba. It will use a mixed-methods approach that includes quantitative surveys and qualitative interviews.

·To identify the most abused drugs among undergraduate students in Abia State Polytechnic Aba.

· To ascertain various psychosocial factors contributing to use among Abia State Polytechnic Aba undergraduate students, particularly about the use of psychoactive substances, which include alcohol, cigarettes, marijuana, cocaine, heroin, amphetamine, and prescription drugs.

·To identify demographic variables contributing to the use of psychoactive substances among undergraduate students in Abia State Polytechnic Aba.

Hypotheses

There will be a high prevalence of psychoactive substance use among undergraduate students of Abia State Polytechnic.

Psychosocial factors will significantly predict psychoactive substance use among undergraduate students of Abia State Polytechnic.

Demographic variables will jointly predict psychoactive substance use among undergraduate students of Abia State Polytechnic.

Study Design

This cross-sectional study, meticulously conducted from July to October 2024 among students in four different schools, was characterized by a rigorous selection process. The participants were chosen with great care through the snowball sampling, ensuring a diverse and representative sample. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS for Windows) version 23. Descriptive and inferential statistics were employed to measure the variables, address the study's objectives, and test the study's hypotheses. Frequency tables were utilized for descriptive statistics, such as the socio-demographic variables and prevalence of substance use. Multiple regression analysis was explored to investigate the predictive relationship between predictor variables and psychoactive substance use, further enhancing the study's representativeness.

Measure

A self-administered research instrument was utilized in the study, which the researchers designed by selecting items and modifying existing study protocol from the Drug Use Disorders Identification Test (DUDIT) and Alcohol Use Disorders Identification Test (AUDIT) to suit the study's objectives. The questionnaire is named Substance Use and Psychosocial Factors Checklist (SUPSF). The SUPSF is comprised of 4 sections. Section A includes the demographics such as sex, age, marital status, year of study, and school. Section B contains questions on the prevalence and frequency of cigarette smoking in the last 30 days and 12 months. Section C has to do with the prevalence of alcohol in the previous 30 days. Section D is made up of the prevalence of different psychoactive drugs and psychosocial factors necessitating use, such as depression, anxiety, academic pressure, peer pressure, and anger management, to maintain focus, gain strength, stay awake, and have fun. A fictional drug, 'Jammy,' was added to the list of psychoactive substances to put the respondents in check and to reduce over-reporting bias. Participants who agreed to have taken this fictional substance were excluded from the study for further analysis to maintain the integrity of the data and reduce the risk of over-reporting.

To ensure the instrument's internal consistency, a pilot study was conducted to test the reliability of items and to check that items were suitable for the study. Twenty-two (22) participants were recruited from various departments (different from those selected in the main study) of the school through snowball sampling technique. All the items in the scale exhibited good internal consistency. They were highly reliable as Cronbach's alpha value of α = 0.941 for psychoactive substance use was obtained, and Cronbach's alpha value α = .843 for psychosocial factors, for drug accessibility α = .956, and drug knowledge α = .924. This high reliability of the instrument instills confidence in the study's findings. Hence, we adopted all the items for the study.

Furthermore, the reliability index of the instrument for the main study was examined. The outcome indicates that the reliability coefficients for the psychoactive substance use section of the SUPSF showed satisfactory internal consistency with Cronbach's alpha value α = 0.94 and norm = 15.05—identical to the findings during the pilot phase. In contrast, the psychosocial factors section of the SUPSF had a Cronbach's value α = 0.89, indicating a very high and robust internal consistency among instrument items.

Data analyses

After recording 500 copies of questionnaires through the snowball technique, copies of the completed online submission were scrutinized, and their data was cleaned with meticulous care. Upon completing the exercise, it was discovered that twenty-eight (28) participants reported knowing and using 'Jammy' and were removed from the study, ensuring the accuracy of the data. Consequently, 472 final copies were used for statistical analysis, indicating a 94.4% response rate. The data obtained were then analyzed using the Statistical Package for Social Sciences (SPSS for Windows) version 23. Descriptive and inferential statistics were employed to measure the variables, address the study's objectives, and test the study's hypotheses. Frequency tables were utilized for descriptive statistics, such as the socio-demographic variables and prevalence of substance use. Multiple regression analysis was explored to investigate the predictive relationship between predictor variables and psychoactive substance use. Factor analysis using principal axis factoring and Cronbach's reliability analysis were also deployed to ensure the instruments were robust and standardized. For all tests and analyses, the level of statistical significance was set at p < 0.05 level of significance, providing the thoroughness and reliability of the study's findings.

Participants

Participants: using the snowball sampling technique, four hundred seventy-two students from different Abia State Polytechnic departments were selected. This method allowed for a diverse and representative sample, enhancing the study's validity. Of the 472 respondents, 288 (61.0%) were males, and 181 (38.3%) were females. The age range of the sample was between 18 and 49.

Table 1: An overview of frequencies and percentages of demographics among participants (n = 472)

Demographics n %

Age 472 100.0

Minimum 18 years

Maximum 49 years

Mean age 29.78 years

Std. 7.29

Gender

Male 288 61.0

Female 181 38.3

Others 3 0.6

Marital Status

Single 25 5.3

In a relationship 110 23.3

Married 111 23.5

Separated 88 18.6

Divorced 87 18.4

Widowed 51 10.8

Religion

Christianity 290 61.4

Islam 178 37.7

Others 4 0.8

Year of study

ND 458 97.0

HND 14 3.0

School

SBMT 98 208

SSIT 130 27.5

SET 146 30.9

SEDT 98 20.8

Total 472 100

The descriptive result in Table 1 showcased the six (6) different demographic variables assessed in the current study. The outcome indicates that the age of participants enrolled in the study was between 18 and 49, with an average of 29.78 years and a standard deviation of 7.29. Other demographic features such as sex, marital status, religion, year of study, and school are clearly outlined in Table 1 above.

Table 2: Summary of prevalence of psychoactive substance use among students selected in the study (n = 472)

Factors	N	%
Prevalence of Cigarettes in the last 12 months	190	40.2
Prevalence of Cigarettes in the last 30 days	184	39.0
Total frequency of use of Cigarettes in the last 30 days 1-2 cigarettes per day 3-5 cigarettes per day 6-10 cigarettes per day Very frequent use of cigarettes	286 53 67 81 85	60.59 11.2 14.2 17.2 18.0
Prevalence of Marijuana in the last 30 days	338	71.61
Prevalence of Amphetamines in the last 30 days	269	57.00
Prevalence of Crack Cocaine in the last 30 days	237	50.21
Prevalence of Heroine in the last 30 days	231	48.94
Prevalence of Tramadol in the last 30 days	223	47.25
Prevalence of Rohypnol in the last 30 days	245	51.91
Prevalence of Cough syrups in the last 30 days	290	61.44
Prevalence of Mixed weed in the last 30 days	320	67.80
Prevalence of Kolos in the last 30 days	231	48.94

Hypothesis one: There will be a high prevalence of psychoactive substance use among undergraduate students of Abia State Polytechnic.

The results, as presented in Table 2, clearly show that the least prevalence of any substance in the last 30 days was 39% (Cigarettes), while the highest substance was Marijuana, with a prevalence of 71.61%. Others were mixed weed (i.e., a concoction of Marijuana and other local substances) with 67.80% and Cough syrups/juice with 61.44%. These findings underscore the high prevalence of substance use among students at Abia State Polytechnic, thereby confirming the first hypothesis. This situation is of grave concern and underscores the urgent need for further research and continuous learning to address this issue. It is crucial that we continue to investigate and educate to combat this problem.

Table 3: Summary of multiple regressions showing the predictive influence of psychosocial factors on psychoactive substance use among undergraduates of Abia State Polytechnic

Hypothesis Two: Psychosocial factors will significantly predict psychoactive substance use among undergraduate students of Abia State Polytechnic.

To examine the psychosocial factors influencing substance use among students of Abia State Polytechnic, a multi-linear regression was employed. The results presented in Table 3 indicate that psychosocial factors yielded a coefficient of multiple correlation (R) of 0.659 and multiple correlation square (R2) of 0.435, meaning that 43.5% of the variance in psychoactive substance use was explained by the influence of psychosocial indices reported by participants. Table 3 also revealed that psychosocial factors significantly predicted the criterion variable (β = -.66; t = -19.02; p<0.05). This means that the less unfavorable psychosocial factors are within the milieu of the students, the more undergraduates tend to indulge in psychoactive substance use, and vice versa. Hence, the second hypothesis, which stated that psychosocial factors would significantly predict psychoactive substance use among undergraduate students of Abia State Polytechnic, was accepted.

Table 4: Summary of multiple regressions showing the predictive influence of demographic factors on psychoactive substance use among undergraduates of Abia State Polytechnic

Hypothesis Three: Demographic variables will jointly predict psychoactive substance use among undergraduate students of Abia State Polytechnic.

To further examine the intricacies involved in psychoactive substance use among undergraduates, the researchers coopted possible confounders, such as demographic factors, into the regression model. The results presented in Table 4 indicate that predictor variables (i.e., sex, age, marital status, religion, year of study, and school) all yielded a coefficient of multiple correlations (R) of 0.443 and multiple correlation square (R2) of 0.196. This invariably implies that the effects of predictor variables measured explained 19.6% of the variance in psychoactive substance use. Table 4 also showed that only age, religion, and year of study were independent predictors of psychoactive substance use among undergraduates (β = 0.59; t = 3.14; p<0.05; β = -.13; t = 2.65; p<0.05; β = -.13; t = -3.04; p<0.05) respectively. A joint prediction of predictor variables on psychoactive substance use was also observed, F(6,471) = 18.88, p<0.05 significance level. Progressively, a stepwise regression was conducted and the results indicated that among the 3 demographic variables that showed independent predictions of criterion variable, age was the best predictor of psychoactive substance use with 17.1% out the 19.6% combined variance, F (1,471) = 97.03, p<0.05; while year of study was the second best predicting demographic factor with a 1.0% variance, F(2,471) = 51.70, p<0.05; and religion was the third best predicting demographic factor with a 1.1% variance, F (3,471) = 37.10, p<0.05 level of significance. Summarily, the third hypothesis, which proposed that demographic variables will jointly predict psychoactive substance use among undergraduate students of Abia State Polytechnic, was also retained.

This study was conducted to investigate the prevalence and psychosocial factors undergraduate students at Abia State Polytechnic in Aba, Nigeria, give for engaging in psychoactive substance use. The first hypothesis stated that there will be a high prevalence of psychoactive substance use among undergraduate students of Abia State Polytechnic. The result of the study revealed that the psychoactive substance mainly currently used by the students was Marijuana, followed by Cough syrup/juice. In contrast, the least used is cigarettes, of which the hypothesis was accepted. These statistics indicate not only a significant level of substance use but also a potential normalization of psychoactive substances within the student culture. The high rate of mixed weed usage may suggest that students may be experimenting with various combinations of substances, potentially increasing the risks associated with their use. The significant prevalence of cough syrups calls for concern; such substances are often misused for their psychoactive effects. This can lead to dependency and other health-related issues. The result agrees with the findings of a similar study conducted among undergraduate students, which reported Cough syrup and Marijuana as commonly used substances (Josephine & Oladipo, 2020; Aguocha & Nwefoh, 2021; Oluwakemi et al., 2024). Our findings are in contrast to studies by Florence et al. (2016), where Marijuana was the second psychoactive substance least commonly used by undergraduates in Benin City, Nigeria. The findings from our study corroborate the hypothesis of high psychoactive substance use among the students. This worrisome trend necessitates urgent attention from school authorities, policymakers, and health professionals to implement effective prevention and intervention strategies. The importance of these strategies cannot be overstated in addressing this issue and enhancing the student's overall well-being and academic performance.

The second hypothesis, which stated that psychosocial factors would significantly predict psychoactive substance use among undergraduate students of Abia State Polytechnic, was also accepted. Our findings highlight the significant role of psychosocial factors in predicting psychoactive substance use among students and young people. The results indicate that nearly half of the variability in substance use behaviors can be explained by the psychosocial environment of the students. It further suggests that more favorable psychosocial conditions are associated with lower levels of substance use among students as a means of coping mechanism. Our results are consistent with a study conducted by Sani et al. (2024) in Kaduna, Nigeria, where psychosocial factors such as relief from stress and peer pressure were identified as crucial determinants of substance use among students and young people.

Similarly, a study conducted in sub-Saharan Africa showed that students who experience high levels of stress and low social support are more likely to resort to substance use, highlighting the importance of psychosocial well-being in this demographic (Jumbe et al., 2021). Academic institutions should prioritize the development of supportive psychosocial environments to mitigate substance use among students. However, it is not just about mitigating substance use but addressing the root causes. Activities promoting social support networks, mental health awareness, and stress management could be effective strategies for reducing this level of substance use. The acceptance of this second hypothesis that psychosocial factors significantly predict psychoactive substance use among undergraduate students underscores the necessity of comprehensive and holistic approaches to substance use prevention. It is not enough to discourage substance use but to create an environment that supports students' mental and emotional well-being, thereby reducing the need for such coping mechanisms.

The third hypothesis that demographic variables will jointly predict psychoactive substance use among students of Abia State Polytechnic was supported. Our result reveals significant findings that contribute to our understanding of substance use within the study population. The coefficient of multiple correlation of our data suggests that approximately a quarter of the variations in psychoactive substance use can be attributed to demographic factors such as age, sex, religion, and year of study. This aligns with a previous study in Imo State, Nigeria, that emphasizes the influence of demographic variables on substance use behaviors among undergraduates (Duru et al., 2017).

Regression analysis revealed that age, religion, and year of study were independent predictors of psychoactive substance use in our research. The positive coefficient for age suggests that older students are more likely to engage in psychoactive substance use. This finding is consistent with the work of Sani et al. (2024), which showed that older adolescents and young adults in Kaduna, Nigeria, exhibit higher levels of substance use due to increased independence and exposure to social situations that may promote such behaviors. However, Siro (2014) found that young people are vulnerable to drug and substance abuse globally. The year of study also negatively correlated with psychoactive substance use in our study, suggesting that students in higher academic years may be more focused on their studies and less engaged in substance use. This is consistent with a previous study by Omole et al. (2022), which showed that the level of study independently and jointly predicted psychoactive substance use by students. The negative coefficient for religion indicates that students with stronger religious beliefs may be less likely to use psychoactive substances. This is supported by findings from a study in southeast Nigeria, where more religiously committed students reported less use of psychoactive substances (Kator et al., 2018). Therefore, religion will negatively predict substance abuse.

Our findings underscore the urgent need for action to address the high prevalence of psychoactive substance use and the various psychosocial factors fueling this destructive behavior among undergraduate students at Abia State Polytechnic. These findings likely reflect a broader trend among Nigerian undergraduate students, demanding immediate attention from school authorities to investigate toxic psychosocial factors in the school environment. The creation of a functional and confidential counseling unit that can relate to these students individually is a pressing need. Policymakers and health professionals should also implement effective prevention and intervention strategies without delay. Addressing this issue is not just a matter of enhancing the student's well-being and academic performance, but it is about securing a positive future for our youth.

Limitations

The cross-sectional study used snowball sampling; only a few students responded.

Its results cannot be generalized to the entire population because we did not get a good percentage of the student population. Also, the prevalence of Substance use was determined through a self-reported questionnaire, so 100% reliability cannot be guaranteed due to possible recall bias.

The questionnaire in this study contained many items, and respondents found it challenging to complete. This could lead to answering any response without proper analysis.

Recommendation

We recommend that school management introduce toxicology test screening to help dictate the early use of substances for intervention. This proactive approach can identify students at risk of substance use early, allowing for timely intervention and support.

School management should, as a matter of urgency, introduce a functional counseling unit that will offer individualized and confidential counseling. This personalized approach is crucial in tackling the various psychosocial factors necessitating substance use. Students need a safe space where they can openly discuss their issues and receive tailored support to address their unique challenges.

The National Board on Technical Education (NBTE) should introduce general courses on drug knowledge to sensitize students on the dangers of substance use.

Declaration by Authors

Ethical Approval: Ethical clearance was obtained from the Ethics Committee, Department of the school. While informed consent was obtained from respondents as they click on the link for the questionnaires

Source of Funding: None

Conflict of Interest: The authors declare no conflict of interest.

ORCID iD

Chiamaka R. Nwaoru https://orcid.org/0009-0008-8940-8649

David O. Iloma https://orcid.org/0000-0002-4370-437x.

Ignatius N. Ijere https://orcid.org/0000-0002-2400-9806

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The authors declare no competing interests.

Prevalence and Psychosocial Factors Influencing Substance Use Among Students of Abia State Polytechnic: Implication for Policy Makers

Status:

Version 1

Abstract

Introduction

Methods

Study Design

Measure

Data analyses

Participants

Results

Discussion and Conclusion

Declarations

References

Additional Declarations

Status:

Version 1