Determinants of substance use among young people attending primary health centers in India

Abstract

Background: Substance use is a complex condition with multidimensional determinants. The present study aims to find the prevalence and determinants of substance use among young people attending primary healthcare centers in India. Methods: A multicentric cross-sectional study was conducted across 15 states in India on 1,630 young people (10-24 years) attending primary health centers. The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to capture data on substance use. The degree of substance involvement was assessed and multivariate regression analysis was conducted to determine the risk factors of substance use. Results: The prevalence of substance use was 32.8%, with a median substance initiation age of 18 years. Among the substance users, 75.5% began before completing adolescence. Tobacco (26.4%), alcohol (26.1%) and cannabis (9.5%) were commonly consumed. Sociodemographic determinants included higher age, male gender, urban residence, positive family history, northeastern state residence and lower socioeconomic class. Over 80% of users had moderate or high involvement.Conclusions: High substance use prevalence among young people in Indian healthcare centers underscores the urgency of targeted intervention. Insights on determinants guide effective prevention strategies for this complex public health issue. Impact statementOur study findings align with the global scenario where tobacco use remains a significant public health concern. India, being the second largest consumer of tobacco globally, faces substantial health risks associated with its use. The study also highlights the high prevalence of alcohol and cannabis use among young individuals. The early initiation of substance use underscores the urgency of targeted interventions during early adolescence. The sociodemographic determinants identified, such as age, male gender, urban residence, family history, and lower socioeconomic class, provide valuable insights for developing targeted prevention and intervention strategies. These determinants mirror findings from previous research, emphasizing the need for multifaceted approaches that consider social, economic and cultural factors influencing substance use. The study's geographical variation in substance use prevalence, with Mizoram having the highest and Kerala having the lowest, suggests the importance of regional context in understanding and Cambridge Prisms: Global Mental Health www.cambridge.org/gmh