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.

Keywords: WHO-ASSIST; adolescents; substance use; tobacco; young people.

Graphical abstract

Figure 1.

Map of India showing the distribution of substance users (N = 1,630). Note: Tobacco was consumed by 26.4% (430/1630), followed by alcohol (26.1%, 424/1630) and cannabis (9.5%, 155/1630). More than one substance was consumed by 22.2% (362/1630). Injectable drugs were used by 3.5% (58/1630), which was 11% (58/524) of the substance users. The median substance use score as per the ASSIST tool was the highest for opioids at 29.5 (12–36) and lowest for hallucinating drugs at 3 (0–6). Tobacco and alcohol had median scores of 15 (11–22) and 16 (6–26), respectively. Among opioid users, majority (55.4%, 51/92) were in the high involvement category (Table 1). Substances were introduced to the users majorly by friends (87.2%, 457/524), followed by family members (7.4%, 39/524). Less than 5% (26/524) started using substances by themselves, either through the internet or accidentally at parties.