Risk and protective factors for adolescent substance use: a comparative study of secondary school students in rural and urban areas of Osun State, Nigeria

Abstract

Abstract Background: Substance use is a leading adolescent health problem globally, but little is known regarding associated factors for adolescent substance use in Nigeria. This study compared the prevalence of substance use among in-school adolescents in urban and rural areas of Osun State, Nigeria, and identified risk and protective factors. Methods: This cross-sectional study involved 600 randomly selected adolescents (aged 10–19 years) from rural and urban areas of Osun State, Nigeria. Data were collected using the facilitated self-completed questionnaire method. Binary logistic regression was used to examine the association of individual, peer, and parental factors with adolescent substance use. Adjusted odds ratio (OR) and 95% confidence interval (CI) were obtained. Results: About two-thirds of respondents had used substances in both rural (65.7%) and urban areas (66.0%) (p=0.93). Logistic analysis showed private school attendance as a risk factor for substance use (OR=2.32, 95% CI=1.20–4.46) and adolescent disapproval of adult substance use as a protective factor (OR=0.47, 95% CI=0.27–0.82) in rural areas. For urban areas, having friends who use substances (OR=4.04, 95% CI=1.39–11.6) and a mother having had tertiary education (OR=3.34, 95% CI=1.06–10.4) were risk factors while parental disapproval of substance use (OR=0.50, 95% CI=0.28–0.90) was a protective factor. Conclusion: Lifetime prevalence of substances is high among in-school adolescents in Osun State. The risk and protective factors for adolescent substance use somewhat differ for rural and urban areas, and these have implications for designing effective intervention strategies.