Cannabis use in sub‐Saharan Africa: A systematic review and meta‐analysis

Abstract

AbstractBackground and AimsThe most available data on the prevalence of cannabis use come from population surveys conducted in high‐income countries in North America, Oceania and Europe. Less is known about the prevalence of cannabis use in Africa. This systematic review aimed to summarize general population‐level cannabis use in sub‐Saharan Africa since 2010.MethodsA comprehensive search was conducted in PubMed, EMBASE, PsycINFO and AJOL databases in addition to Global Health Data Exchange and grey literature without language restriction. Search terms related to ‘substance’, ‘Substance‐Related Disorders’ and ‘Prevalence’ and ‘Africa South of the Sahara’ were used. Studies that reported cannabis use in the general population were selected, while studies from clinical populations and high‐risk groups were excluded. Prevalence data on cannabis use in the general population of adolescents (10–17 years) and adults (≥ 18 years) in sub‐Saharan Africa were extracted.ResultsThe study included 53 studies for the quantitative meta‐analysis and included 13 239 participants. Among adolescents, the life‐time, 12‐month and 6‐month prevalence of cannabis use were 7.9% [95% confidence interval (CI) = 5.4–10.9%], 5.2% (95% CI = 1.7–10.3%) and 4.5% (95% CI = 3.3–5.8%), respectively. The corresponding life‐time, 12‐month and 6‐month prevalence of cannabis use among adults were 12.6% (95% CI = 6.1–21.2%), 2.2% (95% CI = 1.7–2.7%, with data only available from Tanzania and Uganda) and 4.7% (95% CI = 3.3–6.4%), respectively. The male‐to‐female life‐time cannabis use relative risk was 1.90 (95% CI = 1.25–2.98) among adolescents and 1.67 (CI = 0.63–4.39) among adults.ConclusionsLife‐time cannabis use prevalence in sub‐Saharan Africa appears to be approximately 12% for adults and just under 8% for adolescents.