Prevalence, Perceptions, and Social Determinants of Psychoactive Substance Use among Adolescents in Public and Private Secondary Schools in Uyo, Akwa Ibom State, Nigeria

Abstract

Background: Adolescence is a critical developmental stage during which health behaviours with long-term consequences are often established. Psychoactive substance (PAS) use commonly begins during this period, necessitating continuous monitoring and understanding of associated risk factors.

Objective: To compare the prevalence, perceptions, and social determinants of PAS use among adolescents in public and private secondary schools in Uyo, Nigeria.

Methods: A comparative cross-sectional mixed-methods study was conducted among 844 adolescents selected through multistage sampling from public and private secondary schools. Data were collected using a pretested, interviewer-administered questionnaire adapted from the WHO Global Assessment Programme. Quantitative data were analysed using SPSS version 25, with descriptive and inferential statistics applied. Statistical significance was set at p<0.05. Qualitative data were thematically analysed. Ethical approval was obtained from the University of Uyo Teaching Hospital Ethics Committee.

Results: A total of 416 private-school and 428 public-school students participated. Mean ages were 13.1 ± 2.0 years (private) and 13.7 ± 2.2 years (public). Lifetime alcohol use was significantly higher in public schools (4.7%) than private schools (2.2%) (p<0.05). Other PAS use was low and occurred only among students with prior alcohol use. Key predictors of PAS use included family substance use and peer influence in both school types.

Conclusion: PAS use was generally low but higher among public-school students. Alcohol appears to act as a gateway substance. Family and peer influences are significant determinants, highlighting the need for targeted school-based and community interventions.