Abstract
BACKGROUND: Alcohol use is a major global public health issue due to associated negative physical, mental, and social health outcomes among adolescents. This study examined the current alcohol use, drunkenness, and alcohol problems and associated correlates among 16,331 adolescents from eight selected sub-Saharan African countries. METHODS: A secondary analysis of the Global School-based Student Health Survey (GSHS) datasets from eight cross-sectional surveys was conducted. The STATA statistical software package (Version 17) was used for the data analysis. Chi-square and multivariate logistic regression analyses were conducted with statistical significance set at p-value < 0.05. RESULTS: We found that the overall prevalence of current alcohol use, drunkenness, and alcohol-related problems among adolescents was 12.56%, 8.32%, and 4.74%, respectively. Seychelles recorded the highest rates of current alcohol use (47.21%) and lifetime drunkenness (42.17%), while Tanzania reported the lowest for both (2.89% and 1.41%, respectively). The highest prevalence of alcohol-related problems was observed in Namibia (13.76%), with the lowest again in Tanzania (1.89%). Risk factors associated with alcohol use behaviours included male gender, older adolescent age (15-18 years), mental health challenges (anxiety, loneliness, suicidal behaviours), and psychosocial issues (truancy, bullying, fighting, physical attacks, lack of close friends, hunger, cigarette and marijuana use). However, peer support and positive parenting emerged as protective factors. CONCLUSION: This study highlights the urgency of addressing alcohol use behaviours among adolescents, taking into cognizance the prevalence and country-level variations. Multilevel vulnerability and resilience factors consistent with the socio-ecological model were identified, and they should be incorporated into school-based public health interventions to reduce the risk and burden of alcohol use among adolescents in SSA.