Abstract
INTRODUCTION: substance use among adolescents is on the rise, estimated at 15.3% in Buea, Cameroon (2021). However, factors associated with this practice are still understudied in the Cameroonian setting. METHODS: a cross-sectional study (January to May 2022) was conducted to document substance use among students of two high schools in Yaoundé, Cameroon. Socio-demographics, psychosocial parameters, and history of substance use were documented among students via self-administered questionnaires. Validated tools (including the PHQ-4 and the 7-item Weinberger adjustment inventory) were used to assess anxiety, depression, self-esteem, and other youth behavioural risks. Descriptive analyses and multiple logistic regression were performed. RESULTS: we recruited 373 students (43.0% male, mean age: 16 ± 1.6 years). Overall, 42.4% had already consumed at least one substance, notably alcohol (40.5%), vap/shisha (8.3%), and tobacco/cigarettes (2.7%). Previous tramadol use was reported by 6 (1.6%) participants. The multiple logistic regression analysis found that the following factors were associated with increased odds of lifetime substance use among students: male gender (OR: 2.013, 95% CI: 1.127-3.595), depression (OR: 1.238, 95% CI: 1.031-1.487) and low self-esteem (OR: 1.083, 95% CI: 1.003-1.168). Meanwhile, increased parental concerns about drug use served as a protective factor for substance use among the students (OR: 0.196, 95% CI: 0.078-0.496). CONCLUSION: about two-fifths of the enrolled high school students had already consumed one or more psychoactive substances, highlighting the need for urgent preventive interventions. For optimal impact, substance use preventive programs should include self-esteem building among the students and improved parental attitudes towards drugs.