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International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board: Birch, Diana ML / Blum, Robert W. / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie / Tenenbaum, Ariel

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Ahead of print


Tobacco use: the main predictor of illicit substances use among young adolescents in Sousse, Tunisia

Nawel Zammit
  • Corresponding author
  • Department of Epidemiology, Farhat Hached University Hospital, 4000 Sousse, Tunisia, Phone: 00216 97 226 340
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/ Jihen Maatoug / Rim Ghammam / Sana Bhiri / Hassen Ghannem
Published Online: 2018-10-24 | DOI: https://doi.org/10.1515/ijamh-2017-0213



Early adolescence is a critical period usually associated with experimentation with illicit substances. In Tunisia few studies explored these risk behaviors among young adolescents.


To evaluate the prevalence and the predictors of the use of illicit substances among the young adolescents of Sousse.


A cross-sectional study was conducted in the region of Sousse, Tunisia during the 2013/2014 school year among 4272 schoolchildren in 16 public middle schools. Data about psychosocial characteristics and risk behaviors among the schoolchildren, their parents, their siblings and their friends were collected anonymously using a self-administrated questionnaire.


Females represented 50.5% of participants. The mean age of schoolchildren was 13.3 (±1.2) years. Lifetime illicit substances use prevalence was 2.9% [confidence interval (CI) 95%: (2.4%–3.4%)] and lifetime use of tobacco prevalence was 12.9% [CI 95%: (11.9%–13.9%)]. The age of tobacco onset was significantly younger to the age of experimentation with illicit substances. Insomnia, sadness and illicit substances use among peers were associated with illicit substances use among participants. While the most influential risk factor on illicit substances use was current cigarette smoking with an adjusted odds ratio (OR) of 7.2 [CI 95%: (4.5–11.2)].


A national substances use prevention program should be implemented in the schools of Tunisia with an emphasis on tobacco use prevention.

Keywords: adolescent; cannabis; inhalant abuse; tobacco use


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About the article

Received: 2017-12-11

Accepted: 2018-02-19

Published Online: 2018-10-24

Conflicts of interest: none.

Citation Information: International Journal of Adolescent Medicine and Health, 20170213, ISSN (Online) 2191-0278, DOI: https://doi.org/10.1515/ijamh-2017-0213.

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