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

Nawel Zammit 1 , Jihen Maatoug 2 , Rim Ghammam 2 , Sana Bhiri 2 ,  and Hassen Ghannem 2
  • 1 Department of Epidemiology, Farhat Hached University Hospital, 4000 Sousse, Tunisia
  • 2 Department of Epidemiology, Farhat Hached University Hospital, Sousse, Tunisia
Nawel Zammit
  • Corresponding author
  • Department of Epidemiology, Farhat Hached University Hospital, 4000 Sousse, Tunisia
  • Email
  • Search for other articles:
  • degruyter.comGoogle Scholar
, Jihen Maatoug, Rim Ghammam, Sana Bhiri and Hassen Ghannem

Abstract

Introduction

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

Aims

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

Methods

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.

Results

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)].

Conclusion

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

  • [1]

    Castellanos-Ryan N, O’Leary-Barrett M, Conrod PJ. Substance-use in childhood and adolescence: a brief overview of developmental processes and their clinical implications. J Can Acad Child Adolesc Psychiatry. 2013;22(1):41–6.

    • PubMed
    • Export Citation
  • [2]

    McCarty CA, Rhew IC, Murowchick E, McCauley E, Stoep AV. Emotional health predictors of substance use initiation during middle school. Psychol Addict Behav. 2012;26(2):351–7.

    • Crossref
    • PubMed
    • Export Citation
  • [3]

    McArdle P. Use and misuse of drugs and alcohol in adolescence. Br Med J. 2008;337(7660):46–50.

  • [4]

    Scheier LM, Botvin GJ. Effects of early adolescent drug use on cognitive efficacy in early-late adolescence: a developmental structural model. J Subst Abuse. 1995;7(4):379–404.

    • Crossref
    • PubMed
    • Export Citation
  • [5]

    Arria AM, Garnier-Dykstra LM, Caldeira KM, Vincent KB, Winick ER, O’Grady KE. Drug use patterns and continuous enrollment in college: results from a longitudinal study. J Stud Alcohol Drugs. 2013;74(1):71–83.

    • Crossref
    • PubMed
    • Export Citation
  • [6]

    Henningfield JE, Clayton R, Pollin W. Involvement of tobacco in alcoholism and illicit drug use. Br J Addict. 1990;85(2):279–92.

    • Crossref
    • PubMed
    • Export Citation
  • [7]

    Cavazos-Rehg PA, Krauss MJ, Spitznagel EL, Grucza RA, Bierut LJ. Youth tobacco use type and associations with substance use disorders. Addiction. 2014;109(8):1371–80.

    • Crossref
    • PubMed
    • Export Citation
  • [8]

    Gau SS, Chong M-Y, Yang P, Yen C-F, Liang K-Y, Cheng AT. Psychiatric and psychosocial predictors of substance use disorders among adolescents: longitudinal study. Br J Psychiatry. 2007;190(1):42–8.

    • Crossref
    • PubMed
    • Export Citation
  • [9]

    Beal AC, Ausiello J, Perrin JM. Social influences on health-risk behaviors among minority middle school students. J Adolesc Health. 2001;28(6):474–80.

    • Crossref
    • PubMed
    • Export Citation
  • [10]

    Tot S, Yazici K, Yazici A, Metin O, Bal N, Erdem P. Psychosocial correlates of substance use among adolescents in Mersin, Turkey. Public Health. 2004;118(8):588–93.

    • Crossref
    • PubMed
    • Export Citation
  • [11]

    Chekib Z, Zammit N, Manel L, Menel M, Elghardallou M, Jihen S, Illicit substance use among Tunisian college students: prevalence and risk factors. Int J Adolesc Med Health 2017. DOI: Ahead of print.

    • Crossref
    • PubMed
    • Export Citation
  • [12]

    Aounallah Skhiri H, Zalia H, Zid T, Boukassoula H, Ben Salah N. Tunisia drug situation and policy. P-PG/MedNET. 2014:12. Available from: https://www.coe.int/T/DG3/Pompidou/Source/Images/country%20profiles%20fllags/profiles/CP%20Tunisia%20English%20V2.pdf. (cited 2017 Oct 23).

  • [13]

    Degenhardt L, Stockings E, Patton G, Hall WD, Lynskey M. The increasing global health priority of substance use in young people. Lancet Psychiatry. 2016;3(3):251–64.

    • Crossref
    • PubMed
    • Export Citation
  • [14]

    Bogt TF, de Looze M, Molcho M, Godeau E, Hublet A, Kokkevi A, et al. Do societal wealth, family affluence and gender account for trends in adolescent cannabis use? A 30 country cross-national study: trends in adolescent cannabis use. Addiction. 2014;109(2):273–83.

    • Crossref
    • PubMed
    • Export Citation
  • [15]

    Loffredo CA, Shaker YE, Jillson IA, Boulos DN, Saleh DA, Garas M, et al. Prevalence and correlates of substance use by Egyptian school youth. Int J Alcohol Drug Res. 2017;6(1):37.

    • Crossref
    • Export Citation
  • [16]

    Vega WA, Aguilar-Gaxiola S, Andrade L, Bijl R, Borges G, Caraveo-Anduaga JJ, et al. Prevalence and age of onset for drug use in seven international sites: results from the international consortium of psychiatric epidemiology. Drug Alcohol Depend. 2002;68(3):285–97.

    • Crossref
    • Export Citation
  • [17]

    Lubman DI, Yücel M, Lawrence AJ. Inhalant abuse among adolescents: neurobiological considerations. Br J Pharmacol. 2008;154(2):316–26.

    • PubMed
    • Export Citation
  • [18]

    Kurtzman TL, Otsuka KN, Wahl RA. Inhalant abuse by adolescents. J Adolesc Health Off Publ Soc Adolesc Med. 2001;28(3):170–80.

  • [19]

    WHO EMRO. Global Youth Tobacco Survey fact sheets and country reports. Available from: http://www.emro.who.int/fr/tobacco/gtss-youth-survey/gyts-factsheets-reports.html#gyts-country-reports. (cited 2017 Nov 18).

  • [20]

    Taylor M, Collin SM, Munafò MR, MacLeod J, Hickman M, Heron J. Patterns of cannabis use during adolescence and their association with harmful substance use behaviour: findings from a UK birth cohort. J Epidemiol Community Health. 2017;71(8):764–70.

    • Crossref
    • PubMed
    • Export Citation
  • [21]

    Hayatbakhsh MR, Mamun AA, Najman JM, O’Callaghan MJ, Bor W, Alati R. Early childhood predictors of early substance use and substance use disorders: prospective study. Aust N Z J Psychiatry. 2008;42(8):720–31.

    • Crossref
    • PubMed
    • Export Citation
  • [22]

    Humensky JL. Are adolescents with high socioeconomic status more likely to engage in alcohol and illicit drug use in early adulthood? Subst Abuse Treat Prev Policy. 2010;5:19.

    • Crossref
    • PubMed
    • Export Citation
  • [23]

    Hasler BP, Smith LJ, Cousins JC, Bootzin RR. Circadian rhythms, sleep, and substance abuse. Sleep Med Rev. 2012;16(1):67–81.

    • Crossref
    • PubMed
    • Export Citation
  • [24]

    Hernandez L, Cancilliere M, Graves H, Chun T, Lewander W, Spirito A. Substance use and depressive symptoms among adolescents treated in a pediatric emergency department. J Child Adolesc Subst Abuse. 2016;25(2):124–33.

    • Crossref
    • Export Citation
  • [25]

    Scholes-Balog KE, Hemphill SA, Patton GC, Toumbourou JW. Relationships between substance use and depressive symptoms: a longitudinal study of Australian adolescents. J Early Adolesc. 2015;35:538–61.

    • Crossref
    • Export Citation
  • [26]

    Brady KT, Haynes LF, Hartwell KJ, Killeen TK. Substance use disorders and anxiety: a treatment challenge for social workers. Soc Work Public Health. 2013;28(0):407–23.

    • Crossref
    • PubMed
    • Export Citation
  • [27]

    Lijffijt M, Hu K, Swann AC. Stress modulates illness-course of substance use disorders: a translational review. Front Psychiatry (Internet). 2014;5:83.

  • [28]

    Urberg KA, Luo Q, Pilgrim C, Degirmencioglu SM. A two-stage model of peer influence in adolescent substance use: individual and relationship-specific differences in susceptibility to influence. Addict Behav. 2003;28(7):1243–56.

    • Crossref
    • PubMed
    • Export Citation
  • [29]

    Griffin KW, Botvin GJ, Scheier LM, Diaz T, Miller NL. Parenting practices as predictors of substance use, delinquency, and aggression among urban minority youth: moderating effects of family structure and gender. Psychol Addict Behav. 2000;14(2):174–84.

    • Crossref
    • PubMed
    • Export Citation
  • [30]

    Borawski EA, Ievers-Landis CE, Loveergreen LD, Trapl ES. Parental monitoring, negotiated unsupervised time, and parental trust: the role of perceived parenting practices in adolescent health risk behaviors. J Adolesc Health Off Publ Soc Adolesc Med. 2003;33(2):60–70.

    • Crossref
    • Export Citation
  • [31]

    Vermeulen-Smit E, Verdurmen JE, Engels RC, Vollebergh WA. The role of general parenting and cannabis-specific parenting practices in adolescent cannabis and other illicit drug use. Drug Alcohol Depend. 2015;147:222–8.

    • Crossref
    • PubMed
    • Export Citation
  • [32]

    Needle R, McCubbin H, Wilson M, Reineck R, Lazar A, Mederer H. Interpersonal influences in adolescent drug use – the role of older siblings, parents, and peers. Int J Addict. 1986;21(7):739–66.

    • Crossref
    • PubMed
    • Export Citation
  • [33]

    Brook JS, Rubenstone E, Zhang C, Brook DW. Maternal predictors of comorbid trajectories of cigarette smoking and marijuana use from early adolescence to adulthood. Addict Behav. 2012;37(1):139–43.

    • Crossref
    • PubMed
    • Export Citation
  • [34]

    Richardson CG, Kwon JY, Ratner PA. Self-esteem and the initiation of substance use among adolescents. Can J Public Health. 2012;104(1):e60–3.

    • PubMed
    • Export Citation
Purchase article
Get instant unlimited access to the article.
$42.00
Log in
Already have access? Please log in.


or
Log in with your institution

Journal + Issues

The International Journal of Adolescent Medicine and Health ( IJAMH) provides an international and interdisciplinary forum for the dissemination of new information in the field of adolescence. IJAMH covers all aspects of adolescence. The International Editorial Board is dedicated to producing a high quality scientific journal of interest to researchers and practitioners from many disciplines.

Search