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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 33  |  Issue : 3  |  Page : 208-212

A study to assess the prevalence and pattern of substance use among male adolescents in suburban area of Delhi


1 Department of Psychiatric Nursing, Institute of Psychiatry, Kolkata, West Bengal, India
2 Department of Psychiatry, Indira Gandhi Medical College and Research Institute, Kathirkamam, Puducherry, India
3 College of Nursing, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication14-Sep-2017

Correspondence Address:
Liza Thankam Daniel
Asst. Professor, Department of Psychitric Nursing, Institute of Psychiatry, Kolkata - 700 025, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9962.214596

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  Abstract 


Aim of the Study: To assess the prevalence and pattern of substance use among male adolescents in Sunder Nagari, New Delhi. Materials and Methods: A cross-sectional survey was designed to assess the prevalence and pattern of substance use among male adolescents in New Delhi. One hundred and ten adolescents were conveniently selected from Sunder Nagari, New Delhi. Adolescents aged more than 11 years and able to read and write Hindi or English were included in the study. A structured questionnaire for demographic variables was developed by researchers. To assess the prevalence and pattern of substance use, a structured questionnaire was prepared with the reliability coefficient of 0.94 (test-retest reliability) with a content validity index of 0.90 between the experts. Data were collected from the subjects after getting their written consent. Data analyzed using statistical package SPSS version 17.0. The level of significance was set as P < 0.05. Results: The study findings revealed that nearly more than half (55.6%) of the male adolescents reported the use of one or more substances in their lifetime. About 44.26% of the adolescents started to use substances before 13 years of age. Most common reason specified by the subjects to take substance were to be liked by friends (57.38%), to feel like an adult (24.6%), and few of them reported: “like the feeling of substances” (13.11%) as reason for taking substances. Common substances used by the subjects were any kind of tobacco (77.05%), inhalants (26.23%), and alcohol (11.47%). Most of the subjects were getting substances from their friends (85.25%) and only a few (14.75%) by themselves. Association analyses revealed that adolescents who studied less than 10th standard reported more usage of any kind of substances than who studied more than 10th standard. More prevalence of substance use was seen among adolescents who were from nuclear family. Subjects who had less than two siblings reported more substance use. Conclusion: Early onset of substance use is seen among adolescents. Low educational status and the nuclear family are associated with their substance use. Friends are the key source of substances and their initiation of substance use. Based on these findings, following recommendations can be considered. (i) Maintaining the substance use control through legislation by which controlling of selling substances under 18 years of age and prohibition of substance use in public places seem to be effective and (ii) early onset of substance use calls for effective measures directed against the younger age groups. Therefore, educational intervention at the school level appears to be the most feasible measure to prevent the initiation of substance use among adolescents.

Keywords: Male adolescents, pattern, prevalence, substance use


How to cite this article:
Daniel LT, Krishnan G, Gupta S. A study to assess the prevalence and pattern of substance use among male adolescents in suburban area of Delhi. Indian J Soc Psychiatry 2017;33:208-12

How to cite this URL:
Daniel LT, Krishnan G, Gupta S. A study to assess the prevalence and pattern of substance use among male adolescents in suburban area of Delhi. Indian J Soc Psychiatry [serial online] 2017 [cited 2017 Dec 12];33:208-12. Available from: http://www.indjsp.org/text.asp?2017/33/3/208/214596




  Introduction Top


Substance use refers to the use of any psychoactive substance or drug, including licit and illicit drugs, other than when medically indicated.[1],[2] Psychoactive substance use poses a threat to the health, social and economic fabric of families, communities, and nations. Adolescence is a time of experimentation and risk-taking, and the initiation of substance use often begins during this period. The consequences of drug use are often multifaceted. This habit not only affects health, education, and occupational career but also incurs a huge financial and social burden to the society.[3]

According to the World Health Organization substance abuse is persistent or sporadic drug use inconsistent with or unrelated to acceptable medical practice. Today, there is no part of the world that is free from the curse of drug trafficking and drug addiction. All over the world, millions of people with drug addiction are leading miserable lives between life and death. India too is caught in this vicious circle of drug abuse, and the numbers of drug addicts are increasing day by day.[4]

Drug abuse is a complex phenomenon, which has various social, cultural, biological, geographical, historical, and economic aspects. The disintegration of the old joint family system, the absence of parental love and care in modern families where both parents are working, decline of old religious, and moral values, etc., lead to a rise in the number of drug addiction cases, who take drugs to escape hard realities of life. Drug use, misuse, or abuse are also primarily due to the nature of the drug abused, the personality of the individual, and the individual's immediate environment.[5]

The epidemic of substance abuse in a young generation has assumed alarming dimensions in India. Changing cultural values, increasing economic stress, and dwindling supportive bonds are leading to initiation into substance use. Substance use in adolescence is commonly associated with unsafe sexual behavior, school and social misbehavior, poor academic performance, and may eventually lead to the continuation of drug use in adulthood. Student substance use surveys provide an essential source of information to identify the high-risk group, extent, and pattern of substance use and sociodemographic correlates. Such surveys are also vital for planning and coordination of intervention programs and when repeated periodically, they provide a trend of substance use in a population.[6]

The incidence of drug abuse among children and adolescents is higher than the general population. This is notably because youth is a time for experimentation and identity forming. In developed countries, drug abuse among youth is generally associated with particular youth subcultures and lifestyles.[7]

The student drug use survey conducted among senior secondary schools of Imphal revealed that substance use was very common, and more than 50% of the students reported the use of one or more substances. Tobacco and alcohol were the most common substances used. Substance use was higher among males and those students whose fathers or siblings used substances. A majority of the students reported that their friends introduced them to substance use.[8]

A high prevalence of tobacco use (39.5%) was reported among medical students of CMC, Vellore while a high prevalence of cannabis use was found in college students in Varanasi.[9],[10] One study from Tirupati reported that the mode of consumption of tobacco was mostly in the form of smoking (85.5%), and (61.5%) of subjects were smoking 6–10 cigarettes per day.[11]

Drug abuse has created a detrimental impact on the society. It has led to increase in the crime rate. Individuals with addiction resort to crime to pay for their drugs. Drugs remove inhibition and impair judgment egging one to commit offenses. The incidence of eve-teasing, group clashes, assault, and impulsive murders increases with drug abuse. In a study conducted in India, the mean age of the initiation of substance use was 20.89.[12] A significantly higher proportion of substance users were associated with predisposing factors such as joint family, parental abuse status, working status, and illiteracy/school-drop out.[13]

Hence, this community-based study was conducted among male adolescents to investigate the prevalence and pattern of substance use and any associated sociodemographic factors for planning and developing effective strategies to reduce substance use among this high-risk population.


  Materials and Methods Top


A cross-sectional survey was done to assess the prevalence and pattern of substance use among male adolescents in suburban area of New Delhi. One hundred and ten adolescents were conveniently selected from Sunder Nagari, New Delhi. Adolescents aged more than 11 years, able to read and write Hindi or English were included in the study, and persons who are mentally unsound and not willing to participate were excluded from the study. A structured questionnaire for demographic variables was developed by researchers. To assess the prevalence and pattern of substance use, a structured questionnaire was prepared with the reliability coefficient of 0.94 (test-retest reliability) with a content validity index of 0.90 between the experts. Data were collected from the subjects after getting their written consent. Descriptive statistics (mean, frequency, percentage) and inferential statistics (Chi-square test) were applied to analyze the data using statistical package SPSS 17.0 (SPSS Inc., 233 South Wacker Drive, 11th Floor, Chicago). The level of significance was set as P < 0.05.


  Results Top


As shown in [Table 1], all subjects were male and had mean age of 15.06 (standard deviation = 2.358) years. More than half (52.73%) of the subjects had education below 10th standard, nearly two-third of them were from nuclear family and (67.27%). Most of the subjects (75.45%) had monthly family income of <Rs. 5000/- and 68.18% of the subjects had ≤2 siblings in the family.
Table 1: Sociodemographic characteristics of the subjects

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Substance use profile among subjects

As shown in [Table 2], more than half of the subjects (55.38%) were using any kind of substances presently, of which, 60.65% were using the substance once or twice in a month. About 44.26% of the adolescents started to use substances before 13 years of age. Most common reason specified by the subjects to take substance was to be like by friends (57.38%), to feel like an adult (24.6%), and few of them reported like the feeling of substances (13.11%) as reason for taking substances. Common substances used by the subjects were any kind of tobacco (77.05%), inhalants (26.23%), and alcohol (11.47%). Most of the subjects were getting substances from their friends (85.25%) and only a few (14.75%) by themselves.
Table 2: Substance use profile of the subjects

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Relationship between substance use and sociodemographic characteristics

Association analyses were carried out to see the relationship of substance use with sociodemographic variables. As shown in [Table 3], among the sociodemographic variables only educational status of subjects, type of family, and number of siblings had a significant association with substance use. Adolescents who had education <10th standard reported more usage of any kind of substances than who had education more than 10th standard. More prevalence of substance use was expressed by adolescents who were from nuclear family. Subjects who had less than two siblings reported more substance use. No other demographic variables had a significant association with prevalence of substance use among adolescents.
Table 3: Relationship between substance use and sociodemographic characteristics

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  Discussion Top


Substance use surveys among male adolescents provide useful information about the extent and pattern of substance use among children. This cross-sectional study was conducted with the aim to understand prevalence and pattern of substance use among male adolescents in New Delhi. Study findings revealed that nearly more than half (55.6%) of the male adolescents reported the use of one or more substances in their lifetime. All the studies including the present one reported the high prevalence of substance use among male adolescents in India.[7],[8],[9]

There could be several reasons for the high prevalence of tobacco use among youths. Both cigarettes and smokeless tobacco products are easily available to students, and their use is socially acceptable.[14]

The important finding noted in this study is that more than half of the subjects were used substances such as solvents such as (kores, dendrite, petrol, and nail polish) which are very high compared to the previous study finding.[8]

On the other hand, only 20% of the subjects reported that use of alcohol which was comparatively less to previous studies reported from India.[15] In our study, none of the adolescents reported the use of heroin, opiates, and cannabis. This could be because of an effective campaign by governmental and nongovernmental organizations against the use of these substances in the state.

Nearly half of the subjects reported that they were started to use substances before 13 years of age which was similar to the previous study finding.[15] This reflects the easy availability of substances to young population and the use of substances during festivals could be another reason for the high prevalence. Substances such as betel nuts, tobacco, cigarettes, cannabis, and locally prepared alcohol are offered traditionally during various ceremonies in New Delhi.

Most common reason specified by the subjects for taking substances was to be like by friends, and most of them were getting substances from their friends. Friends may influence a person to start using substances by making them available, providing an example, or defining the nature of the physiological experience.[8],[15]

Few of them reported being to feel like adult and like the effects of substances. Experimenting with drugs for enjoyment or out of curiosity however is particularly dangerous because recreational use may progress to more problematic use and dependence. Several school-based education programs that focused on developing refusal skills among children were successful in reducing the prevalence of substance use among adolescents.[16],[17]

Most of the subjects (72.22%) reported the use of substances once or twice in a month which was comparatively less than previous studies.[8],[9],[13] The reason could be because peer pressure continues to use substances and making frequency shorter with knowing the detrimental effects of substance use.

Association analysis revealed that adolescents who studied < 10th standard reported more usage of any kind of substances than who studied more than 10th standard which as reported in the previous study.[13] It might be because of lack of awareness about detrimental effects of drug use and easy availability of substances.

More prevalence of substance use was expressed by adolescents who were from nuclear family.[18] The reason could be a lack of supervision by their parents and no support members in the family to talk about issues related to substance use as reported by subjects who had less than two siblings in the family.

Schools are often recognized as important sites for efforts toward prevention of substance use among adolescents. School substance uses health policy is a key component of health promotion in school. Such policy describes the framework within which the whole school community manages issues relating to substance use. The intervention strategies such as school and community health education programs often include providing factual information about substance use, management of alcohol, tobacco, and drug-related incidents, imparting life skills training, legislation relevant to substance misuse, and provision of staff training can be very useful in the prevention substance use among adolescents.


  Conclusion Top


Our findings indicate a high prevalence of tobacco and inhalants use among adolescents in Delhi. The onset of substance use is early than 13 years. Low educational status and less family members are associated with substance use in adolescents. Friends are the key source of substances and their initiation of substance use. Based on these findings, following recommendations can be considered. (i) Maintaining the substance use control through legislation by which controlling of selling substances under 18 years of age and prohibition of substance use in public places seems to be effective (ii) early onset of substance use calls for effective measures directed against the younger age groups. Therefore, educational intervention at the school level appears to be the most feasible measure to prevent initiatives toward the use of substances. This needs to include substance use and its adverse effects, management of substance use incidents, communication of refusal skills among students and provision for training, and staff development. Parents and siblings should be involved in school education programs concerning substance use and should be motivated to share a healthy relationship with their children and give more time to them, especially in the growing up stage when deviant behavior can influence them easily. Periodic surveys, possibly every 2–3 years, would be useful to address the substance use issues and to evaluate the impact of the preventive measures.

Financial support and sponsorship

Nil

Conflict of interest

There are no conflicts of interest.



 
  References Top

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World Health Organization. Guide to Drug Use Epidemiology. Available from: http://www.whqlibdoc.who.int/hq/2000/a58352_PartA.pdf. [Last accessed on 2007 Jun 17].  Back to cited text no. 1
    
2.
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WHO. Techn Res Ser No.886: 1999. p. 48.  Back to cited text no. 4
    
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Scary State of Drug Addiction in India. Available from: http://www.bjpindia.in/index.php/causes-and-issues/27-youth/78-scarystate-of-drug-addiction-in-india.html?tmpl=component and print=1 & page. [Last accesssed on 2014 Sep 20].  Back to cited text no. 5
    
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Nadeem A, Rubeena B, Agarwal VK, Piyush K. Substance abuse in India. Pravara Med Rev 2009;4:4.  Back to cited text no. 6
    
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Ningombam S, Hutin Y, Murhekar MV. Prevalence and pattern of substance use among the higher secondary school students of Imphal, Manipur, India. Natl Med J India 2011;24:11-5.  Back to cited text no. 8
    
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Venkataraman S, Mukhopadhya A, Muliyil J. Trends of smoking among medical students. Indian J Med Res 1996;104:316-20.  Back to cited text no. 9
    
10.
Reddy DC, Singh SP, Tiwari IC, Shukla KP, Srivastava MK. An epidemiological study of cannabis abuse among college students of Varanasi. Indian J Public Health 1993;37:10-5.  Back to cited text no. 10
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Chavan BS, Arun P, Bhargava R, Singh GP. Prevalence of alcohol and drug dependence in rural and slum population of Chandigarh: A community survey. Indian J Psychiatry 2007;49:44-8.  Back to cited text no. 12
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Kokiwar PR, Jogdand GR. Prevalence of substance use among male adolescents in an urban slum area of Karimnagar district, Andhra Pradesh. Indian J Public Health 2011;55:42-5.  Back to cited text no. 15
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