title: High prevalence of substance use and associated factors among high school adolescents in Woreta Town, Northwest Ethiopia: multi-domain factor analysis.
abstract: BACKGROUND
  Substance use is a major public health concern in global settings, and is very common during adolescence period leading to physical and/or mental health complications. This study assessed the prevalence of substance use and associated factors among high school adolescents in Woreta Town, Northwest Ethiopia, 2012.
  
  
  METHODS
  A school based cross-sectional study was conducted from April 7 to April 15, 2012 amongst 684 9th to 12th grade high school students in the town of Woreta. Participants were selected by stratified sampling, and data were collected using an anonymous questionnaire adapted from the 2008 Community That Care Youth Survey. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with substance use.
  
  
  RESULTS
  A total of 651 students participated in the study with a response rate of 95.2%. The current prevalence of substance use among Woreta high school students was 47.9% and life-time prevalence was 65.4%. The current and lifetime prevalence of alcohol use was 40.9% and 59% respectively. Siblings' use of substances (AOR [95% CI]: 2.72 [1.79, 4.14]), family history of alcohol and substance use (AOR [95% CI] 2.24 [1.39-3.59]) and friends' use of substances (AOR [95% CI] 2.14 [1.44-3.18]) were factors positively associated with substance use. On the other hand, religiosity and social skill were found to be 54% (AOR [95% CI] 0.46, [0.31-0.68]) and 39% (AOR [95% CI] 0.6 [0.40-0.91]) negatively associated with substance use.
  
  
  CONCLUSIONS
  The prevalence of substance use amongst adolescents was high for the three substances namely alcohol, cigarette and khat with alcohol being the most common. Community norms favorable to substance use, family history of alcohol and substance use, siblings' substance use, poor academic performance, low perceived risk of substances and friends' use of substances had positive association with adolescent substance use while religiosity and social skills were found to have negative association with adolescent substance use. Initiate public awareness campaigns to inform adolescents and adults, particularly parents, of the risk of substance use. Developing culture friendly, gender based adolescent and family based programs and initiating public awareness are recommended to decrease substance use by adolescents.
authors.affiliation: Department of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. antenehmessele33@gmail.com.
authors.forename: Anteneh Messele
authors.initials: AM
authors.lastname: Birhanu
authors.forename: Telake Azale
authors.initials: TA
authors.lastname: Bisetegn
authors.forename: Solomon Meseret
authors.initials: SM
authors.lastname: Woldeyohannes
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D029754:Catha; D003430:Cross-Sectional Studies; D005002:Ethiopia / Q000453:epidemiology; D005163:Factor Analysis, Statistical; D005260:Female; D033062:Friends / Q000523:psychology; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D035781:Siblings; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult