Psychoactive substances use and associated factors among middle and high school students in the North Center of Morocco: a cross-sectional questionnaire survey.
Data on psychoactive substance (PAS) consumption among adolescents in the North Center of Morocco are not at all available. Therefore, the current study aimed at investigating the prevalence and the determinants of psychoactive substances use among middle and high school students in this region.



A cross-sectional study was conducted from April 2012 to November 2013 in public middle and high schools in the North Central Region of Morocco. An anonymous self-administered questionnaire was used to assess psychoactive substances use among a representative sample of school students from the 7th to the 12th grade, aged 11-23 years, selected by stratified cluster random sampling. Factors associated with psychoactive substance use were identified using multivariate stepwise logistic regression analyses.



A total of 3020 school students completed the questionnaires, 53.0 % of which were males. The overall lifetime smoking prevalence was 16.1 %. The lifetime, annual and past month rates of any psychoactive substance use among the study subjects were 9.3, 7.5, and 6.3 % respectively. Cannabis recorded the highest lifetime prevalence of 8.1 %, followed by alcohol 4.3 %, inhalants 1.7 %, psychotropic substances without medical prescription 1.0, cocaine 0.7, heroine 0.3, and amphetamine with only 0.2 %. Psychoactive substance use was associated with males more than females. The risk factors identified by multivariate stepwise logistic regression analyses were being male, studying in secondary school level, smoking tobacco, living with a family member who uses tobacco, and feeling insecure within the family.



The prevalence among all school students reported by the current study was comparable to the national prevalence. Efforts to initiate psychoactive substance prevention programs among school students should be made by designing such programs based on the significant factors associated with psychoactive substance use identified in this study.
Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco. b.ensfes@gmail.com.|Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco. b.ensfes@gmail.com.
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Zarrouq
Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.|Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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Bendaou
Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.|Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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El Asri
Unit of Toxicology, Hassan the 2nd University Hospital Center, Fez, Morocco.
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Achour
Laboratory of Clinical Neurosciences, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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Rammouz
Laboratory of Clinical Neurosciences, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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Aalouane
Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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Lyoussi
Service of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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Khelafa
Service of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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Bout
Service of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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Berhili
Service of Psychiatry, Ibn Al Hassan Hospital, Hassan the 2nd University Hospital Center, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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Hlal
Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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Najdi
Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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Nejjari
Laboratory of Epidemiology, Clinical Research, and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco.
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El Rhazi
D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009018:Morocco / Q000453:epidemiology; D015995:Prevalence; D011619:Psychotropic Drugs; D012307:Risk Factors; D012574:Schools; D013334:Students / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
D011619:Psychotropic Drugs
Morocco; Prevalence; Psychoactive substance; Risk factors; School students; Secondary school