Abstract
Background: In South Africa, illicit substance use among school-going adolescents is of great concern and negatively influences the learning and teaching school environment. Little data is available on the prevalence and factors associated with illicit substance use and teachers’ experiences regarding substance use in schools. This dissertation aimed to assess (i) the prevalence, knowledge, and factors that influence illicit substance use among adolescent learners and (ii) teachers’ knowledge and experiences about illicit drugs problem in schools and the impact it had on safety in schools.
Method: A cross-sectional study was conducted among 369 adolescents from 27 secondary schools and 20 teachers in Ekurhuleni Metropolitan Municipality, Gauteng Province, South Africa, between March 2021 and September 2022. This study employed mixed methods research design and utilized self-administered questionnaires and audio-recorded interviews with adolescents and teachers. Information collected includes adolescent learners' socio-demographic characteristics, alcohol use, tobacco, drugs, sexual risk behavior, peer pressure, victimization, knowledge, source of information, and teachers' knowledge and experiences on the drug used by learners in schools. Descriptive statistics and logistic binomial regression analysis were used to identify knowledge and substance use risk factors. Results: Of the 369 adolescents, 175 (48%) were males, and 193 (52%) were females. The mean age of the learners was 17.7±1.74 years, ranging from 13-22 years. The overall prevalence of illicit substance use was 46.07% (95% CI: 40.89-51.03), with 66.4% of learners reported having consumed alcohol, 49.9% had tried to smoke cigarettes, 65.8% having used electronic vapor products, and 80.22% have had friends who have used drugs. Nearly 60% of learners were found to have good knowledge about substance use, with source knowledge from teachers (80%), Radio/TV (75%), Facebook (74%), family (68%), and Newspaper/Magazines (67%). In adjusted logistic regression, the likelihood of reporting illicit substance use increases with age (18-19 years), mixed-race, being not religious, having a sex partner older than 15 years, missing school for more than two days, being forced to do wrong things, ever reported going to a social club or parties with friends and having part-time employed parents. Being religious, staying in a township/suburb for
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more than ten years, inconsistent condom use, engaging in sexual activity while on drugs or drunk, ever reported going to a social club or parties with friends, staying with both parents decrease the likelihood of having poor knowledge about illicit substance use. Five themes emerged from the teacher's thematic analysis of data: i) drug use among school-going adolescent learners, (ii) teacher’s awareness of drug use in schools, (iii) teacher’s experience of drug use among adolescent learners in school, (iv) learner’s accessibility to drugs and (v) teacher's opinion on effective interventions.
Conclusion: Identifying factors and knowledge associated with substance abuse are beneficial to improving learners' knowledge about substance use, but there is predictable evidence that other contributing factors influence the scourge of substance use. Thus, it is imperative to devise and strategize the working programmatic interventions that reduce the prevalence of substance abuse and associated factors of illicit drug use in this key population highly vulnerable.
Keywords: Substance abuse, adolescents, knowledge, and factors.