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Research Article |

Prevalence and Predictors of Substance Use Among Senior High School Students: An Institution-Based Cross-Sectional Study in Ghana

Introduction: Substance use among senior high school students in Ghana has been on the increase. While various studies have investigated the topic, studies that examine the issue in high schools in coastal Ghana are scarce. Also, the relationship between the use of the three most common substances—alcohol, cigarette, and marijuana—is essentially an open question. This study examines the prevalence of substance use among senior high school students in a coast population in Ghana. Methods: An institution-based cross-sectional study was conducted among 405 senior high school students. Data was collected using a self-administered, structured questionnaire via a multistage sampling process. The data was entered, cleaned, coded, and analyzed using SPSS. Pearson Chi-square test was used to determine the association between the independent and dependent variables, and a multiple logistic regression established the strength of the explanatory variables in predicting the outcomes. Associations were significant at p < 0.05. Results: The lifetime prevalence and current prevalence of alcohol consumption were 64.8% and 26.8%, respectively. The lifetime and current prevalence of cigarette smoking were 12.2%, respectively. Regarding marijuana use, the lifetime prevalence was 9.1%, and the current prevalence was 6.3%. Household head (s) [AOR=3.53, 95% CI=1.24, 10.03] and lifetime cigarette smoking predicted alcohol consumption [AOR=5.72, 95% CI=1.50, 21.76]. Religion [AOR=7.19, 95% CI=1.21, 42.58], lifetime alcohol consumption [AOR=5.73, 95% CI=1.51, 21.83], and lifetime marijuana use predicted cigarette smoking [AOR=23.95, 95% CI=8.00, 71.66]. School residency status [AOR=0.15, 95% CI=0.05, 0.47], religion [AOR=6.99, 95% CI=1.07, 45.84], home residency [AOR=12.61, 95% CI=3.07, 51.88], and lifetime cigarette smoking [AOR=25.07, 95% CI=8.00, 78.60] predicted marijuana use. Conclusion: A substantial proportion of the students engage in underage drinking and smoking. The use of marijuana, an illicit substance, is notable. Policymakers should act proactively to prevent an impending public health and legal crisis among senior high school students.

Substance Use, High School, Prevalence, Predictors, Ghana

Kizito Aidam, Emefa Awo Adawudu. (2023). Prevalence and Predictors of Substance Use Among Senior High School Students: An Institution-Based Cross-Sectional Study in Ghana. Science Journal of Public Health, 11(6), 186-194.

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Aboagye RG, Kugbey N, Ahinkorah BO, Seidu AA, Cadri A, Akonor PY. Alcohol consumption among tertiary students in the Hohoe municipality, Ghana: analysis of prevalence, effects, and associated factors from a cross-sectional study. BMC Psychiatry. 2021; 21: 1–10.
2. Li W, Howard MO, Garland EL, McGovern P, Lazar M. Mindfulness treatment for substance misuse: A systematic review and meta-analysis. J Subst Abuse Treat [Internet]. 2017; 75: 62–96. Available from:
3. Whyte AJ, Torregrossa MM, Barker JM, Gourley SL. Editorial: Long-term consequences of adolescent drug use: Evidence from pre-clinical and clinical models. Front Behav Neurosci. 2018; 12: 10–2.
4. Frobel W, Grafe N, Meigen C, Vogel M, Hiemisch A, Kiess W, et al. Substance use in childhood and adolescence and its associations with quality of life and behavioral strengths and difficulties. BMC Public Health [Internet]. 2022; 22: 1–12. Available from:
5. Das JK, Salam RA, Arshad A, Finkelstein Y, Bhutta ZA. Interventions for Adolescent Substance Abuse: An Overview of Systematic Reviews. Journal of Adolescent Health. 2016; 59: S61–75.
6. Khoza A, Shilubane HN. Substance Use and Associated Factors Among in School Adolescents in South Africa. Open Public Health J. 2021; 14: 435–40.
7. Ogundipe O, Amoo EO, Adeloye D. Substance use among adolescents in sub-Saharan Africa: A systematic review and meta-analysis. S Afr J Child Health. 2018; 2016.
8. Tetteh J, Ekem-Ferguson G, Swaray SM, Kugbey N, Quarshie ENB, Yawson AE. Marijuana use and repeated attempted suicide among senior high school students in Ghana: Evidence from the WHO Global School-Based Student Health Survey, 2012. Gen Psychiatr. 2020; 33: 1–10.
9. Kugbey N. Prevalence and correlates of substance use among school-going adolescents (11-18years) in eight Sub-Saharan Africa countries. Subst Abuse Treat Prev Policy. 2023; 18: 1–9.
10. Nkyi A. Substance Abuse among Senior High School Students in Ghana. International J Soc Sci & Education. 2014; 4.
11. Owusu-Sarpong AA, Agbeshie K. Cigarette smoking among in-school adolescents in Yilo Krobo municipality in the Eastern Region of Ghana. Ghana Med J. 2019; 53: 273–8.
12. Snedecor GW, Cochran WG. Statistical methods. 8th ed. Iowa State Univ. Press Iowa. Ames: Iowa State Univ. Press Iowa; 1989.
13. Birhanu AM, Bisetegn TA, Woldeyohannes SM. High prevalence of substance use and associated factors among high school adolescents in Woreta Town, Northwest Ethiopia: multi-domain factor analysis. BMC Public Health. 2014; 14: 1–11.
14. Omair A. Sample size estimation and sampling techniques for selecting a representative sample. Journal of Health Specialties. 2014; 2: 142.
15. Singh A, Masuku M. Fundamentals of Applied Research and Sampling Techniques. International Journal of Medical and Applied Sciences. 2013; 2: 124–32.
16. Osei-Bonsu E. Prevalence of Alcohol Consumption and Factors Influencing Alcohol Use Among the Youth in Tokorni-Hohoe, Volta Region of Ghana. Science Journal of Public Health. 2017; 5: 205.
17. Jacobs W, Idoko E, Montgomery LT, Smith ML, Merianos AL. Concurrent E-cigarette and marijuana use and health-risk behaviors among U.S. high school students. Prev Med (Baltim) [Internet]. 2021; 145: 106429. Available from:
18. Hamdan-Mansour AM, AL-Sagarat AY, Shehadeh JH, Al Thawabieh SS. Determinants of substance use among high school students in Jordan. Current Drug Research Reviews Formerly: Current Drug Abuse Reviews. 2020; 12: 168-74.
19. Mohale D, Mokwena KE. Substance use amongst high school learners in the south of johannesburg: Is this the new norm? South African Family Practice. 2020; 62: 1–6.
20. Melkam M, Segon T, Nakie G, Nenko G, Demilew D. Substance use and associated factors among high school students in Northwest Ethiopia. Pan African Medical Journal. 2023; 44.
21. Ozeylem F, de la Torre-Luque A, Essau CA. Factors related to substance use among adolescents from six low-and middle-income countries. Addictive Behaviors Reports [Internet]. 2021; 14: 100370. Available from:
22. Mokwena KE, Setshego NJ. Substance abuse among high school learners in a rural education district in the Free state province, South Africa. South African Family Practice. 2021; 63: 1–6.
23. Nahvizadeh MM, Akhavan S, Arti S, Qaraat L, Geramian N, Farajzadegan Z, et al. A review study of substance abuse status in high school students, Isfahan, Iran. Int J Prev Med. 2014; 5: S77–82.
24. Mavura RA, Nyaki AY, Leyaro BJ, Mamseri R, George J, Ngocho JS, et al. Prevalence of substance use and associated factors among secondary school adolescents in Kilimanjaro region, northern Tanzania. PLoS One [Internet]. 2022; 17: 1–15. Available from:
25. Bahramnejad A, Iranpour A, Nakhaee N. “Students in public and private schools—which are at higher risk of drug use?”: a survey from Iran. Subst Abuse Treat Prev Policy. 2020; 15: 1–5.
26. Ninkron P, Yau S, Khuntiterakul P, Nakamadee B. Substance use and related risk behaviors among junior high school students in Nakhon Pathom province, Thailand. J Health Res. 2022; 36: 345–53.
27. Caqueo-Urízar A, Peroza E, Escobar-Soler C, Flores J, Urzúa A, Irarrázaval M, et al. Religion Involvement and Substance Use Problems in Schoolchildren in Northern Chile. Religions (Basel). 2022; 13: 1–13.
28. Yeterian JD, Bursik K, Kelly JF. Religiosity as a Predictor of Adolescents’ Substance Use Disorder Treatment Outcomes. Physiol Behav. 2018; 176: 139–48.
29. Felipe AOB, Carvalho AMP, Andrade CUB. Spirituality and religion as protectors for adolescent drug use. SMAD Revista Eletrônica Saúde. 2015; 11: 49.
30. Marsiglia FF, Kulis S, Nieri T, Parsai M. God Forbid! Substance Use Among Religious and Nonreligious Youth. Brain Lang [Internet]. 2004; 88: 1–20. Available from:
31. Furr-Holden CDM, Lee MH, Milam AJ, Johnson RM, Lee KS, Ialongo NS. The growth of neighborhood disorder and marijuana use among urban adolescents: A case for policy and environmental interventions*. J Stud Alcohol Drugs. 2011; 72: 371–9.
32. Furr-Holden CDM, Lee MH, Milam AJ, Duncan A, Reboussin BA, Leaf PJ, et al. Neighborhood Environment and Marijuana Use in Urban Young Adults. Physiol Behav. 2018; 176: 139–48.
33. Wellman RJ, O’loughlin EK, Sylvestre MP, Dugas EN, O’loughlin JL. Factors associated with cannabis use in early adolescence. Health Promotion and Chronic Disease Prevention in Canada. 2023; 43: 14–26.
34. Masemann V. The "Hidden Curriculum " of a West African Girls’ Boarding School. Canadian Journal of Africa. 2017; 8: 479–94.