Substance use among school-going adolescents in India: Results from a nationwide survey

Background In the Indian context, there is no recent data on substance use among school students. We report on the pattern of substance use and associated factors among school students in a cross-sectional nationwide survey conducted in 10 cities of India. Methods From each city, data from 200 students each from three schools (urban-government, urban-private, rural school) were collected. Within each school, a section from each grade (VIII, IX, and XI/XII) was randomly selected. Finally, 5920 students (boys 52.4%, mean [SD] age 14.7 [1.6] years) self-administered the questionnaire in the classroom setting. Results There were 15.1% students who reported lifetime, 10.3% past year, and 7.2% past month use of any substance, including tobacco, with most being used occasionally. Substances used in the past year were tobacco (4%), alcohol (3.8%), opioids (2.8%), cannabis (2%), inhalants (1.9%), and sedatives (0.6%). Substance use was significantly higher among boys than girls and higher with increasing grades. Past year users had significantly high/very high total difficulties score on the Strengths and Difficulties Questionnaire (15.0 [5.1]) compared to non-users (13.4 [5.7]; p<0.001). There was a significant difference between substance users and non-users in the subscales conduct problem, hyper-activity, emotional problems, and in the impact score (p<0.001). Past year users compared to non-users reported higher 'substance use (any)' by family members (p<0.001) and peers (p<0.001). Conclusions A substantial proportion of school students reported using psychoactive substances, mostly for occasional use. School-based prevention efforts are required on a wide scale in the country. We recommend early identification and intervention for substance use in school settings.