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Indian Journal of Community Medicine

Substance Use Among Intercollege Students in District Dehradun

Author(s): R. Juyal, R. Bansal, S. Kishore, K.S. Negi, R. Chandra, J. Semwal

Vol. 31, No. 4 (2006-10 - 2006-12)

R. Juyal(1), R. Bansal(2), S. Kishore(1), K.S. Negi(1), R. Chandra(1), J. Semwal(1)

Abstract

Background: Substance abuse especially amongst youth has been an issue of concern throughout the world. Rapid industrialization, urbanization and changing lifestyles have left the youth struggling for their survival; forcing many to seek refuge in the dark world of substance abuse. India too, is facing a similar situation that has attracted attention of policy makers and recent researchers in recent past. Objective: To find out the prevalence of substance abuse and to study the biosocial determinants of substance abuse among inter college students of district Dehradun. Methods: A Cross-sectional study was conducted among inter college students of district Dehradun. Multistage random sampling was used for the selection of two inter colleges (one rural and one urban). Overall 1094 students from 9th to 12th classes were included in the study. Statistical analysis was done by entering the data in SPSS. Results: The overall prevalence of substance abuse for ever users was 58.7%. Regular use of substances was found to be 31.3 %. The substance use was significantly more among urban students as compared to rural students. Urbanity, male sex and living away from parents were found to be significantly associated with substance abuse.

Keywords: Substance Abuse, Ever Users, Regular Users, Rural – Urban

Introduction

Man has been using plant derived drugs and alcohol for thousands of years. The recorded history indicates that some of these drugs were used not just for their presumed therapeutic effects, but also for recreational purposes to enhance pleasure and relieve stress1. New and often more harmful drugs and patterns of use are replacing traditional practices2. In recent years the consumption of licit (tobacco, alcohol) as well as illicit substances has increased greatly throughout the world. Particularly alarming is the fact that the age of initiation into substance abuse is progressively falling3.

Adolescence is the critical period when the first initiation of substance use takes place. Among the youth, students are particularly involved due to increasing academic pressures. The encouragement by peer groups, the lure of popularity and easy availability of many such substances like alcohol, tobacco (cigarettes and gutkha) and other drugs make a teenager an easy prey. In India approximately 5500 children and adolescents start using tobacco products daily, some as young as 10 years old. The majority of users have first use tobacco prior to the age of 18 years4.

In Uttaranchal, a newly formed state, no authentic study has been done till date to reveal the status of substance abuse among general population as well as student population. This study attempts to throw some light on substance abuse problem in a district of Uttaranchal.

Material and Methods

Multistage random sampling was done to select the requisite sample size. First of all, one block (Doiwala) was chosen out of six educational blocks in district Dehradun by random sampling. Then, a list of all coeducational inter colleges in the Doiwala block was made for rural and urban areas separately. In order to compare the prevalence of substance abuse in both areas, one inter college was randomly selected from rural area and one from urban area.

A sample size of 816 was worked out, based on the prevalence from previous studies of substance abuse in India. All the students in the selected schools, studying in 9th to 12th classes were eligible for the study so as to get the desired sample size. All sections of each class were visited twice at an interval of one week and students present during the visits were included in the study.

A self-administered questionnaire, originally developed by WHO5 was modified and translated into Hindi. The questionnaire elicited information regarding sociodemographic profile of the respondent as well as the details of substance abuse, if any. The substances included were tobacco (in any form), alcohol, cannabis, arecanut / panmasala, opium, sedatives and hard drugs, if any. A false drug named BOD was also included to identify the false respondents. The information included age of onset of use, frequency of use in past one month and source of acquiring the substance.

During the visits, the questionnaires were distributed to the students after explaining them the anonymous nature of data collection. A total of 1123 students were surveyed, out of which 29 were excluded from the study either due to incompletely fi lled forms or due to nonresponse; thus making the sample size 1094.The information so collected was analysed by using SPSS software. Chi-square test was used as per the requirement.

Working Defi nitions:

Ever user: The respondent, who accepts having taken one or more mentioned substances ever in life. Regular user: The respondent, who accepts having used one or more mentioned substances during past one year and has been taking it at least once a week or several times in the previous month.

Results

A total of 1094 students studying in classes 9th to 12th were surveyed in this study, out of which 642 students (58.7%) were found to be ever users, while 343 (31.3%) were regular users.

The prevalence of substance use was higher in urban students (37.9%) as compared to rural students (Table-I). This difference was found to be highly significant (p<0.001).

Table I. Prevalence of Substance Use in Rural and Urban Students.

Residential No. of Ever
users*
Regular
users*
Status Students No. % No. %
Rural 532 267 50.2 130 24.4
Urban 562 375 66.7 213 37.9
Total 1094 642 58.7 343 31.3
*Percentage of total students ( χ2= 13.0, df=l, p<0.001)

The substance use was significantly high among the male students (45.8%) as compared to the female students (7.3%) (P<0.001). Male students belonging to urban area were involved in substance abuse significantly more than the rural male students. (p<0.05)

Table II. Substance Use by Sex.

  Rural Urban Total
Sex No. of
students
No. of
Reg. users
No. of
students
No. of
Reg. users
No. of
students
No. of
Reg. users
male 314 109 (34.7) 370 204 (55.1) 684 313(45.8)
female 218 21(9.6) 192 9(4.7) 410 30(7.3)
Total 532 130 (24.4) 562 213 (37.9) 1094 343 (31.3)

(Figures in parentheses denote the percentages) (χ2= 177.5, df=l, p<0.001)

The prevalence of substance use was found to be significantly more in the students who were living away from their homes (Table-III).

Table III. Substance Use by Residential Status.

Residential Status
(living With)
Reg. users Non users Total
Students
Parents 311 (29.7) 735 (70.3) 1046
Relatives 27 (65.9) 14 (34.1) 41
Rented room 5(71.4) 2(28.6) 7
Total 343 (31.4) 751 (68.6) 1094
(Figures in parentheses denote the percentages) (χ2 = 29.4,df—l, p<0.001) *
*for calculating Chi-Square value, last two rows have been merged. (Chi- Square value was calculated between those living with their parents and those not living with parents)

Discussion

It was found that 58.7% of the students had used one or more substances at least once in life, which is lower than as reported by Taveres et al6 in Brazil (86.8% prevalence of alcohol use); Shah et al7 in primary schoolchildren in Pakistan (74% far arecanut) and 66% in rural schoolchildren in Punjab8 for gutkha. However, it was much higher than 34.2% as reported by Mohan et al9 in a high school survey in Delhi; 18% in schoolchildren in Goa10 and 18% as reported by Kushwaha et al11 in students at Gorakhpur. The reason for a high prevalence of ever use of substances in the present study could be that arecanut/panmasala were included, as these are the substances frequently taken by children and are more or less socially accepted for their age. More over in the last decade, vigorous advertising has led to the increased consumption due to easy availability of Panmasala in the market. This habit can lead to consumption of tobacco and other substances in later life. According to recent researches there is increasing evidence that arecanut products induce a true dependency syndrome. Arecoline is thought to be major component present in the basic nut, which has major effects on various neurotransmitters, particularly on chalinergic neurons12.

Regular substance use was found to be 31.3% in the present study. Here the difference in the substance use prevalence among rural and urban students was significant. Urban students were using more substances as compared to rural students (37.9% and 24.4 % respectively); which supports the observations of Verma et al13 in 1975 at Chandigarh, Khan and Unnitham14 in 1979 in Lucknow and Soyibo et al15 in Jamaica in 1999. However this observation differs from the findings of Sethi and Manchanda16, Mohan et a19 at Delhi and Kapoor et al17 at Haryana; who found no rural urban difference for substance abuse in their respective studies. The substance use was found to be significantly more among male students as compared to female students (45.8% and 7.3% respectively), as also reported by Kapoor et al17 at Haryana (14.2% and 2.3% respectively) and Vaidya et al10 (22.0% and 13.0% respectively) at Goa. Kushwaha et al11 found no female student using any drug in their study at Gorakhpur; although they were just 7% of the study population.

Prevalence of substance abuse was found maximum in the students who were living away from their homes. Only 29.7% of the students living with their parents were found to be using substances regularly; while 66.7% of students living away from their parents were using the mentioned substances. This difference can be very well explained on the basis of the fact that while living at their homes the students are within the supervision and care of their parents, hence substance use in this population is limited as compared to those who are living away from the homes (in this study no hosteller was found). Similarly, Naskar et al18 reported more drug use in hostellers as compared to non hostellers at Calcutta (52.6% and 44.2 % respectively).

So, we can conclude that substance use among students has become quite common in Dehradun as in other parts of the country and urbanity; male sex and living away from home are the risk factors. This information can be of use for the health planners and educationists of this newly formed state, so that corrective actions are taken in time.

References

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(1)Deptt. of Community Medicine, Himalayan Institute of Medical Sciences, Swami Rama Nagar, Doiwala, Dehradun (Uttaranchal)
(2)Deptt. of Community Medicine, Subharti Medical College , Meerut (U.P.),
E-mail: [email protected]
Received: 14-2-05

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