Wubetu et al. BMC Public Health (2020) 20:1691 https://doi.org/10.1186/s12889-020-09797-w RESEARCH ARTICLE Open Access Substances use and its association with socio-demographic, family, and environment-related factors among technical and vocational education and training college students in Ataye, Ethiopia; an institution-based cross-sectional study Abate Dargie Wubetu1* , Sintayehu Getachew2 and Wassie Negash1 Abstract Background: Legal substances use is prevalent in Ethiopia. Substance use can have several health problems that are potentially harmful to educational performance, social issues, psychological and physical wellbeing. This study aimed to know the prevalence of lifetime and last month’s substance use and its associated factors among technical and vocational education and training College students in Ataye town. Methods: An institution-based cross-sectional study was conducted from 1 March to last May 2019. Participants were selected using a simple random sampling technique. Data collected by using a structured and pretested interviewer-administered questionnaire. Data collected by five trained diploma nurses with close supervision. Odds ratio with their 95% confidence interval, and p-value less than 0.05 used to declare the statistical significance of associated factors. Results: Four hundred eighty-three individuals participated in the study, which was a response rate of 94%. The prevalence of lifetime legal substance use was 32.5% (95% CI: 28.2, 36.5). The prevalence of last month’s legal substances use was 21.9% (95% CI = 18.2, 25.5). Among lifetime legal substance users, the majority (25.5%) chewed khat. The others, (19.5%) drunk alcohol, and, 15.3% smoked cigarettes in a lifetime. Lifetime cannabis and cocaine users were 2.5, and 7.2% respectively. Among last month’s legal substance users, (21.9%) chewed khat followed by alcohol drinking (16.6%), and cigarette smoking (15.3%). In the last month, 1.2 and 3.3% of students used cannabis and cocaine respectively. Multivariate logistic regression showed that being male, having a divorced family, living greater than 20 years in the town, having substance user family members, having intimate friend substance users, and easy availability of substances were independent predictors of lifetime legal substances use. (Continued on next page) * Correspondence: [email protected]; [email protected] 1Department of Nursing, College of Health Science and Medicine, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Wubetu et al. BMC Public Health (2020) 20:1691 Page 2 of 11 (Continued from previous page) Conclusions: The prevalence of last month and lifetime legal substance use at Ataye Technical and Vocational Education and Training (TVET) college students were analogous with most studies done in Ethiopia. It is advisable if the college administrators work together with town administrators to mitigate the problem including closing substance use houses around the school. Overall, Substance use among adolescents should get further emphasis to lower the prevalence. Keywords: Prevalence, Lifetime, Last month, Substance use, College students Background adequate studies conducted to explore the prevalence Substance use has the capability of affecting the state of and associated factor of a lifetime and last month’ssub- the body and the mind by either depressing or stimulat- stance use in technical and vocational education and train- ing the central nervous system or producing other bio- ing (TVET) college students. The findings of this study will chemical harmful effects [1–3]. An estimated 5 % of the be useful to the education bureau and school administra- global adult population use drugs at least once in their tions to develop strategies to mitigate students’ substance lifetime as studied in 2015. The more worrisome fact is usebehavior.Thestudyfindingsalsomayhelpcurriculum about 0.6% of the global adult population suffers from developers in formulating and incorporating psycho- drug use disorders [4]. education programs in TVET College that address the risk World drug report revealed that more than a quarter of substance use. School managers also may benefit from of a billion people use drugs globally. Roughly, almost findings so that they may come up with policies and strat- half a million people died because of drug use in 2015, egies for controlling this potentially dangerous habit. according to the World Health Organization (WHO). Of The main aim of this study was to assess the lifetime those deaths, nearly 170,000 (2.7%) deaths directly asso- and last month prevalence of substance use and to iden- ciated with drug use disorders (mainly overdoses), [5]. tify associated factors with it. Each type of substance use According to the Ethiopian Demographic and Health proportions was also described. Survey (EDHS) report, one-third of women and about ha1f of men reported drinking alcohol at some point in their lives. The proportion of legal substances use is in- Methods creasing every year in both sexes. The use of tobacco in- Study area creases with the age of men. There is a wide regional The study was conducted at Ataye TVET College. Ataye variation in cigarette smoking in Ethiopia [6]. TVET College was found in the North Showa zone that Drug use is associated with adverse health conse- found in Amara Regional state of Ethiopia. The study quences. Problems of substance use seem to be a rapidly area is located 272 km from Addis Ababa and 130 km growing concern globally. It is also a major threat among from Debre Berhan town. Orthodox, Muslim, and prot- youth in college and university. Some of the researchers estant followers are the major inhabitants found in the have shown that the use of drugs by school-going youth study area. At Ataye TVET College, there are 1433 stu- does not only decrease their academic performance; but dents enrolled in the academic year. Out of these, 683 also makes them vulnerable to crime. Furthermore, drug were male, and 750 were female students. use exposes them to health risks among other numerous problems [7–13]. Substances use is a common phenomenon among stu- Study design, and period dents in Ethiopia. It has also been noted that family An institution-based cross-sectional study was con- background, student pocket money, peer pressure, acces- ducted from 1 March to last May 2019. sibility of substances, and customs of society contribute to the increased rate of substance use among college stu- dents. Most students, staffs at an institution of higher The study participants education, and youths in the community considered are There are nine departments from the first year to the third at high risk of substance use, [14–20]. year. The departments are Agriculture, hotel kitchen oper- The problem of substance use has historically been ation, Electricity, Auto engine service, Garment, Survey- linked to Ataye town due to the accessibility of sub- ing, Construction, Metalwork, and Road construction. All stances. Khat use is a common phenomenon in the regular Ataye TVET college students, and who were avail- study area [17]. Even though such problems are one of able during the study period considered as the study the top health risks among college students, there are no population. Students could not reach in three visits during the data collection period excluded from the study. Wubetu et al. BMC Public Health (2020) 20:1691 Page 3 of 11 Study variables explanation about the current research. Data collected Dependent variables by five trained diploma nurses with close supervision. A Lifetime and last month substance use. pre-test was conducted on 5% (n = 24) students among similar study populations from non-participating depart- Independent variables ments before 2 weeks of the actual data collection Socio-demographic characteristics: (age, sex, residence, period. After the pretest, the wording and the sharpness economic status, education status, religion, ethnicity, of the questions were modified. The collected data were and, living status, mother education level, father educa- reviewed and checked for completeness before data tion level, and having substance user friend, lack of fam- entry. The data properly coded and entered into Epi Info ily supervision, family conflict, family history of 3.5.1 and exported to SPSS V. 21 for analysis. substance use, family income, availability of substance, source of money, grade level, peer pressure, marital sta- Operational definitions tus of the family. Lifetime legal substance use Use of one or more legal substances (Ethiopia context) Sample size determination for nonmedical purposes (alcohol, khat, and cigarette) The sample size was calculated using a single population after joining the Ataye TVET College. proportion formula. A 15.36% rate of substance use was taken from the related study [17], with a margin of error 5%, confidence level 95%, and non-response rate 10%.