Substance use risk among school going adolescents in India: secondary analysis of Community Based Peer-Led Intervention (CPLI) trial

IF 6.4 Q1 HEALTH CARE SCIENCES & SERVICES

The Lancet regional health. Southeast Asia Pub Date : 2026-08-01 Epub Date: 2026-07-22 DOI:10.1016/j.lansea.2026.100821

U. Venkatesh, Mahashweta Chakrabarty, Palanivel Chinnakali, Krupal Joshi, Sudip Bhattacharya, Aravind P. Gandhi, Rashmi Agarwalla, Richa Tripathi, Vinoth Rajendran, Anand Mohan Dixit

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Abstract

Background

Adolescent substance use is an increasing public health concern in India, yet multicentre studies are limited. In this study we aimed to understand variation in substance use risk across multiple schools in selected districts of India.

Methods

This study utilised cross-sectional baseline data from a multi-centre cluster randomised trial on peer-led intervention to reduce substance use, it included 6168 adolescents from 108 schools across six Indian districts (2025–2026). Substance use risk was assessed through self-reporting of participants using the WHO Alcohol, Smoking and Substance Involvement Screening Test and personality traits were assessed using the Substance Use Risk Profile Scale (SURPS). Determinants were examined using three-level multilevel ordinal logistic regression models accounting for clustering at school levels. Inter-district disparities were investigated using Fairlie decomposition.

Findings

Highest substance use risk was observed in selected schools of Guwahati and lowest in Nagpur and Puducherry. Higher accessibility to substances (high: aOR 1.75, 95% CI: 1.36–2.26), high digital exposure (aOR 1.44, 95% CI: 1.16–1.79), and favourable attitudes towards substance use (aOR 1.30, 95% CI: 1.01–1.69) were associated with increased risk, whereas male adolescents had lower odds than females (aOR 0.74, 95% CI: 0.62–0.88). The Guwahati–Nagpur prevalence gap was 35.1 percentage points, of which 37.9% was explained by observed characteristics, mainly school characteristics, socio-demographic and economic factors, and personality traits.

Interpretation

Substance use risk among adolescents in India varies substantially across settings. Context-specific strategies targeting digital exposure, and local environments may help reduce inequalities in substance use risk.

Funding

This study is supported by Indian Council of Medical Research, Extramural Research Grant (2024-01-00480).

查看原文本刊更多论文

印度学龄青少年的物质使用风险：基于社区的同伴主导干预（CPLI）试验的二次分析

背景：青少年药物使用在印度日益成为一个公共卫生问题，但多中心研究有限。在这项研究中，我们旨在了解印度选定地区多所学校物质使用风险的变化。方法：本研究利用了来自同伴主导干预减少药物使用的多中心聚类随机试验的横断面基线数据，该试验包括来自印度6个地区108所学校的6168名青少年（2025-2026）。物质使用风险通过使用世卫组织酒精、吸烟和物质介入筛查测试的参与者自我报告进行评估，并使用物质使用风险概况量表（SURPS）评估人格特征。决定因素使用三层多层有序逻辑回归模型进行检验，该模型考虑了学校层面的聚类。采用Fairlie分解法对地区间差异进行了调查。结果：在古瓦哈提的选定学校中观察到的物质使用风险最高，在那格浦尔和普都切里最低。较高的物质可及性（高：aOR 1.75, 95% CI: 1.36-2.26）、高数字接触（aOR 1.44, 95% CI: 1.16-1.79）和对物质使用的良好态度（aOR 1.30, 95% CI: 1.01-1.69）与风险增加相关，而男性青少年的风险低于女性（aOR 0.74, 95% CI: 0.62-0.88）。古瓦哈蒂和那格浦尔的患病率差距为35.1个百分点，其中37.9%可以用观察到的特征来解释，主要是学校特征、社会人口和经济因素以及人格特征。解释：印度青少年的物质使用风险在不同环境下差异很大。针对数字暴露和当地环境的具体战略可能有助于减少物质使用风险方面的不平等。资助：本研究由印度医学研究委员会校外研究基金（2024-01-00480）支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

The Lancet regional health. Southeast Asia

CiteScore

2.20

自引率

0.00%

发文量