Alcohol, smoking, and illicit substance use in Cameroon: unveiling related risk factors among university students in Yaounde

Background: Substance use, including alcohol, tobacco and illicit drugs, is a growing public health problem worldwide. There is a rapid increase in substance use among young adults in many sub-Saharan African countries. This study aimed to assess the factors associated with the use of different psychoactive substances among university students in Yaounde. Methods: A cross-sectional and analytical study was conducted from September to October 2023 at Yaounde 1 University in Cameroon. All eligible students aged 18 years and older who gave written informed consent were included. A convenience nonprobability sampling method was used to recruit consenting students. The data collectors were medical students who were trained for 2 days and given appropriate instructions before the survey. The data collected were reviewed and checked for completeness before being entered. The data were analyzed using Statistics 4.3.1. Results: A total of 191 university students were enrolled in the study. Age (p-value=0.002), level of study (p-value=0.048), and smoking status (p-value=0.005) of the participants were significant factors associated with alcohol on univariate analysis. Multivariate logistic regression showed that students aged 20-25 years were significantly 2.9 times more likely to drink alcohol than those aged less than 20 years (p-value=0.003). Students who smoke were 2.7 times more likely to drink alcohol than those who do not smoke (p-value=0.008). Living situation (p=0.013) and drug use status (p-value<0.0001) were significant factors associated with smoking on univariate analysis. On multivariate analysis, drug users were 3.2 times more likely to smoke than drug non-users (p-value<0.0001). Drug use was significantly associated with district of residence of consumer on univariate analysis (p-value=0.024). Living situation (p-value=0.016), faculty/school(p-value=0.04), and district of residence (p-value=0.037) were significantly associated with polysubstance use. Students living in shared accommodation were 3.8 times more likely to be polysubstance users than those living with their families (p-value=0.023). Almost all smokers (95.1%) reported being aware the of the psychosocial, mental and health consequences of substance use (p-value=0.021). Conclusion: Several factors have been associated with substance use among college students. These sociodemographic factors can help to strategize and implement tailored interventions to reduce the risk of subsequent substance dependence and other harmful consequences.