Background

Tobacco, alcohol, and marijuana are the top three substances used by adolescents. The adverse health effects of these three substances are well documented in epidemiological literature, yet little is known about the substance use and associated factors among adolescents in Bangladesh. This study examines the risk factors for tobacco and other substances use among school-going adolescents in Bangladesh.

Methods

We analyzed data from the 2014 Bangladesh Global School-based Student Health Survey (GSHS) of adolescents aged 13–17 years. We used two outcome measures: tobacco use (TU) and other substance use (SU; alcohol and/or marijuana). We examined a set of reported psychosocial and socio-environmental adverse events as risk factors. Logistic regression analyses were used to identify associations.

Results

The prevalence of TU and other SU among school-going adolescents was 9.6% and 2.3%, respectively. The likelihood of TU and other SU was higher among adolescents who reported being bullied (TU: adjusted odd ratio [AOR]: 1.93; 95% confidence interval [CI]: 1.24–3.00; and other SU: AOR: 3.43; 95% CI: 1.46–7.99) and having sexual history (TU: AOR: 19.38; 95% CI: 12.43–30.21; and other SU: AOR: 5.34; 95% CI: 2.17–13.29). Moreover, anxiety-related sleep loss was associated with adolescents’ TU (AOR: 2.41; 95% CI: 1.02–5.82) whereas the likelihood of other SU (AOR: 3.27; 95% CI: 1.14–9.44) was higher among lonely adolescents. Experience of adverse socio-environmental factors, such as parental substance use (TU: AOR: 7.81; 95% CI: 5.08–12.01), poor monitoring (TU: AOR: 1.96; 95% CI: 1.16–3.31) and poor understanding (TU: AOR: 2.22; 95% CI: 1.36–3.65), and lack of peer support (TU: AOR: 3.13; 95% CI: 1.84–5.31; and other SU: AOR: 2.45; 95% CI: 1.02–5.91), and truancy (other SU: AOR: 4.29; 95% CI: 1.81–10.12) were also positively associated with TU and/or other SU. Additionally, higher odds of tobacco use were observed among adolescents who reported 1 (AOR: 4.36 times; 95% CI: 1.34–14.24), 2 (AOR: 8.69 95% CI: 1.67–28.23), and ≥3 (AOR: 17.46; 95% CI: 6.20–49.23) adverse psychosocial experiences than who did not report any psychosocial events.

Conclusions

Tobacco and other substance use among school-going adolescents are prevalent in Bangladesh. Several psychosocial and socio-environmental events are associated with TU and other SU, which should be incorporated into adolescent substance use and health promotion programs.

中文翻译：

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孟加拉国青少年吸烟和其他物质使用相关的心理社会和社会环境因素

 背景

烟草、酒精和大麻是青少年最常吸食的三种物质。这三种物质对健康的不利影响在流行病学文献中有详细记录，但人们对孟加拉国青少年的物质使用和相关因素知之甚少。本研究调查了孟加拉国在校青少年使用烟草和其他物质的危险因素。

 方法

我们分析了 2014 年孟加拉国全球校内学生健康调查 (GSHS) 中 13-17 岁青少年的数据。我们使用了两种结果衡量标准：烟草使用（TU）和其他物质使用（SU；酒精和/或大麻）。我们检查了一组报告的心理社会和社会环境不良事件作为危险因素。使用逻辑回归分析来识别关联。

 结果

在学青少年中TU和其他SU的患病率分别为9.6%和2.3%。在报告受到欺凌的青少年中，TU 和其他 SU 的可能性较高（TU：调整后奇数比 [AOR]：1.93；95% 置信区间 [CI]：1.24–3.00；其他 SU：AOR：3.43；95% CI ：1.46–7.99）并且有性史（TU：AOR：19.38；95% CI：12.43–30.21；其他 SU：AOR：5.34；95% CI：2.17–13.29）。此外，焦虑相关的睡眠不足与青少年的 TU 相关（AOR：2.41；95% CI：1.02–5.82），而孤独青少年中其他 SU 的可能性（AOR：3.27；95% CI：1.14–9.44）更高。不良社会环境因素的经历，例如父母药物使用（TU：AOR：7.81；95％CI：5.08-12.01）、监测不善（TU：AOR：1.96；95％CI：1.16-3.31）和理解不足（ TU：AOR：2.22；95% CI：1.36–3.65），缺乏同行支持（TU：AOR：3.13；95% CI：1.84–5.31；其他 SU：AOR：2.45；95% CI：1.02–5.91 ）和逃学（其他 SU：AOR：4.29；95% CI：1.81–10.12）也与 TU 和/或其他 SU 呈正相关。此外，报告 1（AOR：4.36 倍；95% CI：1.34–14.24）、2（AOR：8.69 95% CI：1.67–28.23）和 ≥ 3（AOR：17.46）的青少年中吸烟的几率较高; 95% CI: 6.20–49.23) 与没有报告任何心理社会事件的人相比，有不良的心理社会经历。

 结论

在孟加拉国，在校青少年中使用烟草和其他物质的情况很普遍。一些社会心理和社会环境事件与 TU 和其他 SU 相关，应将其纳入青少年药物使用和健康促进计划。