These findings will inform the design of quantitative surveys aimed at estimating the prevalence of specific behaviors related to substance use among youth and potential avenues for prevention.

Aims: Substance use among Egyptian youth is an emerging public health problem, yet there is a paucity of information on the prevalence and correlates of these behaviors. To address this gap, we conducted surveys at 25 schools in Egypt in 2013 and 2014. Design:We calculated associations between substance use prevalence and age, gender, residence area, living arrangement, and employment status, along with adjusted odds ratio (OR) and 95% confidence intervals (CI).Setting: Cairo region and southern Egypt. Participants: School youth ages 12-18 (N=1,415).Measures: Self-administered survey on the use of cigarettes, waterpipes, alcohol, hashish, bango, heroin, Tramadol, other oral medications, injected substances, and glue/petrol sniffing; together with the amount and frequency of each substance used and age at initiation, in addition to demographic characteristics.Findings: Seventy-two percent of participants were male. Tobacco and cannabinoids were the most commonly used substances by both genders. Males reported smoking cigarettes (25%), waterpipes (15%), and hashish (6%), drinking alcohol (16%), and taking Tramadol (3%). Younger age (12-14 years) and residence outside of Cairo were somewhat protective. Among males, but not females, having a job increased the odds of smoking cigarettes (OR = 1.8, 95% CI [1.3, 2.6]), waterpipes (OR = 1.9, 95% CI [1.2, 2.9]), or hashish (OR = 2.0, 95% CI [1.1, 3.7]). Conclusions:These findings, consistent with reports from other countries, can inform the design and direct the resources of future public health programs targeting adolescents to prevent the onset of substance use and ultimately addiction in Egypt and elsewhere.

Background: Egyptian street youth use substances including tobacco, illicit drugs, and pharmaceutical drugs. To understand the circumstances, including adverse childhood experiences, that place adolescents at risk for engaging in substance use, we conducted in-depth interviews among a sample of Egyptian street children. Methods: From youth residing at or attending Caritas, a non-profit organization, which provides shelter and education to street youth, seven girls and twelve boys, aged 12 to 18 years, participated in open-ended, in-depth interviews. Results: Eight out of the 19 participants reported family history (early exposure) to substance use; and seven of them were initiated by either a family member (sibling), friend or coworker. Most of the participants reported a history of conflict with or abuse (verbal or physical) by their parents or siblings, or stressful situations at home; they used substance(s) to alleviate their stress. Few attended school, and some were forced to work and help their family. Conclusions: Among Egyptian youth, adverse childhood experiences, such as poverty, child abuse, and family substance use, challenge somewhat susceptible youths and lead them to the path of substance use and addiction. Prevention intervention should be multifaceted, culturally adaptable, and primarily targeting the social environment during childhood.