How to prevent alcohol and illicit drug use among students in affluent areas: a qualitative study on motivation and attitudes towards prevention

Abstract

Background The use of alcohol and illicit drugs during adolescence can lead to serious short- and long-term health related consequences. Despite a global trend of decreased substance use, in particular alcohol, among adolescents, evidence suggests excessive use of substances by young people in socioeconomically affluent areas. To prevent substance use-related harm, we need in-depth knowledge about the reasons for substance use in this group and how they perceive various prevention interventions. The aim of the current study was to explore motives for using or abstaining from using substances among students in affluent areas as well as their attitudes to, and suggestions for, substance use prevention. Methods Twenty high school students (age 15–19 years) in a Swedish affluent municipality were recruited through purposive sampling to take part in semi-structured interviews. Qualitative content analysis of transcribed interviews was performed. Results The most prominent motive for substance use appears to be a desire to feel a part of the social milieu and to have high social status within the peer group. Motives for abstaining included academic ambitions, activities requiring sobriety and parental influence. Students reported universal information-based prevention to be irrelevant and hesitation to use selective prevention interventions due to fear of being reported to authorities. Suggested universal prevention concerned reliable information from credible sources, stricter substance control measures for those providing substances, parental involvement, and social leisure activities without substance use. Suggested selective prevention included guaranteed confidentiality and non-judging encounters when seeking help. Conclusions Future research on substance use prevention targeting students in affluent areas should take into account the social milieu and with advantage pay attention to students’ suggestions on credible prevention information, stricter control measures for substance providers, parental involvement, substance-free leisure, and confidential ways to seek help with a non-judging approach from adults.

Attitudes to Cannabis Use and Public Prevention Information Among Young Adults: A Qualitative Interview Study With Implications for Prevention Practice

“…Although the current study managed to recruit cannabis users who gladly shared their experiences (admittedly anonymously), some informants stated that the present “taboo” around cannabis in Sweden, partly generated by the prohibition by law, counteracted a nuanced communication from the authorities, thereby impeding the credibility of public information. This view is in line with previous research, indicating that an overly one-sided focus on the harmful consequences of cannabis may impede the intended effect of the preventive message ( 57 , 67 ). In congruence with the desire for nuanced information on cannabis, participants in the current study asked for a dialogue with the information provider or sender, in which their own experiences were taken into account.…”

“…The informants highlighted several motives for using cannabis, such as enhancing socialization with friends, increasing personal well-being, and counteracting negative feelings and mental health problems, which are reasons previously reported by young users ( 35 , 36 ). The social aspect of substance use was recently highlighted in a study on Swedish students aged 15–19 years ( 57 ) in a slightly different way; among these younger individuals, peer pressure appeared to be a more prominent social motive than promoting positive experiences when hanging out with friends, whereas, the latter was emphasized more in the current study. The availability of cannabis, however, seems to be important for both adolescents and young adults when using the drug for the first time, as shown in the current study as well as the study on Swedish students ( 57 ).…”

“…The social aspect of substance use was recently highlighted in a study on Swedish students aged 15–19 years ( 57 ) in a slightly different way; among these younger individuals, peer pressure appeared to be a more prominent social motive than promoting positive experiences when hanging out with friends, whereas, the latter was emphasized more in the current study. The availability of cannabis, however, seems to be important for both adolescents and young adults when using the drug for the first time, as shown in the current study as well as the study on Swedish students ( 57 ). Since cannabis use is prohibited by the law in Sweden, the social context with peers who can provide the illegal substance, explain how to use it, and relate the expected effects may be even more important for the initiation of cannabis use among Swedish youth compared to young people in countries where cannabis can be purchased legally and information about its use and effects can be obtained easily.…”

“…In another European study of 86,107 students aged 15–16 years, Piontek et al ( 49 ) similarly highlighted the importance of personal attitudes for cannabis use, based on the finding that the immediate social situation, for example, friends' behavior, was associated with cannabis use. The importance of friends' behavior for substance use was also supported in a recent qualitative interview study among affluent Swedish students aged 15–19, which showed that social availability of the substance and a desire to fit in at parties was a central motive for substance use ( 57 ).…”

“…It may be debated whether people with a personal experience of substance use can be more objectively credible or helpful, but young people seem to place their trust in them. However, it is important to note that the students in the previous study (57) emphasized that the person with personal experience of using drugs should not be just anybody, for example, "a heroin addict who talked about having found Jesus, " but someone with whom they could identify. Credibility can also be increased through identification with the sender by similarity in age.…”