Marijuana use and repeated attempted suicide among senior high school students in Ghana: Evidence from the WHO Global School-Based Student Health Survey, 2012

Abstract

BackgroundThe association between substance use including marijuana use and attempted suicide has been well documented. However, little is known about marijuana use and its association with attempted suicide repetition among young people in low-income and middle-income contexts.AimsThis analysis was conducted to assess the factors associated with marijuana use and ascertain marijuana use as a determinant of repeated attempted suicide among senior high school (SHS) students in Ghana.MethodsData from the 2012 Global School-Based Student Health Survey in Ghana was used for this study. Modified Poisson, Logistic and Probit models weighted with Mahalanobis distance matching within propensity calliper were employed separately to determine the hypothetical association between marijuana use and repeated attempted suicide. All analysis was performed using Stata 16 and p≤0.05 was deemed statistically significant.ResultsThe prevalence estimates of marijuana use and repeated attempted suicide among SHS students in Ghana were 3.4% (95% CI: 2.3 to 5.1) and 11.5% (95% CI: 9.1 to 14.4), respectively. The prevalence of marijuana use was significantly associated with school grade, smoking exposure, parent smoker, alcohol intake and truancy. Marijuana use was positively associated with repeated attempted suicide among SHS in Ghana (φ correlation=0.23, p<0.001). Repeated attempted suicide among students who use marijuana was approximately threefold and fivefold significant compared with non-marijuana use students, based on the Poisson (adjusted prevalence ratio: 3.02; 95% CI: 1.67 to 5.43, p<0.001) and Logistic (adjusted OR:5.06; 95% CI: 3.19 to 11.64, p<0.001) estimates respectively. Also, the Probit model showed that marijuana use significantly increased the log count of repeated attempted suicide by 95% (aβ: 0.95; 95% CI: 0.49 to 1.41, p<0.001).ConclusionMarijuana use does not only influence the onset of suicidal attempts but also repeated attempted suicide among SHS students in Ghana. Special attention is required for suicide attempters with a history of repeated attempts and current marijuana use among SHS students in Ghana. Early identification of the potential risk and protective factors is recommended to inform school-based interventions. National level structured school-based substance abuse interventions and health promotion programmes would be useful.

Marijuana use and suicidal behaviours among school-going adolescents in Africa: assessments of prevalence and risk factors from the Global School-Based Student Health Survey

“…In assessing repeated attempted suicide, this study adopted a similar method employed to assess the association between marijuana use and repeated attempted suicide among senior high school students in Ghana. 23 The previous study reported a 12-month prevalence estimate of repeated attempted suicide to be 11.5%—nearly 2 times the estimate reported by this study. Interestingly, this study has also shown a relatively higher prevalence estimate in West Africa (10.1%), where Ghana is located.…”

“…Generally, whereas marijuana use has been found to worsen negative mental health outcomes and symptoms, including depression, 46 47 there is still limited evidence, particularly, from Africa regarding the association between marijuana use and suicidal behaviour, especially, repeated attempted suicide. 23 48 Evidence of a recent meta-analysis 48 and an earlier longitudinal study 49 suggests that chronic marijuana use represents a risk factor for death by suicide, while frequent use of marijuana presents as a risk factor for a daily experience of suicidal ideation. 50 51 Suicides among adolescents have a variety of causes.…”

“…The key exposure variable considered a priori in this study based on the previous study 23 was marijuana use among senior high school students. Students were asked, During the past 30 days, how many times have you used marijuana?…”

“… 18 21 22 Whereas there is emerging significant evidence on suicidal ideation, planning and attempts, and associated risks and protective factors among adolescents in Africa, 13 we are aware of only one recently published study that has reported the association between marijuana use and repeated attempted suicide among school-going adolescents in Ghana. 23 The evidence suggests that, compared with non-users of marijuana, adolescents who used marijuana were significantly 2 to 5 times likely of repeated attempted suicide during the previous 12 months. 23 This study, therefore, aimed to expand this evidence base by (1) estimating the prevalence of marijuana use and suicidal behaviours, including repeated attempted suicide, (2) determining risk factors associated with the use of marijuana and (3) assessing how marijuana use influences suicidal ideation, planning and repeated attempted suicide among high school students within and across the five subregions of Africa.…”

“… 23 The evidence suggests that, compared with non-users of marijuana, adolescents who used marijuana were significantly 2 to 5 times likely of repeated attempted suicide during the previous 12 months. 23 This study, therefore, aimed to expand this evidence base by (1) estimating the prevalence of marijuana use and suicidal behaviours, including repeated attempted suicide, (2) determining risk factors associated with the use of marijuana and (3) assessing how marijuana use influences suicidal ideation, planning and repeated attempted suicide among high school students within and across the five subregions of Africa.…”