Psychosocial and socio-environmental factors associated with adolescents’ tobacco and other substance use in Bangladesh

Abstract

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.

Bullying among children and adolescents in the SAARC countries: A scoping review

“…Similar to studies done in high income countries ( Wolke and Lereya, 2015 ), significant associations between mental health problems and bullying were seen among bullies, victims and bully victims. This is corroborated in the studies included in this review for depression ( Asad et al., 2017 ; Murshid, 2017 ; Naveed et al., 2019 ), anxiety ( Khan and Khan, 2020 ; Neupane et al., 2020 ), physical violence and injuries ( Pandey et al., 2021 ; Shaikh et al., 2019 ) and substance use ( Khan et al., 2020 ; Neupane et al., 2020 ). Suicidal thoughts and behaviours were analysed in the meta-analysis performed by van Geel et al.…”

“… Khan and Khan, 2020 Bangladesh 2883 11–17 School Cross-sectional research NA aOR of anxiety 6.00 13. Khan et al., 2020 Bangladesh 2989 11–17 School Cross-sectional research NA aOR of Tobacco use 1.93 aOR of other substance use—3.43 14. Khan et al., 2020 Bangladesh 2989 11–17 School Cross-sectional research NA 25.3% age adjusted prevalence of suicidal behaviour aRR of Suicidal behaviour 1.88 15.…”

“… Khan et al., 2020 Bangladesh 2989 11–17 School Cross-sectional research NA aOR of Tobacco use 1.93 aOR of other substance use—3.43 14. Khan et al., 2020 Bangladesh 2989 11–17 School Cross-sectional research NA 25.3% age adjusted prevalence of suicidal behaviour aRR of Suicidal behaviour 1.88 15. Lee et al., 2019 Nepal Sri Lanka 914 1404 NA School Cross-sectional research Nepal 14% Sri Lanka 23.5% Psychological distress OR in Nepal 3.34, in Sri Lanka 2.66 16.…”

“…It is also bullying when a student is teased a lot in an unpleasant way or when a student is left out of things on purpose. It is not bullying when two students of about the same strength or power argue or fight or when teasing is done in a friendly and fun way.” Global School Based Health Survey— Dema et al., 2019 ; Irish and Murshid, 2020 ; Khan et al., 2020 ; Khan and Khan, 2020 ; Murshid, 2017 , 2018 ; Neupane et al., 2020 ; Pandey et al., 2020 , 2021 ; Rahman et al., 2020 ; Shah et al., 2019 ; Shaikh et al., 2019 ; Wang et al., 2020 NA Instruments used: Adolescent Peer Relation Instrument Mansoor and Shahzad, 2020 Validation study, Bangla translation of the cyber victim part of the cyber victim and bullying scale Mallik and Radwan, 2020 No details given Bullying behaviour scale Abid et al., 2017 No details given Bullying victimization questionnaire SEHER intervention trial— Shinde et al., 2018 , 2020 ; Singla et al., 2021 Coefficient alpha mentioned, translated and contextualized Hindi version of the Korean-Peer Nomination Inventory (K–PNI) Sethi et al., 2019 No details given Illinois Bully scale Sharma et al., 2020 ; Thakkar et al., 2019 , 2021 Coefficient alpha mentioned for English and Hindi versions Illinois Bully scale and Cyber harassment student survey Sharma et al., 2017 No details given International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool for Children Haque et al., 2021 Not details given Interview Naveed et al., 2019 ; Naveed et al., 2020 11 ite...…”

“…Significant associations have been found in relation to bullying behaviours (for victims, bullies and bully victims) and various mental health outcomes, including depressive symptoms (OR = 1.97) ( Bhatt et al., 2020 ), Anxiety symptoms (aOR = 2.40–6.00) ( Khan and Khan, 2020 ; Neupane et al., 2020 ), psychological distress (OR = 2.66–3.44) ( Lee et al., 2019 ), suicidal ideas and attempts (OR = 2.23–5.88 & OR = 2.94–6.60) ( Irish and Murshid, 2020 ; Rahman et al., 2020 ), and tobacco use (aOR 1-93-2.05) ( Khan et al., 2020 ; Neupane et al., 2020 ). Both externalizing and internalizing symptoms were significantly higher when considering combined bullying as compared to either traditional or cyberbullying in both sexes ( Chudal et al., 2021 ).…”