Knowledge, attitude and practice on substance use among high school students in Nairobi, Kenya
Abstract
The main objective of this study was to determine the knowledge, attitude and practice of
substance use among high school students. This study focused on alcohol, tobacco, miraa
and bhang. The study was carried out in Nairobi Province in both public and private
schools, which were either boarding or day schools. This was a cross- sectional study
with focus group discussions and in-depth interviews. Multistage sampling was done and
481 students filled a standardised self-administered questionnaire.
Most of the students had fair knowledge about the drug effects. This knowledge ranged
from 72.4% for alcohol to 62.4% for tobacco. Ninety-nine percent of the respondents felt
that drug use was a serious problem among high school students. There was a strong
disapproval among the students towards the use of the various drugs in the following
percentages 47%,54%,45% and 64% for alcohol, tobacco, khat and bhang respectively.
However the Form 2 and 4 students seemed liberal in attitude and behaviour towards the
use of these drugs while the Form 1 pupils were more emphatic to reject use and the
Form 3 students seemed to be inbetween the two extremes. Use of miraa was
significantly more likely to be approved by the day scholars than the boarders (p =
0.008). Attitude was significantly related to past year use of alcohol (p = 0.0017) or miraa
(p = 0.0026), so that poor attitude was a predictor to the use of alcohol or miraa. The
level of knowledge on the effects of the drugs on use was not related to the use of any of
the drugs (p > 0.05). There was no significant relationship between being a day scholar or
boarder and the use of the various drugs.
Lifetime prevalence drug use ranged from 57.5% for alcohol to 12.9% for bhang for the
males, while the females had a range of 44.9% for alcohol to 6.6% for bhang. Past year
use prevalence had a similar trend but with lower percentages. Being in the informal
clubs or activities was significantly related to lifetime use of alcohol (p=0.002) and miraa
(p=O.03). Similarly the past year use of alcohol had a significant relationship with the I
informal clubs (p=0.04). Poly-drug use was common among the tobacco smokers and
there was significant relationship between tobacco smoking and the use of alcohol
(p=O.002),miraa (p=0.00 1) or bhang (p < 0.05). Initiation into the use of these drugs was
found to be mainly by friends from their peer groups. Other initiators included family
members like parents or older siblings, drug pushers/dealers. Many miscellaneous
reasons for non-use or stopping to use drugs were mentioned, these included' smoking
gives you a bad breath', ' chewing miraa is disgusting', ' bhang made me feel bad'.
These could be used as a basis for developing Health Education for this population.
Lack of confidentiality in the counselling departments of schools, poor example from
teachers/parents, poor communication with parents and lack of access to psychologists or psychiatrists are some of the reasons given by the students for not fully accepting the
intervention. strategies that should help them out of drug problems. The focus group
discussions suggested ways of improving prevention of drug use, this included
rehabilitation of drug victims, increased awareness of the problem in schools starting
from upper primary and encouragement of peer counselling among students.
It can be recommended from the study that Health Education information should contain
all aspects about drugs so as to give comprehensive knowledge, attitude and skills for
effective change. Health Education messages on drug use should be developed with the
purpose of gathering the attention of target groups which include the upper primary and
high school classes, the informal clubs/activities, tobacco users and community groups.
Peer counselling should be instituted in all schools and all intervention areas should have
a conducive environment that encourages students to seek help and support from their
strategies.
Citation
Masters of Public Health of the University of Nairobi, 2001Publisher
School of Medicine