Main Article Content
Polysubstance use, the use of more than one substance, is a current problem among adolescents. The study assessed the prevalence of polysubstance use and associated factors among grade 11 students in Bangkok, Thailand. A web-based, cross-sectional study was conducted utilizing the secondary datasets of the Bangkok Behaviour Surveillance Survey (BBSS) in 2017, and the data were collected from June to July 2017. The BBSS is conducted every two years. In the process of analysis, 1,755 adolescents were included. Chisquare test and multiple logistic regression were performed to identify the association between independent variables and polysubstance use.
The prevalence of use of alcohol, cigarette, and marijuana were 26.2%, 14.4%, and 5.9%, respectively. The polysubstance use during the past 12 months was 14.1%. Among 484 student substance users, more than half reported polysubstance use, and 17.4% have used all three substances. Male students were more likely to use polysubstance than females. Having a close friend who uses substances, persuasion of a close friend, recent grade point average (GPA), socio-economic status (SES), and sexual orientation were significantly associated with polysubstance use. As for psychological factors, anxiety and depression were not associated with polysubstance use. However, having had adverse childhood experiences (ACEs) was associated with polysubstance use. In addition, sexual perception and experience and risky sexual behaviour scores were significantly associated with polysubstance use. The multiple logistic regression analysis showed that having a boy/girlfriend, close friends smoking cigarettes, recent low GPA, sexual perception, sexual experience, and high and moderate SES significantly predicted polysubstance use.
Such findings can be used by prevention specialists and health educators to develop and implement alcohol tobacco and marijuana prevention programs and interventions specifically tailored to Thai adolescents.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
2.Kelly AB, Evans‐Whipp TJ, Smith R, Chan GC, Toumbourou JW, Patton GC, et al. A longitudinal study of the association of adolescent polydrug use, alcohol use and high school non‐completion. Addiction. 2015;110(4):627-35.
3.Gonzales R, Anglin MD, Beattie R, Ong CA, Glik DC. Perceptions of chronicity and recovery among youth in treatment for substance use problems. Journal of Adolescent Health. 2012;51(2):144-9.
4.Hanson KL, Cummins K, Tapert SF, Brown SA. Changes in neuropsychological functioning over 10 years following adolescent substance abuse treatment. Psychology of Addictive Behaviors. 2011;25(1):127.
5.Hingson RW, Heeren T, Winter MR. Age at drinking onset and alcohol dependence: age at onset, duration, and severity. Archives of pediatrics & adolescent medicine. 2006;160(7):739-46.
6.Grant BF, Dawson DA. Age at onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: results from the National Longitudinal Alcohol Epidemiologic Survey. Journal of substance abuse. 1997;9:103-10.
7.Buchmann AF, Blomeyer D, Jennen‐Steinmetz C, Schmidt MH, Esser G, Banaschewski T, et al. Early smoking onset may promise initial pleasurable sensations and later addiction. Addiction biology. 2013;18(6):947-54.
8.Gillespie NA, Neale MC, Kendler KS. Pathways to cannabis abuse: a multi‐stage model from cannabis availability, cannabis initiation and progression to abuse. Addiction. 2009;104(3):430-8.
9.McDonough MH, Jose PE, Stuart J. Bi-directional effects of peer relationships and adolescent substance use: A longitudinal study. Journal of youth and adolescence. 2016;45(8):1652-63.
10.Dishion TJ, Loeber R. Adolescent marijuana and alcohol use: The role of parents and peers revisited. The American journal of drug and alcohol abuse. 1985;11(1-2):11-25.
11.Martin CS, Arria AM, Mezzich AC, Bukstein OG. Patterns of polydrug use in adolescent alcohol abusers. The American journal of drug and alcohol abuse. 1993;19(4):511-21.
12.Conway KP, Vullo GC, Nichter B, Wang J, Compton WM, Iannotti RJ, et al. Prevalence and patterns of polysubstance use in a nationally representative sample of 10th graders in the United States. Journal of Adolescent Health. 2013;52(6):716-23.
13.Weissman DG, Schriber RA, Fassbender C, Atherton O, Krafft C, Robins RW, et al. Earlier adolescent substance use onset predicts stronger connectivity between reward and cognitive control brain networks. Developmental cognitive neuroscience. 2015;16:121-9.
14.Van Leeuwen AP, Verhulst FC, Reijneveld SA, Vollebergh WA, Ormel J, Huizink AC. Can the gateway hypothesis, the common liability model and/or, the route of administration model predict initiation of cannabis use during adolescence? A survival analysis—the TRAILS study. Journal of Adolescent Health. 2011;48(1):73-8.
15.Quek L-H, Chan GC, White A, Connor JP, Baker P, Saunders JB, et al. Concurrent and simultaneous polydrug use: latent class analysis of an Australian nationally representative sample of young adults. Frontiers in public health. 2013;1:61.
16.Banks DE, Rowe AT, Mpofu P, Zapolski TC. Trends in typologies of concurrent alcohol, marijuana, and cigarette use among US adolescents: An ecological examination by sex and race/ethnicity. Drug & Alcohol Dependence. 2017;179:71-7.
17.Hall W, Pacula RL. Cannabis use and dependence: public health and public policy: Cambridge university press; 2003.
18.Lotrean LM, Kremers S, Ionut C, de Vries H. Gender differences regarding the alcohol–tobacco relationship among Romanian adolescents—A longitudinal study. European journal of public health. 2009;19(3):285-9.
19.Matuszka B, Bácskai E, Czobor P, Gerevich J. Physical aggression and concurrent alcohol and tobacco use among adolescents. International Journal of Mental Health and Addiction. 2017;15(1):90-9.
20.Schmid B, Hohm E, Blomeyer D, Zimmermann US, Schmidt MH, Esser G, et al. Concurrent alcohol and tobacco use during early adolescence characterizes a group at risk. Alcohol and Alcoholism. 2007;42(3):219-25.
21.Drugs EMCf, Addiction D. Polydrug Use: Patterns and Responses: Selected Issues 2009: OOPEC; 2009.
22.Milam J, Slaughter R, Meeske K, Ritt‐Olson A, Sherman Bien S, Freyer DR, et al. Substance use among adolescent and young adult cancer survivors. Psycho‐oncology. 2016;25(11):1357-62.
23.Organization WH. Global School-based Student Health Survey. Thailand: 2008 fact sheet. 2013.
24.Redonnet B, Chollet A, Fombonne E, Bowes L, Melchior M. Tobacco, alcohol, cannabis and other illegal drug use among young adults: The socioeconomic context. Drug and alcohol dependence. 2012;121(3):231-9.
25.Farrell S, Manning WG, Finch MD. Alcohol dependence and the price of alcoholic beverages. Journal of Health Economics. 2003;22(1):117-47.
26.Collins J-L, Thompson K, Sherry SB, Glowacka M, Stewart SH. Drinking to cope with depression mediates the relationship between social avoidance and alcohol problems: A 3-wave, 18-month longitudinal study. Addictive behaviors. 2018;76:182-7.
27.Howell AN, Leyro TM, Hogan J, Buckner JD, Zvolensky MJ. Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers. Addictive behaviors. 2010;35(12):1144-7.
28.Paulus DJ, Valadka J, Businelle MS, Gallagher MW, Viana AG, Schmidt NB, et al. Emotion dysregulation explains associations between anxiety sensitivity and hazardous drinking and drinking motives among adult treatment-seeking smokers. Psychology of Addictive Behaviors. 2017;31(2):189.
29.DeMartini KS, Carey KB. The role of anxiety sensitivity and drinking motives in predicting alcohol use: A critical review. Clinical psychology review. 2011;31(1):169-77.
30.Fletcher JM. Adolescent depression and educational attainment: results using sibling fixed effects. Health economics. 2010;19(7):855-71.
31.Mchugh RK, Votaw VR, Sugarman DE, Greenfield SF. Sex and gender differences in substance use disorders. Clinical psychology review. 2018;66:12-23.
32.Kuhn C. Emergence of sex differences in the development of substance use and abuse during adolescence. Pharmacology & therapeutics. 2015;153:55-78.
33.Moss HB, Chen CM, Yi H-y. Early adolescent patterns of alcohol, cigarettes, and marijuana polysubstance use and young adult substance use outcomes in a nationally representative sample. Drug and alcohol dependence. 2014;136:51-62.
34.Ansari-Moghaddam A, Rakhshani F, Shahraki-Sanavi F, Mohammadi M, Miri-Bonjar M, Bakhshani N-M. Prevalence and patterns of tobacco, alcohol, and drug use among Iranian adolescents: A meta-analysis of 58 studies. Children and Youth Services Review. 2016;60:68-79.
35.Kelly AB, Chan GC, Mason WA, Williams JW. The relationship between psychological distress and adolescent polydrug use. Psychology of Addictive Behaviors. 2015;29(3):787.
36.Dong M, Anda RF, Felitti VJ, Dube SR, Williamson DF, Thompson TJ, et al. The interrelatedness of multiple forms of childhood abuse, neglect, and household dysfunction. Child abuse & neglect. 2004;28(7):771-84.
37. Htike M, Thepthein B and Chucharoen P,A web-based survey on adverse childhood experience, anxiety, depression, sexual behavior affecting methamphetamine use among adolescents in Bangkok, Thailand J Pub. Health Dev. 2017;15(3):17-31
38.Thepthien B, Altaf L, Chuchareon P, Srivanichakron S. Substance abuse in early adolescents and HIV preventive behaviors: findings from a school-based cross-sectional survey for the period from 2009 to 2013, Bangkok Thailand. AIDS care. 2016;28(10):1327-31.
39.Trenz RC, Scherer M, Duncan A, Harrell PT, Moleko AG, Latimer WW. Latent class analysis of polysubstance use, sexual risk behaviors, and infectious disease among South African drug users. Drug and alcohol dependence. 2013;132(3):441-8.
40.Leigh BC, Ames SL, Stacy AW. Alcohol, drugs, and condom use among drug offenders: An event-based analysis. Drug and alcohol dependence. 2008;93(1-2):38-42.
41.Tetrault JM, Fiellin DA, Niccolai LM, Sullivan LE. Substance use in patients with sexually transmitted infections: results from a national US survey. The American journal on addictions. 2010;19(6):504-9.
42.Cook RL, Comer DM, Wiesenfeld HC, Chang C-CH, Tarter R, Lave JR, et al. Alcohol and drug use and related disorders: An underrecognized health issue among adolescents and young adults attending sexually transmitted disease clinics. Sexually Transmitted Diseases. 2006;33(9):565-70.