Asian Journal of Medicine and Health

The consumption of psychoactive substances (PAS) among adolescents has become a major public health concern. As adolescents in different geographical settings experience unique exposures and challenges, understanding the pattern and determinant factors of PAS use across these settings is crucial for targeted interventions. This study aimed to evaluate the patterns of PAS consumption and identify the determinants influencing such behaviour among adolescents in urban and rural communities of Abia State, Nigeria. A cross-sectional study involving 1,036 adolescents from urban and rural settings of Abia State was conducted. Descriptive statistics, chi-square tests, and logistic regression were used to analyze the data. The findings revealed that alcohol was the most commonly initiated substance in both rural (76.6%) and urban (73.6%) areas. The majority of users consumed substances occasionally or regularly. Crucially, peer usage emerged as the most significant predictor of adolescent substance use, with those having substance-using peers being 17.3 times more likely to use themselves. Additionally, mother's occupation was also found to be a significant determinant, with adolescents of mothers in menial jobs or unemployed 1.8 times more likely to use substances. On the other hand, factors like the father's occupation and emotional support were less predictive. Such findings are pivotal in informing targeted interventions to curb psychoactive substance use among adolescents in Nigeria.