Abstract

Background: Substance abuse among university students is a growing concern that poses significant challenges to public health and academic success. Understanding students’ knowledge, practices and factors influencing substance abuse is important in informing targeted interventions and policies to reduce substance abuse and its associated harms within this vulnerable population.

Aim: This study aims to assess knowledge, practice, prevalence and factors influencing substance abuse among undergraduate students in the University of Buea.

Materials and methods: An institutional cross-sectional study was carried out from March to June 2025, using a sample size of 367 participants from the University of Buea. The data was collected using a structured pre-tested questionnaire. Participants were selected using Simple random sampling and convenience sampling. Descriptive and analytical statistics were done to describe the study population and determine association. Data was coded, entered into Microsoft excel 2016, cleaned and exported into SPSS (Statistical Package for Social Sciences) Version 30.0 for analysis. Variables were represented with percentages, mean and standard deviation. A chi-square test was used to determine the association between dependent variables (sociodemographic data) and independent variables (knowledge, practice, influencing factors, prevalence). A p-value of < 0.05 was considered statistically significant and the confidence interval was set at 95%.

Results: Out of the 367 participants with mean age of 22.5 (SD=0.35), 75.30%% had a high knowledge of substance abuse and 24.70% had a poor knowledge. 47% frequently practiced substance abuse while 53% were infrequent in this practice. The main factor influencing substance abuse among undergraduate students was mental health challenges.

Conclusion: Level of knowledge of substance abuse among students was generally high, with most students engaging in this practice (66%) and 47% abusing substances frequently. The main factors influencing this practice were mental health challenges, easy access to substances and social environment. Addressing these factors are essential and will significantly contribute to reducing substance abuse and its associated health and social consequences in Cameroon.

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Substance use for medicinal, religious, and recreational purposes dates back centuries. The earliest mentions of the use of alcoholic or fermented beverages in Chinese writing goes as far as the 7th millennia BC, although there is also evidence from Sumerian writing of the use of opium from the poppy plant [1]. Africa has a long history of drug cultivation, production, trade and consumption and there are also plants and herbs with psychoactive effects like cannabis resin (known as hashish in North Africa), Catha edulis (known in East Africa as Kath), and cannabis (known in Southern Africa as dagga) that have also been used traditionally for centuries and abused. From the past few years, rapidly growing grand trade and recreational use of opiates, synthetic psychoactive stimulants and prescription medications have been growing threats in Africa [2]. Results of prospective studies examining patterns of drug use among the population have revealed substance use peaks between 18 years and 25 years of age, with substance abuse among youths greater than that of older people [3]. Before West Africa was considered a transit zone for drugs, it also produced cannabis products, which were shipped to the United States and Europe. Although at the same time, marijuana was being imported to Nigeria from South Africa and Congo [4]. In the past, East Africa wasn’t as heavily involved in drug trafficking as West Africa. However, over the past few decades, there has been a noticeable rise in both the volume and variety of drugs moving through countries like Kenya, Uganda, and Tanzania [1]. This growing trend in heroin and cocaine trafficking has also contributed to increased substance abuse in the region, as a portion of these drugs now makes its way into local communities [1].

Substance abuse refers to excessive use of a drug in a way that is detrimental to self, society, or both, which might result in physical and psychological dependence [5]. According to the World Health Organisation (2017), substance abuse refers to the detrimental consumption of psychoactive substances that includes alcohol and other illicit drugs [6]. Substance abuse among undergraduates has been a significant public health concern, with various studies highlighting its knowledge, practice and influencing factors. A study conducted at the University of Uyo revealed that 27.5% of undergraduates had engaged in psychoactive substance use. The substances most commonly used were alcohol (100% of users), codeine (79.8%), tramadol (74.2%), and cigarettes (41.6%).  Similarly, research in Osun State identified peer influence as the main factor influencing substance abuse among undergraduates [7]. Further studies supported these findings. For instance, research at Ambrose Alli University in Edo State identified peer pressure, environmental factors, and emotional instability as significant contributors to drug abuse among undergraduates [8], while another study at Tai Solarin University in Ogun State highlighted cultural factors like festivals and religious practices as significant contributors [9]. Similarly, research in South Africa demonstrated how mental health challenges like depression and anxiety contribute to the issue [10]. A study conducted at the University of Benin, Nigeria, found that 97.2% of undergraduates demonstrated good knowledge of substance abuse, but the lifetime prevalence of substance use was 44.4% [11]. Further studies in Port Harcourt University indicate that knowledge of substance abuse among students is relatively high, with over 96% of students recognizing the risks associated with consuming substances. However, these studies also found that only-child syndrome, peer influence, and neighborhood environment continue to drive substance use despite this awareness [12]. A study at the University of Venda, South Africa, revealed that while students had high knowledge on substance abuse, this did not necessarily translate into appropriate practices, highlighting the gap between knowledge and practice [13]. A study conducted among undergraduate students at the University of Nairobi found that despite students being aware of the health risks associated with alcohol and drug use, peer pressure and social influences were significant predictors of their substance abuse behaviors [14]. Research indicates that students often perceive substance use as a normative aspect of university life, which can significantly influence their engagement in such behaviors [15]. Additionally, the transition to university life introduces various stressors, and some students may resort to substance use and abuse as a coping mechanism [16].

The harmful use of alcohol and drugs is a global problem that results in about 2.5 million deaths each year. [13,17] The use of psychoactive substances, such as cannabis, amphetamines, cocaine and opioids has been reported among 155 to 250 million people in the world. Medical conditions such as lung cancer, myocardial infarction, cerebrovascular disease, cardiomyopathy, alcohol-related psychosis, alcohol dependence syndrome, cirrhosis of the liver, chronic pancreatitis, and cancer of the oesophagus have been associated with substance abuse [13]. Substance abuse among undergraduate university students in the Southwest Region of Cameroon presents significant public health challenges, influenced by a complex interplay of knowledge, practices, and socio-environmental factors [16]. A study conducted in Buea, the regional capital, revealed a 15.3% prevalence of non-medical use of prescription drugs among adolescent students, with tramadol being the most commonly misused substance [17]. The ongoing Anglophone crisis has worsened mental health issues, leading to increased substance use and abuse as a coping mechanism. A cross-sectional study in the conflict-affected Southwest region identified recreational drug use as a prevalent issue, with factors such as exposure to traumatic events and daily stressors contributing to this trend [18]. In the Molyko community of Buea Sub-Division, research has highlighted youths’ awareness of the causes, effects, and potential remedies for substance abuse. Despite this knowledge, the prevalence and practice of substance abuse remains a concern[19].

1.2 STATEMENT OF THE PROBLEM

Substance abuse among undergraduate university students in the Southwest Region of Cameroon has become a growing public health concern, with increasing rates of alcohol, prescription drug, and illicit drug abuse. In society, substance abuse leads to various issues, including an increase in criminal activity, declining mental and physical health and strain on social systems. Many students are unaware of the long-term impacts that substance abuse can have on their health and well-being, whereas, those who are aware also continue to abuse substances, often influenced by peer pressure, stress, and other socio-environmental factors such as the ongoing Anglophone crisis, which worsens mental health issues and substance misuse behaviors [17,18].

In the university environment, students often exhibit knowledge about the harmful effects of substance abuse but fail to translate this awareness into healthier behaviors due to social and peer influences [19]. This highlights the importance of not only increasing knowledge about substance abuse and its dangers but also addressing the social and environmental factors that encourage its practice. Recent studies have found that approximately 40-50% of university students report regular alcohol consumption, while 20-30% engage in smoking or the use of illegal drugs which can result in overdose and death [17,20]. Addressing these issues requires a multiple approach that includes improving students’ knowledge about substance abuse, implementing effective prevention programs, and creating supportive environments that reduce the factors that drive students toward substance abuse.

1.3 RESEARCH OBJECTIVES

1.3.1 General Objective

To assess the level of knowledge, practice and factors influencing  substance abuse among undergraduate students in the University of Buea.

1.3.2 Specific Objectives

1. To assess the level of knowledge of substance abuse among undergraduate students in the University of Buea.
2. To evaluate the substance abuse practices among undergraduate students of the University of Buea.
3. To determine the factors influencing substance abuse among undergraduate students in the University of Buea.
4. To determine the prevalence of substance abuse among undergraduate students in the University of Buea.

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