Risk factors of addictive behavior in adolescents in Tunisia

Abstract Background Adolescence is a period of physical, psychological and sociocultural transformation, but also of curiosity and experimentation. In Tunisia, the levels of use of some psychoactive substances, especially alcohol, tobacco and cannabis, remain high among adolescents, despite progress in regulatory efforts to limit access to these products by minors, and regular prevention campaigns. We aimed to determine the prevalence of addictive behavior among students in the region of Sousse and to specify the risk factors. Materials/Methods We conducted a cross-sectional epidemiological study in two public schools in the governorate of Sousse during the 2017/2018 school year. All students in each class were included when they agreed to participate in the study. The data was collected by anonymous self-questionnaire, then processed and analyzed using the SPSS version 20 software. Results In total, 294 students participated in this study with a mean age of 17.03 ± 1.51 years. A female predominance was noted (56.1%). The prevalence of addictive behavior was 52% (95% CI = [45.9% - 57.8%]). In univariate analysis, male gender, advanced age, and repeating the study year were significantly associated with addictive behavior (p = 0.014, p < 10-3, p = 0.004 respectively). However, multivariate analysis showed that the probability of addictive behavior decreased in students who read books frequently (OR = 0.6, 95% CI = [0.37 - 0.96], p = 0.03). The only independent risk factor associated with addictive behavior was age (OR = 1.34, 95% CI = [1.14 - 1.59], p < 10-3). Conclusions The findings have implications for identifying protection factors and risk factors for addictive behaviors, and the development of primary prevention strategies derived from such factors. Key messages Our results highlight the need to better understand behaviors at risk in Tunisia and the perceptions of prevention policies among students. Knowledge of related factors is important for prevention program planning.