Patterns of Psychoactive Substance Misuse in Undergraduate University Students: The Case of Mekelle University, Ethiopia

Background: Substance misuse is a public health concern among University students. Understanding the critical times and places for substance misuse among University students helps to inform effective preventive strategies. However, there is a dearth of studies in Ethiopian Universities on this topic. Here, we aimed to explore the patterns of psychoactive substance misuse, specifically about time and places, among undergraduate students at Mekelle University. Subject and Methods: An explorative qualitative study design was conducted in 2017. Five focus-group discussions among substance user students followed by eleven in-depth interviews with the user and non-user students, proctors, and a bar owners were conducted. In addition, four key informant researchers were involved. Participants were purposefully selected. The data were audio taped, transcribed verbatim and imported into Atlas.ti qualitative data analysis software version 7.5 for coding and analysis. Data were analyzed inductively to capture the emerging themes. Results: Our study showed that students consume alcohol in the evenings, on weekend days, holidays, after exams and at celebrations; smoke cigarettes after waking in the morning and after eating lunch. Concurrent substance use like smoking cigarettes, chewing Khat and drinking alcohol was evident. Khat chewing was reported mainly around noon, in the afternoon and on weekends. Substance use generally peaks at weekends, at the start and end of academic semesters, and when graduation approaches. However, students who become addicted may continue using substances. Students easily accessed and used substances around and inside the gates of the campuses. Conclusion: Event-specific celebrations are linked with substance misuse among University students. The ease with which students can access substances around the campuses increases the likelihood of substance misuse. Proactive interventions that include the provision of alcohol-free recreational alternatives to events on campus, high-risk substance misuse surveillance, tobacco cessation interventions, and promoting plain packaging are recommended.