|Year : 2019 | Volume
| Issue : 14 | Page : 54-59
Alcohol use among secondary school students in Nigeria: A worrisome trend
Adewoyin Adejoke Osonuga1, Bola Deborah Ogunmoroti1, Ayokunle Osonuga2, Adebayo Da'costa2
1 Department of Adult Nursing, Babcock University, Irepodun, Ilisan-remo, Nigeria
2 Department of Emergency Medicine, Medway Maritime Hospital, Kent, England
|Date of Submission||01-Dec-2018|
|Date of Acceptance||01-Jun-2019|
|Date of Web Publication||04-Oct-2019|
Dr. Ayokunle Osonuga
Department of Internal Medicine, Babcock University Teaching Hospital, Ilisan-remo, Ogun State
Source of Support: None, Conflict of Interest: None
Background: Alcohol abuse is a global health problem, resulting in a spectrum of biopsychosocial and medical consequences. In recent times, there has been a surge in the number of adolescents who have been exposed to alcohol abuse and its attending consequences. This study aimed at identifying the reasons for alcohol abuse and assessed the knowledge of students about the harmful effects of alcohol. Materials and Methods: The study was a cross-sectional study involving 384 students who were selected by convenience sampling after ethical approval and consent was granted. A pretested questionnaire was administered to get basic biodata. This questionnaire also had five-scale questions to elicit other variables of interest. Data were analyzed using Microsoft Excel and SPSS. Results: 66% of respondents reported to have taken alcohol before, at ceremonies or while hanging out with friends. Alcohol caused problems with the law and family problems in about half of the respondents. Assault and high-risk sexual behaviors were not uncommon (5% and 12%, respectively). Most respondents knew of the consequences of alcohol abuse but gave reasons for taking alcohol; social media (96.2%), fun (94.8%), coping with stress of school (73.9%), and adolescence (93.8%) were common among other reasons. Conclusion: Alcohol problems are common in our secondary schools, stakeholders should be aware of this. We recommend expert support for students, especially in secondary schools, so that we can save the next generation from self-destructing.
Keywords: Abuse, alcohol, secondary schools
|How to cite this article:|
Osonuga AA, Ogunmoroti BD, Osonuga A, Da'costa A. Alcohol use among secondary school students in Nigeria: A worrisome trend. N Niger J Clin Res 2019;8:54-9
|How to cite this URL:|
Osonuga AA, Ogunmoroti BD, Osonuga A, Da'costa A. Alcohol use among secondary school students in Nigeria: A worrisome trend. N Niger J Clin Res [serial online] 2019 [cited 2020 Feb 25];8:54-9. Available from: http://www.mdcan-uath.org/text.asp?2019/8/14/54/268536
| Introduction|| |
Alcohol is a colorless flammable liquid found in wine, beer, spirit, and other drinks, as a by-product of the fermentation of yeast, sugars, and starch. It has also been described as a drug with a depressant effect on the central nervous system. It is primarily metabolized by the liver through biochemical pathways.
The health and social consequences of alcohol abuse are quite worrisome. It encompasses wide spectrum clinical and psychological outcomes including intoxication, dependence and increased risk of physical injury to the person and other members of the society, disruption of family life, mood disorders, and schizophrenia.,
Furthermore, alcohol abuse has been linked to a number of medical conditions, affecting different systems, including the cardiovascular, respiratory, and endocrine (especially diabetes) systems.,, It has also been implicated in immunosuppression and other metabolic disorders most importantly obesity, anemia, and malnutrition. It is also a known risk factor for a couple of malignancies; with some previous workers attributing 20%–30% of the etiological agents of these cancers to alcohol.,
Other outcomes include homicide, suicide, increased risk of automobile accidents, violence, high risk of sexual behaviors, and reduction in quality of life. This makes it the third largest risk factor for disease and disability globally.
Despite the deleterious effects of alcohol abuse, it one of the most common psychoactive drugs consumed globally, after caffeine. This makes it a global health challenge. However, the pattern of alcohol consumption and abuse vary depending on the studied population; 69.5%, 52.7%, 37.3%, and 29.3% in Europe, America, Western Pacific Region, and Africa respectively. In Nigeria, different studies put the prevalence of alcohol use at about 9.2%–65%. The result of this trend has also reflected on fatal outcomes; the WHO puts the percentage of death directly associated to alcohol use at 4%.,,
Up to 51% of secondary school students have consumed alcohol at one point in time., These alarming figures have been attributed to lax policies to regulate alcohol, ease of access, and lack of implementation of a minimum drinking age by government and breweries, and social media.,,
The later finding is worrying as there appears to be a surge of alcohol abuse among youths and adolescents, with the age of onset of alcohol consumption decreasing dramatically in Nigeria and other countries. One study described alcohol as the most widely used substance in adolescence.
With the established burden of alcohol abuse, the aim of this study was to describe the prevalence, and impact of alcohol abuse on students in selected secondary schools in southwest Nigeria.
| Materials and Methods|| |
This study was a descriptive cross-sectional study carried out among 384 students from the senior secondary school classes of two Government secondary schools, located in Ogun state, southwest Nigeria.
Data collection tool
A self-administered questionnaire was designed to elicit the variables of interest and broken into four main segments. This included biodata, alcohol use behavior, reason(s) for alcohol use, and the effect of alcohol abuse. This questionnaire was then pretested among 10 nursing tutors before the administration to the students. The five-point scoring scale was used where necessary along with closed- and open-ended questions.
Assessment reasons and consequences of taking alcohol and effects of alcohol consumption: This was determined by the five-point scoring scale. Student's response to questions was graded as strongly agree (SA), agree (A), unaware, disagree (D), and strongly disagree (SD).
This was calculated using an online sample calculator based on Fisher's formula, we arrived at a sample size of 384 (n = 384).
The two schools were chosen by balloting. Connivance sampling was used in the study to recruit the respondents.
Data analysis was done using SPSS version 20 (IBM, Armonk, NY, United States of America). Descriptive statistics were mainly used to determine frequencies and percentages. Graphs were plotted using Microsoft Excel 2016.
Ethical approval was obtained from the Babcock University Research Ethics Committee. Consent was sought from parents, the pupils, and the principals of the schools where the study was carried out.
No information that could reveal the identity of the respondents, and we tried as much as possible that confidentiality was not breached. Returned questionnaires were checked for completeness and computed for analysis of the collected data.
| Results|| |
Basic demographics of the respondents
Most of the respondents were in the SS2 class with commerce and arts dominating the majors the students undertake. Furthermore, we had more female respondents than male [Table 1]. The most predominant religion was Christianity, followed by Islam. About 60.2% of the respondents lived with both parents, while 26%, 10.7%, and 3.1% lived with their mothers, guardians, and father, respectively.
Alcohol consumption patterns of the respondents
In this study, 66% of respondents (n = 255), reported to had taken alcohol before; mostly in the form of beer. The age of onset of alcohol intake was between 12 and 20 years. Among those who had taken alcoholic drinks; 14.6% have taken alcohol once, another 14.6% took alcohol every day whereas the remainder (37.2%) took alcohol occasionally (3–4 times a week).
Meanwhile, alcohol was taken with friends (49.8%) and at ceremonies (43.9%) most of the time. Only 6.3% of respondents took alcohol at will. In addition, most respondents took alcohol during the school year, mostly after the close of school (82%).
Experienced effects, consequences of alcohol use and attempts to quit
14.5% of them have suffered a negative consequence of alcohol abuse. Most had got into trouble with their parents (26%) or law enforcement agencies, especially the police (24%). Other effects elicited included stealing (20%), bar fights (10%), high-risk sexual behaviors (12%), assault and domestic violence (5%), and school absenteeism (3%). However, very few students self-reported to have quit taking alcohol. The remaining respondents were either not ready (3.1%) to quit or were hoping to quit (74.9%, n = 191). The remainder had thought of quitting but had no concrete plan on doing so (7.5%, n = 19).
Perceived effects of alcohol misuse or abuse and reasons for alcohol use
The respondents were well aware of the consequences of alcohol use. However, more than 80% think that alcohol use was due to curiosity, alcohol use among parents, and social media among others. Having excess money to spend or availability of alcoholic products least informed decision to take alcohol.
| Discussion|| |
This study was an attempt to describe the prevalence, and impact of alcohol abuse on students in selected secondary schools in southwest Nigeria. We further explored students' perception of the causes and consequence of alcohol abuse.
From our study, the prevalence of alcohol use among secondary students was 66% [Figure 1]. This is alarming as most of these students are between the ages of 12 and 20 years [Figure 3]. This trend has been described by other workers., The WHO reports that 43% of adolescents between the ages of 15 and 19 years currently drink alcohol globally.,
The most common alcoholic drink consumed by the students who took alcohol was beer [Figure 2]. In Nigeria, a bottle of beer costs about 295.83 Naira, which is just under a dollar. Exotic alcoholic wines could cost as much as 3000 Naira or even more. This may explain why most students who took alcohol took beer (38.4%). However, in recent times, there has been an increase in the consumption of spirits among these cohorts. In a study done by Eze et al., as much as, 51.5% of respondents take local cocktails, including spirits. The cost could also account for this, as local gin is relatively inexpensive.
|Figure 2: The kinds of alcohol is commonly consumed by the respondents (Expressed in percentages)|
Click here to view
The age of first alcohol use has been linked to future heavy abuse of alcohol and the development of alcohol-related disorders., In our study, all respondents who took alcohol had taken alcohol by or before their 20th birthday [Figure 3]. They are therefore at risk of psychosocial, behavioral, and medical problems including malignancies.
|Figure 3: 100% of respondents had their initial alcohol intake between the age of 12 and 20 years|
Click here to view
Though, most alcohol use was after school hours [Figure 4], we however did not prove the effect of timing of alcohol use with academic performance in this present study. In our study, 14.5% of respondents have had problems with alcohol [Figure 5]. Mostly with the law enforcement and their parents (50%). This is similar to what moss observed in his work. Greenfield buttressed this in his study when he concluded that in 1 out of 4 crimes committed in the United States, the offender drank alcohol before committing the crime. About 12% of respondents engaging in high-risk sexual behaviors is worrying as this has been linked to transmission of sexually transmitted infections, including HIV and Hepatitis B, and sexual violence against women. This again is in agreement with Lan et al. who studied the link between alcohol abuse, sexual risk behavior, and HIV.
Occasional alcohol consumption was common in this cohort (37.2%). Those who consumed alcohol took it with their friends or at ceremonies (93.7%). It is a commonplace to see friends gather together in South-west Nigeria to have drinks together, especially at parties, mostly because these drinks are free or paid for by their richer friends. This may explain why only 6.3% of those who consumed alcohol took it at will.
Alcohol is known to be an addictive substance. Recent data suggest that alcohol intake levels escalate when the endogenous corticostriatal BDNF pathway becomes dysregulated or breaks down. This has some serious implications on our findings. In our study, only 14.5% of respondents reported to have quit taking alcohol [Figure 6]. Majority, however, were either undecided or hoped to quit soon. The addiction cycle is a complex cycle, and indeed, these students need help to break the cycle. The students were quite knowledgeable about the consequences of alcohol abuse [Figure 7]; however, this did not translate to behavior change as we have seen previously [Figure 6].
|Figure 7: The responses of students to the possible consequences of Alcohol abuse|
Click here to view
Finally, we tried to elicit the reasons for alcohol abuse among the respondents; various reasons were given in [Figure 8]. However, unlike what was thought previously, the availability of alcoholic products did not seem to be the main factor the students considered when giving reasons in alcohol abuse. Instead, majority of the respondents identified social factors such as peer pressure, dealing with school and adolescent issues as the reason for alcohol abuse. A new emerging trend, we can see is the influence of social media on alcohol habit. Previous workers in other countries have also observed this and even sparked a discussion about a paper published by Lobstein et al. with Carah and Meurk. We agree with other workers that contents of social media can be difficult to control., However, counseling services, adolescent psychological support (from experienced clinical psychologist and psychiatrists), despite their busy schedule, will be helpful. The reason we are suggesting this is because as much as 74% and 93% of the respondent feel alcohol use was due to students being overwhelmed coping with school and the challenges of adolescence [Figure 8].
|Figure 8: The responses of students to the possible reasons for alcohol abuse|
Click here to view
| Conclusion|| |
Alcohol abuse among secondary school students is not a new phenomenon. However, more worrying is the trend of its increasing prevalence. A multidisciplinary team involving all stakeholders-parents, teachers, social media publicists and bloggers, health-care professionals among a few need to work together to prevent the next generation from self-destructing.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Bai FW, Anderson WA, Moo-Young M. Ethanol fermentation technologies from sugar and starch feedstocks. Biotechnol Adv 2008;26:89-105.
Schütze M, Boeing H, Pischon T, Rehm J, Kehoe T, Gmel G, et al.
Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. BMJ 2011;342:d1584.
Woods-Jaeger BA, Nobles RH, Warren L, Larimer ME. The relationship between emotion regulation, social support, and alcohol-related problems among racially diverse adolescents. J Child Adolesc Subst Abuse 2016;25:245-51.
Schinke S, Schwinn T, Cole K. Preventing alcohol abuse among early adolescents through family and computer-based interventions: Four-year outcomes and mediating variables. J Dev Phys Disabil 2006;18:149-61.
Boffetta P, Hashibe M. Alcohol and cancer. Lancet Oncol 2006;7:149-56.
Eze NM, Njoku HA, Eseadi C, Akubue BN, Ezeanwu AB, Ugwu UC, et al.
Alcohol consumption and awareness of its effects on health among secondary school students in Nigeria. Medicine (Baltimore) 2017;96:e8960.
Stolle M, Sack PM, Thomasius R. Binge drinking in childhood and adolescence: Epidemiology, consequences, and interventions. Dtsch Arztebl Int 2009;106:323-8.
Grant BF, Goldstein RB, Saha TD, Chou SP, Jung J, Zhang H, et al.
Epidemiology of DSM-5 alcohol use disorder: Results from the national epidemiologic survey on alcohol and related conditions III. JAMA Psychiatry 2015;72:757-66.
Alex-Hart BA, Opara PI, Okagua J. Prevalence of alcohol consumption among secondary school students in Port Harcourt, Southern Nigeria. Niger J Paediatr 2015;42:39-45.
Pinsky I, Sanches M, Zaleski M, Laranjeira R, Caetano R. Patterns of alcohol use among Brazilian adolescents. Braz J Psychiatry 2010;32:242-9.
Saffer H, Dave D. Alcohol advertising and alcohol consumption by adolescents. Health Econ 2006;15:617-37.
Dawson DA, Goldstein RB, Saha TD, Grant BF. Changes in alcohol consumption: United States, 2001-2002 to 2012-2013. Drug Alcohol Depend 2015;148:56-61.
O'Malley PM, Johnston LD, Bachman JG. Alcohol use among adolescents. Alcohol Health Res World 1998;22:85-93.
Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med 2013;35:121-6.
] [Full text]
Liang W, Chikritzhs T. Age at first use of alcohol and risk of heavy alcohol use: A population-based study. Biomed Res Int 2013;2013:721761.
Maimaris W, McCambridge J. Age of first drinking and adult alcohol problems: Systematic review of prospective cohort studies. J Epidemiol Community Health 2014;68:268-74.
Moss HB. The impact of alcohol on society: A brief overview. Soc Work Public Health 2013;28:175-7.
Greenfeld LA. Alcohol and Crime: An Analysis of National Data on the Prevalence of Alcohol Involvement in Crime. Report Prepared for Assistant Attorney General's National Symposium on Alcohol Abuse and Crime. Washington, DC: U.S. Department of Justice; 1998.
Lan CW, Scott-Sheldon LA, Carey KB, Johnson BT, Carey MP. Prevalence of alcohol use, sexual risk behavior, and HIV among Russians in high-risk settings: A Systematic review and meta-analysis. Int J Behav Med 2017;24:180-90.
Logrip ML, Barak S, Warnault V, Ron D. Corticostriatal BDNF and alcohol addiction. Brain Res 2015;1628:60-7.
Lobstein T, Landon J, Thornton N, Jernigan D. The commercial use of digital media to market al
cohol products: A narrative review. Addiction 2017;112 Suppl 1:21-7.
Carah N, Meurk C. We need a media platform perspective on alcohol marketing: A reply to lobstein et al.
World Health Organization. Set of Recommendations on the Marketing of Foods and Non-Alcoholic Beverages to Children. Geneva: World Health Organization; 2010.
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8]