Objective: To examine the situation of drug use, and association between drug use and drug literacy in secondary school students.

Materials and Methods: A census of 2,404 students from 3,468 secondary school students was conducted during their second semester of the academic year 2015. There were 1,120 males, 1,284 females, 1,536 students in grades 7 and 8 (junior secondary school) and 868 students in grades 10 and 11 (senior secondary school). The census was done in the 23 primary and secondary educational opportunity expansion schools. A self-administrative questionnaire was used. Data were analyzed using descriptive statistics, odds ratio [OR] with 95% confidence interval [CI], Chi-square, and multiple logistic regression.

Results: The response rate was 89.4%, in which females (53.4%) and junior secondary school students (65.7%) were predominant. Fifty-four-point-six-percent of the participating students had used any type of drug, including tobacco and alcohol, 59.5% (OR 0.69, 95% CI 0.58 to 0.82, p<0.001) were males, 61.9% were aged 15 to 19 years (OR 1.59, 95% CI 1.33 to 1.90, p<0.001), and 62.1% (OR 1.60, 95% CI 1.33 to 1.92, p<0.001) were senior secondary school students. The types of drug use included alcohol (48.6%), tobacco (27.0%), cannabis (6.2%), inhalants (6.2%), and methamphetamine and other amphetamine-type stimulants [ATS] (3.5%). The lifetime prevalence rate of drug users was 54.6% and in the past three months, the prevalence rate of drug users was 24.0%. Most students who had never used the drugs had drug literacy for 85.1% (OR 0.48, 95% CI 0.39 to 0.60, p<0.001). The literacy was associated with tobacco (AOR 0.32, 95% CI 0.19 to 0.54, p<0.001) and cannabis (AOR 0.24, 95% CI 0.16 to 0.38, p<0.001). During the previous three months, the proportion of drug use had declined, but the use was in a high-risk level. Drug literacy was significantly related to the risk level in tobacco and alcohol use (p<0.01). The factors associated with drug use were age, gender, educational level, and drug literacy (p<0.01).

Conclusion: There is evidence of drug use in the secondary school students and the use is in a high-risk level for all types of drug. The types of drug use varied in different age groups. The students who have never used the drug have drug literacy higher than those who used the drugs. Therefore, knowledge about drug use should be given appropriately to the students’ age, gender, and educational level.

Keywords: Secondary school students, Drug use, Drug literacy, Thailand