Association of Adolescent Substance Use: Behavioral Problems and Family Background among School Students in Tsunami Affected Area in Southern Thailand
Nantawat Sitdhiraksa MD, PhD*, Vinadda Piyasil MD**, Pornjira Pariwatcharakul MD, MSc*, Sirirat Ularntinon MD**, Nuttorn Pityaratstian MD***, Supachoke Singhakant MD, MSc*, Woraphat Ratta-apha MD*, Nattha Saisavoey MD*, Panom Ketumarn MD*
Affiliation : * Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Pediatrics, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand *** Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective : To study the prevalence of substance use and associated factors in school students in Tsunami affected areas in
southern Thailand.
Material and Method: The study was a school-based, cross-sectional, anonymous survey that used a translated questionnaire,
ESPAD-03, in 5 schools. Chi-square tests and odds ratios were used to evaluate factors associated with substance use.
Results : Two thousand seven hundred and sixteen students (87.8%) were enrolled in the study. Lifetime, last 12 months, and
last 30 days prevalence rates of any substance use were 50.3, 33.9, and 24.8%, respectively. Lifetime, last 12 months, and last
30 days prevalence rates of alcohol use were 43.2, 30.1, and 17.5%, respectively. Lifetime and last 30 days prevalence rates
of smoking were 21.7 and 12.0%. Fighting, stealing, truancy, running away, unsafe sex, and thought of self-harming were
associated with alcohol and substance use. Siblings and friends with alcohol and substance use were risk factors. Close
support from parents and friends were protective factors.
Conclusion : There was a high prevalence of smoking, alcohol, and substance use among school students in Tsunami affected
areas. Behavioral problems and psychosocial risk factors were associated with history of smoking, alcohol and substance
use. School-based intervention in students with behavioral problems seems to be a worthwhile investment. However, longitudinal
studies should be done to confirm the correlation of PTSD and substance use.
Keywords : Substance use, Adolescent, Tsunami, Behavioral problem, Risk, Protective factor
