The prevalence of tobacco, alcohol, stimulant, khat, and cannabis use among school-going students in African and Arab countries: a systematic review and meta-analysis.

Abstract

Background: The objectives of this review and meta-analysis were twofold: first, to determine the prevalence of substance use among school-going children in Arab and African countries; and second, to highlight the considerable influence of variables such as the nation's region and the timeframe of the study on the prevalence of substance use.

Methods: Research was sourced from Science Direct, Scopus, Web of Science, Google Scholar, and PubMed. Thirty-seven articles were incorporated in accordance with the PRISMA guidelines. This review included studies published from 2013 to 2023. The statistical meta-analysis was performed using Comprehensive Meta-Analysis ver. 3 software. Across 37 studies, the total number of study participants was 73,508.

Results: The meta-analysis revealed that tobacco was the most commonly used substance, with a prevalence of 16% (95% confidence interval [CI], 12.7%-20.02%). This was closely followed by alcohol, which had a prevalence of 15% (95% CI, 10.5%-22.8%), stimulants at 11.4% (95% CI, 7.4%-17%), khat at 10% (95% CI, 5.7%-15%), and cannabis at 8% (95% CI, 3.3%-18.4%). Notably, alcohol was the only substance that showed an increasing trend in prevalence from before to after 2019, rising from 13.3% (95% CI, 6.2%-26.1%) to 17% (95% CI, 10.2%-27%) (p<0.001). Additionally, the prevalence of substance use varied significantly between Arab and African countries (p<0.001).

Conclusion: Although the prevalence of substance use among school-going populations has significantly decreased over time, with the exception of alcohol, it is imperative that both African and Arab countries implement comprehensive measures and stringent laws to address the production and marketing of substances.