Correlation between religiosity and family functioning among secondary school students in high-risk residing areas and factors associated with substance use

Introduction: Substance use in adolescents poses a complex societal challenge that undermines nation-building and socioeconomic growth. Religiosity refers to a person's religious beliefs, habits, and involvement in religious activities. Family functioning refers to the overall health and operation of a family unit, which includes communication, emotional bonding, support, roles, and behavioral control. Both aspects play a significant impact in determining substance use in adolescents. This study is to assess the correlation between religiosity, and family functioning, and to determine factors associated with substance use among adolescents in secondary schools in high-risk areas. Methods: A cross-sectional study was conducted among 312 adolescents from selected secondary schools in substance use hotspot areas in Northern Malaysia. Alcohol, Smoking, and Substance Involvement Screening Tool-Lite (ASSIST-Lite), Family Adaptation and Cohesion Scale version IV (FACES-IV), and Hatta Islamic Religiosity Scale (HIRS) were used as instruments. Results: The prevalence of substance use among adolescents was 9.6%(n=30). Most of the users used a single substance (76.7%; n=23) and only (23.3%; n=7) used multiple substances. The mean age was 14.13 years (SD:0.67), and the majority were Malays (99.0%; n=309) with a background in Muslim religion. Adolescent substance use was significantly associated with gender (16.3% in males and 6.3% in females) and having a recent family history of substance use (16.8%). A negative correlation was found between substance use and family functioning; balanced flexibility (rs=-0.12; P=<0.05), family communication (rs=-0.12; P=<0.05), and family satisfaction (rs=-0.15; P=<0.01). There was a positive correlation between substance use and chaotic family (rs=0.12; P=<0.05). Regression analysis reveals that only male adolescents and a recent family history of substance use were significant predictors of substance use. Family satisfaction was the only significant protective factor. There was no significant association between substance use and religiosity (rs=-0.01; P= 0.83). Conclusions: These findings can assist policymakers, healthcare professionals and schools develop particular interventions to reduce substance use, especially in high-risk communities, and increase adolescents' well-being in general.