cannabis use in Morocco. MEDSPAD 2006: Lifetime prevalence of cannabis use among students aged between 15 and 17 years was 12.5% among boys, and ...
Lifetime prevalence of psychoactive substances use among middle school students in Morocco B. Zarrouq Zarrouq,, I. Rammouz, Rammouz, K. Bendaou, Bendaou, A. Bout, S. Khlafa, Khlafa, N. Berhili, Berhili, H. Hlal, Hlal, B. Lyoussi, Lyoussi, C. Nejjari, Nejjari, K. El Rhazi Sidi Mohammed Ben Abdallah University , Fez, Morocco
1
BACKGROUND (1) Epidemiology of tobacco consumption in Morocco
GYTS 2001: 2.6% currently smoke cigarettes (Boys = 3.9%, Girls = 1.0%). GYTS 2006: 3.5% currently smoke cigarettes (Boys = 4.3%, Girls = 2.1%) GYTS 2010: 2.8% currently smoke cigarettes, 4.9% currently smoke shisha and 9.0% currently use other tobacco products (Boys = 10.9%, Girls = 6.3%) (GYTS Morocco report, 2010). 2
BACKGROUND (2) Epidemiology of Alcohol use in Morocco
GSHS: The consumption of alcohol at least once during the life time has been detected in 5.5% of students aged from 13 to 15 years. The prevalence was higher among boys than girls (7.5% vs 2.6%) (report by the World health survey of students in schools in Morocco, 2010) 3
BACKGROUND (3) Epidemiology of cannabis use in Morocco
MEDSPAD 2006: Lifetime prevalence of cannabis use among students aged between 15 and 17 years was 12.5% among boys, and 1.5% among girls. MEDSPAD 2010: 7.2% of students aged 15-17 said they had used cannabis or its derivatives in their lifetime (12.5% of the boys and 2.5% of the girls) (MedSPAD report 2006 and 2010).
SPECIFIC AIMS To estimate the prevalence of psychoactive substance use and its determinants among middle school students in the north central region of Morocco. To evaluate the level of tobacco dependence, and the type of cannabis use. 5
METHODS (1) Study type A cross-sectional study was conducted from April 2012 to November 2013. Population study Public middle school of the North-Center of Morocco. Sampling Stratified cluster random sampling. The sampling unit was the class. 6
METHODS (2) DATA COLLECTION Anonymous self-administered questionnaire consisting of 3 sections: • A Socio-demographic Section • A Section on the consumption of tobacco • A section on the use of alcohol and psychoactive substances. 7
METHODS (3) Toxicological analyzes Urine samples of students from secondary schools in the North Centre of Morocco were collected. Specific qualitative immunochromatographic tests to detect 9 addictive substances (cannabis, benzodiazepines, metamphetamin, tricyclic antidepressants, cocaine, amphetamines, barbiturates, morphine and ecstasy) have been performed.
METHODS (4) HONC Scale (Hooked On Nicotine Checklist) • • • • • •
Have you ever tried to quit smoking, but couldn’t? Do you smoke now because it is really hard to quit? Have you ever felt like you were addicted to tobacco? Do you ever have strong cravings to smoke? Have you ever felt like you really needed a cigarette? Is it hard to keep from smoking in places where you are not supposed to, like school? When you tried to stop smoking (or, when you haven’t used tobacco for a while) • did you find it hard to concentrate because you couldn’t smoke? • did you feel more irritable because you couldn’t smoke? • did you feel a strong need or urge to smoke? • did you feel nervous, restless or anxious because you couldn’t smoke? 9
METHODS (5) Cannabis Abuse Screening Test (CAST)
1) Have you ever smoked cannabis before midday? 2) Have you ever smoked cannabis when you were alone? 3) Have you ever had memory problems when you smoked cannabis? 4) Have friends or members of your family ever told you that you ought to reduce your cannabis use? 5) Have you ever tried to reduce or stop your cannabis use without succeeding? 6) Have you ever had problems because of your use of cannabis (argument, fight, accident, bad result at school, etc.)?
RESULTS (1) Table I: Sociodemographic characteristics of the study population (n = 1657) Socio-demographic characteristics Age Sex
Location
Socio-economic level
Parents' marital status
n
%
14.7 ± 1.5 years Male
934
56.4
Female
723
43.6
Urban
1097
66.2
Rural
560
33.8
Low
257
15.9
Medium
1225
75.9
High
131
8.1
Married
1438
90.1
Divorced
62
3.8
Widowers
71
4.3
Separated
30
1.8
11
RESULTS (2) Tobacco consumption • The overall prevalence of tobacco use was 11.9% (95% CI: 10.3 %– 13.5%). • The prevalence of current cigarettes smokers was 6.9% (95% CI: 5.7% - 8.3%). • Boys were more likely than girls to use tobacco (boys 19.2%, girls 2.5%, p
