Substance Use Among Adolescents: A Study on Lifetime Prevalence, Crafft-based Screening, and Associated Factors in Eastern India
DOI:
https://doi.org/10.48165/jfmt.2026.43.03.15Keywords:
Adolescent, Substance Related Disorders, Mass Screening, CRAFFT questionnaireAbstract
Substance use among adolescents is a growing public health problem, influenced by neurodevelopmental vulnerability and social influences. Even though prevalence is on the rise in India, data from Eastern India remain scarce. This study estimated the lifetime prevalence of substance use, identified factors associated with it, and tested the performance of the CRAFFT screening tool among adolescents. A cross-sectional community-based study was conducted among 409 adolescents aged 10–21 years attending a primary health centre on the outskirts of Bhubaneswar, Odisha. Data collection was conducted using a pre-tested questionnaire that covered sociodemographic details, patterns of substance use, and responses to the CRAFFT (version 2.1) screening tool. Associations were assessed using the Chi-square test and risk ratio analysis, while independent predictors were identified through multivariate logistic regression. The diagnostic accuracy of CRAFFT was evaluated using ROC analysis. Among 409 adolescents studied, lifetime substance use was 41.1% and past-year use 37.7%. Tobacco was most common, followed by alcohol and cannabis. Peer use and independent income showed strong associations, doubling risk. The mean CRAFFT score rose with age, and at a cut-off of 2, demonstrated 98% specificity, validating its effectiveness for screening. Substance use among adolescents in Eastern India has reached alarming levels, primarily influenced by peer and economic factors. CRAFFT screening demonstrates strong potential for early triage at the primary care level, suggesting a need for routine screening, brief intervention, and community-based prevention strategies.
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