Marijuana use and suicidal behaviours among school-going adolescents in Africa: assessments of prevalence and risk factors from the Global School-Based Student Health Survey
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ GLOBAL HEALTH
Abstract
Background Marijuana use among adolescents, including
high school students, has been consistently reported to be
associated with a high incidence of suicidal behaviours.
Little empirical research has been conducted on the
propensity impact of marijuana use on suicidal behaviours
in Africa.
Aims To assess factors associated with marijuana use
and further quantify marijuana use as an associated factor
of suicidal behaviours, including repeated attempted
suicide, suicidal ideation and suicide planning, among high
school students in Africa.
Methods A cross-sectional
study was conducted among
32 802 school-going
adolescents using the Global
School-Based
Student Health Survey data from 10 African
countries grouped into West Africa, North Africa, South-East
Africa, South Africa and East Africa subregions.
Marijuana use and repeated attempted suicide were the
main outcome variables. We employed double selection
least absolute shrinkage and selection operator poisson
regression model to assess risk factors associated with
marijuana use and dominance analysis to establish ranked
important and common risk factors. Inverse probability
weighting poisson regression adjustment was applied to
assess impact.
Results The prevalence of marijuana use and repeated
attempted suicide were 3.7% (95% CI: 3.1 to 4.3) and
6.6% (95% CI: 5.9 to 7.4), respectively. The most important
risk factor for marijuana use generally across the
countries and specifically in three subregions was alcohol
consumption, which constituted approximately 40% of
the impact. The average treatment effect on the treated
(ATT) indicated that marijuana use significantly increased
the risk of suicidal ideation, suicide planning and repeated
attempted suicide by 12% (ATT=0.12 (95% CI: 0.02 to
0.22)), 18% (ATT=0.18 (95% CI: 0.13 to 0.22)) and 31%
(ATT=0.31 (95% CI: 0.20 to 0.41)), respectively.
Conclusions Marijuana use was significantly associated
with suicidal behaviours (suicidal ideation, planning and
repeated attempted suicide) among the students. To
achieve Sustainable Development Goal 3.5 (to strengthen
prevention and treatment of substance abuse), school-based
psychosocial interventions should be streamlined to
adequately assess and manage marijuana use. Targeting
the most dominant risk factors in this population could
translate into the reduction of suicidal behaviours in
countries within Africa.
Description
Research Article
Keywords
Marijuana, suicidal behaviours, Africa, school-going adolescents, Student Health Survey, Global School-Based Student Health Survey, prevalence and risk factors