HAWASSA UNIVERSITY, COLLEGE OF HEALTH SCIENCES AND MEDICINE

RESEARCH PROPOSAL FOR 4TH YEAR MRT STUDENTS

DEPARTMENT OF MEDICAL RADIOLOGY TECHNOLOGY

PREVALENCE OF SUBSTANCE USE AND ASSOCIATED FACTORS AMONG

HAWASSA UNIVERSITY UNDERGRAGUATE STUDENTS’ IN HAWASSA
UNIVERSITY, SIDAMA, ETHIOPIA,2016 EC.

INVESTIGATORS’S NAME ID Numbers

1. Kibreab Sello NaScR/2514/13
2. Minase Lemma NaScR/1834/13
3. Osama Essa NaScR/2031/13
4. Kidist Mesfin NaScR/1511/13
5. Yosef Fikadu NaScR/2776/13
6. Sehinemariam Sisay NaScR/2180/13

To be submitted Ms. Samrawit F. (BSc,

MSc)

HAWASSA, ETHIOPIA
 Feb, 2016. EC.

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Acknowledgment

We would like to thank Hawassa University College of Medicine and Health Sciences for giving
us the opportunity to develop this research proposal. We would like also to thank our instructor
for giving us suggestions in the development of this proposal. Also, we would like to express our
special thanks to our beloved friend who has given us a computer access wisely. We would also
express our thanks to all persons who helped and encouraged us in one way or another in
connection with our all work.

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Contents
Acknowledgment........................................................................................................................................i
List of Abbreviations and Acronyms.......................................................................................................iv
Summary...................................................................................................................................................vi
1. Introduction.......................................................................................................................................1
1.1 Background......................................................................................................................................1
1.2 Statement of the problem................................................................................................................1
1.3. Significance of the study.................................................................................................................2
2. Literature Review..............................................................................................................................3
2.1 Prevalence of substance abuse in the University student..............................................................3
2.2 Prevalence of substance abuse globally in the University student...............................................3
2.3 Prevalence of substance abuse in Africa in the University student..............................................3
2.4 Prevalence of substance abuse in Ethiopia in the University student..........................................4
2.5 Factors affecting substance abuse..................................................................................................4
2.5.1 Personal factors.........................................................................................................................5
2.5.2 Family factors...........................................................................................................................5
2.5.3 Social factors.............................................................................................................................6
2.5.4 Environmental factors..............................................................................................................6
3. Objectives...............................................................................................................................................6
3.1 General objectives: -........................................................................................................................6
3.2 Specific objectives:...........................................................................................................................6
4. Methodology..........................................................................................................................................7
4.1. Study area.......................................................................................................................................7
4.1.2 Study period..............................................................................................................................7
4.2 Study design.....................................................................................................................................7
4.3 Population........................................................................................................................................7
4.3.1 Source population.....................................................................................................................7
4.3.2 Target population.....................................................................................................................7
4.4. Sample population..........................................................................................................................7
4.5 inclusion and exclusion criteria......................................................................................................7

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 4.5.1 Inclusion Criteria......................................................................................................................7
4.5.2 Exclusion Criteria.....................................................................................................................7
4.6. Sample size......................................................................................................................................7
4.7 Sampling method/ procedure..........................................................................................................8
4.8 Study Variables................................................................................................................................8
4.8.1. Dependent Variable.................................................................................................................8
4.8.2 Independent Variables.............................................................................................................8
4.9 Operational Definition.....................................................................................................................8
4.10 Data Collection...............................................................................................................................9
4.10.1. Data Collection Tools and Measurements............................................................................9
4.10.2 Data analysis, Interpretation and Presentation....................................................................9
4.11 Data Quality Management..........................................................................................................10
4.12 Ethical consideration...................................................................................................................10
4.13 Dissemination plan.....................................................................................................................10
6. Budget Breakdown..............................................................................................................................12
6.1 Stationary cost...............................................................................................................................12
6.2 Miscellaneous cost..........................................................................................................................12
6.2 Budget Summery...........................................................................................................................12
References................................................................................................................................................13
Annex I: Consent Form...........................................................................................................................15
Annex II: Annex ΙΙ: Questionnaire (English)........................................................................................15
Part I Socio-demographic Information..............................................................................................15
Part II Questions related to experience of substance use..................................................................17
Part III Cause of substance use by students......................................................................................20

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Lists of Tables

Table 1 Work Plan.........................................................................................................................17

Table 2 Stationary cost..................................................................................................................18
Table 3 miscellaneous cost............................................................................................................18
Table 4 budget summery...............................................................................................................18

iv
List of Abbreviations and Acronyms

AAU Addis Ababa University

AIDS Acquired Immune Deficiency
Syndrome
ETB Ethiopian Birr
HIV Human Immune Deficiency Virus
PAS Psychoactive Substance
WHO World Health Organization
HU Hawassa University
SPSS Statistical Package for Social Sciences
EPI-INFO Epidemiological information
STDs Sexually Transmitted Disease

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 Summary
Background
Substance abuse is a harmful practice that exposes young people to social and health issues and
is a global burden on youth. It's critical to understand the prevalence and risk factors for
substance use among college students in order to plan recurring, locally relevant treatments. The
purpose of this study is to evaluate the prevalence and risk factors for substance use among
students at Hawassa University.

Objective: to determine the prevalence of substance abuse and the risk factors linked with it
among undergraduate students at Hawassa University in the Ethiopian calendar year 2016.

Methods: A quantitative cross-sectional study will be conducted. To choose the students, a

stratified two-stage sampling procedure will be used. The World Health Organization Model
Students' Substance Use Core Questionnaire will be used as guidance for assessing substance use
behaviors.

Work plan: This study will be conducted from February to June with a total budget of 10,940
ETB

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1. Introduction

1.1 Background

Substance abuse is a global problem that affects young people, often leading to unhealthy habits
that cause social and health problems for young people. Teenagers and young adults are
susceptible to a range of harmful sexual, physical, psychological, and social activities. Among
the issues facing the younger population group today is substance consumption, both legal and
illicit, and the multifaceted effects of this behavior. Many young people today are found in
higher education institutions, where they are exposed to a variety of novel and dangerous
activities. (1)
In addition to biological and psychological susceptibility, university students may be more likely
to participate in risky behaviors like substance abuse due to peer pressure, social pressure,
environmental factors, academic expectations, and lack of parental influence.
College and University students, who make up a younger demographic in Ethiopia, are
particularly vulnerable to issues like alcohol, khat, and tobacco usage. Among University
students at Axum, the lifetime prevalence of alcohol consumption, khat chewing, and cigarette
smoking were 34.5%, 28.7%, and 9.5%, respectively. In a similar vein, the current rates of
alcohol consumption, cigarette smoking, and khat chewing were 27.9%, 32.8%, and 9.3%,
respectively. The most popular justifications for smoking cigarettes, drinking wine, and
consuming khat were to relieve stress, unwind, and stay awake while reading, respectively.
Substance usage was highly correlated with having family members who drink alcohol and peer
friends who chew khat. (2)
It's critical to understand the prevalence and risk factors for substance use among college
students in order to plan recurring, locally relevant treatments. The purpose of this study is to
evaluate the prevalence and risk factors for substance use among students at Hawassa University.

1.2 Statement of the problem

One of the main health problems for undergraduate students is substance use, including
substance use disorders and related illnesses. Substance abuse, including the use of alcohol, khat,
and tobacco, is one of the world's most pressing public health and socioeconomic issues. The
usage of these substances has detrimental effects on one's health, finances, and the environment.
Because of their near contact to drugs, health practitioners have historically been associated with
the problem of substance use. The primary risk factor for chronic illnesses like cancer, chronic
lung disease, diabetes, and other cardiovascular disorders has been substance abuse, much like
tobacco smoking. Ethiopians, including university students, use these drugs and deal with the
fallout. (3)
In Ethiopia, the most often used drugs are khat, alcohol, and tobacco (cigarettes). Yemenis,
Somalis, Ethiopians, and other East African communities chew khat leaves as a social pastime,
both in their home countries and in the diaspora. This habit has "amphetamine like" effects. In
Ethiopia, drinking alcohol, chewing khat, and smoking cigarettes have all become widespread
habits among high school, college, and university students. These young people's usage of
cigarettes, khat, and alcohol can be detrimental.

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It result in poorer academic performance, a higher chance of getting HIV and other STDs, or
other mental illnesses like psychosis, sadness, and anxiety. Substance abuse has emerged as a
significant global public health and socioeconomic issue, with Ethiopia being no exception.
It is having a significant impact on the "young generations," who make up the majority of the
population and are anticipated to govern the nation in the near future. University students are
particularly susceptible to these issues, which could be brought on by their unfamiliar
surroundings and inadequate parental supervision, their youth and the yearning to experience
life, peer pressure, and the lack of preventive initiatives. (4)

The World Health Organization's estimates for 2024 state that approximately 275 million people
(or 5.8% of the world's population between the ages of 15 and 64) used psychoactive drugs in the
year prior, and an estimated 37 million people are estimated to be afflicted by drug use disorders,
which include harmful patterns of drug use or drug dependence. (5)

Overall, the research mentioned above showed that different colleges had diverse drug usage
patterns and risk factors. The local community's production and modification of drugs,
particularly Khat, may have a significant impact on how often kids use drugs. The majority of
study conducted in Ethiopian colleges focused on alcohol, khat, and cigarettes, with little
attention paid to illegal substances like cocaine and cannabis.
Despite the fact that Ethiopia has seen a great deal of research, our study areas have not seen any
comparable studies.
Additionally, there will occasionally be an increase in the prevalence of substance use among
college students, which will have a negative impact on academic performance. At light of the
aforementioned reports of substance use at several Ethiopian universities and colleges, the
primary goal of this study is to investigate the prevalence of substance use among undergraduate
students at Hawassa University and any relationships that may exist between these behaviors and
related variables.

1.3. Significance of the study

There are various reasons why the incidence of substance use and related factors among
undergraduate university students are important to examine. It tackles a public health issue by
offering data to create focused interventions. Substance abuse has a detrimental impact on one's
health and well-being, increasing the risk of addiction, cognitive decline, mental health
problems, and poor academic performance, among other problems. To enhance academic
performance, it is helpful to identify susceptible groups and establish support networks by
comprehending the aspects linked to substance use. In order to inform preventative interventions,
it also analyzes risk and protective factors, such as psychological, social, environmental, and
individual factors.
The results of the study support evidence-based preventive and intervention programs that are
customized to the requirements of students. They also support legislative reforms, peer support,
counseling services, and educational campaigns aimed at lowering drug use and encouraging
healthier lifestyles. Furthermore, for HU undergraduate students who do not use substances, the
study will provide insight or raise awareness of the severity of substance use and related issues.
It also acts as a resource to encourage more research in this field for scholars and students who
are interested in the subject.

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2. Literature Review

2.1 Prevalence of substance abuse in the University student

In reviewing the global research related to the prevalence of substance abuse among university
students, multiple studies have been conducted in various countries. The studies encompass a
wide range of countries and regions, documenting varying rates and contributing factors.
2.2 Prevalence of substance abuse globally in the University student
Hazraa Al Hinaai et al.'s cross-sectional survey among 375 students in Asia in 2021 revealed
that the participants' lifetime prevalence of drug misuse (including alcohol and tobacco use)
was 41.3% overall, while the prevalence without alcohol and tobacco use was 29.9%. With a
frequency of about 23.5%, tobacco was the most often used drug, followed by alcohol with
10.7%. When it came to substance addiction, male students were far more likely than female
students to abuse any kind of substance. (6)
According to a 2019 survey conducted in Iran by Akbar Babeei et al. among Shahid Beheshti
University dormitory students, 15.4% of the students reported abusing drugs or alcohol. When
it came to the types of drugs that students used, smoking (4.47%) and hookah (42.9%) had the
highest rates. Among the students who took drugs, 48% began using them when they were just
18 years old or younger. In dorms and parks, roughly 58% of students took narcotics for the
first time. Substance misuse occurred often during student gatherings and friend parties
(47.5%). (7)
Using a cross-sectional study design, John et al.'s 2020 assessment of substance use among
university students in Nigeria found that, out of a sample size of 400, drug and substance abuse
prevalence was 45.7%; one in four students abused substances despite having an aggregate risk
awareness level of 94.6%. The most often abused substances were cigarettes and alcohol
(61.5% and 54.5%, respectively). Cannabis was ranked lower on the list of pharmaceuticals
than codeine-containing syrup and tramadol. (8)
A study conducted in Cameroon on 650 university students revealed an overall prevalence of
substance usage of 89.9%. 29.9% of people reported using several substances. As of right now,
the most commonly used drugs were cannabis (2.0%), alcohol (19.7%), tobacco (26.2%), and
tramadol (2.8%).(9)

2.3 Prevalence of substance abuse in Africa in the University student

According to the study done in Nairobi by chege, et.al in 2022 using a cross-sectional study
design in 387 university students, the study found that the Prevalence of substance use was
43.7% [95% CI: 38.7%-48.7%], the substance with highest use were Alcohol 39.6%, cannabis
24.7%, cigarette 17%. Cannabis was associated with the most frequent use and the substance
with the highest risk of harmful use. (10)
A report focusing on university students from western Kenya confirmed that around 50% of
college students suggested ingesting alcohol the week previous to the survey. Another study of
college students in South Africa found that 67.5 percent of them were currently drinking

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 alcohol. Sudan, on the other hand, has the lowest rate of alcohol usage among college students,
at 2.7 percent, according to research. Sudan is a largely Muslim country that follows strict
Sharia law.
The introduction of prescription drugs in Africa has dramatically expanded the availability and
use of PAS. However, alcohol, and khat are hashish still the most common addictive materials
in Africa. In Zambia, 20% of college and high school students have been substance user. (11)
A study done in South Africa to assess substance users of university student using cross
sectional study design by Dr Alem in 2014, the study showed that Substance abuse casts a long
shadow across African universities, with varying intensities depending on the country. Alcohol
reigns supreme, with prevalence ranging from 28.7% in Ghana to a staggering 64.8% in South
Africa. Cannabis trails closely, particularly in South Africa (19.7%) and Kenya (8.2%).
Tobacco use shows similar geographic diversity, with South Africa again leading the pack
(38.4%) and Ghana boasting the lowest rate (8.3%). Khat, primarily consumed in East Africa,
finds its highest users in Ethiopia (9.2%). Other illicit drugs are less prevalent, though South
Africa still reports the highest usage (5.2%). (12)

2.4 Prevalence of substance abuse in Ethiopia in the University student

According to a 2019 study conducted in Ethiopia by Gebremariam utilizing a cross-sectional
study design, the lifetime usage of alcohol, cigarettes, and chat tobacco among students was
determined to be 36.3%, 10.9%, and 7.4%, respectively. Throughout one's lifetime, 4.2% and
4.5% of people used cannabis and shisha, respectively. Approximately 17%, 5.7%, and 3.1%
of students, respectively, now use alcohol, cigarettes, and chat rooms. (13)
According to a survey conducted at Ambo University, 72.6 percent of students were
determined to be social substance users. Males made up 78.3 percent of substance users, while
females made up 21.7 percent. Alcohol was used by 55.9% of those who took part, khat by
51%, cigarettes by 25.9%, hashish by 7.1 percent, and other substances by 25.9%. (14)
Furthermore, a study by Jimma University found that the prevalence of khat chewing, tobacco
smoking and alcohol consumption was 33.1%, 21.3% and 36.4%, respectively. It will be
difficult to achieve social and economic development in the country if certain measures are not
taken. (15)
The reported prevalence of tobacco smoking was 1.8 percent at AAU School of Medicine
whereas 51.1 percent at Adama University. According to a study conducted at Gondar
University, the prevalence of substance use was 62.9 percent. In research conducted in Jimma
university students 2002 discovered that 24.79 percent of them chewed khat with 27 percent of
males and 17.43 percent of females consuming it. (16)

2.5 Factors affecting substance abuse

The usage of PAS by university students can be explained by a variety of circumstances.
Students' expectations and capacity to cope with and adapt to the extremely competitive and
demanding new environment have a significant impact on risky behaviors in higher education.

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Hazaa Al Hinaai et al. conducted a cross-sectional survey in 2021 with 375 students in Asia.Use
of tobacco products was significantly correlated with alcohol abuse and misuse of other
substances. The majority of the negative consequences linked to substance abuse that research
participants described were social problems (27.7%) and health-related issues (25.8%).
Substance misuse also had a significant effect on their performance (23.8%). In addition, 4.7% of
respondents struggled with legal matters, while 15.4% of respondents faced money difficulties.
Remarkably, just 49.1% of respondents thought that substance abuse was a significant issue. (6)
According to a study conducted in Cameroon on 650 university students, 91.7% of substance
users said that they used drugs to decompress or unwind. The two most common negative
outcomes mentioned were financial loss (16.7%) and disagreements or quarrels (18%). The
primary source of substance usage was peers (66.9%). The main predictor of substance use on
multivariate analysis was male sex (95% CI): 0.801 (1.128, 4.398). (9)
In 2019, Gebremariam conducted a cross-sectional study design in Ethiopia to evaluate
university substance use. The study found that several factors, including being male, eating at the
university cafe, attending a private preparatory school, having a higher monthly income, and
having friends and family who use drugs, were significantly linked to students' substance use
behaviors. (13)
According to a study done at Haramaya University, there was a comparatively high prevalence
of substance use issues overall. The growth of appropriate recreational activities and educating
first-year students about improved stress coping strategies are the main causes of substance
usage. The likelihood of ever using drugs was found to be substantially correlated with factors
such as sex, monthly income, sexual risk behavior, and family history of substance abuse. (17)

2.5.1 Personal factors

Having a strong religious conviction protects against substance use. These components
encourage people to participate in healthful activities while also raising their sense of self-worth,
lowering stress, and strengthening their ability to handle obstacles in life. Ambo University
performed a poll which revealed that 40.6 percent of substance users take drugs as a stress
reliever, and 29.4% of substance use is linked to stress and discontent in the dorm. Furthermore,
14% of users begin using drugs in an effort to raise their IQ, and 14% do so because they are
reasonably priced.

2.5.2 Family factors

Family support and solid emotional interactions have been demonstrated in studies to help
youngsters avoid high-risk behaviors, norm-breaking, and ultimately substance use. Families
nowadays encounter a variety of obstacles, including marital strife, poverty, the absence of one
parent, and poor parent-child communication, all of which can negatively impact children. As a
result, these problems have the potential to disrupt and impair family support.
A study in Turkey also found that individuals living away from their parents were also more
likely to be influenced by others and to engage in high-risk activities, according to a Turkish
study. According to a study conducted at Ambo University, parents have a 9.8% influence on
their children's substance use.

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 2.5.3 Social factors

According to different studies, students of university who have substance using parents,
relatives, acquaintances, peer groups, or lovers are more likely to use substances, and many
students use substances because they are afraid of not being accepted in social circles with
substance-abusing peers. Furthermore, when young people are lonely, they are more likely to
put their substance abstinence on hold in order to make friends. According to a survey
conducted among Ambo University students, the most common cause for drug usage among
substance users is peer pressure 66.4 percent, and 37.8 percent of substances users’ uses drug
to be social with their friends. In addition, 27.6% of users use substances in order to be
accepted by their peers.
2.5.4 Environmental factors

According to a study conducted at Ambo University, the impact of the media accounts for 18.2
percent of substance usage, while the availability of the substance accounts for 30.1 percent.
Furthermore, a shortage of recreational areas on campus accounts for 52 percent of the reasons
for substance abuse among university students.

3. Objectives

3.1 General objectives: -

 To assess the prevalence of substance use and its associated factors among
Hawassa university undergraduate students at Hawassa University in2016
E.C.
3.2 Specific objectives:
 To determine the number of students that uses substance among Hawassa
university undergraduate students, Ethiopia
 To evaluate factors that associated with drug use among Hawassa university
undergraduate students, Ethiopia

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4. Methodology
4.1. Study area

Four sites of Hawassa University—the Main Campus, the Referral Campus, the Agricultural
Campus, and the Wondogenet Forestry College—will host the study. The first three are in the
Sidama Region's Hawassa City, which is 278 kilometers south of Addis Ababa via Batu.The
village is located at 7°3' latitude northward and 38°28' longitude eastward in terms of astronomy.
The settlement is situated at an elevation of roughly 1708 meters above sea level. The fourth
campus, Wondogenet Forestry College, is located in Wondogenet town. There are around 59
academic departments in the University.

4.1.2 Study period

According to the Ethiopian calendar, the study will be carried out with undergraduate students at
Hawassa University from January 25 to May 20, 2016 E.C.

4.2 Study design

At Hawassa University Ethiopia, an institutional-based quantitative cross-sectional study will be
conducted to evaluate the prevalence of substance use and factors related with it among
undergraduate students.
4.3 Population
4.3.1 Source population
All Hawassa University students will be the source population
4.3.2 Target population
Every undergraduate students at Hawassa University Ethiopia
4.4. Sample population
All undergraduate students enrolled at Hawassa University during the study period who meet the
eligibility requirements will be included in the sample population.
4.5 inclusion and exclusion criteria

4.5.1 Inclusion Criteria

 Every HU regular undergraduate student who has agreed to participate in the study time and
is in attendance.
4.5.2 Exclusion Criteria

 Students from HU who refuse to take part in the research.

 Students at HU who expressed interest in participating but were not present on the day of
data collection.
 HU non-regular students
4.6. Sample size
A single population proportion calculation will be used to determine the sample size, taking into
account the percentage of substance users among Hawassa University College of Medicine and
Health Science students.

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4.7 Sampling method/ procedure

These students will be selected using a two-stage stratified sampling process among several
departments. The entire sample size will be allocated proportionately to the colleges to which the
students are first classified according to their particular institutions. A lottery will be used to
choose one or more departments from each institution, depending on the sample size in each
college.
Each academic year will get a portion of the college's overall sample size, which will be assigned
to the department or departments of choice. Ultimately, the questionnaires will be handed out to
the students in the classroom using the systematic sampling technique, beginning in the right
front corner and proceeding one chair at a time until the section's required sample size is reached.

4.8 Study Variables

4.8.1. Dependent Variable

 The dependent variable is substance use.

4.8.2 Independent Variables

 Socio demographic characteristics: (Age, sex, education status (year of study), religion
and ethnicity)
 Family factors: (lack of family supervision, -Family conflict, marital status of family, -
Family drug utilization and Family education level).
 Socio-cultural status :( Availability of substance and Peer pressure).
 Economic factors :( Monthly pocket money, Family occupation and Family income).

4.9 Operational Definition

Substance: Any drug that induces changes in mood, thinking, feeling, or behavior that might
lead to dependency, such as alcohol, cocaine, cigarettes, cannabis, and shisha is considered an
addictive stimulant.

Substance Use. In this study, it was defined as an individual's lifetime use of at least one of the
substances (alcohol, khat, cigarettes, and illicit drugs) to change their behavior or mood.

Current use: Students who, within 30 days of the data collecting period, used two or more
substances at least once.

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Life time substance use: Students who have used two or more drugs at least once in their lives

Perception: acknowledgment of substance abuse and its effects by HU undergraduate students.

Associated factor: The term "associated factors" in this study refers to factors that influence or
contribute to substance use among undergraduate students at HU.

Ever Use: defined as the use of any substance by a person at least once in their lifetime.

Illicit Drugs: It is characterized as the use of drugs that are illegal to produce, sell, or consume,
such as heroin, hashish, and cannabis.

4.10 Data Collection

4.10.1. Data Collection Tools and Measurements

Items from the World Health Organization (WHO) Model Students' Substance Use Core
Questionnaire (18) will be used to evaluate substance use. Sections on socio-demographics,
alcohol, tobacco smoking, cannabis, heroin, other drug usage and cause of substance used by
students are included in this core questionnaire.
We only evaluate substances (alcohol, khat, tobacco, cannabis, cocaine, and heroin) that are
widely recognized in Ethiopia. The survey will not include other substances that are included in
the WHO core module, such as injectable medicines, opium, sedatives and hypnotics,
amphetamines or other stimulants, volatile inhalants, opiate medications, and tranquillizers.
Students who are scheduled to attend class on the distribution day will get questionnaires from
certified data collectors. The researchers will give a succinct overview of the project, outlining
the methodology for gathering data and advising the students not to write their names on the
surveys. Teachers won't be present when the study is conducted.

4.10.2 Data analysis, Interpretation and Presentation

First, the data was manually cleansed, and questionnaires that did not meet the minimal
requirements for completeness were not allowed to be entered. The data collected was cleaned,
coded, and entered using EPI-INFO version 3.5.1. Using the Statistical Package for Social
Sciences (SPSS) version 21 software, descriptive statistics, bivariate analysis, and multivariate
analysis were performed on the data.

There was bivariate and univariate analysis performed. Odds ratios were used to calculate
associations, with a significance level of p < 0.05 and a 95% confidence interval.
For a subsequent multivariate study, the factors from the bivariate analysis that proved to be
significant were kept. Next, in order to forecast independent parameters linked to substance use
and control confounding variables, logistic regression analysis will be performed.

9
4.11 Data Quality Management

The questionnaire will be pretested on 5% of randomly chosen undergraduate students from HU

Referral Campus prior to the data collection period. Prior to the survey, the facilitators, who will
collect the data, will receive the necessary training and instructions. The pre-test will evaluate the
questionnaire's comprehensibility, dependability, and subject matter sensitivity. Determine which
questions are unclear, and then make the appropriate changes to them in light of the results.
Before entering the data, the gathered information will be examined and verified for accuracy.

4.12 Ethical consideration

The Institutional Review Board of the College of Medicine and Health Sciences, HU's ethical
review committee will authorize the study, and formal authorization in the form of a letter should
be provided. The goals and intentions of the research are communicated to the participants. The
willingness and cooperation of study participants will be the foundation for all we accomplish.
At every stage, information confidentiality will be guaranteed.

4.13 Dissemination plan

The findings of this study will be shared with the college of medicine and health sciences so that
they can be incorporated into the decision-making process. Ultimately, the results will be
attempted to be published in various journals.

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 5 .Work plan

NO Activity Responsible January February March April May

1 Topic selection Investigators

2 Proposal writing Investigators

3 Proposal submission Investigators

4 Proposal Investigators
Presentation
5 Select and train Advisor’s
collector’s
6 Data collection Investigators

7 Data arrangement Investigators

8 Data analysis Investigators

9 Report writing Investigators

1o Research submission Investigators

11 Research presentation Investigators

Table 1 Work Plan

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6. Budget Breakdown
6.1 Stationary cost
No Item description Quantity Unit cost Total Cost(ETB)
.
1 Paper A4 size 5 packet 500 2500
2 Pen 25 20 500
3 Paper binder 30 100 3000
4 Pencil 10 15 150
5 Eraser 10 10 100
Subtotal cost 6250
Table 2 Stationary cost

6.2 Miscellaneous cost

No Items / service required Unit of Quantity/repetition Unit Total

measureme price cost
nt ETB
1 Photo copy and printing Page 2000 2 4000
service
2 Transportatio Wondogenet Tarif 4 60 240
n and other
Hawassa city Tariff 30 15 450
services
campuses
during data
collection
3 Subtotal 4690
Table 3 miscellaneous cost

6.2 Budget Summery

No Types of cost Total cost ETB
1 Material cost 6250
2 Miscellaneous cost 4690
3 Total 10940
Table 4 budget summery

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References

1. Gowing Lr ARASmJERWJ. Global stastics on adictive behaviours. status report. 2014;

110(6): 904-19.
2. organization wh. Global status report on alcohol and health. 2014.
3. Desta E SMWDGB. The prevalence of substance use and associated factors among medical
interns of Jimma University, South West Ethiopia. 2018;: 1071.
4. FA Y. Factors influencing substance abuse among undergraduate students in Osun State,
Nigeria.. African research review. 2010; 4: 4.
5. Shao H DHGQYDCZZY. Trends of the global burden of disease attributable to cannabis use
disorder in 204 countries and territories. International Journal of Mental Health and
Addiction. 2023;: 1-23.
6. Al-Hinaai H ABIAFBASY. The prevalence of substance misuse and its effects among
Omani college students: a cross-sectional study. Oman medical journal. 2021 January ; 1.
7. Heydarabadi AB RABHVMSKPRKSIM. Prevalence of substance abuse among dormitory
students of Shahid Beheshti University of Medical Sciences, Tehran, Iran. International
journal of high risk behaviors & addiction.. 2015 June; 2: 4.
8. Olanrewaju JA HEEJUMOQBRFJOJBOIOJ. An assessment of drug and substance abuse
prevalence: a cross-sectional study among undergraduates in selected southwestern
universities in Nigeria. Journal of international medical research. 2022 October ; 10: 50.
9. Ngahane BH MTBEELBBBMMOAJ. Prevalence, knowledge and factors associated with
shisha smoking among university students in Cameroon.. The International Journal of
Tuberculosis and Lung Disease. 2023 Augest; 8: 606.
10. M. C. Prevalence of Substance Use Among Undergraduate Medical Students at the
University of Nairobi. Doctoral dissertation, University of Nairobi). .
11. Mwanza N MG. tudents’ perspectives on drugs and alcohol abuse at a public university in
Zambia. HTS Teologiese Studies/Theological Studies. 2023 Augest; 3: 79.
12. Tshitangano TG TO. Substance use amongst secondary school students in a rural setting in
South Africa: Prevalence and possible contributing factors. frican Journal of Primary Health
Care and Family Medicine. 2016 January ; 2: 1-6.
13. Gebremariam TB MKNT. Substance use and associated factors among Debre Berhan
University students, Central Ethiopia. substance abuse treatment, prevention, and policy.
2018 December ; 1: 1-8.
14. Birhanu A HK. Prevalence and factors associated to depression among Ambo university
students, Ambo, West Ethiopia. prevalence. 2016;: 25.
15. Desta E SMWDGB. The prevalence of substance use and associated factors among medical
interns of Jimma University, South West Ethiopia. ournal of Substance Abuse &
Alcoholism.. 2018; 1: 1071.
16. Tesfaye G DAHM. Substance use and associated factors among university students in
Ethiopia: a cross-sectional study. Journal of addiction. 2014 October ;: 2014.
17. Derese A SAMC. Assessment of substance use and risky sexual behaviour among Haramaya
University Students, Ethiopia. Ethiopia. Science Journal of Public Health. 2014; 2: 102-10.
18. Masjedi MR AEZFPR. Cigarette and hookah smoking in adolescent students using World
Health Organization Questionnaire Global Youth Tobacco Survey (GYTS): a pilot study in
Varamin City, Iran in 2016. Asian Pacific journal of cancer prevention: APJCP. 2020

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 October ; 10: 3033.

Annex I: Consent Form

Do you agree to participate in this study?

Yes

14
 No

Signature of participant signature of investigator

Date

Thank you for taking part in this research

Annex II: Annex ΙΙ: Questionnaire (English)

IINSTRUCTIONS

This is not a test: there are no right or wrong answers, but please answer carefully. For each
question pick the answer that fits you the best and choose one possible answer and circle it.Pick
only one answer for each question. Look at the example below:

Have you drunk any water during the last 30 days?

A No
B Yes, on 1-5 days
C Yes, on 6-19 days 0
D Yes, on 20 or m o r e days

The answer chosen was "D", indicating that the person who answered the question had drunk
water on 20 or more days during the previous 30 days. If you do not know the answer to a
question, or if you feel that you cannot answer honestly, leave the question blank.
Complete as many questions as possible.

Part I Socio-demographic Information

1. Are you a male or a female?

a) Female
b) male
2. What is your age? _____Years

3. What is your religion?

a) Orthodox
b) Muslim

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 c) Protestant
d) Others (specify………….
4. What is your educational Status?

a) Year one
b) Year two
c) Year three
d) Year four
e) Year five
f) Year six
g) Year seven

5. Where is your Family Residence?

a) 1 Urban
b) 2 Rural

6. How money your family monthly Average -income?

a) Less than 1000 ETB

b) Between 1001 to 5000 ETB
c) Between 5001 to 10000
d) above 10000 ETB

7. Marital status of parent

a) Married
b) Divorced
c) widowed

8. To which ethnic group do you belong to?

a) SNNPR
b) 2 Amhara
c) Oromo
d) Others (specify)__________
9. Your Mother’s educational level

a) Illiterate
b) Elementary to Grade 12

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 c) College or University

10 Your Father Education level

a) Illiterate
b) Elementary to Grade 12
c) College or University

Part II Questions related to experience of substance use

Alcohol

1. Have you ever drunk any alcoholic beverage (including beer, wine, and spirits)?
a) No
b) Yes

2. Have you drunk any alcoholic beverage in the pas t 12 months?

a) No
b) Yes

3. Have you drunk any alcoholic beverage during the past 30 days?

a) No
b) Yes, on 1-5 days
c) Yes, on 6-19 days
d) Yes, on 20 or m o r e days

4. How old were you when you first had a drink of beer, wine, or spirit s — m o r e than j u s t a
sip?

a) Have never drink alcoholic beverages

b) 10 years old, or less □
c) 11-12 years old
d) 13-14 years old
e) 15-1 6 years old
f) 17-1 8 years old
g) 19 years old, or more

Smoking

1. Have you ever smoked, chewed, or sniffed any tobacco product (such as cigarettes, cigars,
pipe tobacco, chewing tobacco)?

17
 a) N o
b) Yes
2. Have you smoked, chewed, or sniffed a tobacco product in the past 12 months?

a) N o
b) Yes
3. Have you smoked, chewed, or sniffed a tobacco products during the past 30 days?

a) N o
b) Yes

4. How old were you when you first smoked, chewed, or sniffed a
Tobacco product?
a) Have never smoked, chewed, or sniffed tobacco products
b) Below years old, or less
c) 11-12 years old
d) 13-14 years old
e) 15-16 years old
f) 17-18 years old
g) 19 years old, or more

Cannabis

1. H a v e you ever taken any cannabis (marijuana, pot, hashish, grass, ganja)?

a) N o
b) Yes

2. Have you taken any cannabis in the past 12 months?

a) N o
b) Yes

3. Have you taken any cannabis during the past 30 days?

a) No
b) Yes, on 1-5 days
c) Yes, on 6-19 days
d) Yes, on 20 or more days

4 How old were you when you first took cannabis?

a) Have never taken cannabis

b) 10 years old, or less

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 c) 11-12 years old
d) 13-14 years old
e) 15-16 years old
f) 17-18 years old
g) 19 years old, or more

Heroin

1. Have you ever taken any heroin (horse, smack, H)?

a) N o
b) Yes

2. Have you taken any heroin in the past 12 months?

a) N o
b) Yes
3. Have you taken any heroin during the past 30 days?
a) No
b) Yes, on 1-5 days
c) Yes, on 6-19 days
d) Yes, on 20 or more days
4. How old were you when you first took heroin?

a) Have never taken heroin

b) 10 years old, or less
c) 11-12 years old
d) 13-14 years old
e) 15-16 years old
f) 17 -1 8 years old
g) 19 years old, or more

Cocaine

1. Have you ever taken any cocaine?

a) No
b) Yes
2. Have you taken any cocaine in the past 12 months?

a) No
b) Yes

3. Have you taken any cocaine during the past 30 days?

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 a) No
b) Yes, on 1-5 days
c) Yes, on 6-19 days
d) Yes, on 20 or more days

4. How old were you when you first took cocaine?

a) Have never taken cocaine took cocaine?

b) 10 years old, or less
c) 11-12 years old
d) 13-14 years old
e) 15-16 years old
f) 17 -1 8 years old
g) 19 years old, or more

Part III Cause of substance use by students

1. What is the Causes of substance/drug use?

a) Peer Group Influence

b) Lack of parental care/supervision
c) Lake of recreation area
d) The Need for Energy to read for Long Hours
e) Availability of the Substance/Drugs easily
f) Self-treatment
g) Family conflict

2. Any family member who use drugs

a) No
b) Yes

3. Having intimate friend who uses substance

a) No
b) Yes
4. Are substances easy to get in your community/village?
c) No
d) Yes

5. Source of income to purchase substance

a) Family

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 b) Friends
c) My income

6. Do you know that substance abuse is dangerous to health?

a) No
b) Yes

7. What do you think the influence of substance use on education?

a) Increase educational performance

b) Decrease educational performance

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