The influence of protective and risk factors in individual, peer and school domains on Thai adolescents' alcohol and illicit drug use: A survey

Highlights

• Low school commitment was strongly associated with illicit drug use.

• Having friends with delinquent behaviors increased the risk of substance abuse.

• Students with high levels of moral belief were less likely to use alcohol.

• Peer influence is a significant contributor in substance abuse.

Abstract

This study investigates risk and protective factors for substance abuse in a sample of 1778 students attending technical colleges in Bangkok and Nakhon Ratchasima provinces of Thailand using a self-report questionnaire modified from the Communities That Care youth survey. Low school commitment was strongly associated with illicit drug use, with adjusted odds ratios ranging from 2.84 (glue sniffing) to 10.06 (ecstasy). Having friends using drugs, and friends with delinquent behaviors increased the risk of using alcohol and illegal drugs, with adjusted odds ratios of 6.84 and 6.72 respectively for marijuana use. For protective factors, approximately 40–60% of students with high levels of moral belief, participation in religious activities, and social skills were less likely to use alcohol. It is concluded that peer influence is a significant contributor to Thai adolescents' participation in substance abuse and that engaging in religiosity may assist adolescents to internalize negative aspects of harmful drugs into positive perceptions and encourage them to avoid alcohol and illegal drugs.

Introduction

Alcohol and drug use in adolescence and early adulthood is acknowledged to be a public health problem worldwide. Comparative cross-national surveys have indicated that alcohol is more widely used by adolescents than illicit drugs (Daosodsai et al., 2007, Vega et al., 2002), although when alcohol consumption is combined with illegal drug use the risk of disease and injury increases significantly. Thailand is a country in South-East Asia where alcohol and illicit drug use is a major cause of mortality and morbidity in youth. In 2007, almost 55% of injured victims and 70% of arrested perpetrators in Thailand were impaired by alcohol consumption (World Health Organization-Kobe Centre, 2007). A Thai national survey of health risk behaviors demonstrated that approximately 40% of students had consumed alcohol in the last month and used at least one illegal drug during their lifetime (Ruangkanchanasetr, Plitponkarnpim, Hetrakul, & Kongsakon, 2005).

In Thailand, technical and vocational education is available for students who have completed Year 9 in junior high school. Students undertake a three-year Vocational Education Certificate, which is equivalent to grade 12 in an academic stream, and can choose to follow this with a two-year Vocational Education Diploma (Hawley, 2003). Compared with students in academic streams, vocational technical students are from low socioeconomic backgrounds and are more likely to participate in alcohol consumption (Assanangkornchai, Mukthong, & Intanont, 2009), substance abuse (Sattah et al., 2002), and violence (fighting and sexual assault) (Liu et al., 2006, Manopaiboon et al., 2003, Wongtongkam et al., in press). A school-based survey in Northeast Thailand found that prevalence rates for alcohol, tobacco and illicit drug use were higher in technical colleges than in academic schools (39.9% vs 17.3%, 17.9% vs 4.9%, and 3.3% vs 1.4% respectively; Daosodsai et al., 2007).

Risk and protective factors for youth substance abuse occur at individual, peer, family, school, and community levels (Hawkins et al., 1992, Oesterle et al., 2012). Individual and peer factors are particularly important in adolescence, with a number of studies indicating that intrapersonal or individual characteristics, such as impulsivity, sensation seeking (Xiao, 2008) and risk-taking behavior (Feldstein & Miller, 2006) are correlated with both antisocial behavior (Griffin, Botvin, Scheier, Doyle, & Williams, 2003) and alcohol and/or illicit drug use (Stephenson, Hoyle, Palmgreen, & Slater, 2003). In adolescence, young people spend substantial time with peers and conform to peer group norms. Thus, the peer relationship has a considerable influence on behavior (Hussong, 2004) and norms and attitudes toward substance use (Beyers et al., 2004, Van Horn et al., 2007). Despite these individual and peer aspects, school environments provide a setting for building protective factors and reducing rates of health risk behavior in youths. Schools offer many opportunities to influence youths, allowing them to develop academically and vocationally through initiating quality relationships with peers and teachers. There is also evidence that school connectedness acts as an important protective factor against substance use (Bond et al., 2007, Catalano et al., 2004).

This study explores aspects of individual, peer, and school protective and risk factors related to alcohol and illicit drug use in Thai adolescents. Identifying the effects of risk and protective factors is necessary to allow the development of prevention and intervention programs to address these problems prior to adulthood, and yet the literature on protective and risk factors related to alcohol and illicit drug use among Asian adolescents is currently limited.