4. Gender differences and trends in substance use among Tunisian adolescent students

Within the critical socioeconomic context observed in Tunisia across years, substance use is becoming a refuge for vulnerable people in particular youth. In order to tackle this public health problem, epidemiological surveillance of substance use and identification of high-risk groups are key axes to adapt prevention and control of substance use. We aim to study gender differences in substance use prevalence and its trends among school youth.

Study based on the results of the three national MedSPAD surveys conducted on 2013 (15-17y; n=3,482); 2017 (15-17y; n=5,122); 2021 (16-18y; n=6,201). We used anonymous self-administered questionnaires. We assessed the lifetime (LT) use prevalence for tobacco, alcohol, cannabis, medications without prescription, cocaine and ecstasy. Gender differences and trends between 2013 and 2021 were studied.

Girls represented 60.4% of the sample. LT prevalence was 30.7% for tobacco, Alcohol: 8.0%, cannabis: 7.9%, Medication without prescription: 8.4%, cocaine: 0.5% and ecstasy: 1.1%. LT prevalence increased significantly from 2013 to 2021, except for cocaine and ecstasy; considerable gender disparities were observed: LT prevalence was significantly higher among boys except for medications without prescription for which the prevalence was significantly higher among females.

Substance use is increasing continuously among Tunisian school youth. Gender disparities would reflect differences in risk factors exposure that needs further investigations and targeting of preventive measures.