Drug use and attitudes toward COVID-19 vaccination in a representative sample of undergraduate students

Attitudes toward COVID-19 vaccination (ATV) have been studied in association with several factors (e.g., demographics, health status, psychological conditions), but not much in association with drug use. This study explores whether drug users differ from nonusers with respect to ATV.

Data were obtained from a survey conducted in the fall of 2021. The population of interest was all students in traditional (not online) undergraduate programs in public and private institutions in Cyprus. Using probability sampling, 120 audiences were selected from 32 institutions and, depending on restrictions, they were either visited for in-person group administration or directed to answer the questionnaire online. The questionnaire was successfully completed by 2882 students. The questionnaire included questions corresponding to EMCDDA's key epidemiological indicators for cigarettes, alcohol, cannabis, tranquilizers, MDMA, amphetamines, cocaine, heroin, LSD and new drugs, questions of theoretical interest and demographics. The question representing ATV was: 'Let's assume that you have not been infected or vaccinated: would you get vaccinated if you had the opportunity to do so now?' with answer options 'Yes', 'I am not sure' and 'No'. A binary variable, with 'yes' answers coded 1, 'no' answers coded 0 and 'not sure' answers excluded, was modelled as the outcome in logistic regression equations with drug use variables as focal predictors.

The analysis shows no effect of any substance use variable on ATV, except for cigarette smoking, which has an anti-vax effect. Gender (male), age, high school GPA, parents' income and education and non-EU citizenship have pro-vax effects, while religiosity has an anti-vax effect. Given the size and representativeness of the sample, the finding that drug use does not affect ATV, is valuable information in understanding ATV and in responding to vaccination hesitancy, especially within the public health approach to substance use. The same applies for the anti-vax effect of cigarette smoking.