Assessing the prevalence, determinants, and health impact of substance use among university students in Bangladesh.

BACKGROUND

Substance use is a pressing and rapidly escalating concern among university students, particularly in low-resource settings like Bangladesh where comprehensive data is scarce. This study was conducted with a sense of urgency to investigate the prevalence and determinants of substance use, as well as its associated health burdens, among university students in Bangladesh.

METHODS

This was a rigorous cross-sectional study conducted from 26 May to 31 July 2025. A total of 509 students (mean age = 22.4 years) from four randomly selected public universities were recruited using a multistage random sampling technique. A comprehensive semi-structured questionnaire was used to collect data on socio-demographics, lifestyle factors, health indicators, and substance use. Binary logistic regression models were employed to identify determinants and assess associations with health outcomes, ensuring a thorough and reliable methodology.

RESULTS

The current, past-year, and lifetime prevalence of substance use were 16.1% (95% CI: 12.9%-19.3%, 19.6% (95% CI: 16.2%-23.1%), and 25.1% (95% CI: 21.3%-28.9%), respectively, with higher rates among males compared to female students (20.0% vs. 6.7%). Seven determinants were identified in the logistic regression: (i) age ((aOR = 3.157; 95% CI: 1.136-8.774; p < 0.05), (ii) family history of substance use (aOR = 5.834; 95% CI: 2.802-12.146; p < 0.01), (iii) having substance-using friends (aOR = 2.199; 95% CI: 1.005-4.811; p < 0.05), (iv) family income (aOR = 2.840 95% CI: 1.050-7.683; p < 0.05), (v) physical inactivity (aOR = 0.184; 95% CI: 0.059-0.576; p < 0.01) & (aOR = 0.256; 95% CI: 0.099-0.661; p < 0.01), (vi) eating habits (aOR = 3.703; 95% CI: 1.866-7.348;p < 0.01), and (vii) sleep disturbances (aOR = 15.935; 95% CI: 6.410-39.614; p < 0.01). Substance use was significantly associated with increased odds of poor self-rated health (aOR = 5.71; 95% CI: 1.29-25.29), hypertension (aOR = 2.95; 95% CI: 1.11-7.84), depression (aOR = 2.33; 95% CI: 1.06-5.14), and stress (aOR = 3.00; 95% CI: 1.29-6.94).

CONCLUSION

These findings have the potential to significantly shape public health policies and student-focused programs aimed at reducing substance use and its related health burdens. They underscore the need for targeted prevention, psychosocial support, and campus-based initiatives, thereby highlighting the practical relevance and importance of the research.