Awareness, Misconceptions, and Legal Knowledge Regarding Legal and Illegal Substances and their Association with Substance use among School-Going Adolescents: A Cross-Sectional Study

Abstract

Adolescence is a critical phase during which experimentation with psychoactive substances often begins. Misconceptions, poor legal awareness, and peer or family influence increase vulnerability to substance use. Understanding these factors is essential for developing effective school-based prevention strategies. Context: Substance use among adolescents is an emerging public health problem in India, with early initiation leading to long-term health and social consequences. Aim: To assess awareness, misconceptions, and legal awareness regarding legal and illegal substances among school-going adolescents, and to examine their association with substance use. Setting and Design: A school-based cross-sectional study conducted among students of classes 9 and 10 from selected government and private schools. Methods and Material: Four hundred students were selected using multistage cluster sampling. Data were collected through a pretested, self-administered questionnaire assessing knowledge, misconceptions, legal awareness, sources of information, and substance use. Statistical Analysis Used: Descriptive statistics and Chi-square test were used. A p-value <0.05 was considered statistically significant. Results: The mean age was 14.54 ± 0.49 years. The prevalence of ever use of tobacco, alcohol, and inhalants was 9.8%, 7.3%, and 2.5%, respectively. Substance use was significantly higher among students with poor knowledge (15.6%), high misconceptions (14.0%), and low legal awareness (13.6%) (p<0.05). Strong associations were observed with family (22.5%) and peer substance use (30.3%) (p<0.001). School-based education was associated with better knowledge and fewer misconceptions. Conclusion: Substance use among adolescents is influenced by misinformation, inadequate legal awareness, and social environment. Strengthening school-based educational and preventive programs is essential. Key Messages: Improving awareness and legal literacy through schools can significantly reduce adolescent substance use.