Cross-sectional study of co-occurring addiction problems among high school students in Tunisia

Background:Addictive behaviours are a major public health problem, especially among adolescents, who are susceptible to experiencing multiple co-occurring addictions.Aim:To assess the prevalence of addiction problems and co-occurrences of addictive behaviours (substance abuse, problematic video gaming and social media addiction) and disorders among high school students in Sousse, Tunisia.Methodology:A cross-sectional study was conducted in 2018 in public high schools, in the urban area of Sousse, Tunisia. A structured self-administered questionnaire was used to obtain relevant information from the students. Statistical analysis was performed using SPSS version 10 and confidence intervals of 95% were calculated. Chi-square test was used to compare qualitative variables and multinomial regression was conducted to determine independent factors related to the number of addictive behaviour co-occurrences.Results:Of the 1399 high school students, 60.5% were girls and mean age was 17 ± 2.28 years. Analysis of single addiction problems revealed 20.9% prevalence for all tobacco products, 10.1% for alcohol, 7.0% for all drugs, 36.1% for Facebook, and 35.3% for video games. Analysis of co-occurring addiction problems showed that 46.0% of the study population had 1 addiction problem, 12.2% had 2 addiction problems, 4.5% had 3, and 2.7% had the maximum number of 4 addiction problems. Multinomial regression showed an increase in co-occurrence of addiction problems among boys (aOR = 217.004; P < 0.001), participants who had repeated a school grade (aOR = 0.232; P < 0.001), those who had moderate or severe depression (aOR = 0.232; P < 0.001), and those who were anxious (aOR = 0.335; P = 0.003) and had alexithymia (aOR = 0.361; P = 0.005).Conclusion:The rate of co-occurrent addictions among adolescents in Sousse, Tunisia, is alarming. Problematic use of Facebook, gaming and tobacco use were the most frequent addictive behaviours. There is an urgent need for effective and multisectoral programmes to prevent addictions among children in Tunisia and other countries in the Middle East and North Africa Region.

Clustering of chronic disease risk factors with tobacco smoking habits among adults in the work place in Sousse, Tunisia.

INTRODUCTION: The aim of our study was to explore the major non-communicable risk factors (unhealthy diet, sedentarily, alcohol consumption) of smokers and nonsmokers in workplaces. METHODS: A cross-sectional study was derived from an initial assessment in workplaces which was part of a community-based intervention to prevent chronic disease risk factors conducted in 2009 in the region of Sousse, Tunisia. The surveyed subjects were employees in six factories spread across three delegations in the region. Overall, 1770 of 2250 employees participated in the assessment. In this study, the clustering of non-communicable diseases risk factors with smoking habits was made only for male employees including in this study 1099 among 2250. Data were collected at worksites by a questionnaire, via interview or self-report. The main items assessed socio-demographics characteristics, smoking status, eating habits, level of physical activity and alcohol use of the participants. RESULTS: The percentage of male smokers was 54.0%(n=594). Their average age of daily smoking initiation was 19.22 (±4.24 years). The percentage of male smokers consuming 5 fruits and vegetables per day was significantly lower than nonsmokers (57.2% vs 63.5%, p=0.04). The proportion of male smokers consuming alcohol was about three times that of nonsmokers (16.5% vs 5.8%, p=0.001). The proportion of male employees who agree with anti-smoking laws in work places was higher for nonsmokers than for smokers. CONCLUSION: A strong association existed between smoking and risky lifestyles factors in the work place. Such findings are potentially useful in directing intervention efforts regarding smoking cessation in occupational settings.