Cannabis use among young people in Nigeria: Exploring the context of use and associated factors

Background: Cannabis is the most widely used illicit substance in Nigeria and is the first illicit substance young people are likely to use. There is evidence to show that cannabis use causes health and social problems that are more severe among young people. Cannabis use is criminalised in Nigeria and the context of use relating to motivation, risk factors and situations in which it is used is poorly understood. Aim: This research aimed to explore the context and factors that are associated with cannabis initiation and continued use among young people in Nigeria with a view to making evidence based recommendations for health promotion. Methods: Two studies were conducted in Lagos state among young people aged 16-21 years utilising the Theory of Triadic Influence as a framework. A quantitative study entailed the use of questionnaires to evaluate risk factors for the initiation and use of cannabis among 909 secondary school students in Lagos state. Binary logistic regression and multinomial logistic regression utilising latent class models were the analytical strategies used. A qualitative study utilising interviews and focus groups among 39 young people explored motivations, meanings and the context of cannabis use. Interviews were analysed using thematic analysis. Results: Findings showed that initiation was influenced by subcultural issues and individual factors influenced continued use. There was a tendency for continuation after initiation that was possibly linked to its use as a coping strategy for social inequalities, failed aspirations, family conflicts and the criminal identity. Cannabis users were more likely to be older, higher sensation seekers and were associated with family members or peers who used cannabis. Recommendation: These findings suggest that a non-judgemental participatory approach is needed to understand how the current cannabis policy affects young people. It is important to contextualise the needs of young people in programme planning