Pa ge 1 Pa ge 1 American Journal of Life Science and Innovation (AJLSI) Spectrum of Adolescent Marijuana Use in Secondary Schools at Sagamu, South-West Nigeria: Factors, Determinants and Scope Ejiroghene Oluwafunke Okorosobo1, Ademola Mufutau Amosu1, Aloysius Obinna Ikwuka2*, Francis Chigozie Udeh2 Volume 3 Issue 2, Year 2024 ISSN: 2833-1397 (Online) DOI: https://doi.org/10.54536/ajlsi.v3i2.2993 https://journals.e-palli.com/home/index.php/ajlsi Article Information ABSTRACT Received: May 22, 2024 Accepted: June 25, 2024 Published: June 28, 2024 Adolescents’ use of marijuana is a challenge of public health concern, and this also relates to several communities in Nigeria. The use of marijuana and other substances has been reported among the youths. However, the contributing factors to its consumption among these consumers are yet to be fully documented in some Nigerian states. This research aimed to investigate the spectrum of marijuana use among adolescents in secondary schools at Sagamu. The study employed a descriptive, cross-sectional design. A multi-stage sampling technique was used to select 388 respondents. A semi-structured questionnaire with Cronbach’s alpha of 0.72 was employed. The predisposing, reinforcing, and enabling factors were measured on an 18-point rating scale. Pearson’s correlation and linear regression analysis were conducted to give statistical responses to the research hypotheses using SPSS version 23. The response rate in this research was 98%. The mean age of the respondents was 15.46±1.37years. 56.2% were females, 74.5% were Christians, and 84% were Yoruba. 4.6% of the respondents have an uneducated dad, 3.9% have an uneducated mum, 70.6% have a self-employed dad, and 78.1% have a self-employed mum. 92.5% of the respondents have a good knowledge of marijuana use. 77.6% have a positive attitude towards marijuana use. 48.7% of the respondents could be influenced by the reinforcing and enabling factors, and there was a 7.2% prevalence rate of marijuana use. There was a significant association between peer influence and marijuana use (R=0.105; R2=0.11; p=0.39), but none between respondents’ predisposing factors and marijuana use (p>0.05). Peer influence was the only significant determinant of marijuana use among the respondents. Peer education from homes, schools, and governments is therefore recommended to promote the non-use of marijuana and other substances among adolescents. Keywords Spectrum, Adolescent, Marijuana Use, Secondary Schools, Sagamu, South-West Nigeria, Factors, Determinants, Scope INTRODUCTION Adolescent substance use involves the use of illegal drugs, cigarette smoking, alcohol consumption, and misuse of prescription drugs among adolescents, whom theWorld Health Organization (WHO) described as people aged between 10 to 19 years and make up 20% of the global population (United Nations Children’s Emergency Fund (UNICEF, 2022). Substance use burden increases among adolescents and young adults, with an unequal distribution across age groups, countries, and epidemiological parameters (Global Burden of Disease Collaborative Network, 2015). The use of marijuana poses a danger to adolescents, which ripple with long-term consequences for the general population. The age of initiation is the mid-teens in many developed countries (United Nations Office of Drugs and Crime [UNODC], 2021; WHO, 2016). In the United States of America, 75.6% of high school students were reported to have used addictive substances, including marijuana, cigarettes, alcohol, or cocaine. In addition, 90% of the US population is initiated into substance use before the age of eighteen, of which 25% become addicted (Center on Addiction and Substance Abuse [CASA], 2011). Apart from marijuana, other substances such as alcohol, tobacco, illicit drugs, e.g., cocaine, heroin, and opiates which are commonly abused, have harmful effects on the brain and other vital organs, e.g., lungs (Baysah, 2023; Udeh, 2023a; Udeh, 2023b). Cystic fibrosis is a genetic disease affecting mainly the lungs (Ikwuka, 2023a). Other affected organs include the pancreas, liver, kidneys, and intestine. Clinical features of cystic fibrosis include dyspnea, cough with sputum, sinusitis, poor growth, fatty stool, finger and toe clubbing, etc (Ikwuka, 2023a). Cough with sputum can be complicated by blood in the sputum (hemoptysis), which can lead to anemia (Ikwuka, 2023e; Musa, 2023). Marijuana use has been linked to mental health disorders. Different researchers are still investigating the links between marijuana use and metabolic disorders, although some studies have reported no significant association between marijuana use and metabolic disorders. Among emerging adults, current marijuana users were 54% less likely than never to present with metabolic syndrome. Current (AOR 0.49; 95% CI, 0.25-0.97) and past (AOR 0.61; 95% CI, 0.40-0.91) middle-aged adult marijuana users were less likely to have metabolic syndrome than never users (Vidot, 2016). Metabolic disorders, e.g. Hypertension, Adiposity, Diabetes mellitus and Dyslipidemia, collectively known as Metabolic Syndrome Diseases (MSDs) are diseases related to one another (Ikwuka, 2015; Ikwuka, 2017a; Ikwuka, 2017c; Ikwuka, 1 School of Public and Allied Health, Babcock University, Ilisan-Remo, Nigeria 2 College of Medicine and Health Sciences, American International University West Africa, Banjul, The Gambia * Corresponding author’s e-mail: aloysiussweet@yahoo.com Pa ge 2 https://journals.e-palli.com/home/index.php/ajlsi Am. J. Life Sci. Innov. 3(2) 1-12, 2024 2023c; Ikwuka, 2023f; Ikwuka, 2024; Virstyuk, 2016). Different studies have shown that MSDs are associated with asymptomatic hyperuricemia, systemic immune inflammatory processes, and fibrogenesis all of which can lead to nephropathy (Ikwuka, 2017d; Ikwuka, 2017e; Ikwuka, 2018c; Ikwuka, 2018d; Ikwuka, 2019a; Ikwuka, 2019c; Ikwuka, 2022; Ikwuka, 2023d; Virstyuk, 2017a; Virstyuk, 2018a; Virstyuk, 2019; Virstyuk, 2021a; Virstyuk, 2021b). Substance use disorder is an expensive and preventable public health problem. The assessment of the annual cost of substance use disorder in United States hospitals showed that a total of 13.2 billion dollars was the annual estimated attributable medical cost for substance use disorders (Peterson, 2021). A single cause (determinant) cannot initiate the use of marijuana among adolescents, rather it is a complex of predisposing, reinforcing, and enabling factors. There is a multilevel complexity as these factors are further composed of individual determinants as described and used in constructing the research instrument for this study. The predisposing factors include age, gender, ethnicity, parents’ socio-economic status, knowledge, and attitude. Reinforcing factors include family and/or siblings’ use of marijuana; and peer influence. The enabling factors include easy access, availability, cost of marijuana, and the school environment. Physiological, genetic, and psychological determinants are also associated with substance use. These determinants are strongly influenced and the key influencers include family, social networks, and peer pressure, with best friend use reported to influence the most (English, 2023). Certain substances used and abused are derived from agricultural products e.g. beer from wheat and barley, hallucinogens from certain plants, tobacco from dried tobacco leaves, and marijuana from varieties of cannabis plants such as the Cannabis sativa, Cannabis ruderalis, and Cannabis indica (Gloss, 2015). The agricultural source of marijuana therefore makes it easy to procure for recreational use. Marijuana plant contains numerous cannabinoids including Δ−9-tetrahydrocannabinol (the principal cannabinoid) and cannabidiol (World Health Organization [WHO], 2024; National Center for Complementary and Integrative Health, 2018). Cannabis usage is associated with oxidative stress. Linked to the induction of oxidative stress are major free radicals. Among these major free radicals, superoxide anions, hydroxyl radicals, and hydroperoxyl radicals are of physiological significance. A non-radical of physiological significance is hydrogen peroxide (Ama, 2023; Ekechi, 2023a; Ikwuka, 2023b; Uche, 2023). Marijuana use has been reported to lead to addiction, poor concentration, poor academic performance, thefts, organized crime, violence, mental illnesses, injuries, infections, and behavioral disorders in the involved individuals (Centers for Disease Control and Prevention [CDC], 2023; National Center for Drug Abuse Statistics [NCDAS], 2024). Other substances including tobacco, alcohol, and illicit drugs like opiates, heroin, and cocaine are also popular and toxic (Baysah, 2023; Udeh, 2023a; Udeh, 2023b). Interestingly, marijuana and individual cannabinoids have been reported to help manage the side effects of cancer and cancer therapies, but no research has shown that they can cure cancer (National Academies of Sciences, Engineering, and Medicine, 2017). Substance use burden increases in adolescence and young adulthood (Center on Addiction and Substance Abuse, 2011). Globally, an estimated 181.8 million individuals who were between 15 and 64 years old used non-medical marijuana in 2013. Marijuana was the most commonly used hard drug among youths in 2019, and in 2021 it became the most cultivated and trafficked drug worldwide (United Nations Office of Drugs and Crime [UNODC], 2021). In 2023, among teenagers in the United States of America (USA), marijuana was the second most abused substance after alcohol (National Center for Drug Abuse Statistics, 2024). There were 70.46 million users in the USA, 61.99 million users in Asia, 53.6 million users in Africa, 29.47 million users in Europe, and 3.4 million users in Oceania (Statista, 2023). Irrespective of age, 37.7% of women in developed countries/regions like the USA, West and Central Europe (European Monitoring Center for Drugs and Drug Addiction [EMCDDA], 2023), Australia, and New Zealand consume marijuana, while only 10.5% of women in Africa and Asia use it (Statista, 2023). In a national survey in Nigeria, the Northwest region has the highest number of marijuana users (Akannam, 2008). It is also published from a high school students survey that 65% of the students used drugs to be happy with their friends (Abudu, 2008). In Sagamu, the people call marijuana other names like hemp, “ganja”, “igbó”, “pot”, “káyá”, “wee-wee”, “ojà”, gbáná and abana. It was also reported that 76% of secondary school students in Sagamu used illicit drugs, and 49.3% used them for calmness and sleep (Ojieabu, 2017), in the form of self- medication (Oriavwote, 2022). Metabolic syndrome diseases (MSDs) are interrelated diseases with very high economic costs, morbidity, and mortality rates, thus requiring the search for new and effective treatment options (Ikwuka, 2024). Treatment optimization in MSD patients using a combination of HMG-CoA and SGLT-2 inhibitors, and A2RB (AT1) has resultant clinical effectiveness as indicated by marked improvements in metabolic functions of the heart, liver, pancreas, and kidney (Ikwuka, 2017b; Ikwuka, 2018a; Ikwuka, 2018b; Ikwuka, 2021; Virstyuk, 2017b; Virstyuk, 2018b; Virstyuk, 2018c; Ikwuka, 2024). In addition, Glucagon-like Peptide 1 Receptor Agonists (GLP-1 RAs) e.g. Liraglutide have been found to improve the efficacy of treatment and clinical course of type 2 diabetes mellitus and hypertension in patients with such comorbidities (Ikwuka, 2019b). It has also been reported that coconut water has hepatorenal protective functions against alloxan-induced type 1 diabetes mellitus (Ekechi, 2023b). Pa ge 3 https://journals.e-palli.com/home/index.php/ajlsi Am. J. Life Sci. Innov. 3(2) 1-12, 2024 With the increased prevalence of marijuana use among adolescents and the high incidence of implications on health and the economy, evaluating the spectrum of marijuana use among adolescents would be very important. It will also be important to analyze the association between predisposing factors, reinforcing factors, enabling factors, and marijuana use. An efficient approach to prevent adolescent marijuana use would be very beneficial to both public health and the economy. Therefore, as part of the Sustainable Development Goals (SDG), this study would give clearer insights into the determinants and scope of marijuana use among adolescents and provide answers to strengthen the prevention of its use among adolescents especially those in secondary schools. In addition, this study will expose where further research can be done, and suggest areas where laws, policies, and interventions can be developed and implemented. MATERIALS AND METHODS Study Area The study was conducted at Sagamu, the headquarters of Sagamu Local Government Area (LGA) in Ogun State, South-West Nigeria. With a land area of 68.03 km2, it is surrounded by Odogbolu LGA in the east, Lagos State in the south, Ikenne LGA in the north, and Obafemi Owode LGA in the west. The major economic engagement of the locals is kolanut farming. Study Population The study population comprised adolescents between the ages of 11 and 19 who attended secondary schools located within the study area. Sample Size The Cochran formula for descriptive, cross-sectional, qualitative study was used: Sample size for large population >10,000 = n = (Z2 PQ)/d2 Z = standard normal deviate (at 5% type 1 error) = 1.96 P = prevalence of drug use in Nigeria = 65% (Abudu, 2008) Q = complementary proportion equivalent to = 1-P = 1-0.65 = 0.35 d = degree of accuracy desired (absolute precision) = 5% = 0.05 n = (1.962×0.65×0.35)/0.052 = 359.57 ~ 360 With the inclusion of a 10% non-response rate, 396 students were later expected to be recruited for the study. Sample Size Justification The Cochran formula was appropriate for this descriptive, cross-sectional, qualitative study. A cross-sectional study could be qualitative or quantitative, with specific formulas for each, and in situations where the study population is less or greater than 10,000 (Udeh, 2023c). The appropriate formula was used with a study population above 10,000, thereby justifying the sample size. Inclusion and Exclusion Criteria Respondents included students between the ages of 11 and 19 who consented to participate voluntarily. Students outside the age range who did not consent to participate voluntarily were excluded. Study Design All the secondary schools in Sagamu were listed. The engaged secondary schools were selected using simple random sampling by balloting. A proportionate sampling technique was used to derive the number of participants per school, and a systematic sampling technique was used to get the number of students needed from each school. Structured, self-administered questionnaires were presented to the respondents and the sections included the socio-demographic characteristics, knowledge of marijuana use, attitude towards marijuana use, and associated factors (reinforcing and enabling) for marijuana use. The questionnaire was validated by face validity, item validity, and construct validity. The questionnaire was confirmed reliable after a pilot study was conducted with 10% of the sample size among students outside the study area. Also, the Cronbach alpha analysis was 0.72. Data Analysis Participants responded to the questions on knowledge with a “Yes” or “No”. The attitude, reinforcing, and enabling factors were responded to, using a four-point Likert scale. The Likert scale rating was calculated by multiplying the highest point by the number of variables. The hypotheses were tested with Pearson correlation and linear regression analysis at p-value<0.05. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. Ethical Considerations The Babcock University Health Research Ethical Committee (BUHREC) granted permission to conduct this study. The Ministry of Education at Sagamu, and the secondary schools involved also permitted the conduct of this study. Each participant individually consented willingly, and all data extracted were kept confidential. RESULTS AND DISCUSSIONS Eight questionnaires were invalid as the participants did not fill in the parameters asked, giving a 98% response rate. The results are presented below in tables and figures. Table 1: Socio-demographic characteristics of the respondents (n=388) Socio-demographic variables considered Respondents in this study (n=388) Frequency(n) Percentage (%) Age (in years) 11-13 19 4.9 Pa ge 4 https://journals.e-palli.com/home/index.php/ajlsi Am. J. Life Sci. Innov. 3(2) 1-12, 2024 A majority (76.0%) of the students were between ages 14- 16, with the mean age of respondents being 15.46±1.37 years. 218 (56.2%) were female, and the majority (74.5%) were Christians. The students were somewhat evenly distributed among the classes. However, the lowest number was in senior secondary school one (SS1) or Grade 10. 84.0% were Yorubas. Approximately 39.4% of the respondents’ fathers had secondary school education and less than half (45.4%) of their mothers had secondary school education. Predisposing Factors to Marijuana Use among the Respondents Virtually all (96.1%) of the respondents have heard of Table 2: Respondents’ knowledge about marijuana use (n=388) Socio-demographic variables considered Respondents in this study (n=388) Frequency(n) Percentage (%) Have you heard about marijuana before? Yes 373 96.1 No 15 3.9 My knowledge about marijuana is from Family members 22 5.7 Friend 54 13.9 14-16 295 76.0 17-19 74 19.1 Mean age (x̄) = 15.46±1.37 Gender Male 170 43.8 Female 218 56.2 Religion Christianity 289 74.5 Islam 96 24.7 Traditional 3 0.8 Class SS1 (Grade 10) 110 28.4 SS2 (Grade 11) 138 35.6 SS3 (Grade 12) 140 36.1 Ethnicity Yoruba 326 84.0 Igbo 45 11.6 Hausa 7 1.8 Others 10 2.6 Father’s educational level No formal education 18 4.6 Elementary school 30 7.7 Secondary school 153 39.4 HND/University 129 33.2 Postgraduate 58 14.9 Mother’s educational level No formal education 15 3.9 Elementary school 34 8.8 Secondary school 176 45.4 HND/University 110 28.4 Postgraduate 53 13.7 Pa ge 5 https://journals.e-palli.com/home/index.php/ajlsi Am. J. Life Sci. Innov. 3(2) 1-12, 2024 marijuana use before the study. More than half (52.8%) of the respondents knew about marijuana from school, while only 5.7% knew about marijuana from family members. A majority (96.1%) of the respondents knew that marijuana is an illicit drug and 81.4% of them knew that marijuana is used to treat mental disorders like anxiety when administered at a low dose. A majority (95.6%) of the respondents knew that marijuana is harmful to health. 93.3% of the respondents knew that addiction is an effect of marijuana use. Concerning forms of marijuana use, cigarette (33.0%) and powder (29.4%) forms were the most popularly known forms among the respondents. Other forms were known by just a few number of the respondents viz liquid (13.4%), eating/chewing (10.7%), and inhalable vapor (13.4%). Media 107 27.6 School 205 52.8 Marijuana is an illicit drug. Yes 373 96.1 No 15 3.9 Marijuana is used to treat mental disorders like anxiety at a low dose. Yes 316 81.4 No 72 18.6 Using marijuana is harmful to health. Yes 371 95.6 No 17 4.4 Addiction is an effect of marijuana use. Yes 362 93.3 No 26 6.7 *Forms of marijuana use Cigarette 275 33.0 Powder 245 29.4 Liquid 112 13.4 Eating/Chewing 89 10.7 Inhalable vapor 112 13.4 *Marijuana used can result to Anxiety 97 18.4 Poor judgment 71 13.5 Death 85 16.1 Increased appetite 93 17.6 Cancer 181 34.3 Note: * indicates questions with multiple response Table 3: Respondents’ attitude towards marijuana use (n=388) S/No. Items SA A D SD n (%) n (%) n (%) n (%) 1 My family and friends use it, therefore, I should do so too. 9(2.3) 8(2.1) 87(22.4) 284(73.2) 2 I will openly discuss about marijuana use among adolescents. 100(25.8) 161(41.5) 65(16.8) 62(15.9) 3 I believe marijuana boosts self-confidence. 34(8.8) 64(16.5) 108(27.8) 182(46.9) 4 I would likely use marijuana because it helps the brain to function better. 5(1.3) 8(2.1) 89(22.9) 286(73.7) 5 I will make use of small quantities of marijuana since it is not dangerous. 7(1.8) 12(3.1) 94(24.2) 275(70.9) 6 I do not like my friends using marijuana. 189(51.3) 88(22.7) 36(9.3) 65(16.7) Note: SA (Strongly Agree, 3); A (Agree, 2); D (Disagree, 1); SD (Strongly Disagree, 0). Likert rating scale = 3×6 = 18 Pa ge 6 https://journals.e-palli.com/home/index.php/ajlsi Am. J. Life Sci. Innov. 3(2) 1-12, 2024 Most (73.2%) of the respondents strongly disagreed that they should use marijuana because their family and friends use it. 67.3% of the respondents either strongly agreed or agreed that they can openly discuss marijuana use among adolescents. 27.8% of the respondents disagreed that marijuana boosts self-confidence whereas 46.9% strongly disagreed. A majority (73.7%) of the respondents strongly disagreed that they would use marijuana because it helps the brain to function better. Most (70.9%) of the respondents strongly disagreed that they would make use of small quantities of marijuana since it is not dangerous. More than half (51.3%) of the respondents strongly agreed that they do not like their friends to use marijuana. Reinforcing and Enabling Factors for Marijuana Use among the Respondents Table 4: Respondents’ reinforcing and enabling factors for marijuana use (n=388) S/No. Items SA A D SD n (%) n (%) n (%) n (%) 1 Peer influence is not a consideration in adolescents’ marijuana use 44(11.3) 75(19.3) 119(30.7) 150(38.7) 2 Family and siblings’ use of marijuana may encourage adolescents to use it 79(20.4) 103(26.5) 66(17.0) 140(36.1) 3 Easy access to marijuana may aid its use 92(23.7) 148(38.1) 64(16.5) 84(21.7) 4 Marijuana’s low cost enables one to easily access the substance 81(20.9) 127(32.7) 92(23.7) 88(22.7) 5 The school environment supports adolescents’ marijuana use 14(3.6) 18(4.6) 75(19.3) 281(72.5) 6 Enforcing substance use regulations and policies will reduce marijuana use 149(28.4) 132(34.0) 43(11.1) 64(26.5) Note: Items 1 and 2 are reinforcing factors; Items 3-6 are enabling factors; SA (Strongly Agree, 3); A (Agree, 2); D (Disagree, 1); SD (Strongly Disagree, 0). Likert rating scale = 3×6 = 18 Table 5: Summary of descriptive statistics of variables in the study Variables Maximum Points on a Scale of Measure Respondents in this study (n=388) Prevalence (%) x̄ (S.E.) ±SD Attitude towards marijuana use 18 13.98(0.13) 2.52 77.6 Reinforcing and enabling factors 18 8.77(0.16) 3.20 48.7 38.7% strongly disagreed and 30.7% only disagreed that peer influence is not a consideration in adolescents’ marijuana use. Few (20.4%) of the respondents strongly agreed that family and siblings’ use of marijuana may encourage adolescents to use marijuana. Approximately 23.7% of the respondents strongly agreed that easy access to marijuana aids its use. The respondents almost equally agreed and disagreed that the low cost of marijuana enables one to easily access the substance. Most (72.4%) of the respondents strongly disagreed that the school environment supports adolescents’ marijuana use. Few (28.4%) of the respondents strongly agreed that enforcing substance use regulations and policies will reduce marijuana use. The respondents’ attitude towards marijuana use measured on an 18-point rating scale showed that the respondents’ mean score was 13.98±2.52, translating to an attitudinal prevalence of 77.6% which means that only 77.6% of the respondents have a positive attitude towards marijuana use (see Table 5). In addition, on an 18-point rating scale, the reinforcing and enabling factors for marijuana use among the respondents had a mean score of 8.77±3.20 which means that these factors can influence 48.7% of the respondents (See Table 5). Table 6: Table 6: Relationship between predisposing factors (level of knowledge and attitude), reinforcing factors (peer influence and family influence), and enabling factors with marijuana use among the respondents Hypotheses Factors Variables Marijuana use; (n=388) R p-value 1 Predisposing Level of knowledge 0.14 0.79** Attitude towards marijuana use -0.05 0.30** 2 Reinforcing Peer influence 0.11 0.03* Family influence -0.29 0.57** Pa ge 7 https://journals.e-palli.com/home/index.php/ajlsi Am. J. Life Sci. Innov. 3(2) 1-12, 2024 Test of Hypotheses Pearson correlation and linear regression analysis were conducted at a 0.05 level of significance. At p≤0.05, the null hypothesis was rejected and the alternate hypothesis was accepted. On the other hand, with p>0.05, the null hypothesis was accepted and the alternate hypothesis was rejected. Hypothesis 1 H0: There is no significant relationship between predisposing factors and marijuana use among adolescents. H1: There is a significant relationship between predisposing factors and marijuana use among adolescents. Result As seen in Table 6, the respondents’ predisposing factors (knowledge [R=0.14; p=0.79], and attitude [R=-0.05; p=0.30]) had a p-value>0.05, thus confirming H0 and rejecting H1. Therefore, there is no significant relationship between predisposing factors and marijuana use among adolescents. Hypothesis 2 H0: There is no significant relationship between reinforcing factors (peer influence and family influence) and marijuana use among adolescents. H1: There is a significant relationship between reinforcing factors (peer influence and family influence) and marijuana use among adolescents. Result As seen in Tables 6 and 7, peer influence has p<0.05 while family influence has p>0.05. This means that there is a significant relationship between peer influence and marijuana use. On the other hand, there is no significant relationship between family influence and marijuana use. Hypothesis 3 H0: There is no significant relationship between enabling factors and marijuana use among adolescents. H1: There is a significant relationship between enabling factors and marijuana use among adolescents. Result Table 6 shows that easy access to marijuana, affordability of marijuana, school support for non-use of marijuana, and policies on marijuana use, all had a p-value>0.05, thus confirming H0 and rejecting H1. Therefore, there is no significant relationship between enabling factors and marijuana use among adolescents. DISCUSSION Adolescents in high school tend to be exposed to various vices like alcohol abuse, illicit drug use, smoking, prostitution, etc by their peers. To shy away from segregation or avoid being termed weak, some of them bend to peer influence and get engaged in these bad habits. In this study, the spectrum of adolescent marijuana use including associated factors, determinants and scope among adolescents attending secondary schools in Sagamu, South-West Nigeria were evaluated. This study shares similar socio-demographic characteristics with that of another study (Almahdi, 2018). The similarities are that most of the respondents were 14-16 years old, and female respondents were more than males. Sagamu is the headquarters of Sagamu Local Government Area (LGA) in Ogun State, South- West Nigeria. South-West Nigeria is a geopolitical zone, occupied and dominated by the Yoruba tribe. This fact explains why most (84.0%) of the respondents were Yorubas. Less than half of the parents had university degree or postgraduate qualification. Fathers achieved this feat as 48.1% of them either had a first degree or a postgraduate degree, as against 42.1% of the mothers. The data obtained on the predisposing factors (knowledge and attitude towards marijuana use) indicated that a majority (92.5%) of the respondents have a high basic knowledge of marijuana use and 77.6% of them have a positive attitude towards marijuana use. This result on knowledge is similar to the finding of another study which reported that most of the school-going adolescents in Ramotswa, Botswana are aware of substance use and abuse (Gotsang, 2017). However, unlike this study which showed that the highest number of the students first learned about marijuana in school, most of the students in Ramotswa learned about marijuana from television. Table 7: Association between peer influence and marijuana use among the respondents Variable Marijuana use Respondents in this study (n=388) Peer influence R R2 B Βeta F p-value 0.105 0.011 0.245 0.245 4.311 0.039 3 Enabling Easy access to marijuana -0.09 0.69** Affordability of marijuana -0.02 0.59** School support for non-use 0.06 0.18** Policies on marijuana use -0.03 0.55** Note: * = statistically significant; **= not statistically significant Pa ge 8 https://journals.e-palli.com/home/index.php/ajlsi Am. J. Life Sci. Innov. 3(2) 1-12, 2024 An international prospective study on the knowledge and attitude of adolescents to marijuana use also showed that 20% of the respondents admitted not being knowledgeable about marijuana while the remaining 80% only had partial knowledge of marijuana (Jacobs, 2021). As only a few of them could identify the forms of marijuana; therefore, the level of knowledge does not translate to respondents using marijuana. It was also reported that 40% of secondary school students in Oyo State, Southwest Nigeria had positive attitude towards substance use (Ajibola, 2018) which is lower than the 77.6% reported in this study. The high values reported on knowledge and attitude in this study could be attributed to the measures the schools are currently taking to enlighten their students on substance use and its adverse effects. The reinforcing and enabling factors were evaluated to likely influence 48.7% of the respondents in this study. The reinforcing factors made up of peer influence and family influence are similar to the variables evaluated by another study on the assessment of alcohol and substance use among undergraduates in Southwest Nigeria (Adekeye, 2012). The answers on the enabling factors including easy access to marijuana, its affordability, school support for non-use of marijuana, and policies on marijuana use were distributed almost evenly among the respondents. This divided opinion explains why the reinforcing and enabling factors could influence almost half (48.7%) of the respondents. The prevalence rate of marijuana use among the respondents was low as approximately 30 (7.2%) out of the 388 agreed to have either used or are currently using marijuana. A different study reported a higher prevalence rate and found that 65% of high school students in Nigeria use substances like tobacco, alcohol, cannabis, etc. (Abudu, 2008). This nationwide analysis showed that students use these drugs for a good time with their pals (Abudu, 2008). A similar study in Sagamu, this study area, reported a 76% prevalence rate among secondary school students (Ojieabu, 2017), and a 17.4% prevalence rate of substance use among students in Ramotswa, Botswana has also been reported (Gotsang, 2017). Another study reported 2% prevalence rate of marijuana use among school-going adolescents in eight Sub-Saharan African countries: Benin, Ghana, Liberia, Mauritius, Mozambique, Namibia, Seychelles, and Tanzania (Kugbey, 2023). The test of Hypothesis 1 in this study revealed that there is no significant relationship between predisposing factors (knowledge and attitude) and marijuana use among adolescents. This means that knowledge and attitude are not significant determinants of marijuana use, a hypothesis supported by the findings of another study (Duru, 2017) which stated that predisposing factors do not influence substance use. However, another study has reported that there is a significant relationship between knowledge and marijuana use (Kugbey, 2023). Adolescence comes with various challenges. A child acquires knowledge as he grows. However, due to the curious nature of adolescents, they tend to indulge in some acts they categorically know have implications. This explains why the high knowledge and positive attitude do not significantly determine marijuana use by the respondents. The test of Hypothesis 2 showed that peer influence is a significant determinant of marijuana use (p<0.05), whereas family influence is not (p>0.05). The findings on reinforcing factors in this study are almost similar to that of another study which stated that both parental use and peer influence have no significant contribution (p>0.05) to student’s use of alcohol and other substances including marijuana (Adekeye, 2015). As adolescents progress to secondary school, they spend more time with their friends at school as their time at home reduces. This idea gives insight to why peer influence could significantly determine marijuana use and family influence could not. Strict training by a parent that uses marijuana may likely make an adolescent not use marijuana, but once there is an interaction with friends that use it, such an adolescent may choose to have a taste of it due to adolescent curiosity. Finally, the test of Hypothesis 3 in this study showed that the enabling factors are not significant determinants of marijuana use among the respondents. Prospects for further research will be to recommend that socio- demographic variables like age, gender, religion, family size, and family income be statistically analyzed to identify their significant relationships with marijuana use. CONCLUSION Peer influence was the only significant determinant of marijuana use among adolescents attending secondary schools in Sagamu, South-West Nigeria. Other determinants e.g. knowledge, attitude, family or siblings’ use of marijuana, easy access to marijuana, low cost of marijuana, school support for non-use of marijuana, and policies on marijuana use are not significant determinants of marijuana use among adolescents. The scope of marijuana use in this study includes the prevalence rate of marijuana use, which was low (7.2%), and the purpose of marijuana use, which was mainly for exam success. Even though the variables that make up the predisposing, reinforcing (except peer influence), and enabling factors have no significant relationship with marijuana use; nevertheless, 48.7% is a huge figure to ignore. Therefore, families, schools, and governments must contribute their quota in reducing marijuana use among adolescents. Acknowledgments Special thanks to all secondary school students in Sagamu, South-West Nigeria who voluntarily consented to participate in this study after making an informed decision. 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