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Study breakdown

Marijuana Use Among Ugandan School Adolescents Linked to Male Sex and Mental Health History

Cross SectionalModerate evidence
The takeaway

Among 1,833 Ugandan secondary school students, 2.6% reported significant marijuana use, with male sex and mental illness history as the strongest predictors.

Public health researchers, school-based intervention designers, anyone interested in global adolescent cannabis use

Mental illness history nearly tripled the odds of marijuana use among Ugandan adolescents

What the researchers found

Male adolescents had 2.2 times the odds of marijuana use compared to females (AOR 2.21). Having a history of mental illness nearly tripled the odds (AOR 2.87). Urban school attendance more than doubled the odds of substance-related impairment (AOR 2.37).

Why it matters

Most adolescent substance use research comes from high-income countries. This large study from Uganda provides data on cannabis use patterns in a context where legalization debates are less prominent but adolescent vulnerability remains a concern.

The numbers in context

2.6% marijuana use prevalence (n=46 of 1,833); 3.0% alcohol; 1.7% tobacco; 6.2% any substance impairment; mean age 15.1 years; 60% female; male sex AOR 2.21 for marijuana; mental illness history AOR 2.87 for marijuana, 2.69 for alcohol

How the study worked

Cross-sectional survey of 1,833 adolescents aged 10-18 from eight secondary schools in two Ugandan districts, using the Child and Adolescent Symptom Inventory-5. Schools were stratified by ownership and geographic setting. Logistic regression identified independent predictors.

What this study cannot tell us

Cross-sectional design cannot determine causation, convenience sampling from only two districts, self-report measures subject to social desirability bias, relatively low prevalence limits statistical power for subgroup analyses

How to read the evidence

Large cross-sectional study with validated measures and adjusted analyses, but limited to two districts and self-report data

When this study was published

Published 2025

The bigger picture

The finding that mental illness history nearly triples marijuana use risk among Ugandan adolescents mirrors patterns seen globally, suggesting that mental health support in schools could be a key intervention point regardless of cultural context.

Questions still open

  • Would similar patterns appear in out-of-school Ugandan youth? Does the mental health-marijuana association reflect self-medication or shared vulnerability? How do urban-rural differences in access affect use patterns?

Common questions

How common is marijuana use among Ugandan school adolescents?
In this study of 1,833 students across two districts, 2.6% reported significant marijuana use, lower than alcohol (3.0%) but higher than tobacco (1.7%).
What predicted marijuana use in this population?
Being male (2.2x higher odds) and having a history of mental illness (2.9x higher odds) were the strongest independent predictors of marijuana use.

Read the original research

Prevalence and factors associated with alcohol and substance use among secondary school adolescents in central and Eastern Uganda: a cross-sectional study.

BMC public health, 26(1), 252

Citation

Bing, Wentrell; Abbo, Catherine; Dickson-Gomez, Julia; Kiconco, Arthur; Odokonyero, Felix Raymond; Bobholz, Max; Shour, Abdul R; Kasasa, Simon; Kabanda, Richard; Kalani, Kenneth; Cassidy, Laura D; Anguzu, Ronald. (2025). Prevalence and factors associated with alcohol and substance use among secondary school adolescents in central and Eastern Uganda: a cross-sectional study.. BMC public health, 26(1), 252. https://doi.org/10.1186/s12889-025-25944-7

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