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?
What predicted marijuana use in this population?
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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