South Africans Viewed All Substance Users Negatively, but Saw Cannabis as Less Dangerous Than Alcohol

What the researchers found

Researchers presented 868 people with vignettes describing substance use involving alcohol, cannabis, methamphetamine, or heroin. Respondents held equally negative views across substances, with one notable exception: cannabis users were rated as significantly less dangerous than alcohol users.

Gender influenced responses: people were more likely to offer help to women who used alcohol but more likely to suggest forced treatment for men. Respondents who scored higher on their own substance use measures held more negative attitudes toward substance users. Black African respondents were more likely to offer help.

Why it matters

Stigma is a major barrier to seeking treatment for substance use disorders. Understanding how stigma varies by substance type, user gender, and cultural context helps design more effective anti-stigma campaigns and treatment outreach.

The numbers in context

868 respondents surveyed. 8 vignettes across 4 substances and 2 genders. Cannabis rated significantly less dangerous than alcohol. People with higher own substance use scores held more negative attitudes toward other users.

How the study worked

Street-intercept convenience sample of 868 South African adults. Each respondent received one of 8 vignettes varying by substance (alcohol, cannabis, methamphetamine, heroin) and protagonist gender. Attitudes were measured using standardized attribution scales. The ASSIST measured respondents' own substance use.

What this study cannot tell us

Convenience sampling via street intercept is not representative of the broader South African population. Vignette-based responses may not predict actual behavior toward substance users. The study was conducted in one country with a specific cultural context around substance use.

How to read the evidence

Convenience sample survey with vignettes; provides attitudinal data but cannot establish representative population views.

When this study was published

Published in 2012. Public attitudes toward cannabis have continued to shift globally as legalization debates progress.

The bigger picture

The finding that cannabis was perceived as less dangerous than alcohol in South Africa mirrors patterns found in other countries, suggesting this perception may be widespread. The gender disparities in attitudes (help for women, coercion for men) have implications for how treatment services are designed and promoted.

Questions still open

• Do these stigma patterns affect who actually seeks treatment for substance use? Would anti-stigma campaigns reduce the gender disparities in how substance users are treated? Why did people with higher own substance use hold more negative views of other users?

Common questions

Read the original research

Negative attributions towards people with substance use disorders in South Africa: variation across substances and by gender.

BMC psychiatry, 12, 101

Citation

Sorsdahl, Katherine; Stein, Dan J; Myers, Bronwyn. (2012). Negative attributions towards people with substance use disorders in South Africa: variation across substances and by gender.. BMC psychiatry, 12, 101. https://doi.org/10.1186/1471-244X-12-101

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